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1.
J Nanobiotechnology ; 22(1): 217, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38725012

RESUMO

Excess free radicals at the wound site can cause an inflammatory response, which is not conducive to wound healing. Hydrogels with antioxidant properties can prevent inflammatory storms by scavenging free radicals from the wound site and inhibiting the release of inflammatory factors. In this study, we prepared the carboxymethyl chitosan (CMCS)/polyvinyl pyrrolidone (PVP)/Molybdenum (IV) Selenide (MoSe2), and platelet-rich plasma (PRP) (CMCS/PVP/MoSe2/PRP) hydrogels for accelerating the repair of wounds. In the hydrogels, the MoSe2 can scavenge various free radicals to reduce oxidative stress at the site of inflammation, endowed the hydrogels with antioxidant properties. Interestingly, growth factors released by PRP assisted the tissue repair by promoting the formation of new capillaries. CMCS as a backbone not only showed good biocompatibility and biodegradability but also played a significant role in maintaining the sustained release of growth factors. In addition, incorporating PVP enhanced the tissue adhesion and mechanical properties. The multifunctional composite antioxidant hydrogels have good swelling properties and biodegradability, which is completely degraded within 28 days. Thus, the antioxidant CMCS/PVP/MoSe2/PRP hydrogels provide a new idea for designing ideal multifunctional wound dressings.


Assuntos
Antioxidantes , Bandagens , Quitosana , Hidrogéis , Plasma Rico em Plaquetas , Povidona , Cicatrização , Quitosana/química , Quitosana/análogos & derivados , Quitosana/farmacologia , Cicatrização/efeitos dos fármacos , Antioxidantes/farmacologia , Antioxidantes/química , Povidona/química , Povidona/análogos & derivados , Hidrogéis/química , Hidrogéis/farmacologia , Plasma Rico em Plaquetas/química , Animais , Camundongos , Masculino , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Humanos
2.
J Appl Biomater Funct Mater ; 22: 22808000241245298, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38733215

RESUMO

In the current study, Cnicus benedictus extract was loaded into electrospun gelatin scaffolds for diabetic wound healing applications. Scaffolds were characterized in vitro by mechanical testing, cell culture assays, electron microscopy, cell migration assay, and antibacterial assay. In vivo wound healing study was performed in a rat model of diabetic wound. In vitro studies revealed fibrous architecture of our developed dressings and their anti-inflammatory properties. In addition, Cnicus benedictus extract-loaded wound dressings prevented bacterial penetration. In vivo study showed that wound size reduction, collagen deposition, and epithelial thickness were significantly greater in Cnicus benedictus extract-loaded scaffolds than other groups. Gene expression studies showed that the produced wound dressings significantly upregulated VEGF and IGF genes expression in diabetic wounds.


Assuntos
Bandagens , Diabetes Mellitus Experimental , Gelatina , Cicatrização , Animais , Gelatina/química , Cicatrização/efeitos dos fármacos , Ratos , Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Experimental/patologia , Masculino , Humanos , Ratos Sprague-Dawley , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Antibacterianos/química , Antibacterianos/farmacologia , Alicerces Teciduais/química
3.
J Orthop Surg Res ; 19(1): 276, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38698470

RESUMO

BACKGROUND: Tourniquets are common adjuncts in the operating theatre but can be associated with post-operative pain. This study was designed to compare what effect pre-tourniquet Esmarch bandage exsanguination has on pain, compared to pre-tourniquet exsanguination by elevation alone. METHODS: 52 volunteers (104 lower limbs) were included in this study with each volunteer acting as their own matched control. The primary outcome was patient reported pain, measured in both legs simultaneously using area under curve. Secondary outcomes were pain score during inflation and deflation, cumulative pain score, duration of recovery and blood pressure during testing. RESULTS: Pain after Esmarch was superior to elevation as measured by area under pain curve (68.9 SD 26.1 vs 77.2 SD 27.3, p = 0.0010), independent of leg dominance. Cumulative pain scores demonstrated the same superiority after inflation (50.7 SD 17.1 vs 52.9 SD 17.0, p = 0.026) but not after deflation (p = 0.59). Blood pressure was not significantly different. Time to full recovery of the lower limb was the same for both groups-7.6 min (SD 2.1 min, p = 0.80). CONCLUSION: Previous studies describe a positive effect on pain when Esmarch bandage was used prior to tourniquet inflation for upper limb. Our findings suggest the same benefit from Esmarch when it was used on lower limbs-particularly during inflation of tourniquet. In addition to pain profiles, surgeon preference and patient factors need to be considered when deciding between elevation and Esmarch bandage.


