Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 145
Filtrar
1.
Eur J Immunol ; 54(8): e2350792, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38727188

RESUMO

Loss of perfusion in the burn wound might cause wound deepening and impaired healing. We previously showed persistent microvascular thrombosis coinciding with intraluminal neutrophils extracellular traps in human burned skin. This study investigates the presence of intraluminal citrullinated histone 3 (H3cit) from different cellular origins (neutrophils, monocytes, and lymphocytes) in relation to microvascular thrombosis of burn wounds. Eschar was obtained from burn patients (n = 18) 6-40 days postburn with a mean total burned body surface area of 23%. Microvascular presence of tissue factor (TF), factor XII (FXII) and thrombi was assessed by immunohistochemistry. Intramicrovascular cell death was analyzed via immunofluorescent microscopy, combining antibodies for neutrophils (MPO), monocytes (CD14), and lymphocytes (CD45) with endothelial cell markers CD31 and H3cit. Significantly increased microvascular expression of TF, FXII, and thrombi (CD31+) was found in all eschar samples compared with control uninjured skin. Release of H3cit from different cellular origins was observed in the lumen of the dermal microvasculature in the eschar tissue 7-40 days postburn, with release from neutrophilic origin being 2.7 times more abundant. Intraluminal presence of extracellular H3cit colocalizing with either MPO, CD14, or CD45 is correlated to increased microvascular thrombosis in eschar of burn patients.


Assuntos
Queimaduras , Citrulinação , Histonas , Neutrófilos , Trombose , Humanos , Queimaduras/imunologia , Queimaduras/metabolismo , Queimaduras/complicações , Histonas/metabolismo , Histonas/imunologia , Neutrófilos/imunologia , Neutrófilos/metabolismo , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Trombose/metabolismo , Trombose/imunologia , Trombose/patologia , Tromboplastina/metabolismo , Idoso , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Fator XII/metabolismo , Microvasos/patologia , Microvasos/imunologia , Microvasos/metabolismo , Monócitos/imunologia , Monócitos/metabolismo , Pele/patologia , Pele/imunologia , Pele/metabolismo , Pele/irrigação sanguínea , Linfócitos/imunologia , Linfócitos/metabolismo , Antígenos Comuns de Leucócito/metabolismo , Armadilhas Extracelulares/imunologia , Armadilhas Extracelulares/metabolismo , Adulto Jovem
2.
Mol Pharm ; 21(6): 2637-2658, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38728585

RESUMO

To date, the widespread implementation of therapeutic strategies for the treatment of chronic wounds, including debridement, infection control, and the use of grafts and various dressings, has been time-consuming and accompanied by many challenges, with definite success not yet achieved. Extensive studies on mesenchymal stem cells (MSCs) have led to suggestions for their use in treating various diseases. Given the existing barriers to utilizing such cells and numerous pieces of evidence indicating the crucial role of the paracrine signaling system in treatments involving MSCs, extracellular vesicles (EVs) derived from these cells have garnered significant attention in treating chronic wounds in recent years. This review begins with a general overview of current methods for chronic wound treatment, followed by an exploration of EV structure, biogenesis, extraction methods, and characterization. Subsequently, utilizing databases such as Google Scholar, PubMed, and ScienceDirect, we have explored the latest findings regarding the role of EVs in the healing of chronic wounds, particularly diabetic and burn wounds. In this context, the role and mode of action of these nanoparticles in healing chronic wounds through mechanisms such as oxygen level elevation, oxidative stress damage reduction, angiogenesis promotion, macrophage polarization assistance, etc., as well as the use of EVs as carriers for engineered nucleic acids, have been investigated. The upcoming challenges in translating EV-based treatments for healing chronic wounds, along with possible approaches to address these challenges, are discussed. Additionally, clinical trial studies in this field are also covered.


