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1.
Int J Mol Sci ; 22(12)2021 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-34204292

RESUMO

Skin injury is quite common, and the wound healing is a complex process involving many types of cells, the extracellular matrix, and soluble mediators. Cell differentiation, migration, and proliferation are essential in restoring the integrity of the injured tissue. Despite the advances in science and technology, we have yet to find the ideal dressing that can support the healing of cutaneous wounds effectively, particularly for difficult-to-heal chronic wounds such as diabetic foot ulcers, bed sores, and venous ulcers. Hence, there is a need to identify and incorporate new ideas and methods to design a more effective dressing that not only can expedite wound healing but also can reduce scarring. Calcium has been identified to influence the wound healing process. This review explores the functions and roles of calcium in skin regeneration and reconstruction during would healing. Furthermore, this review also investigates the possibility of incorporating calcium into scaffolds and examines how it modulates cutaneous wound healing. In summary, the preliminary findings are promising. However, some challenges remain to be addressed before calcium can be used for cutaneous wound healing in clinical settings.


Assuntos
Cálcio/metabolismo , Cicatrização/fisiologia , Animais , Bandagens , Cálcio/farmacologia , Cálcio na Dieta/administração & dosagem , Fibroblastos/metabolismo , Humanos , Queratinócitos/metabolismo , Nanopartículas/química , Neovascularização Fisiológica , Regeneração , Pele/lesões , Pele/metabolismo , Nanomedicina Teranóstica , Engenharia Tecidual , Tecidos Suporte , Cicatrização/efeitos dos fármacos
2.
Biomed Res Int ; 2021: 5554500, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34124245

RESUMO

Objective: We aimed to evaluate the advantages of preoperative digital design of skin flaps to repair fingertip defects during the COVID-19 pandemic. We combined digital design with a 3D-printed model of the affected finger for preoperative communication with fingertip defect patients under observation in a buffer ward. Methods: From December 2019 to January 2021, we obtained data from 25 cases of 30 fingertip defects in 15 males and 10 females, aged 20-65 years old (mean 35 ± 5 years). All cases were treated by digitally designing preoperative fingertip defect flaps combined with a 3D-printed model. Preoperative 3D Systems Sense scanning was routinely performed, 3-matic 12.0 was used to measure the fingertip defect area ranging from 1.5 cm × 3.5 cm to 2.0 cm × 5.0 cm, and the skin flap was designed. The flap area was 1.6 cm × 3.6 cm to 2.1 cm × 5.1 cm. CURA 15.02.1 was used to set parameters, and the 3D model of the affected finger was printed prior to the operation. Full-thickness skin grafts were taken from donor areas for repair. Results: No vascular crises occurred in any of the 25 cases, and all flaps survived. The postoperative follow-up occurred over 3-12 months. All patients were evaluated 3 months after operation according to the trial standard of hand function evaluation of the Chinese Hand Surgery Society. The results showed that 20 cases had excellent outcomes (80%), four cases had good outcomes (16%), and one case had a fair outcome (4%). The excellent and good rate was 96%. Conclusions: During the COVID-19 epidemic, fingertip defects were treated with preoperative digital design of fingertip defect flaps combined with 3D printing. Precision design saves surgery time and improves the success rate of surgery and the survival rates of skin flaps. In addition, 3D model simulations improve preoperative communication efficiency, and the personalized design improves patient satisfaction.


Assuntos
COVID-19/epidemiologia , Traumatismos dos Dedos/cirurgia , Dedos/cirurgia , Pandemias , Cuidados Pré-Operatórios/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante de Pele/métodos , Adulto , Idoso , COVID-19/psicologia , China/epidemiologia , Feminino , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Anatômicos , Impressão Tridimensional/instrumentação , Procedimentos Cirúrgicos Reconstrutivos/psicologia , SARS-CoV-2/patogenicidade , Transplante de Pele/psicologia , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/inervação , Resultado do Tratamento , Cicatrização/fisiologia
3.
Biomed Res Int ; 2021: 5554500, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1263956