Assuntos
Extremidade Inferior , Dor Pós-Operatória , Torniquetes , Humanos , Masculino , Feminino , Adulto , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Exsanguinação/etiologia , Exsanguinação/terapia , Bandagens , Pessoa de Meia-Idade , Adulto Jovem , Medição da Dor/métodos
4.
Pak J Pharm Sci ; 37(1(Special)): 185-189, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38747268

RESUMO

Burn is a debilitating and devastating emergency with many physical and psychological sequelae. Essential steps in burn wound management include cleansing/wound debridement, application of topical antimicrobial and dressing of affected body areas. Objective of this study is comparison in effectiveness of Hydro-fiber Silver dressing and 1% silver sulfadiazine dressing in management of pediatric burn patients in terms of wound healing. After ethical approval, 264 patients were enrolled and divided into two groups. Patients were managed with hydro-fiber silver dressing in group A and 1% silver sulfadiazine dressing in group B. An experienced pediatric surgeon examined the wounds for re epithelialization and efficacy was labeled after 15 days. Out of 264 enrolled patients 148(56.06%) were males and 116(43.94%) were females. Mean age of patients was 3.73±2.34 years. Type of burn was Scald in 215(81.4%) patients and flame in 49(18.6%). Depth of burn was 2nd degree in 185(70.08%) patients and 3rd degree in 79(29.92%) patients. Mean TBSA was 19.93±9.62%. In group A the efficacy was achieved in 91(68.9%) patients whereas in group B the efficacy was achieved in 73(55.3%) patients (p-value<0.05). Hydro-fiber Silver dressing is significantly more efficacious as compared to 1% silver sulfadiazine dressing for treatment of pediatric burn.


Assuntos
Bandagens , Queimaduras , Sulfadiazina de Prata , Humanos , Sulfadiazina de Prata/uso terapêutico , Sulfadiazina de Prata/administração & dosagem , Queimaduras/terapia , Queimaduras/tratamento farmacológico , Feminino , Masculino , Pré-Escolar , Criança , Cicatrização/efeitos dos fármacos , Resultado do Tratamento , Lactente , Anti-Infecciosos Locais/uso terapêutico , Anti-Infecciosos Locais/administração & dosagem , Prata/uso terapêutico
6.
J Infus Nurs ; 47(3): 175-181, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38744242

RESUMO

Due to low compliance by bedside nursing with a central line-associated bloodstream infection (CLABSI) prevention bundle and increased CLABSI rates, a mandatory re-education initiative at a 1200-bed university-affiliated hospital was undertaken. Despite this, 2 units, housing high-risk immunocompromised patients, continued to experience increased CLABSI rates. A quality improvement before-after project design in these units replaced bedside nursing staff with 2 nurses from the vascular access team (VAT) to perform central vascular access device (CVAD) dressing changes routinely every 7 days or earlier if needed. The VAT consistently followed the bundled components, including use of chlorhexidine gluconate (CHG)-impregnated dressings on all patients unless an allergy was identified. In this case, a non-CHG transparent semipermeable membrane dressing was used. There were 884 patients with 14 211 CVAD days in the preimplementation period and 1136 patients with 14 225 CVAD days during the postimplementation period. The VAT saw 602 (53.0%) of the 1136 patients, performing at least 1 dressing change in 98% of the patients (n = 589). The combined CLABSI rate for the 2 units decreased from 2.53 per 1000 CVAD days preintervention to 1.62 per 1000 CVAD days postintervention. The estimated incidence rate ratio (IRR) for the intervention was 0.639, a 36.1% reduction in monthly CLABSI rates during the postimplementation period.


Assuntos
Bandagens , Infecções Relacionadas a Cateter , Cateterismo Venoso Central , Clorexidina , Humanos , Infecções Relacionadas a Cateter/prevenção & controle , Clorexidina/uso terapêutico , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Cateterismo Venoso Central/efeitos adversos , Melhoria de Qualidade , Dispositivos de Acesso Vascular , Controle de Infecções/métodos , Hospitais Universitários
7.
Int Wound J ; 21(5): e14861, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38738669

