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1.
Skin Res Technol ; 30(4): e13685, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38558086

RESUMEN

BACKGROUND: Wound healing has evolved in recent years, resulting in diverse therapeutic options. OBJECTIVE: This study evaluated the effects of the somatic antigen of the hydatid cyst protoscolex on wound healing in mice with full-thickness skin wounds. METHODS: Fifty-four adult mice, weighing 25 ± 5 g and approximately 60 days old, were divided into three groups (A, B, and C), each further divided into three subgroups. Subgroups A1, A2, and A3 were assigned negative controls. B1, B2, and B3 received hydatid cyst somatic antigen tests at 10 µg/SC, whereas C1, C2, and C3 received somatic antigen tests at 20 µg/SC. Under general anesthesia, a wound biopsy puncture of 9.8 mm in diameter was performed on the mice's back and spine. In the experimental group, antigen and alum adjuvant were administered subcutaneously around the wound, while the control group received Phosphate-Buffered Saline (PBS). Using digital images, a geometric assessment was conducted on days 0, 1, 3, 6, 9, 12, 15, 18, and 21 post-wounding. The obtained images were analyzed by Image J software and after analyzing the data by SPSS software. RESULTS: A significant difference in terms of epithelization was observed in the antigen treatment group with a dose of 20 µg on days 3 and 6 (P < 0.05). Furthermore, the 20 µg antigen group was significantly higher than the 10 µg antigen group in terms of this factor on day 3 (P < 0.05). Skin samples were taken from all wounds on days 3, 10 and 21 for microscopic evaluation. Regarding epithelization, on day 10, a significant difference was observed in the treatment group with a concentration of 10 µg with the control group and the treatment group with a concentration of 20 µg (P < 0.05). CONCLUSION: Based on the results of the present study, it can be concluded that somatic antigens of protoscolex hydatid cyst are dose-dependent and antigens with a dose of 20 µg by subcutaneous injection accelerate wound healing and epithelialization.


Asunto(s)
Equinococosis , Cicatrización de Heridas , Ratones , Animales , Inyecciones Subcutáneas
2.
Skin Res Technol ; 30(4): e13671, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38558153

RESUMEN

BACKGROUND: Nowadays, diabetic wound healing remains a crucial challenge due to their protracted and uncertain healing process. Traditional Chinese medicine (TCM) has demonstrated the therapeutic value of Sanguis draconis (SD)-Salvia miltiorrhiza (SMR) Herb Pair in diabetic wound healing. However, new administration modes are urgently needed for their convenient and wide-ranging applications. OBJECTIVE: We propose a soluble polyvinylpyrrolidone-based microneedle patch containing the herbal extracts of SD and SMR (MN-SD@SMR) for diabetic wound healing. METHODS: The herbal extracts of SD and SMR are purification and concentration via traditional lyophilization. SD endowed MN-SD@SMR with functions to improve high glycemic blood environment and migration of keratinocyte and fibroblast cells. RESULTS: SMR in MN-SD@SMR could improve blood flow velocity and microcirculation in the wound area. The effectiveness of transdermal release and mechanical strengths of MN-SD@SMR were verified. CONCLUSION: Integrating the advantages of these purified herbal compositions, we demonstrated that MN-SD@SMR had a positive healing effect on the wounds in vitro and vivo. These results indicate that soluble polyvinylpyrrolidone-based microneedle patch containing the herbal extracts of SD and SMR has a promising application value due to their superior capability to promote diabetic wound healing.


Asunto(s)
Diabetes Mellitus , Medicamentos Herbarios Chinos , Salvia miltiorrhiza , Humanos , Povidona , Diabetes Mellitus/tratamiento farmacológico , Cicatrización de Heridas
3.
Int J Nanomedicine ; 19: 3045-3070, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38559447