Assuntos
Vesículas Extracelulares , Células-Tronco Mesenquimais , Cicatrização , Vesículas Extracelulares/transplante , Vesículas Extracelulares/metabolismo , Humanos , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Cicatrização/fisiologia , Animais , Transplante de Células-Tronco Mesenquimais/métodos , Doença Crônica , Ensaios Clínicos como Assunto , Queimaduras/terapia
3.
J Wound Care ; 33(4): 229-242, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38573907

RESUMO

OBJECTIVE: The effective assessment of wounds, both acute and hard-to-heal, is an important component in the delivery by wound care practitioners of efficacious wound care for patients. Improved wound diagnosis, optimising wound treatment regimens, and enhanced prevention of wounds aid in providing patients with a better quality of life (QoL). There is significant potential for the use of artificial intelligence (AI) in health-related areas such as wound care. However, AI-based systems remain to be developed to a point where they can be used clinically to deliver high-quality wound care. We have carried out a narrative review of the development and use of AI in the diagnosis, assessment and treatment of hard-to-heal wounds. We retrieved 145 articles from several online databases and other online resources, and 81 of them were included in this narrative review. Our review shows that AI application in wound care offers benefits in the assessment/diagnosis, monitoring and treatment of acute and hard-to-heal wounds. As well as offering patients the potential of improved QoL, AI may also enable better use of healthcare resources.


Assuntos
Inteligência Artificial , Qualidade de Vida , Humanos , Cicatrização , Atenção à Saúde
4.
J Pak Med Assoc ; 74(1): 67-71, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38219168

RESUMO

Objective: To determine the prevalence, antibiotic susceptibility and effect of Pseudomonas aeruginosa in relation to burn patients. METHODS: The cross-sectional study was conducted at the Centre for Advanced Studies in Vaccinology and Biotechnology, University of Balochistan, Quetta, Pakistan, from March 2018 to May 2021, and comprised pus swab cultures were isolated from inpatients with 2nd and 3rd degree burns aged up to 60 years at Bolan Medical Complex Hospital and Sandeman Provinical Hospital, the two main government tertiary care hospitals in Quetta. The samples were immediately cultured, and evaluated using biochemical tests, antibiotic susceptibility and molecular identification using polymerase chain reaction. Data was analysed using SPSS 20. RESULTS: Of the 720 burn wound samples, 424(58.9%) were positive for Pseudomonas aeruginosa; 304(42%) males and 120(16%) females (p<0.02). The overall mean age of the patients was 27.7±6.2 years (range: 1-60 years). The mean total burn surface area was not significantly different in positive 29.6±6.2% and negative 30.3±6.2% cases (p>0.05). The time leading to skin grafts in positive patients was 29.5±6.5 days compared to 22.3±6.3 days for negative patients (p< 0.007), and the time required for wound healing was 25.0±4.7 days and 16.7±5.2 days, respectively (p<0.001). Length of hospital stay of Pseudomonas aeruginosa positive patients was 38.0±7.8 days compared to 32.1±6.8 days for negative patients (p<0.001). Conclusion: Nosocomial infections and multidrug resistance species were observed frequently at the burn wound site. P. aeruginosa.


Assuntos
Queimaduras , Infecções por Pseudomonas , Infecção dos Ferimentos , Masculino , Feminino , Humanos , Idoso , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Pseudomonas aeruginosa , Prevalência , Estudos Transversais , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/epidemiologia , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/epidemiologia , Queimaduras/epidemiologia , Queimaduras/tratamento farmacológico , Cicatrização , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Testes de Sensibilidade Microbiana
5.
Ann Chir Plast Esthet ; 69(1): 70-78, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37770323

RESUMO

Fat transfer is increasingly used as part of our reconstructive armamentarium to address the challenges encountered in burn wounds and reconstructive surgery. The present systematic review aimed to evaluate the effectiveness of autologous fat transfer for acute burn wound management. A systematic review of the US National Library of Medicine, Cochrane Library, Web of Science, and Embase was conducted on October 15, 2022 (registration number CDR42022369726). A database watch was performed until submission of the manuscript. The review focused on wound healing. All studies reporting fat transfer in adult patients (at least 5 patients reported) with deep 2nd degree burn wounds were included. The database search yielded a total of 720 records and 367 patients were included from 3 studies. A statistically significant improvement in scar texture, scar appearance, and time to healing was reported in one study in the fat transfer group versus control (P<0.001). Similarly, scores for scar color, scar thickness, scar stiffness, and scar regularity increased significantly. The small number of included studies and their heterogeneity did not allow a meta-regression to be performed. This systematic review emphasizes the limited evidence currently available regarding the use of autologous fat transfer to improve burn wound healing in adult patients, even though it seems promising. Future search should focus on randomized controlled trials with a larger number of participants.