RESUMO

Effective fluid handling by wound dressings is crucial in the management of exuding wounds through maintaining a clean, moist environment, facilitating healing by removing excess exudate and promoting tissue regeneration. In this context, the availability of reliable and clinically relevant standardised testing methods for wound dressings are critical for informed decision making by clinicians, healthcare administrators, regulatory/reimbursement bodies and product developers. The widely used standard EN 13726 specifies the use of Solution A, an aqueous protein-free salt solution, for determining fluid-handling capacity (FHC). However, a simulated wound fluid (SWF) with a more complex composition, resembling the protein, salt, and buffer concentrations found in real-world clinical exudate, would provide a more clinically relevant dressing performance assessment. This study compared selected physicochemical parameters of Solution A, an alternative, novel simulated wound fluid (SWF A), and a benchmark reference serum-containing solution (SCS) simulating chronic wound exudate. Additionally, FHC values for eight advanced bordered and non-bordered foam dressings were determined for all three test fluids, following EN 13726. Our findings demonstrate a close resemblance between SWF A and SCS. This study highlights the critical importance of selecting a physiochemically appropriate test fluid for accurate FHC testing resulting in clinically meaningful evaluation of dressing performance.


Assuntos
Bandagens , Exsudatos e Transudatos , Cicatrização , Ferimentos e Lesões , Humanos , Exsudatos e Transudatos/química , Ferimentos e Lesões/terapia
8.
Cochrane Database Syst Rev ; 5: CD006214, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38712723

RESUMO

BACKGROUND: Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue may expedite wound healing. There are numerous methods of debridement available, but no consensus on which one is most effective for surgical wounds. OBJECTIVES: To assess the effects of different methods of debridement on the rate of debridement and healing of surgical wounds. SEARCH METHODS: In October 2021, we searched the Cochrane Wounds Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL. To identify additional studies, we searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies, reviews, meta-analyses, and health technology reports. There were no restrictions on language, date of publication, or study setting. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that enrolled people with a surgical wound that required debridement, and reported time to complete wound debridement or time to wound healing, or both. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, risk of bias assessment using the RoB 1 tool, data extraction, and GRADE assessment of the certainty of evidence. MAIN RESULTS: In this fourth update, we identified one additional study for inclusion. The review now includes six studies, with 265 participants, aged three to 91 years. Five studies were published between 1979 and 1990 and one published in 2014. The studies were carried out in hospital settings in China, Denmark, Belgium, and the UK. Six studies provided six comparisons. Due to the heterogeneity of studies, it was not appropriate to conduct meta-analyses. Four studies evaluated the effectiveness of dextranomer beads/paste; however, each study used a different comparator (Eusol-soaked dressings, 10% aqueous polyvinylpyrrolidone, 0.1% chloramine-soaked packs, and silicone foam elastomer dressing). One study compared streptokinase/streptodornase with saline-soaked dressings, and one compared endoscopic surgical debridement with conventional 'open' surgical debridement. Five studies reported time to complete debridement (reported as time to a clean wound bed) and three reported time to complete healing. One study reported effect estimates (surgical debridement via endoscopy versus surgical debridement) for time to a clean wound bed and time to complete wound healing, and it was possible to calculate effect estimates for one other study (dextranomer paste versus silicone foam elastomer) for time to complete wound healing. For the other four studies that did not report effect estimates, it was not possible to calculate time to a clean wound bed or time to complete wound healing due to missing variance and participant exclusions. None of the included studies reported outcomes pertaining to proportion of wounds completely healed, rate of reduction in wound size, rate of infection, or quality of life. All studies had unclear or high risk of bias for at least one key domain. Dextranomer paste/beads (autolytic debridement) compared with four different comparators Four studies compared dextranomer paste or beads with Eusol-soaked gauze (20 participants), 10% aqueous polyvinylpyrrolidone (40 participants), 0.1% chloramine-soaked dressings (28 participants), or silicone foam elastomer (50 participants). There is very low-certainty evidence that there may be no clear difference in time to a clean wound bed between dextranomer beads and Eusol gauze. The study did not report adverse events. There is very low-certainty evidence that there may be no difference in time to a clean wound bed between dextranomer paste and 10% aqueous polyvinylpyrrolidone gauze. There was low-certainty evidence that there may be no difference in deaths and serious adverse events. There may be a difference in time until the wounds were clinically clean and time to complete wound healing between dextranomer paste and 0.1% chloramine favouring 0.1% chloramine, but we are very uncertain. There is low-certainty evidence that there may be no difference in deaths and serious adverse events. There is very low-certainty evidence that there may be no difference in time to complete healing between dextranomer beads and silicone foam elastomer. The study did not report adverse events. Streptokinase/streptodornase solution (enzymatic) compared with saline-soaked dressings One study (21 participants) compared enzymatic debridement with saline-soaked dressings. There is low-certainty evidence that there may be no difference in time to a clean wound bed or secondary suture between streptokinase/streptodornase and saline-soaked dressings. There is very low-certainty evidence that there may be no difference in deaths and serious adverse events. Surgical debridement via endoscopic ('keyhole') surgery compared with surgical debridement by 'open' surgery (the wound is opened using a scalpel) One study (106 participants) reported time to complete wound healing and time to a clean wound bed. There is low-certainty evidence that there may be a reduction in time to complete wound healing and very low-certainty evidence that there may be no difference in time to a clean wound bed with surgical debridement via endoscopy compared to 'open' surgical debridement. The study did not report adverse events. Overall, the evidence was low to very low-certainty for all outcomes. Five included studies were published before 1991 and investigated treatments that are no longer available. Worldwide production of dextranomer products has been discontinued, except for dextranomer paste, which is currently only available in South Africa. Furthermore, Eusol, used in one study as the comparator to dextranomer, is rarely used due to risk of harmful effects on healthy tissue and the enzymatic agent streptokinase/streptodornase is no longer available worldwide. AUTHORS' CONCLUSIONS: Evidence for the effects of different methods of debridement on complete wound debridement and healing of surgical wounds remains unclear. Adequately powered, methodologically robust RCTs evaluating contemporary debridement interventions for surgical wounds are needed to guide clinical decision-making.