RESUMO

Objective: We aimed to evaluate the advantages of preoperative digital design of skin flaps to repair fingertip defects during the COVID-19 pandemic. We combined digital design with a 3D-printed model of the affected finger for preoperative communication with fingertip defect patients under observation in a buffer ward. Methods: From December 2019 to January 2021, we obtained data from 25 cases of 30 fingertip defects in 15 males and 10 females, aged 20-65 years old (mean 35 ± 5 years). All cases were treated by digitally designing preoperative fingertip defect flaps combined with a 3D-printed model. Preoperative 3D Systems Sense scanning was routinely performed, 3-matic 12.0 was used to measure the fingertip defect area ranging from 1.5 cm × 3.5 cm to 2.0 cm × 5.0 cm, and the skin flap was designed. The flap area was 1.6 cm × 3.6 cm to 2.1 cm × 5.1 cm. CURA 15.02.1 was used to set parameters, and the 3D model of the affected finger was printed prior to the operation. Full-thickness skin grafts were taken from donor areas for repair. Results: No vascular crises occurred in any of the 25 cases, and all flaps survived. The postoperative follow-up occurred over 3-12 months. All patients were evaluated 3 months after operation according to the trial standard of hand function evaluation of the Chinese Hand Surgery Society. The results showed that 20 cases had excellent outcomes (80%), four cases had good outcomes (16%), and one case had a fair outcome (4%). The excellent and good rate was 96%. Conclusions: During the COVID-19 epidemic, fingertip defects were treated with preoperative digital design of fingertip defect flaps combined with 3D printing. Precision design saves surgery time and improves the success rate of surgery and the survival rates of skin flaps. In addition, 3D model simulations improve preoperative communication efficiency, and the personalized design improves patient satisfaction.


Assuntos
COVID-19/epidemiologia , Traumatismos dos Dedos/cirurgia , Dedos/cirurgia , Pandemias , Cuidados Pré-Operatórios/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante de Pele/métodos , Adulto , Idoso , COVID-19/psicologia , China/epidemiologia , Feminino , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Anatômicos , Impressão Tridimensional/instrumentação , Procedimentos Cirúrgicos Reconstrutivos/psicologia , SARS-CoV-2/patogenicidade , Transplante de Pele/psicologia , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/inervação , Resultado do Tratamento , Cicatrização/fisiologia
5.
Med Clin North Am ; 105(4): 663-679, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34059244

RESUMO

Lower extremity ulcerations contribute to significant morbidity and economic burden globally. Chronic wounds, or those that do not progress through healing in a timely manner, are estimated to affect 6.5 million people in the United States alone causing, significant morbidity and economic burden of at least an estimated $25 billion annually. Owing to the aging population and increasing rates of obesity and diabetes mellitus globally, chronic lower extremity ulcers are predicted to increase. Here, we explore the pathophysiology, diagnosis, and management of the most (and least) commonly seen lower extremity ulcers.


Assuntos
Úlcera da Perna/diagnóstico , Úlcera da Perna/economia , Úlcera da Perna/terapia , Extremidade Inferior/patologia , Adulto , Idoso , Envelhecimento/fisiologia , Aterosclerose/complicações , Doença Crônica , Comorbidade , Efeitos Psicossociais da Doença , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Úlcera da Perna/fisiopatologia , Extremidade Inferior/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia , Cicatrização/fisiologia
6.
Int J Mol Sci ; 22(11)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34064054

RESUMO

It is now more than 90 years since Irving Langmuir used the technical term "plasma" to describe an ionized gas [...].


Assuntos
Plasma/metabolismo , Biologia/métodos , Humanos , Cicatrização/fisiologia
7.
Int J Mol Sci ; 22(11)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071384

RESUMO

Since the effect of MFs (magnetic fields) on various biological systems has been studied, different results have been obtained from an insignificant effect of weak MFs on the disruption of the circadian clock system. On the other hand, magnetic fields, electromagnetic fields, or electric fields are used in medicine. The presented study was conducted to determine whether a low-frequency RMF (rotating magnetic field) with different field parameters could evoke the cellular response in vitro and is possible to modulate the cellular response. The cellular metabolic activity, ROS and Ca2+ concentration levels, wound healing assay, and gene expression analyses were conducted to evaluate the effect of RMF. It was shown that different values of magnetic induction (B) and frequency (f) of RMF evoke a different response of cells, e.g., increase in the general metabolic activity may be associated with the increasing of ROS levels. The lower intracellular Ca2+ concentration (for 50 Hz) evoked the inability of cells to wound closure. It can be stated that the subtle balance in the ROS level is crucial in the wound for the effective healing process, and it is possible to modulate the cellular response to the RMF in the context of an in vitro wound healing.