RESUMEN

Background: Diabetes Mellitus is a multisystem chronic pandemic, wound inflammation, and healing are still major issues for diabetic patients who may suffer from ulcers, gangrene, and other wounds from uncontrolled chronic hyperglycemia. Marshmallows or Althaea officinalis (A.O.) contain bioactive compounds such as flavonoids and phenolics that support wound healing via antioxidant, anti-inflammatory, and antibacterial properties. Our study aimed to develop a combination of eco-friendly formulations of green synthesis of ZnO-NPs by Althaea officinalis extract and further incorporate them into 2% chitosan (CS) gel. Method and Results: First, develop eco-friendly green Zinc Oxide Nanoparticles (ZnO-NPs) and incorporate them into a 2% chitosan (CS) gel. In-vitro study performed by UV-visible spectrum analysis showed a sharp peak at 390 nm, and Energy-dispersive X-ray (EDX) spectrometry showed a peak of zinc and oxygen. Besides, Fourier transforms infrared (FTIR) was used to qualitatively validate biosynthesized ZnO-NPs, and transmission electron microscope (TEM) showed spherical nanoparticles with mean sizes of 76 nm and Zeta potential +30mV. The antibacterial potential of A.O.-ZnO-NPs-Cs was examined by the diffusion agar method against Gram-positive (Staphylococcus aureus and Bacillus subtilis) and Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa). Based on the zone of inhibition and minimal inhibitory indices (MIC). In addition, an in-silico study investigated the binding affinity of A.O. major components to the expected biological targets that may aid wound healing. Althaea Officinalis, A.O-ZnO-NPs group showed reduced downregulation of IL-6, IL-1ß, and TNF-α and increased IL-10 levels compared to the control group signaling pathway expression levels confirming the improved anti-inflammatory effect of the self-assembly method. In-vivo study and histopathological analysis revealed the superiority of the nanoparticles in reducing signs of inflammation and wound incision in rat models. Conclusion: These biocompatible green zinc oxide nanoparticles, by using Althaea Officinalis chitosan gel ensure an excellent new therapeutic approach for quickening diabetic wound healing.


Asunto(s)
Althaea , Quitosano , Diabetes Mellitus , Nanopartículas del Metal , Óxido de Zinc , Humanos , Animales , Ratas , Óxido de Zinc/química , Quitosano/química , Althaea/metabolismo , Interleucina-6 , Factor de Necrosis Tumoral alfa , Nanopartículas del Metal/química , Antibacterianos/farmacología , Antibacterianos/química , Cicatrización de Heridas , Antiinflamatorios/farmacología , Inflamación , Flores , Pruebas de Sensibilidad Microbiana , Extractos Vegetales/farmacología , Extractos Vegetales/química , Espectroscopía Infrarroja por Transformada de Fourier , Difracción de Rayos X
4.
Rev Med Suisse ; 20(867): 622-630, 2024 Mar 27.
Artículo en Francés | MEDLINE | ID: mdl-38563536

RESUMEN

Chronic lower-extremity ulcers are a growing public health problem, resulting in significant costs for society and patients, and having a significant impact on the quality of life of patients and informal caregivers. As general practitioners are often solicited early on, the acquisition of basic knowledge regarding wound care management is therefore essential to initiate local care, to make an early diagnosis and identify emergencies and patients that need a referral. The CASE and TIMERS frameworks enable a holistic assessment of the patient and the wound, to propose a treatment of the wound based on its etiology combined with appropriate local wound care. This framework allows also to identify atypical, severe, or recalcitrant wounds requiring specialized advice.


Les plaies chroniques des membres inférieurs sont un problème grandissant de santé publique, occasionnant des dépenses conséquentes et entraînant une répercussion non négligeable sur la qualité de vie des patients et de leurs proches aidants. Les médecins de premier recours étant le plus souvent les premiers intervenants, l'acquisition d'un socle commun de connaissances est donc essentielle pour la bonne prise en soin initiale des plaies chroniques, obtenir un diagnostic précoce et identifier les urgences et les patients à référer. L'approche selon les principes CASE et TIMERS permet une évaluation holistique du patient et de sa plaie, et de proposer un traitement étiologique associé à des soins locaux adaptés. Celle-ci permet également d'identifier les plaies atypiques, sévères ou récalcitrantes, nécessitant un avis spécialisé.