Assuntos
Desbridamento , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecção da Ferida Cirúrgica , Cicatrização , Desbridamento/métodos , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Ferida Cirúrgica/terapia , Adolescente , Viés , Idoso de 80 Anos ou mais , Criança , Fatores de Tempo , Bandagens , Adulto Jovem , Pré-Escolar
9.
J Nanobiotechnology ; 22(1): 232, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720301

RESUMO

Diabetic wounds pose a challenge to healing due to increased bacterial susceptibility and poor vascularization. Effective healing requires simultaneous bacterial and biofilm elimination and angiogenesis stimulation. In this study, we incorporated polyaniline (PANI) and S-Nitrosoglutathione (GSNO) into a polyvinyl alcohol, chitosan, and hydroxypropyltrimethyl ammonium chloride chitosan (PVA/CS/HTCC) matrix, creating a versatile wound dressing membrane through electrospinning. The dressing combines the advantages of photothermal antibacterial therapy and nitric oxide gas therapy, exhibiting enduring and effective bactericidal activity and biofilm disruption against methicillin-sensitive Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and Escherichia coli. Furthermore, the membrane's PTT effect and NO release exhibit significant synergistic activation, enabling a nanodetonator-like burst release of NO through NIR irradiation to disintegrate biofilms. Importantly, the nanofiber sustained a uniform release of nitric oxide, thereby catalyzing angiogenesis and advancing cellular migration. Ultimately, the employment of this membrane dressing culminated in the efficacious amelioration of diabetic-infected wounds in Sprague-Dawley rats, achieving wound closure within a concise duration of 14 days. Upon applying NIR irradiation to the PVA-CS-HTCC-PANI-GSNO nanofiber membrane, it swiftly eradicates bacteria and biofilm within 5 min, enhancing its inherent antibacterial and anti-biofilm properties through the powerful synergistic action of PTT and NO therapy. It also promotes angiogenesis, exhibits excellent biocompatibility, and is easy to use, highlighting its potential in treating diabetic wounds.


Assuntos
Antibacterianos , Bandagens , Biofilmes , Óxido Nítrico , Terapia Fototérmica , Ratos Sprague-Dawley , Cicatrização , Animais , Cicatrização/efeitos dos fármacos , Óxido Nítrico/farmacologia , Óxido Nítrico/metabolismo , Ratos , Antibacterianos/farmacologia , Antibacterianos/química , Antibacterianos/uso terapêutico , Biofilmes/efeitos dos fármacos , Terapia Fototérmica/métodos , Masculino , Quitosana/química , Quitosana/farmacologia , Nanofibras/química , Escherichia coli/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Diabetes Mellitus Experimental/complicações , Staphylococcus aureus/efeitos dos fármacos , Álcool de Polivinil/química , Álcool de Polivinil/farmacologia , S-Nitrosoglutationa/farmacologia , S-Nitrosoglutationa/química
10.
Carbohydr Polym ; 337: 122147, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38710554