Assuntos
Cálcio/metabolismo , Campos Eletromagnéticos , Fibroblastos/metabolismo , Queratinócitos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Cicatrização/fisiologia , Animais , Linhagem Celular , Sobrevivência Celular/genética , Fibroblastos/citologia , Expressão Gênica , Humanos , Queratinócitos/citologia , Camundongos , Rotação , Cicatrização/genética , Proteína cdc42 de Ligação ao GTP/genética
8.
Biosensors (Basel) ; 11(6)2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34063972

RESUMO

Telemedicine (TM) can revolutionize the impact of diabetic wound care management, along with tools for remote patient monitoring (RPM). There are no low-cost mobile RPM devices for TM technology to provide comprehensive (visual and physiological) clinical assessments. Here, a novel low-cost smartphone-based optical imaging device has been developed to provide physiological measurements of tissues in terms of hemoglobin concentration maps. The device (SmartPhone Oxygenation Tool-SPOT) constitutes an add-on optical module, a smartphone, and a custom app to automate data acquisition while syncing a multi-wavelength near-infrared light-emitting diode (LED) light source (690, 810, 830 nm). The optimal imaging conditions of the SPOT device were determined from signal-to-noise maps. A standard vascular occlusion test was performed in three control subjects to observe changes in hemoglobin concentration maps between rest, occlusion, and release time points on the dorsal of the hand. Hemoglobin concentration maps were compared with and without applying an image de-noising algorithm, single value decomposition. Statistical analysis demonstrated that the hemoglobin concentrations changed significantly across the three-time stamps. Ongoing efforts are in imaging diabetic foot ulcers using the SPOT device to assess its potential as a smart health device for physiological monitoring of wounds remotely.


Assuntos
Dispositivos Ópticos , Smartphone , Telemedicina , Cicatrização/fisiologia , Pé Diabético , Hemoglobinas , Humanos , Monitorização Fisiológica/métodos
9.
J Wound Care ; 30(5): 394-398, 2021 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-33979220

RESUMO

BACKGROUND: Dermatitis of surrounding skin may complicate hard-to-heal leg ulcers, delaying wound healing. The coexistence of hard-to-heal leg ulcers and irritant or allergic contact dermatitis may create difficulties for both diagnostic and therapeutic management. OBJECTIVE: The aim of our study was to evaluate the incidence of dermatitis occurring in the surrounding skin in a population affected by hard-to-heal leg ulcers during treatment, and to differentiate between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) with the use of a patch test. Furthermore, we investigated which medications were most probably related to these conditions. METHOD: We conducted an observational study from 21 February to 21 July 2017, enlisting all patients affected by hard-to-heal leg ulcers who attended the Wound Care Service of the Dermatologic Department of ASST, Spedali Civili, Brescia, Italy. RESULTS: We enrolled 95 patients; 81 patients did not develop dermatitis, while 14 patients developed dermatitis of the surrounding skin. These patients underwent a patch test which gave a positive result in seven patients, permitting the diagnosis of ACD. CONCLUSION: Our study confirmed the incidence of dermatitis of the surrounding skin reported in the literature but reassessed the incidence of ACD as opposed to ICD.


Assuntos
Bandagens/efeitos adversos , Dermatite Irritante/diagnóstico , Úlcera da Perna/terapia , Cicatrização/fisiologia , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Humanos , Irritantes , Itália/epidemiologia , Úlcera da Perna/diagnóstico , Úlcera da Perna/epidemiologia
10.
Nat Commun ; 12(1): 2595, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33972536

RESUMO

Tissue regeneration is a process that recapitulates and restores organ structure and function. Although previous studies have demonstrated wound-induced hair neogenesis (WIHN) in laboratory mice (Mus), the regeneration is limited to the center of the wound unlike those observed in African spiny (Acomys) mice. Tissue mechanics have been implicated as an integral part of tissue morphogenesis. Here, we use the WIHN model to investigate the mechanical and molecular responses of laboratory and African spiny mice, and report these models demonstrate opposing trends in spatiotemporal morphogenetic field formation with association to wound stiffness landscapes. Transcriptome analysis and K14-Cre-Twist1 transgenic mice show the Twist1 pathway acts as a mediator for both epidermal-dermal interactions and a competence factor for periodic patterning, differing from those used in development. We propose a Turing model based on tissue stiffness that supports a two-scale tissue mechanics process: (1) establishing a morphogenetic field within the wound bed (mm scale) and (2) symmetry breaking of the epidermis and forming periodically arranged hair primordia within the morphogenetic field (µm scale). Thus, we delineate distinct chemo-mechanical events in building a Turing morphogenesis-competent field during WIHN of laboratory and African spiny mice and identify its evo-devo advantages with perspectives for regenerative medicine.