Asunto(s)
Úlcera de la Pierna , Cicatrización de Heridas , Humanos , Calidad de Vida , Extremidad Inferior , Úlcera de la Pierna/diagnóstico , Úlcera de la Pierna/etiología , Úlcera de la Pierna/terapia
5.
Ann Plast Surg ; 92(4S Suppl 2): S172-S178, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38556669

RESUMEN

INTRODUCTION: The fully synthetic skin substitute, NovoSorb Biodegradable Temporizing Matrix (BTM), may be a cost-effective alternative to the animal-derived Integra Dermal Regeneration Template (IDRT). However, the current literature insufficiently compares the two. Therefore, our study compared clinical, aesthetic, and economic outcomes in treating soft tissue wounds with IDRT, an animal-derived template, vs BTM, a fully synthetic template. METHODS: Our single-center retrospective study compared outcomes of 26 patient cases treated with BTM (57.7%) or IDRT (42.3%) during 2011-2022. RESULTS: The mean surgery time was significantly shorter in BTM cases (1.632 ± 0.571 hours) compared with IDRT cases (5.282 ± 5.102 hours, P = 0.011). Median postoperative hospital stay was notably shorter for BTM placement than IDRT placement (0.95 vs 6.60 days, P = 0.003). The median postoperative follow-up length approached a shorter duration in the BTM group (P = 0.054); however, median follow-up visits were significantly lower in the BTM group compared with the IDRT group (5 vs 14, P = 0.012). The median duration for complete wound closure was shorter for BTM (46.96 vs 118.91 days, P = 0.011). Biodegradable Temporizing Matrix demonstrated a notably lower infection rate (0.0%) compared with IDRT (36.4%, P = 0.022). Integra Dermal Regeneration Template exhibited higher wound hypertrophy rates (81.8%) than BTM (26.7%, P = 0.015). Revisionary surgeries were significantly more frequent in the BTM group (P < 0.001). Failed closure, defined as requiring one or more attempts, exhibited a significant difference, with a higher risk in the IDRT group (26.7%) compared with BTM (6.7%, P = 0.003). Biodegradable Temporizing Matrix showed a lower mean Vancouver Scar Scale adjusted fraction (0.279) compared with IDRT (0.639, P < 0.001). Biodegradable Temporizing Matrix incurred lower costs compared with IDRT but displayed a lower mean profit per square centimeter ($10.63 vs $22.53, P < 0.001). CONCLUSION: Economically, although the net profit per square centimeter of dermal template may favor IDRT, the ancillary benefits associated with BTM in terms of reduced hospital stay, shorter surgery times, fewer follow-up visits, and lower revisionary surgery rates contribute substantially to overall cost-effectiveness. Biodegradable Temporizing Matrix use reflects more efficient resource use and potential cost savings, aligning with broader trends in healthcare emphasizing value-based and patient-centered care.


Asunto(s)
Dermis Acelular , Cirugía Plástica , Animales , Humanos , Cicatrización de Heridas , Estudios Retrospectivos , Estética , Trasplante de Piel
6.
Clin Ter ; 175(2): 135-143, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38571472

RESUMEN

Background: Recently, cold atmospheric plasma (CAP), as well as adipose mesenchymal stem cells derived exosomes (ADMSCs-EX), have been applied separately to wound healing treatment. However, no study has investigated the additive effect on the healing mechanism of these two methods in the same skin lesion treatment model. Aim: We conduct this study to describe the results of using CAP and human ADMSCs-EX on in vitro wound healing. Methods: Exosomes were isolated from donor adipose tissue samples by ultracentrifugation method, characterized by transmission electron microscopy (TEM) and Western blot. Assessment in vitro wound healing on proliferation and migration evaluation experiments on human fibroblasts with culture medium supplemented with 10µg total exosomal proteins/1 mL and irradiated with CAP with an intensity of 30 seconds/cm2. Results: Experimental results to evaluate the ability to stimulate fibroblast migration, showed that cell migration speed in the group supplemented with ADMSCs-EX was equivalent to the group with a combination of CAP and ADMSCs-EX and had the highest rate with 87.8 ± 4.2 % and 84.4 ± 5.3 % while in the control group it was the lowest with 61.9 ± 11.4% (p<0.05). The group supplemented with CAP gave fibroblast proliferation and migration results similar to the control group (p>0.05), showing the safety of CAP with the growth of the cells. Conclusions: Therefore, in animal models, we intend to use a combination of these two therapies by using ADMSCs-EX injection therapy into the dermis at the wound edge to avoid the impact of CAP affecting the cell proliferation.