Assuntos
Queimaduras , Procedimentos de Cirurgia Plástica , Adulto , Humanos , Cicatriz/cirurgia , Tecido Adiposo , Cicatrização , Queimaduras/cirurgia
6.
Cytotherapy ; 25(2): 105-119, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36115756

RESUMO

Adipose tissue presents a comparably easy source for obtaining stem cells, and more studies are increasingly investigating the therapeutic potential of adipose-derived stem cells. Wound healing, especially in chronic wounds, and treatment of skin diseases are some of the fields investigated. In this narrative review, the authors give an overview of some of the latest studies concerning wound healing as well as treatment of several skin diseases and concentrate on the different forms of application of adipose-derived stem cells.


Assuntos
Dermatopatias , Cicatrização , Humanos , Pele , Adipócitos , Tecido Adiposo , Células-Tronco , Dermatopatias/terapia
7.
Int Wound J ; 20(1): 8-17, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35560869

RESUMO

A meta-analysis was performed to evaluate the effect of stem cells treatment in managing burn wounds. A systematic literature search up to March 2022 incorporated 24 studies reported between 2013 and 2021 including 400 animals with burn wounds at the beginning of the study; 211 were using stem cells treatment, and 189 controlled. Statistical tools like the contentious method were used within a random or fixed-influence model to establish the mean difference (MD) with 95% confidence intervals (CIs) to evaluate the influence of stem cells treatment in managing burn wounds. Stem cells treatment had a significantly higher burn wound healing rate (MD, 15.18; 95% CI, 11.29-19.07, P < .001), higher blood vessel number (MD, 12.28; 95% CI, 10.06-14.51, P < .001), higher vascular endothelial growth factor (MD, 10.24; 95% CI, 7.19-13.29, P < .001), lower interleukin-1 level (MD, -98.48; 95% CI, -155.33 to -41.63, P < .001), and lower tumour necrosis factor α level (MD, -28.71; 95% CI, -46.65 to -10.76, P < .002) compared with control in animals' models with burn wounds. Stem cells treatment had a significantly higher burn wound healing rate, higher blood vessel number, higher vascular endothelial growth factor, lower interleukin-1 level, and lower tumour necrosis factor α level compared with control in animals' models with burn wounds. Further studies are required to validate these findings.


Assuntos
Queimaduras , Fator de Necrose Tumoral alfa , Animais , Fator A de Crescimento do Endotélio Vascular , Queimaduras/terapia , Células-Tronco , Interleucina-1
8.
Int Wound J ; 2023 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-37776166

RESUMO

The meta-analysis aimed to assess the efficiency of platelet-rich plasma (PRP) in the management of burn wounds (BWs). Using dichotomous or contentious random- or fixed-effects models, the outcomes of this meta-analysis were examined and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. Thirteen examinations from 2009 to 2023 were enrolled for the present meta-analysis, including 808 individuals with BWs. PRP had significantly shorter healing time (MD, -5.80; 95% CI, -7.73 to -3.88, p < 0.001), higher healing rate (OR, 3.14; 95% CI, 2.05-4.80, p < 0.001), higher healed area percent (MD, 12.67; 95% CI, 9.79-15.55, p < 0.001) and higher graft take area percent (MD, 4.39; 95% CI, 1.51-7.26, p = 0.003) compared with standard therapy in patients with BW. However, no significant difference was found between PRP and standard therapy in graft take ratio (OR, 1.70; 95% CI, 0.86-3.34, p = 0.13) and infection rate (OR, 0.55; 95% CI, 0.20-1.47, p = 0.23) in patients with BW. The examined data revealed that PRP had a significantly shorter healing time, a higher healing rate, a higher healed area percent and a higher graft take area percent; however, no significant difference was found in graft take ratio or infection rate compared with standard therapy in patients with BW. Yet, attention should be paid to its values since all of the selected examinations had a low sample size and some comparisons had a low number of selected studies.