RESUMO

Treatment of infected wound by simultaneously eliminating bacteria and inducing angiogenesis to promote wound tissue regeneration remains a clinical challenge. Dynamic and reversable hydrogels can adapt to irregular wound beds, which have raised great attention as wound dressings. Herein, a sprayable chitosan-based hydrogel (HPC/CCS/ODex-IGF1) was developed using hydroxypropyl chitosan (HPC), caffeic acid functionalized chitosan (CCS), oxidized dextran (ODex) to crosslink through the dynamic imine bond, which was pH-responsive to the acidic microenvironment and could controllably release insulin growth factor-1 (IGF1). The HPC/CCS/ODex-IGF1 hydrogels not only showed self-healing, self-adaptable and sprayable properties, but also exhibited excellent antibacterial ability, antioxidant property, low-cytotoxicity and angiogenetic activity. In vivo experiments demonstrated that hydrogels promoted tissue regeneration and healing of bacteria-infected wound with a rate of approximately 98.4 % on day 11 by eliminating bacteria, reducing inflammatory and facilitating angiogenesis, demonstrating its great potential for wound dressing.


Assuntos
Antibacterianos , Quitosana , Hidrogéis , Neovascularização Fisiológica , Cicatrização , Quitosana/química , Quitosana/farmacologia , Hidrogéis/química , Hidrogéis/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Antibacterianos/química , Camundongos , Neovascularização Fisiológica/efeitos dos fármacos , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/química , Anti-Inflamatórios/uso terapêutico , Humanos , Masculino , Fator de Crescimento Insulin-Like I , Staphylococcus aureus/efeitos dos fármacos , Bandagens , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Dextranos/química , Dextranos/farmacologia , Angiogênese
11.
Carbohydr Polym ; 337: 122146, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-38710570

RESUMO

Diabetic wounds remain a global challenge due to disordered wound healing led by inflammation, infection, oxidative stress, and delayed proliferation. Therefore, an ideal wound dressing for diabetic wounds not only needs tissue adhesiveness, injectability, and self-healing properties but also needs a full regulation of the microenvironment. In this work, adhesive wound dressings (HA-DA/PRP) with injectability were fabricated by combining platelet rich plasma (PRP) and dopamine-modified-hyaluronic acid (HA-DA). The engineered wound dressings exhibited tissue adhesiveness, rapid self-healing, and shape adaptability, thereby enhancing stability and adaptability to irregular wounds. The in vitro experiments demonstrated that HA-DA/PRP adhesives significantly promoted fibroblast proliferation and migration, attributed to the loaded PRP. The adhesives showed antibacterial properties against both gram-positive and negative bacteria. Moreover, in vitro experiments confirmed that HA-DA/PRP adhesives effectively mitigated oxidative stress and inflammation. Finally, HA-DA/PRP accelerated the healing of diabetic wounds by inhibiting bacterial growth, promoting granulation tissue regeneration, accelerating neovascularization, facilitating collagen deposition, and modulating inflammation through inducing M1 to M2 polarization, in an in vivo model of infected diabetic wounds. Overall, HA-DA/PRP adhesives with the ability to comprehensively regulate the microenvironment in diabetic wounds may provide a novel approach to expedite the diabetic wounds healing in clinic.


Assuntos
Antibacterianos , Diabetes Mellitus Experimental , Ácido Hialurônico , Hidrogéis , Plasma Rico em Plaquetas , Cicatrização , Ácido Hialurônico/química , Cicatrização/efeitos dos fármacos , Hidrogéis/química , Hidrogéis/farmacologia , Animais , Plasma Rico em Plaquetas/química , Antibacterianos/farmacologia , Antibacterianos/química , Diabetes Mellitus Experimental/tratamento farmacológico , Camundongos , Ratos , Bandagens , Masculino , Proliferação de Células/efeitos dos fármacos , Humanos , Ratos Sprague-Dawley , Estresse Oxidativo/efeitos dos fármacos , Dopamina/química , Fibroblastos/efeitos dos fármacos , Adesivos/química , Adesivos/farmacologia
12.
BMC Pediatr ; 24(1): 314, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714985

RESUMO

Aplasia cutis congenita (ACC) is a congenital disorder that can be classified into nine types, with Type I ACC being the most common. Type V ACC associated with fetus papyraceus is a rare subtype of ACC. We report the case of a Type V ACC in a male newborn with extensive abdominal skin defects. The patient received conservative treatment using hydrogel foam and silicone foam dressings. Approximately five weeks later, the patient was discharged when more than 60% of the skin had completed epithelialization. After discharge from West China Second University Hospital, Chengdu , the patient continued to be followed up regularly at the Burns and Plastic Surgery Clinic at local hospital in Gansu. We followed up the child by telephone. After 4 months of follow-up, scar tissue formation was observed in the trunk area. The infant is 2 years and 5 months old now, physical examination did not reveal any organ problems.