Asunto(s)
Exosomas , Células Madre Mesenquimatosas , Gases em Plasma , Animales , Humanos , Gases em Plasma/farmacología , Tejido Adiposo , Cicatrización de Heridas
7.
An Acad Bras Cienc ; 96(1): e20231143, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38597495

RESUMEN

Plants used in traditional medicine offer an affordable new alternative in tissue repair therapy. This study aimed to evaluate the effectiveness of the 5% Rhizophora mangle cream compared to the 5% dexpanthenol cream in healing open surgical wounds on the upper eyelid. A total of 18 patients were submitted to the experiment and divided into 2 groups with 9 patients each who used topically and daily 5% dexpanthenol cream (control group) or 5% R.mangle cream (intervention group) for 7 days. Clinical, morphometric and histomorphometric analyses of wounds and surgical procedures for skin removal were performed. In the morphometric analysis, all wounds treated with R.mangle and dexpanthenol creams showed complete macroscopic scars, without inflammatory signs and infection free. The skin hydration values in pre and post application periods of the cream were 43.82 ± 43.93 and 62.12 ± 67.40 respectively. The histomorphometric study showed lower values of epithelium distance in R. mangle group and higher in dexpanthenol group with significant difference between groups (p < 0.05). The R.mangle 5% cream proved to be effective in healing wounds of human upper eyelid skin with a significant improvement in epithelization compared to dexpanthenol 5% cream.


Asunto(s)
Ácido Pantoténico/análogos & derivados , Rhizophoraceae , Cicatrización de Heridas , Humanos , Brasil , Párpados/cirugía
8.
Braz Oral Res ; 38: e025, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38597545

RESUMEN

Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.


Asunto(s)
Láseres de Semiconductores , Labio , Humanos , Masculino , Persona de Mediana Edad , Láseres de Semiconductores/uso terapéutico , Labio/cirugía , Labio/irrigación sanguínea , Resultado del Tratamiento , Cicatrización de Heridas
9.
Clin Exp Pharmacol Physiol ; 51(5): e13857, 2024 05.
Artículo en Inglés | MEDLINE | ID: mdl-38566371

RESUMEN

Chronic stress often triggers gastrointestinal complications, including gastric injury and ulcers. Understanding the role of heat shock protein 27 (HSP27) in stress-induced gastric ulcers could unveil novel therapeutic targets. Here, we established a stress-induced gastric ulcer rat model using water immersion restraint stress and administered adenovirus-packaged HSP27 overexpression vector. Gastric ulcer severity was scored, and mucosal changes were assessed. Gastric epithelial and endothelial cells were treated with lipopolysaccharide and transfected with HSP27 overexpression vectors to evaluate cell viability, migration and angiogenesis. Expression levels of HSP27, C-X-C motif chemokine ligand 12 (CXCL12) and C-X-C motif chemokine receptor 4 (CXCR4) were measured in tissues and cells. HSP27 expression was initially low during stress-induced gastric ulceration but increased during ulcer healing. HSP27 overexpression accelerated ulcer healing in rats, promoting gastric epithelial cell proliferation and migration and gastric endothelial cell angiogenesis through the CXCL12/CXCR4 axis. Inhibitor IT1t reversed the effects of HSP27 overexpression on cell proliferation, migration and angiogenesis. In summary, HSP27 overexpression facilitated ulcer healing, which was partially mediated by the CXCL12/CXCR4 axis.


Asunto(s)
Úlcera Gástrica , Animales , Ratas , Quimiocina CXCL12/genética , Células Endoteliales/metabolismo , Proteínas de Choque Térmico HSP27/genética , Úlcera Gástrica/etiología , Úlcera Gástrica/metabolismo , Úlcera , Cicatrización de Heridas
10.
Front Immunol ; 15: 1342895, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38566997