9.
Infect Immun ; 89(11): e0033621, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34424744

RESUMO

Cutaneous thermal injuries from burns/explosives are a major cause of morbidity and mortality and represent a monumental burden on our current health care system. Injury severity is predominantly due to potentially lethal sepsis caused by multidrug-resistant (MDR) bacteria such as Pseudomonas aeruginosa (MDR-PA). Thus, there is a critical need to develop novel and effective antimicrobials for the (i) prevention, (ii) treatment, and (iii) healing of such wounds that are complicated by MDR-P. aeruginosa and other bacterial infections. AB569 is a novel bactericidal tandem consisting of acidified NaNO2 (A-NO2-) and Na2-EDTA. Here, we first show that AB569 acts synergistically to kill all human burn wound strains of P. aeruginosa in vitro. This was found to be due, in part, to the generation of A-NO2--mediated nitric oxide (NO) formation coupled with the metal chelating properties of Na2-EDTA. Using a murine scald burn wound model of P. aeruginosa infection, an AB569-Solosite gel formulation eradicated all bacteria. Futher, we also demonstrate enhanced AB569-mediated wound healing by not only accelerating wound contraction, but also by reducing levels of the proinflammatory cytokines interleukin-6 (IL-6) and IL-1ß while increasing the levels of anti-inflammatory cytokine, IL-10, and granulocyte-colony-stimulating factor (G-CSF). We also observed better epidermal restoration in AB569-treated wounds. Taken together, we conclude that this study provides solid foundational evidence that AB569 can be used topically to treat highly problematic dermal insults, including wound, burn, blast, and likely, diabetic infections in civilian and military populations, and help relieve the economical burden that MDR organisms have on the global health care system.


Assuntos
Antibacterianos/farmacologia , Queimaduras/tratamento farmacológico , Ácido Edético/farmacologia , Nitritos/farmacologia , Pseudomonas aeruginosa/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Queimaduras/complicações , Queimaduras/microbiologia , Colágeno/genética , Modelos Animais de Doenças , Ácido Edético/uso terapêutico , Géis , Óxido Nítrico/biossíntese , Nitritos/uso terapêutico , Infecções por Pseudomonas/tratamento farmacológico
10.
J Surg Res ; 267: 182-196, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34153561

RESUMO

BACKGROUND: Negative pressure wound therapy (NPWT) is an option for securing meshed split thickness skin grafts (mSTSGs) after burn excision to optimize skin graft adherence. Recently, the use of autologous skin cell suspension (ASCS) has been approved for use in the treatment of burn injuries in conjunction with mSTSGs.To date, limited data exists regarding the impact of NPWT on healing outcomes when the cellular suspension is utilized. It was hypothesized that NPWT would not negatively impact wound healing of ASCS+mSTSG. MATERIALS AND METHODS: A burn, excision, mSTSG, ASCS ± NPWT model was used. Two Duroc pigs were utilized in this experiment, each with 2 sets of paired burns. Four wounds received mSTSG+ASCS+NPWT through post-operative day 3, and 4 wounds received mSTSG+ACSC+ traditional ASCS dressings. Cellular viability was characterized prior to spraying. Percent re-epithelialization, graft-adherence, pigmentation, elasticity, and blood perfusion and blood vessel density were assessed at multiple time points through 2 weeks. RESULTS: All wounds healed within 14 days with minimal scar pathology and no significant differences in percent re-epithelialization between NPWT, and non-NPWT wounds were observed. Additionally, no differences were detected for pigmentation, perfusion, or blood vessel density. NPWT treated wounds had less graft loss and improved elasticity, with elasticity being statistically different. CONCLUSIONS: These data suggest the positive attributes of the cellular suspension delivered are retained following the application of negative pressure. Re-epithelialization, revascularization, and repigmentation are not adversely impacted. The use of NPWT may be considered as an option when using ASCS with mSTSGs for the treatment of full-thickness burns.