Assuntos
Epiderme/anatomia & histologia , Epiderme/metabolismo , Folículo Piloso/metabolismo , Morfogênese/fisiologia , Regeneração/fisiologia , Proteína 1 Relacionada a Twist/metabolismo , Cicatrização/fisiologia , Animais , Epiderme/fisiologia , Perfilação da Expressão Gênica , Folículo Piloso/anatomia & histologia , Folículo Piloso/fisiologia , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Análise em Microsséries , Microscopia de Força Atômica , Modelos Psicológicos , Morfogênese/genética , Murinae , RNA-Seq , Regeneração/genética , Medicina Regenerativa , Transdução de Sinais/genética , Transdução de Sinais/fisiologia , Análise Espaço-Temporal , Proteína 1 Relacionada a Twist/genética , Cicatrização/genética
11.
J Wound Ostomy Continence Nurs ; 48(3): 195-198, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951708

RESUMO

PURPOSE: The purpose of this technologic analysis was to evaluate single-use negative pressure wound therapy (sNPWT) devices. APPROACH: Published literature regarding negative pressure wound therapy, particularly focusing on single-use or disposal devices, was reviewed. Varied features of devices currently available in the United States were drawn from use instructions published by individual manufacturers. Safety information regarding sNPWT was derived from the Manufacturer and User Facility Device Experience (MAUDE) Database. CONCLUSIONS: Single-use or disposable negative pressure wound therapy devices provide a safe and effective alternative to traditional negative pressure wound therapy. These devices promote healing of select open wounds and reduce complication rates in closed surgical incisions, when used in accordance with manufacturer guidelines. They may be used in any setting, but they are designed for use in home care and may be applied as a primary treatment option or following a course of traditional negative pressure wound therapy.


Assuntos
Tratamento de Ferimentos com Pressão Negativa , Ferida Cirúrgica , Cicatrização/fisiologia , Humanos , Tratamento de Ferimentos com Pressão Negativa/instrumentação , Tratamento de Ferimentos com Pressão Negativa/métodos , Infecção da Ferida Cirúrgica , Estados Unidos
12.
J Wound Ostomy Continence Nurs ; 48(3): 199-202, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951709

RESUMO

PURPOSE: The purpose of this technologic analysis was to critique technologic features of devices designed to deliver negative pressure wound therapy with instillation or irrigation (iNPWT). APPROACH: Published literature regarding negative pressure wound therapy (NPWT) devices with the added feature of instillation or irrigation was reviewed to provide an overview of iNPWT. Varied features of devices currently available in the United States were described based on instructions published by individual manufacturers. Safety information regarding iNPWT was derived from the Manufacturer and User Facility Device Experience (MAUDE) Database. CONCLUSIONS: The additional option of instillation or irrigation available with some NPWT devices may provide clinical benefits in carefully selected patients. Advantages may be related to facilitated removal of thick exudate and necrotic tissue. Devices with instillation options are indicated for inpatient settings, with ongoing monitoring of health care professionals. A simpler device with an intermittent irrigation option may be used in the home setting, with proper supervision. More research is needed to demonstrate the clinical effectiveness and cost of the therapy.


Assuntos
Tratamento de Ferimentos com Pressão Negativa/instrumentação , Irrigação Terapêutica/métodos , Humanos , Resultado do Tratamento , Cicatrização/fisiologia
13.
J Wound Ostomy Continence Nurs ; 48(3): 256-261, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951716