Assuntos
Tratamento Conservador , Displasia Ectodérmica , Humanos , Masculino , Displasia Ectodérmica/terapia , Recém-Nascido , Bandagens
13.
Can Vet J ; 65(5): 504-506, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38694733

RESUMO

An 8-month-old intact male golden retriever dog was seen as a case requiring urgent attention 2 d after an altercation with a cat. The dog was febrile, anorexic, and reluctant to move. There was soft-tissue swelling on the left ventral abdomen that progressed to necrotizing cellulitis. Despite the severity of the wound, client financial constraints necessitated management on a low-cost, outpatient basis using empirical antibiotics and raw-honey bandages. The wound resolved fully in 5 wk.


Résolution de cellulite nécrosante chez un chien grâce à la gestion de base des plaies. Un chien golden retriever mâle intact de 8 mois a été considéré comme un cas nécessitant une attention urgente 2 jours après une altercation avec un chat. Le chien était fébrile, anorexique et hésitait à bouger. Il y avait une enflure des tissus mous sur l'abdomen ventral gauche qui a évolué vers une cellulite nécrosante. Malgré la gravité de la blessure, les contraintes financières des clients ont nécessité une prise en charge ambulatoire à faible coût, utilisant des antibiotiques empiriques et des bandages au miel cru. La plaie s'est complètement résolue en 5 semaines.(Traduit par Dr Serge Messier).


Assuntos
Antibacterianos , Celulite (Flegmão) , Doenças do Cão , Cães , Animais , Masculino , Celulite (Flegmão)/veterinária , Celulite (Flegmão)/tratamento farmacológico , Antibacterianos/uso terapêutico , Bandagens/veterinária , Necrose/veterinária
14.
AAPS PharmSciTech ; 25(5): 110, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38740721

RESUMO

Antimicrobial peptide LL37 is a promising antibacterial candidate due to its potent antimicrobial activity with no known bacterial resistance. However, intrinsically LL37 is susceptible to degradation in wound fluids limits its effectiveness. Bacterial toxins which are released after cell lysis are found to hinder wound healing. To address these challenges, encapsulating LL37 in microspheres (MS) and loading the MS onto activated carbon (AC)-chitosan (CS) hydrogel. This advanced wound dressing not only protects LL37 from degradation but also targets bacterial toxins, aiding in the healing of chronic wound infections. First, LL37 MS and LL37-AC-CS hydrogel were prepared and characterised in terms of physicochemical properties, drug release, and peptide-polymer compatibility. Antibacterial and antibiofilm activity, bacterial toxin elimination, cell migration, and cell cytotoxicity activities were investigated. LL37-AC-CS hydrogel was effective against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. LL37-AC-CS hydrogel bound more endotoxin than AC with CS hydrogel alone. The hydrogel also induced cell migration after 72 h and showed no cytotoxicity towards NHDF after 72 h of treatment. In conclusion, the LL37-AC-CS hydrogel was shown to be a stable, non-toxic advanced wound dressing method with enhanced antimicrobial and antitoxin activity, and it can potentially be applied to chronic wound infections to accelerate wound healing.


Assuntos
Antibacterianos , Bandagens , Quitosana , Escherichia coli , Hidrogéis , Microesferas , Pseudomonas aeruginosa , Staphylococcus aureus , Quitosana/química , Antibacterianos/farmacologia , Antibacterianos/administração & dosagem , Antibacterianos/química , Hidrogéis/química , Hidrogéis/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Humanos , Pseudomonas aeruginosa/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/prevenção & controle , Peptídeos Catiônicos Antimicrobianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/química , Peptídeos Catiônicos Antimicrobianos/administração & dosagem , Catelicidinas , Testes de Sensibilidade Microbiana/métodos , Toxinas Bacterianas , Liberação Controlada de Fármacos , Movimento Celular/efeitos dos fármacos , Carbono/química , Biofilmes/efeitos dos fármacos
15.
Int J Biol Macromol ; 266(Pt 2): 131277, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38565366