Assuntos
Queimaduras , Tratamento de Ferimentos com Pressão Negativa , Animais , Queimaduras/patologia , Projetos Piloto , Pele/patologia , Transplante de Pele , Suspensões , Suínos
11.
Exp Mol Pathol ; 122: 104674, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34437877

RESUMO

Thermal injuries cause severe damage on the cellular and tissue level and are considered especially challenging in the clinical routine. Complex interactions of different cell types and pathways dictate the formation of burn wounds. Thus, complications like burn wound progression, where so far viable tissue becomes necrotic and the size and depth of the wound increases, are difficult to explain, mainly due to the lack of simple model systems. We tested the behavior of human fibroblasts after heat treatment. A prominent response of the cells is to activate the heat shock response (HSR), which is one of the primary emergency mechanisms of the cell to proteotoxic stress factors such as heat. However, after a powerful but not lethal heat shock we observed a delayed activation of the HSR. Extending this model system, we further investigated these static cells and observed the emergence of senescent cells. In particular, the cells became ß-galactosidase positive, increased p16 levels and developed a senescence-associated secretory phenotype (SASP). The secretion of cytokines like IL-6 is reminiscent of burn wounds and generates a bystander effect in so far non-senescent cells. In agreement with burn wounds, a wave of cytokine secretion enhanced by invading immune cells could explain complications like burn wound progression. A simple cell culture model can thus be applied for the analysis of highly complex conditions in human tissues.


Assuntos
Queimaduras/genética , Senescência Celular/genética , Resposta ao Choque Térmico/genética , Fenótipo Secretor Associado à Senescência/genética , Queimaduras/patologia , Proliferação de Células/genética , Fibroblastos/metabolismo , Humanos , Transdução de Sinais/genética , Cicatrização/genética
12.
Int J Mol Sci ; 22(16)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34445299

RESUMO

Deep partial-thickness burns damage most of the dermis and can cause severe pain, scarring, and mortality if left untreated. This study serves to evaluate the effectiveness of crosslinked keratin-alginate composite sponges as dermal substitutes for deep partial-thickness burns. Crosslinked keratin-alginate sponges were tested for the ability to support human dermal fibroblasts in vitro and to support the closure and healing of partial-thickness burn wounds in Sus scrofa pigs. Keratin-alginate composite sponges supported the enhanced proliferation of human dermal fibroblasts compared to alginate-only sponges and exhibited decreased contraction in vitro when compared to keratin only sponges. As dermal substitutes in vivo, the sponges supported the expression of keratin 14, alpha-smooth muscle actin, and collagen IV within wound sites, comparable to collagen sponges. Keratin-alginate composite sponges supported the regeneration of basement membranes in the wounds more than in collagen-treated wounds and non-grafted controls, suggesting the subsequent development of pathological scar tissues may be minimized. Results from this study indicate that crosslinked keratin-alginate sponges are suitable alternative dermal substitutes for clinical applications in wound healing and skin regeneration.


Assuntos
Alginatos/uso terapêutico , Queimaduras/terapia , Queratinas/uso terapêutico , Cicatrização , Alginatos/química , Alginatos/farmacologia , Animais , Curativos Hidrocoloides , Queimaduras/patologia , Queimaduras/fisiopatologia , Células Cultivadas , Derme/efeitos dos fármacos , Derme/patologia , Derme/fisiopatologia , Humanos , Hidrogéis/química , Hidrogéis/uso terapêutico , Queratinas/química , Queratinas/farmacologia , Masculino , Teste de Materiais , Índice de Gravidade de Doença , Pele/efeitos dos fármacos , Pele/patologia , Pele/fisiopatologia , Suínos , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologia
13.
Am J Emerg Med ; 38(4): 853.e5-853.e6, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31839516

RESUMO

INTRODUCTION: To the majority of health care professionals, burns present as a challenging and potentially distracting diagnosis. Because of their perceived complexity, they often eclipse other medical problems which can often be life threatening. Pressure related injuries, in rare instances can mimic and be mistaken for full thickness burns. Long lies may cause pressure necrosis of decubitus areas and compartment syndrome of vulnerable areas. Compartment syndrome, is a surgical emergency requiring prompt diagnosis and intervention. It may be missed in the context of a long lie after a collapse and maybe detrimental to patients' prognosis. METHODS: We reviewed cases referred to our Burns unit in the last four months to find cases of pressure related injuries referred as burn wounds. Furthermore, we also performed a literature search to find any similar cases to ours. RESULTS: Two cases, with acute pressure related injuries from long lies had been mistaken for burn wounds, were referred to our unit in the last four months. In one case a missed compartment syndrome resulted in a below elbow amputation. CONCLUSION: Pattern analysis and recognition are very important diagnostic tools in medicine. Detailed history taking and examination cannot be emphasised enough. Training both emergency departments and plastic surgeons in recognising long lie related injuries will decrease possible associated dangers such as missing a compartment syndrome.