RESUMEN

Excessive fibrous capsule formation around silicone mammary implants (SMI) involves immune reactions to silicone. Capsular fibrosis, a common SMI complication linked to host responses, worsens with specific implant topographies. Our study with 10 patients investigated intra- and inter-individually, reduced surface roughness effects on disease progression, wound responses, chronic inflammation, and capsular composition. The results illuminate the significant impact of surface roughness on acute inflammatory responses, fibrinogen accumulation, and the subsequent fibrotic cascade. The reduction of surface roughness to an average roughness of 4 µm emerges as a promising approach for mitigating detrimental immune reactions, promoting healthy wound healing, and curbing excessive fibrosis. The identified proteins adhering to rougher surfaces shed light on potential mediators of pro-inflammatory and pro-fibrotic processes, further emphasizing the need for meticulous consideration of surface design. The composition of the implant capsule and the discovery of intracapsular HSP60 expression highlight the intricate web of stress responses and immune activation that can impact long-term tissue outcomes.


Asunto(s)
Inflamación , Prótesis e Implantes , Humanos , Siliconas , Fibrosis , Cicatrización de Heridas
11.
J Cell Biol ; 223(7)2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38587472

RESUMEN

The wound-healing process is a paradigm of the directed migration of various pools of stem cells from their niche to the site of injury where they replenish damaged cells. Two decades have elapsed since the observation that wounding activates multipotent hair follicle stem cells to infiltrate the epidermis, but the cues that coax these cells out of their niche remain unknown. Here, we report that Caspase-1, a protein classically known as an integral component of the cytosolic inflammasome, is secreted upon wounding and has a non-canonical role in the extracellular milieu. Through its caspase activation recruitment domain (CARD), Caspase-1 is sufficient to initiate the migration of hair follicle stem cells into the epidermis. Uncovering this novel function of Caspase-1 also facilitates a deeper understanding of the mechanistic basis of the epithelial hyperplasia found to accompany numerous inflammatory skin diseases.


Asunto(s)
Caspasa 1 , Dermatitis , Folículo Piloso , Células Madre , Cicatrización de Heridas , Animales , Ratones , Caspasa 1/metabolismo , Movimiento Celular , Dermatitis/metabolismo , Dermatitis/patología , Cabello , Folículo Piloso/citología , Folículo Piloso/metabolismo , Inflamación/metabolismo
12.
Int Wound J ; 21(4): e14807, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38591163

RESUMEN

Skin Cutaneous Melanoma (SKCM) is a form of cancer that originates in the pigment-producing cells, known as melanocytes, of the skin. Delay wound healing is often correlated with the occurrence of and progression of SKCM. In this comprehensive study, we investigated the intricate roles of two important wound healing genes in SKCM, including Matrix Metalloproteinase-2 (MMP2) and Matrix Metalloproteinase-9 (MMP9). Through a multi-faceted approach, we collected clinical samples, conducted molecular experiments, including RT-qPCR, bisulphite sequencing, cell culture, cell Counting Kit-8, colony formation, and wound healing assays. Beside this, we also used various other databases/tools/approaches for additional analysis including, UALCAN, GEPIA, HPA, MEXPRESS, cBioPortal, KM plotter, DrugBank, and molecular docking. Our results revealed a significant up-regulation of MMP2 and MMP9 in SKCM tissues compared to normal counterparts. Moreover, promoter methylation analysis suggested an epigenetic regulatory mechanism. Validations using TCGA datasets and immunohistochemistry emphasized the clinical relevance of MMP2 and MMP9 dysregulation. Functional assays demonstrated their synergistic impact on proliferation and migration in SKCM cells. Furthermore, we identified potential therapeutic candidates, Estradiol and Calcitriol, through drug prediction and molecular docking analyses. These compounds exhibited binding affinities, suggesting their potential as MMP2/MMP9 inhibitors. Overall, our study elucidates the diagnostic, prognostic, and therapeutic implications of MMP2 and MMP9 in SKCM, shedding light on their complex interplay in SKCM occurrence and progression.