RESUMO

Bacteria-infected wound healing has attracted widespread attention in biomedical engineering. Wound dressing is a potential strategy for repairing infectious wounds. However, the development of wound dressing with appropriate physiochemical, antibacterial, and hemostatic properties, remains challenging. Hence, there is a motivation to develop new synthetic dressings to improve bacteria-infected wound healing. Here, we fabricate a biocompatible sponge through the covalent crosslinking of collagen (Col), quaternized chitosan (QCS), and graphene oxide (GO). The resulting Col-QCS-GO sponge shows an elastic modulus of 1.93-fold higher than Col sponge due to enhanced crosslinking degree by GO incorporation. Moreover, the fabricated Col-QCS-GO sponge shows favorable porosity (84.30 ± 3.12 %), water absorption / retention (2658.0 ± 113.4 % / 1114.0 ± 65.7 %), and hemostasis capacities (blood loss <50.0 mg). Furthermore, the antibacterial property of the Col-QCS-GO sponge under near-infrared (NIR) irradiation is significantly enhanced (the inhibition rates are 99.9 % for S. aureus and 99.9 % for E. coli) due to the inherent antibacterial properties of QCS and the photothermal antibacterial capabilities of GO. Finally, the Col-QCS-GO+NIR sponge exhibits the lowest percentage of wound area (9.05 ± 1.42 %) at day 14 compared to the control group (31.61 ± 1.76 %). This study provides new insights for developing innovative sponges for bacteria-infected wound healing.


Assuntos
Antibacterianos , Quitosana , Grafite , Hemostáticos , Cicatrização , Animais , Ratos , Antibacterianos/farmacologia , Antibacterianos/química , Bandagens , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Quitosana/química , Quitosana/farmacologia , Colágeno/química , Colágeno/farmacologia , Escherichia coli/efeitos dos fármacos , Grafite/química , Grafite/farmacologia , Hemostasia/efeitos dos fármacos , Hemostáticos/farmacologia , Hemostáticos/química , Porosidade , Staphylococcus aureus/efeitos dos fármacos , Cicatrização/efeitos dos fármacos
16.
Int Wound J ; 21(4): e14758, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38629618

RESUMO

A meta-analysis was conducted to comprehensively explore the effects of platelet-rich plasma (PRP) combined with negative pressure wound therapy (NPWT) in treating patients with chronic wounds. Computer searches were conducted, from database infection to November 2023, in EMBASE, Google Scholar, Cochrane Library, PubMed, Wanfang and China National Knowledge Infrastructure databases for randomized controlled trials (RCTs) on the use of PRP combined with NPWT technology for treating chronic wounds. Two researchers independently screened the literature, extracted data and conducted quality assessments according to the inclusion and exclusion criteria. Stata 17.0 software was employed for data analysis. Overall, 18 RCTs involving 1294 patients with chronic wounds were included. The analysis revealed that, compared with NPWT alone, the use of PRP combined with NPWT technology significantly improved the healing rate (odds ratios [OR] = 1.92, 95% confidence intervals [CIs]: 1.43-2.58, p < 0.001) and total effective rate (OR = 1.31, 95% CI: 1.23-1.39, p < 0.001), and also significantly shortened the healing time of the wound (standardized mean difference = -2.01, 95% CI: -2.58 to -1.45, p < 0.001). This study indicates that the treatment of chronic wounds with PRP combined with NPWT technology can significantly enhance clinical repair effectiveness and accelerate wound healing, with a high healing rate, and is worth further promotion and practice.


Assuntos
Tratamento de Ferimentos com Pressão Negativa , Plasma Rico em Plaquetas , Humanos , Bandagens , Cicatrização
17.
Int Wound J ; 21(4): e14872, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38629691

RESUMO

Silver nanoparticle dressings have gained popularity recently as a way to treat challenging wounds. Notwithstanding the properties of Ag-NPS (silver nanoparticles) described by several articles, there is a lack of clinical studies that guide healthcare professionals to specific and conscious use. In this case series, Ag-NPS dressing was tested on a randomized group of 10 patients with complex wounds requiring conservative treatment. Each case was analysed, recording the patient's history, the peculiar characteristics and the progressive changes in the wound. The wound bed and the quality of the peri-wound skin improved and a decrease in signs of infection was observed. The application of the dressing was simple and comfortable for the patient and it was appreciated for its sealing ability. A few capacity restrictions showed up: those should be read as elements to improve the indications for this peculiar dressing. The thin tissue matrix of the Ag-NPS dressing does not allow for massive absorption and also performs poorly in reducing little exudate. The reduction in wound width is also limited: reconstructive surgery was required in half of the enrolled patients to achieve wound healing.