Assuntos
Queimaduras/diagnóstico , Erros de Diagnóstico , Úlcera por Pressão/diagnóstico , Acidentes por Quedas , Idoso , Queimaduras/patologia , Síndromes Compartimentais/diagnóstico , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/patologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pressão/efeitos adversos , Úlcera por Pressão/patologia
14.
J Wound Care ; 29(Sup12): S38-S43, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33320761

RESUMO

OBJECTIVE: The purpose of this study was to identify the potential of resveratrol in inhibiting the growth and production of two enzymes, hyaluronidase and protease, in Stenotrophomonas maltophilia, which has become a burn wound pathogen of great significance. METHOD: Stenotrophomonas maltophilia (ATCC 17666) was cultured in nutrient broth and the microbial load was standardised to 0.5 McFarland standard at 600nm. The study included antimicrobial assays (well diffusion and resazurin dye binding method), hyaluronidase expression regulation assay (hyaluronic acid hydrolysis assay and turbidity assay) and protease expression regulation assay (casein hydrolysis assay and determination of specific activity of protease using tyrosine standard). RESULTS: The minimum inhibitory concentration (MIC) of resveratrol against Stenotrophomonas maltophilia was found to be 125µg/ml. Hyaluronidase production in the organism treated with resveratrol was found to be half that in the untreated organism. The specific activity of protease produced by the organism treated with resveratrol was found to be one-quarter that in the untreated organism, as analysed by the tyrosine standard estimation protocol. CONCLUSION: Resveratrol was found to be a potent compound to treat Stenotrophomonas maltophilia infections. In addition to the antimicrobial and enzyme-regulatory properties of resveratrol, it also shows anti-oxidant and anti-inflammatory properties. This finding has great scope clinically as resveratrol may prove to be an ideal drug to treat burn wound infections.


Assuntos
Antibacterianos/uso terapêutico , Queimaduras/tratamento farmacológico , Resveratrol/farmacologia , Stenotrophomonas maltophilia/efeitos dos fármacos , Queimaduras/patologia , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana , Resveratrol/uso terapêutico , Stenotrophomonas maltophilia/enzimologia
15.
Sensors (Basel) ; 20(3)2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32033414

RESUMO

The need for technologies to monitor the wound healing under dressing materials has led us to investigate the feasibility of using microwave and millimetre wave radiations due to their sensitivity to water, non- ionising nature, and transparency to dressing materials and clothing. This paper presents synthetic aperture radar (SAR) images obtained from an active microwave and millimetre wave scanner operating over the band 15-40 GHz. Experimental images obtained from porcine skin samples with the presence of dressing materials and after the application of localised heat treatments reveal that SAR images can be used for diagnosing burns and for potentially monitoring the healing under dressing materials. The experimental images were extracted separately from the amplitude and phase measurements of the input reflection coefficient (S11). The acquired images indicate that skin and burns can be detected and observed through dressing materials as well as features of the skin such as edges, irregularities, bends, burns, and variation in the reflectance of the skin. These unique findings enable a microwave and millimetre-wave scanner to be used for evaluating the wound healing progress under dressing materials without their often-painful removal: a capability that will reduce the cost of healthcare, distress caused by long waiting hours, and the healthcare interventional time.