Asunto(s)
Melanoma , Neoplasias Cutáneas , Humanos , Melanoma/genética , Melanoma/terapia , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/terapia , Metaloproteinasa 2 de la Matriz/genética , Metaloproteinasa 9 de la Matriz , Simulación del Acoplamiento Molecular , Cicatrización de Heridas/genética , Mutación , Metilación
13.
J Wound Care ; 33(Sup4a): cxi-cxvii, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38588055

RESUMEN

OBJECTIVE: Scar tissue formation, as a normal part of wound healing, initiates in the proliferation phase, continues after the remodelling phase, and may cause an unpleasant appearance or disruption in normal functioning. This study investigated the effects of a topical gel on acute wound healing and reducing scars in a rat model. METHOD: ChitoScar (ChitoTech Company, Iran), a commercial scar-reducing gel based on chitosan, was analysed for antibacterial and antiviral activity through a quantitative suspension test. Its cytotoxic effect was investigated, and then irritation and delayed-type hypersensitivity tests were carried out on rabbits through direct application of the gel. Furthermore, the effect of the chitosan-based gel on wound healing and scar tissue formation was studied in rats with an acute wound in two groups: the treatment group (topical application of the chitosan-based gel); and the control group (without treatment). Histopathological examination was carried out based on the inflammatory cells, collagen fibre, keratinocytes and fibroblasts. RESULTS: Analysis revealed that the chitosan-based gel had no cytotoxicity and caused no erythema, oedema, local or other systemic adverse response. Wound healing occurred earlier in the treatment group, which was a result of a significant increase in re-epithelialisation, angiogenesis, fibroblast population and collagen fibre thickness (p<0.05). In the treatment group, wounds healed completely after 21 days and scars totally disappeared after 28 days, while in the control group, wound healing remained incomplete with distinct scar tissue. CONCLUSION: The results demonstrated the positive effect of the chitosan-based gel on the duration and quality of the wound healing process, as well as minimising the scar tissue formation in this in vivo study.


Asunto(s)
Quitosano , Cicatriz , Ratas , Conejos , Animales , Quitosano/farmacología , Quitosano/uso terapéutico , Cicatrización de Heridas , Piel , Colágeno/farmacología
14.
J Wound Care ; 33(Sup4a): xci-xcviii, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38588058

RESUMEN

OBJECTIVE: A diabetic foot ulcer (DFU) is a complication of type 2 diabetes that is difficult to treat. Buerger-Allen exercise has shown effectiveness in improving foot circulation and neuropathy in several studies; however, to the best of our knowledge, no randomised controlled study has investigated its effectiveness for DFU healing. Therefore, this study aimed to assess the effects of Buerger-Allen exercise on the healing of DFUs in patients with type 2 diabetes. METHOD: This is a parallel-group randomised controlled trial (RCT). Of 50 patients with neuropathic DFUs, 41 completed the study. They were assigned randomly to a study group (n=21) and a control group (n=20). Patients in the study group received the standard medical treatment and semi-supervised Buerger-Allen exercise for three sessions per week for four weeks, while patients in the control group only received the standard medical treatment. The outcome measures were: ankle-brachial pressure index (ABPI); ulcer size; ulcer depth; SINBAD score; and ulcer risk for poor outcomes (based on the SINBAD score). RESULTS: The study group's mean age was 49.48±6.45 years and the control group's mean age was 49.15±5.85. The study group's ABPI increased significantly compared to the baseline (1.17±0.04 versus 1.11±0.05, respectively; p<0.001) and the control group (1.17±0.04 versus 1.14±0.05, respectively; p=0.04) post-intervention. Ulcer size also reduced significantly in the study group compared to the baseline (2.63±2.0 versus 7.48±5.55cm2, respectively; p<0.001) and the control group (2.63±2.0 versus 6.43±4.45cm2, respectively; p<0.001) post-intervention. Ulcer depth decreased significantly in the study group compared to the baseline (1.71±1.05 versus 4.19±1.74mm, respectively; p<0.001) and the control group (1.71±1.05 versus 2.80±1.57mm, respectively; p=0.01) post-intervention. Furthermore, the SINBAD score in the study group decreased significantly compared to the baseline (1.38±0.86 versus 2.14±1.06, respectively; p<0.001) and the control group (1.38±0.86 versus 2.0±0.79, respectively; p=0.02) post-intervention. Moreover, the ulcer risk for poor outcomes, based on the SINBAD score, reduced significantly only in the study group, compared to the baseline (p=0.041). The control group showed non-significant changes compared to the baseline in all outcome measures (p>0.05). CONCLUSION: From the findings of this RCT, Buerger-Allen exercise, in combination with standard wound care, may help accelerate the healing of neuropathic DFUs in patients with type 2 diabetes, and could be suggested as part of the management plan for such conditions as an easy-to-perform offloading exercise intervention.