Assuntos
Queimaduras , Nanopartículas Metálicas , Prata , Humanos , Bandagens , Queimaduras/tratamento farmacológico , Nanopartículas Metálicas/uso terapêutico , Prata/uso terapêutico , Cicatrização
18.
Colloids Surf B Biointerfaces ; 238: 113915, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38631281

RESUMO

Hydrogels have emerged as a new type of wound dressing materials that involved in different stages of the healing processes. However, most of the existing wound dressings mainly offer a protective and moisturizing layer to prevent cross-infection, while the anti-inflammatory and anti-oxidative properties are frequently induced by extra addition of other bioactive molecules. Here, a novel type of sulfated glyco-functionalized hydrogels for wound dressing was prepared through the hybrid supramolecular co-assembly of carbohydrate segments (FG, FGS and FG3S), fluorenylmethoxycarbonyl-diphenylalanine (Fmoc-FF), and diphenylalanine-dopamine (FFD). Implanting sulfated carbohydrates can mimic the structure of glycosaminoglycans (GAGs), promoting cell proliferation and migration, along with anti-inflammatory effects. In situ polymerization of FFD introduced a secondary covalent network to the hydrogel, meanwhile, providing anti-oxidation and adhesion properties to wound surfaces. Furthermore, the dynamic supramolecular interactions within the hydrogels also confer self-healing capabilities to the wound dressing materials. In vivo experiments further demonstrated significantly accelerated healing rates with the multifunctional hydrogel FG3S-FFD, indicating high application potential.


Assuntos
Anti-Inflamatórios , Bandagens , Hidrogéis , Cicatrização , Cicatrização/efeitos dos fármacos , Hidrogéis/química , Hidrogéis/farmacologia , Hidrogéis/síntese química , Anti-Inflamatórios/farmacologia , Anti-Inflamatórios/química , Animais , Camundongos , Proliferação de Células/efeitos dos fármacos , Humanos , Sulfatos/química , Sulfatos/farmacologia , Adesivos/química , Adesivos/farmacologia , Movimento Celular/efeitos dos fármacos , Masculino
19.
Int J Biol Macromol ; 267(Pt 2): 131335, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38604431

RESUMO

Nanoparticles (NPs) have been extensively investigated for their potential in nanomedicine. There is a significant level of enthusiasm about the potential of NPs to bring out a transformative impact on modern healthcare. NPs can serve as effective wound dressings or delivery vehicles due to their antibacterial and pro-wound-healing properties. Biopolymer-based NPs can be manufactured using various food-grade biopolymers, such as proteins, polysaccharides, and synthetic polymers, each offering distinct properties suitable for different applications which include collagen, polycaprolactone, chitosan, alginate, and polylactic acid, etc. Their biodegradable and biocompatible nature renders them ideal nanomaterials for applications in wound healing. Additionally, the nanofibers containing biopolymer-based NPs have shown excellent anti-bacterial and wound healing activity like silver NPs. These NPs represent a paradigm shift in wound healing therapies, offering targeted and personalized solutions for enhanced tissue regeneration and accelerated wound closure. The current review focuses on biopolymer NPs with their applications in wound healing.


Assuntos
Nanopartículas , Cicatrização , Cicatrização/efeitos dos fármacos , Biopolímeros/química , Biopolímeros/uso terapêutico , Biopolímeros/farmacologia , Humanos , Nanopartículas/química , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Bandagens , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Quitosana/química
20.
Biomater Sci ; 12(10): 2460-2479, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38578143

RESUMO

Chronic wounds have gradually evolved into a global health challenge, comprising long-term non-healing wounds, local tissue necrosis, and even amputation in severe cases. Accordingly, chronic wounds place a considerable psychological and economic burden on patients and society. Chronic wounds have multifaceted pathogenesis involving excessive inflammation, insufficient angiogenesis, and elevated reactive oxygen species levels, with bacterial infection playing a crucial role. Hydrogels, renowned for their excellent biocompatibility, moisture retention, swelling properties, and oxygen permeability, have emerged as promising wound repair dressings. However, hydrogels with singular functions fall short of addressing the complex requirements associated with chronic wound healing. Hence, current research emphasises the development of multifunctional antibacterial hydrogels. This article reviews chronic wound characteristics and the properties and classification of antibacterial hydrogels, as well as their potential application in chronic wound management.


Assuntos
Antibacterianos , Hidrogéis , Cicatrização , Hidrogéis/química , Hidrogéis/farmacologia , Hidrogéis/administração & dosagem , Antibacterianos/farmacologia , Antibacterianos/química , Humanos , Cicatrização/efeitos dos fármacos , Animais , Doença Crônica , Bandagens
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