Assuntos
Bandagens , Queimaduras/diagnóstico por imagem , Radar , Pele/diagnóstico por imagem , Cicatrização , Algoritmos , Animais , Calibragem , Micro-Ondas , Suínos , Tomografia de Coerência Óptica , Ultrassom
16.
Int J Mol Sci ; 21(24)2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33352826

RESUMO

Wound management remains a challenge worldwide, although there are several developed wound dressing materials for the management of acute and chronic wounds. The wound dressings that are currently used include hydrogels, films, wafers, nanofibers, foams, topical formulations, transdermal patches, sponges, and bandages. Hydrogels exhibit unique features which make them suitable wound dressings such as providing a moist environment for wound healing, exhibiting high moisture content, or creating a barrier against bacterial infections, and are suitable for the management of exuding and granulating wounds. Biopolymers have been utilized for their development due to their non-toxic, biodegradable, and biocompatible properties. Hydrogels have been prepared from biopolymers such as cellulose and chitosan by crosslinking with selected synthetic polymers resulting in improved mechanical, biological, and physicochemical properties. They were useful by accelerating wound re-epithelialization and also mimic skin structure, inducing skin regeneration. Loading antibacterial agents into them prevented bacterial invasion of wounds. This review article is focused on hydrogels formulated from two biopolymers-chitosan and cellulose-for improved wound management.


Assuntos
Celulose/química , Quitosana/química , Hidrogéis/química , Cicatrização , Animais , Biopolímeros/química , Queimaduras/etiologia , Queimaduras/terapia , Ensaios Clínicos como Assunto , Complicações do Diabetes , Humanos , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/terapia
17.
AAPS PharmSciTech ; 21(8): 323, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33200249

RESUMO

Crude ginger has been used to treat wounds since ancient times till nowadays. The present study aimed at designing and characterizing topical hydrogel films loaded with ginger extract for wound healing in animal model. The hydrogel films were prepared using PVA and gelatin. The prepared films were evaluated for FTIR analysis, surface morphology, pH, swelling behavior, in vitro release, and % drug content. The wound-healing activity of the extract-loaded hydrogel films was compared with commercially available Silver Sulfadiazine® cream. The drug was compatible with the selected polymers and indicated the suitability of the selected polymers for preparation of topical hydrogel films. The SEM images clearly indicated porous structure of the prepared hydrogel films. Slight changes were observed in pH, ranging from 4.98 ± 0.079 in the beginning of the study to 4.9 ± 0.58 in the end. The swelling percentage after 8 h was 257.7%. The films released 78.7 ± 1.7% of the drug in 250 min. The percent drug content was 97.78 ± 5% which did not change significantly during the storage period. The hydrogel films showed similar wound-healing activity as compared to the commercial product (p > 0.05; ANOVA), while greater wound-healing activity as compared to the control group (p < 0.05; ANOVA) evidenced by intensive collagen formation in histopathological analysis.


Assuntos
Queimaduras/patologia , Gelatina/química , Metilgalactosídeos/química , Cicatrização , Animais , Técnicas In Vitro , Modelos Animais , Extratos Vegetais , Sulfadiazina de Prata
18.
Mol Pharm ; 16(9): 3916-3925, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31318574

RESUMO

Biofilm resistance is one of the severe complications associated with chronic wound infections, which impose extreme microbial tolerance against antibiotic therapy. Interestingly, deoxyribonuclease-I (DNase-I) has been empirically proved to be efficacious in improving the antibiotic susceptibility against biofilm-associated infections. DNase-I hydrolyzes the extracellular DNA, a key component of the biofilm responsible for the cell adhesion and strength. Moreover, silver sulfadiazine, a frontline therapy in burn wound infections, exhibits delayed wound healing due to fibroblast toxicity. In this study, a chitosan gel loaded with solid lipid nanoparticles of silver sulfadiazine (SSD-SLNs) and supplemented with DNase-I has been developed to reduce the fibroblast cytotoxicity and overcome the biofilm-imposed resistance. The extensive optimization using the Box-Behnken design (BBD) resulted in the formation of SSD-SLNs with a smooth surface as confirmed by scanning electron microscopy and controlled release (83%) for up to 24 h. The compatibility between the SSD and other formulation excipients was confirmed by Fourier transform infrared, differential scanning calorimetry, and powder X-ray diffraction studies. Developed SSD-SLNs in combination with DNase-I inhibited around 96.8% of biofilm of Pseudomonas aeruginosa as compared to SSD with DNase-I (82.9%). In line with our hypothesis, SSD-SLNs were found to be less toxic (cell viability 90.3 ± 3.8% at 100 µg/mL) in comparison with SSD (Cell viability 76.9 ± 4.2%) against human dermal fibroblast cell line. Eventually, the results of the in vivo wound healing study showed complete wound healing after 21 days' treatment with SSD-SLNs along with DNase-I, whereas marketed formulations SSD and SSD-LSNs showed incomplete healing after 21 days. Data in hand suggest that the combination of SSD-SLNs with DNase-I is an effective treatment strategy against the biofilm-associated wound infections and accelerates wound healing.