RESUMO

BACKGROUND: Bevacizumab is a humanized monoclonal antibody to vascular endothelial growth factor (VEGF) that has been used as a systemic chemotherapy treatment of various malignancies in adults since 2000. It has been used for pediatric patients over the last decade. In addition, bevacizumab is used for neonatal intravitreal administration for retinopathy of prematurity, a major complication of preterm birth, characterized by incomplete and abnormal vascularization of the retina that can lead to retinal detachment and blindness without treatment. CASES: The objective of this multiple case series is to report impaired wound healing seen in 3 adolescents and 1 premature neonate receiving bevacizumab and to propose collagen-based dermal template as a choice for the management of such wounds. The 3 adolescents were undergoing treatment of malignancies and developed wound healing complication within weeks of receiving anti-VEGF. The premature neonate experienced an extravasation and had a slow wound healing trajectory after receiving intravitreal administration of bevacizumab for retinopathy of prematurity. All wounds achieved closure following topical treatment with a collagen dermal template. CONCLUSION: Use of bevacizumab is increasing in the pediatric population. Clinicians should be aware of compromised wound healing and higher likelihood of wound dehiscence after bevacizumab administration. We recommend waiting for at least 4 to 6 weeks between anti-VEGF administration (either systemic or vitreous) and elective surgical procedures, consistent with adult literature recommendations. If patient has an existing wound, we assert that bevacizumab should not be administered until that wound is healed. If wound healing is stalled, we recommend dermal template as a safe and effective accelerator of wound healing.


Assuntos
Colágeno/uso terapêutico , Fatores de Crescimento Endotelial/administração & dosagem , Retinopatia da Prematuridade/tratamento farmacológico , Cicatrização/fisiologia , Adolescente , Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Criança , Feminino , Humanos , Recém-Nascido , Injeções Intravítreas , Gravidez , Nascimento Prematuro/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular/uso terapêutico
14.
J Wound Care ; 30(Sup5): S32-S36, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33979231

RESUMO

OBJECTIVE: Debridement, the removal of nonviable tissue, forms the foundation of wound care practice. Clinicians have a variety of debridement methods at their disposal: sharp, biologic, enzymatic, autolytic and mechanical. The choice of debridement technique depends on the patient care setting, ulcer type and the clinician's experience, training, comfort level and licensure. This prospective study evaluated a novel debridement instrument, EZ-Debride (MDM Ventures, US). Cutting flutes on the head of the tool permit uniform removal of dead tissue while lessening the risk of deeper injury. It may also minimise pain during the debridement procedure. METHOD: Subjects with hard-to-heal wounds, drawn from a single wound care centre, participated in this institutional review board-approved prospective clinical study. Pain was measured before, during and after debridement using a numerical scale. Assessment of bacterial burden using fluorescence imaging (MolecuLight, Canada) was performed before and after debridement. RESULTS: Enrolment of 10 male and 12 female subjects, with a total of 28 wounds, was carried out over a two-month period by two investigators at a single institution. The average age of subjects was 64 years (range: 22-95 years). The average wound duration was 29 weeks (range: 6-142 weeks). Wound types included diabetic foot, venous leg and pressure ulcers, post-surgical and traumatic wounds. The average pain score at the time of enrolment was 3.9. Subjects reported an average increase in pain with debridement of 0.6 points (range: 0-8). Fluorescence imaging demonstrated a reduction in bacterial load in 69% of cases, with complete resolution in 19% of wounds. Haemostasis was achieved with direct pressure in all cases and the only adverse event was a wound infection that occurred four days after debridement. CONCLUSION: The results suggest that this novel debridement tool can safely remove nonviable tissue with minimal discomfort and reduce bacterial burden similar to results achieved by sharp debridement.


Assuntos
Desbridamento/instrumentação , Pé Diabético/cirurgia , Cicatrização/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Desbridamento/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento
15.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48188

RESUMO

Este mapa apresenta uma visão geral e uma síntese gráfica das evidências sobre a aplicação clínica do laser para fotobiomodulação na saúde bucal. A partir de uma ampla busca bibliográfica foram incluídos no mapa 121 estudos de revisão sistemática e de metanálise, que foram avaliados, caracterizados e categorizados por intervenção (laser), por desfechos em saúde bucal. Principais Achados: • Os estudos avaliaram os efeitos de 8 tipos de intervenção com fotobiomodulação (6) e laser (2) aplicados a 44 desfechos relacionados a saúde bucal e distribuídos em 5 grupos: doenças da boca (15), doenças dentárias (4), sinais e sintomas (8), cicatrização (4) e procedimentos odontológicos (8). ● A intervenção mais avaliada foi com espectro da luz infravermelha (29%), seguido da luz vermelha (28%) e terapia fotodinâmica (PDT) (10%). E, os desfechos mais avaliados com estas intervenções foram: alívio da dor, periodontite e mucosite. ● A maioria dos estudos (84%) indicou efeito positivo ou potencialmente positivo das intervenções para os desfechos em saúde bucal. O efeito foi inconclusivo para 13% dos desfechos, e negativo ou potencialmente negativo para apenas 5 desfechos. Alguns estudos não informaram o efeito da intervenção para 10 desfechos.


Assuntos
Saúde Bucal , Cicatrização/fisiologia , Doenças da Boca/terapia , Doenças Dentárias/terapia , Fatores Biológicos , Procedimentos Cirúrgicos Bucais
16.
J Wound Care ; 30(Sup4): S42-S52, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1187162

RESUMO

OBJECTIVE: Management of chronic wounds remains one of the major challenges for health professionals and patients. An evidence-based decision is important to ensure that patients are receiving the best treatment proven to reduce healing time and improve outcomes, including economic benefits and patients' health-related quality of life (HRQoL). Due to recent restrictions because of the COVID-19 pandemic, including closure of wound care centres within hospitals and a drop in patient volume, chronic wound management needs simple-to-use dressings which are still effective and evidence-based solutions. This systematic review was conducted to identify the clinical evidence available on a sucrose octasulfate dressing (TLC-NOSF, UrgoStart dressing range, Laboratoires Urgo, France) to explore its efficacy in the management of chronic wounds, particularly lower limb ulcers, diabetic foot ulcers and pressure ulcers. METHOD: A literature search of PubMed, Cochrane Library and Google Scholar was conducted based on the PICO model (patient/population, intervention, comparison and outcomes) to retrieve publications of different levels of evidence in order to evaluate outcomes of the use of TLC-NOSF dressings. RESULTS: A total of 21 publications of different levels, ranging from double-blind randomised control trials to case reports, involving over 12,000 patients, were identified through PubMed, with a further eight publications through Google Scholar and two publications through Cochrane Library. A total of seven results were omitted due to the lack of relevance or repetition. CONCLUSION: All the evidence provided suggest that these dressings provide clinicians with an evidence-based option for the management of chronic wounds; that the TLC-NOSF dressings are beneficial in promoting the healing process, reducing healing times, enhancing patients' HRQoL, and in allowing a more cost-effective procedure.


Assuntos
Curativos Hidrocoloides , Doença Crônica/terapia , Pé Diabético/terapia , Lesão por Pressão/terapia , Sacarose/análogos & derivados , Sacarose/uso terapêutico , Cicatrização/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade
17.
J Wound Care ; 30(Sup4): S38-S40, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33856926

RESUMO

OBJECTIVE: Hard-to-heal wounds are a surgical challenge, and diabetic foot ulcers (DFUs) are one of the most common and severe varieties. Previous studies have shown that autologous fat grafting (AFG) and negative pressure wound therapy (NPWT) have the potential to promote wound healing. This case study describes how these two methods together helped in the healing of a serious DFU. CASE HISTORY: A 65-year-old female patient had a severe DFU on her right foot, with a 30-year history of disease and renal failure. By the time symptoms were evident, regular dressing changes and antibiotic treatment were inadequate. She received surgical debridement, AFG and NPWT. Finally, as the granulation tissue covered the full wound bed, the wound was closed by split-thickness skin grafting. One month later, the DFU was fully healed with no recurrences. CONCLUSION: The application of AFG or components of adipose tissue to treat hard-to-heal wounds has been researched at both the molecular level and in clinic. In this case, we have proved the curative effect of jointly using AFG and NPWT.


Assuntos
Tecido Adiposo/transplante , Desbridamento , Diabetes Mellitus , Pé Diabético/terapia , Tratamento de Ferimentos com Pressão Negativa , Cicatrização/fisiologia , Idoso , Pé Diabético/cirurgia , Feminino , Humanos
18.
Int J Mol Sci ; 22(9)2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33925176

RESUMO

Mechanical stress following injury regulates the quality and speed of wound healing. Improper mechanotransduction can lead to impaired wound healing and scar formation. Vimentin intermediate filaments control fibroblasts' response to mechanical stress and lack of vimentin makes cells significantly vulnerable to environmental stress. We previously reported the involvement of exosomal vimentin in mediating wound healing. Here we performed in vitro and in vivo experiments to explore the effect of wide-type and vimentin knockout exosomes in accelerating wound healing under osmotic stress condition. Our results showed that osmotic stress increases the size and enhances the release of exosomes. Furthermore, our findings revealed that exosomal vimentin enhances wound healing by protecting fibroblasts against osmotic stress and inhibiting stress-induced apoptosis. These data suggest that exosomes could be considered either as a stress modifier to restore the osmotic balance or as a conveyer of stress to induce osmotic stress-driven conditions.


Assuntos
Fibroblastos/metabolismo , Vimentina/metabolismo , Cicatrização/fisiologia , Adipócitos/metabolismo , Animais , Apoptose/fisiologia , Diferenciação Celular , Linhagem Celular , Movimento Celular , Exossomos/metabolismo , Humanos , Filamentos Intermediários/metabolismo , Mecanotransdução Celular , Células-Tronco Mesenquimais/metabolismo , Camundongos , Pressão Osmótica/fisiologia , Estresse Mecânico , Vimentina/fisiologia
19.
Int J Mol Sci ; 22(7)2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33805585

RESUMO

Extracellular vesicles (EVs) have an important role in mediating intercellular signaling in inflammation and affect the kinetics of wound healing, however, an understanding of the mechanisms regulating these responses remains limited. Therefore, we have focused on the use of cutaneous injury models in which to study the biology of EVs on the inflammatory phase of wound healing. For this, the foreign body response using sterile subcutaneous polyvinylalcohol (PVA) sponges is ideally suited for the parallel analysis of immune cells and EVs without the need for tissue dissociation, which would introduce additional variables. We have previously used this model to identify mediators of EV biogenesis, establishing that control of how EVs are made affects their payload and biological activity. These studies in normal mice led us to consider how conditions such as immunodeficiency and obsesity affect the profile of immune cells and EVs in this model using genetically defined mutant mice. Since EVs are intrinsically heterogenous in biological fluids, we have focused our studies on a novel technology, vesicle flow cytometry (vFC) to quantify changes in EVs in mouse models. Here, we show that myeloid-derived immune cells and EVs express proteins relevant in antigen presentation in PVA sponge implants that have distinct profiles in wildtype, immune-deficient (NOD scid) vs. diabetic (Leprdb) mice. Together, these results establish a foundation for the parallel analysis of both immune cells and EVs with technologies that begin to address the heterogeneity of intercellular communication in the wound bed.


Assuntos
Antígenos CD/imunologia , Vesículas Extracelulares/fisiologia , Pele/lesões , Pele/patologia , Animais , Antígenos CD/genética , Antígenos CD/metabolismo , Diabetes Mellitus Experimental/imunologia , Modelos Animais de Doenças , Vesículas Extracelulares/imunologia , Vesículas Extracelulares/patologia , Cinética , Masculino , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos NOD/genética , Camundongos Endogâmicos NOD/imunologia , Camundongos Obesos/imunologia , Células Mieloides/imunologia , Álcool de Polivinil , Cicatrização/imunologia , Cicatrização/fisiologia
20.
Molecules ; 26(9)2021 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33919399

RESUMO

Wound healing involves a series of cellular events in damaged cells and tissues initiated with hemostasis and finally culminating with the formation of a fibrin clot. However, delay in the normal wound healing process during pathological conditions due to reactive oxygen species, inflammation and immune suppression at the wound site represents a medical challenge. So far, many therapeutic strategies have been developed to improve cellular homeostasis and chronic wounds in order to accelerate wound repair. In this context, the role of Nuclear factor erythroid 2-related factor 2 (Nrf2) during the wound healing process has been a stimulating research topic for therapeutic perspectives. Nrf2 is the main regulator of intracellular redox homeostasis. It increases cytoprotective gene expression and the antioxidant capacity of mammalian cells. It has been reported that some bioactive compounds attenuate cellular stress and thus accelerate cell proliferation, neovascularization and repair of damaged tissues by promoting Nrf2 activation. This review highlights the importance of the Nrf2 signaling pathway in wound healing strategies and the role of bioactive compounds that support wound repair through the modulation of this crucial transcription factor.


Assuntos
Fator 2 Relacionado a NF-E2/metabolismo , Transdução de Sinais , Cicatrização/fisiologia , Animais , Apoptose , Autofagia , Biomarcadores , Movimento Celular , Proliferação de Células , Citoproteção/genética , Regulação da Expressão Gênica , Humanos , Oxirredução , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Pele/metabolismo
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