Asunto(s)
Diabetes Mellitus Tipo 2 , Pie Diabético , Humanos , Adulto , Persona de Mediana Edad , Pie Diabético/terapia , Pie Diabético/complicaciones , Pie , Ejercicio Físico , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/terapia , Cicatrización de Heridas
15.
J Wound Care ; 33(Sup4a): lxxxv-xc, 2024 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-38588057

RESUMEN

Biosurgery (larval therapy) has been used for centuries. However, in recent times, this treatment has been replaced with the use of antibiotics for the treatment of wounds. Due to increasing antibiotic resistance, larval therapy is once again coming to the fore as an effective and efficient treatment. Due to the increasing ageing population, along with an increase in patients with arterial occlusive disease, diabetes and immobility, the number of patients with hard-to-heal wounds will increase. The stressors associated with wounds, such as pain, limited physical functionality, depression and social withdrawal, have a negative impact on patient quality of life. This case report documents the performance of biosurgery in a patient with multimorbidities.


Asunto(s)
Pie Diabético , Úlcera del Pie , Humanos , Desbridamiento , Pie Diabético/cirugía , Calidad de Vida , Cicatrización de Heridas , Úlcera del Pie/cirugía , Bacterias
16.
BMC Ophthalmol ; 24(1): 155, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38594682

RESUMEN

INTRODUCTION: In recent years, insulin eye drops have attracted increasing attention from researchers and ophthalmologists. The aim of this study was to investigate the efficacy and possible mechanism of action of insulin eye drops in diabetic mice with corneal wounds. METHODS: A type 1 diabetes model was induced, and a corneal epithelial injury model of 2.5 mm was established. We used corneal fluorescein staining, hematoxylin-eosin (H-E) staining and the Cochet-Bonnet esthesiometer to examine the process of wound healing. Subsequently, the expression levels of Ki-67, IL-1ß, ß3-tubulin and neuropeptides, including substance P (SP) and calcitonin gene-related peptide (CGRP), were examined at 72 h after corneal injury. RESULTS: Fluorescein staining demonstrated an acceleration of the recovery of corneal epithelial injury in diabetic mice compared with the saline treatment, which was further evidenced by the overexpression of Ki-67. Moreover, 72 h of insulin application attenuated the expression of inflammatory cytokines and neutrophil infiltration. Remarkably, the results demonstrated that topical insulin treatment enhanced the density of corneal epithelial nerves, as well as neuropeptide SP and CGRP release, in the healing cornea via immunofluorescence staining. CONCLUSIONS: Our results indicated that insulin eye drops may accelerate corneal wound healing and decrease inflammatory responses in diabetic mice by promoting nerve regeneration and increasing levels of neuropeptides SP and CGRP.


Asunto(s)
Lesiones de la Cornea , Diabetes Mellitus Experimental , Epitelio Corneal , Queratitis , Ratones , Animales , Epitelio Corneal/metabolismo , Insulina , Diabetes Mellitus Experimental/complicaciones , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/metabolismo , Péptido Relacionado con Gen de Calcitonina/metabolismo , Soluciones Oftálmicas , Antígeno Ki-67/metabolismo , Córnea/fisiología , Lesiones de la Cornea/tratamiento farmacológico , Cicatrización de Heridas , Queratitis/metabolismo , Fluoresceína/metabolismo , Inflamación/metabolismo
17.
Br J Nurs ; 33(8): 372-380, 2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38639750

RESUMEN

This article provides a comprehensive overview of the wound healing process, emphasising the critical role of surgical staples in primary intention healing. It outlines the four distinct phases of wound healing including haemostasis, inflammation, proliferation, and maturation - and discusses the mechanisms by which surgical staples enhance this natural biological process. Special focus is given to the aseptic non-touch technique (ANTT), which is crucial in preventing infections during the staple removal procedure. The article further explores the procedural steps involved in the removal of surgical staples and highlights the holistic aspects of patient care that need to be considered. This includes strategies for effective pain management, ensuring informed consent, and maintaining a sterile environment. By integrating clinical skills with a thorough understanding of wound care, this article aims to improve nursing practices in surgical settings, promoting better patient outcomes and recovery.


Asunto(s)
Control de Infecciones , Cicatrización de Heridas , Humanos , Suturas , Inflamación , Infección de la Herida Quirúrgica/prevención & control
18.
Pol Merkur Lekarski ; 52(2): 240-245, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38642361

RESUMEN

Platelet-rich plasma is an autologous product used in restorative medicine. It contains a high concentration of platelets, which are rich in growth factors and other biologically active substances known for their ability to stimulate regenerative processes in the body. Currently, research is being conducted into the use of platelet-rich plasma in many areas of medicine. This publication provides information on the nature, mechanism of action, therapeutic properties and application of autologous platelet-rich plasma in medicine. Furthermore, ongoing investigations explore its potential in wound healing, orthopedics, dermatology, and even in dentistry, showcasing its versatility and promising outcomes across various medical disciplines. Additionally, the safety and efficacy of platelet-rich plasma therapies are subjects of continual scrutiny, aiming to refine protocols and expand its clinical utility with robust scientific evidence. The growing interest in this regenerative approach underscores its potential as a valuable tool in modern medical practice. Platelet-rich plasma therapy represents a promising avenue for personalized medicine, offering tailored treatment approaches that capitalize on the body's own healing mechanisms to promote tissue repair and regeneration.


Asunto(s)
Plasma Rico en Plaquetas , Cicatrización de Heridas , Humanos , Medicina Regenerativa
19.
J Drugs Dermatol ; 23(4): 281-284, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38564379

RESUMEN

BACKGROUND: In the aesthetics practice, measures to accelerate wound healing and minimize downtime following procedures have been largely restricted to topical serums and platelet-rich plasma (PRP), which can have varying levels of success. Here, the authors present a case series of patients treated in clinical practice with cell-free exosomes derived from human placental mesenchymal stem cells (Exovex, Exocelbio, Doylestown, PA). Topical administration of exosomes after either aesthetic treatment or traumatic injury (a dog bite) had a marked effect on healing. Effects were assessed visually, and case-study images are shared. Individuals demonstrated significantly accelerated recovery and wound healing within hours to days, depending on the procedure. Patients who had undergone the same aesthetic procedure prior without exosomes reported satisfaction with reductions in pain, swelling, redness, and post-procedure downtime. No adverse events were reported by patients after treatment. Together, these case series suggest that exosome treatment can accelerate wound healing safely and effectively and support topical use in an office-based setting. These findings also highlight the need for more formal evaluation of the effects of exosomes on wound healing in reducing aesthetic procedure recovery times for surgical and non-surgical interventions. Significant Finding: The case series presented here illustrates the potential for exosomes to be a versatile and important part of clinical care, especially in situations where expedited healing is central to patient safety and/or satisfaction. These results provide strong support for additional research.  Meaning: Topical administration of cell-free exosomes has the potential to improve patient care and satisfaction with aesthetic interventions. Early experience, illustrated by the presented case studies, has been remarkably positive and treatment has the potential to dramatically improve the standard of care.  Online ahead of print.


Asunto(s)
Exosomas , Células Madre Mesenquimatosas , Animales , Perros , Femenino , Humanos , Embarazo , Aceleración , Placenta , Cicatrización de Heridas
20.
Front Immunol ; 15: 1370107, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38596673

RESUMEN

Tissue damage elicits a wound healing response of inflammation and remodeling aimed at restoring homeostasis. Dysregulation of wound healing leads to accumulation of effector cells and extracellular matrix (ECM) components, collectively termed fibrosis, which impairs organ functions. Fibrosis of the central nervous system, neurofibrosis, is a major contributor to the lack of neural regeneration and it involves fibroblasts, microglia/macrophages and astrocytes, and their deposited ECM. Neurofibrosis occurs commonly across neurological conditions. This review describes processes of wound healing and fibrosis in tissues in general, and in multiple sclerosis in particular, and considers approaches to ameliorate neurofibrosis to enhance neural recovery.


Asunto(s)
Esclerosis Múltiple , Humanos , Cicatrización de Heridas , Sistema Nervioso Central , Fibrosis , Biología
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