Assuntos
Biofilmes/efeitos dos fármacos , Desoxirribonuclease I/farmacologia , Sistemas de Liberação de Medicamentos/métodos , Nanopartículas/química , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/fisiologia , Sulfadiazina de Prata/farmacologia , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Animais , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Quitosana/química , Desoxirribonuclease I/química , Composição de Medicamentos/métodos , Excipientes/química , Fibroblastos/metabolismo , Humanos , Masculino , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/microbiologia , Ratos , Ratos Wistar , Sulfadiazina de Prata/química , Pele/citologia , Resultado do Tratamento
19.
Infection ; 47(2): 195-200, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30132251

RESUMO

BACKGROUND: Skin and soft tissue infections have a high disease burden in children. The emergence of multidrug-resistant bacteria over the last decades has heavily influenced hospitalization rates, morbidity and mortality. In addition, with increased survival rates in neonatology and oncology, health-care associated infections are more frequently encountered. There is a growing need for fast and feasible diagnostic tools for the recognition of microorganisms and drug resistances. METHODS: In this prospective study, we compared results of routine culture with the multiplex PCR based Unyvero Implant and Tissue Infection (ITI) application. Specimens were obtained from different sources from neonates and children. RESULTS: We analyzed specimens from 29 patients (72.4% male) with a median age of 8.1 years (range 0.03-15.2). Concordance between Unyvero ITI and culture was reached in 16 of 29 samples (55.2%). Unyvero ITI yielded an overall sensitivity and specificity of 76.3% and 96.5%, respectively. Accuracies were best for non-fermenting bacteria, for which sensitivity was 100% and specificity 98.2%. Detection rates were lower for Gram-positive bacteria (68.8 and 95.2%, respectively). Unyvero correctly detected one blaOXA-24/40 producing Acinetobacter baumannii, while none of the six gyrA87 had a correlate in antimicrobial susceptibility testing. CONCLUSIONS: Unyvero ITI quickly provides additional information relevant for clinical decision-makers. Sensitivity of the PCR must be improved especially for Gram-positive bacteria, and further studies are needed to assess the impact on clinical decision-making and outcome.


Assuntos
Bactérias/isolamento & purificação , Doenças do Tecido Conjuntivo/diagnóstico , Infecção Hospitalar/diagnóstico , Farmacorresistência Bacteriana Múltipla , Reação em Cadeia da Polimerase Multiplex/métodos , Próteses e Implantes , Dermatopatias/diagnóstico , Adolescente , Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/genética , Criança , Pré-Escolar , Doenças do Tecido Conjuntivo/microbiologia , Infecção Hospitalar/microbiologia , Feminino , Alemanha , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Dermatopatias/microbiologia
20.
Sensors (Basel) ; 19(5)2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-30861994

RESUMO

A flat circular transmission line-based 300 MHz resonator was implemented for the non-contact assessment of burn depths in biological tissues. Used as a transmit-and-receive sensor, it was placed at a 2 mm distance from organic material test samples (pork fillet samples) which were previously burned on their surface in various heating conditions involving different temperatures, durations, and procedures. Data extracted from the sensor by means of a distant monitoring coil were found to clearly correlate with the depth of burn observed in the tissue samples (up to 40% sensor output changes for a 7 mm burn depth) and with the heating conditions (around 5% sensor output changes observed in samples burned with identical heating procedures but at two different temperatures-75 °C and 150 °C-and around 40% sensor output changes observed between samples heated at the same temperature but with different heating procedures). These results open the way for the development of easy-to-implement assessment and monitoring techniques for burns, e.g., integrated in wearable medical dressing-like monitoring devices.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA