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Advances in Wound Care

Anitha P Ambika, Sreesha N Nair
Significance: Compounds derived from plants are gaining importance for the treatment of several diseases. Many plants from the Convolvulaceae family contain compounds that have demonstrated wound healing and antidiabetic activity. Such compounds can be effectively used as a part of treatments to promote wound healing in diabetics and used in combination with antimicrobial therapy to reduce the likelihood of drug resistance and allergic reactions. Novel strategies for developing herbal formulations such as nanoparticles and adhesive patches can improve the delivery of plant-based therapeutic agents...
January 1, 2019: Advances in Wound Care
Daniel V Zurawski, Chad C Black, Yonas A Alamneh, Lionel Biggemann, Jaideep Banerjee, Mitchell G Thompson, Matthew C Wise, Cary L Honnold, Robert K Kim, Chrysanthi Paranavitana, Jonathan P Shearer, Stuart D Tyner, Samandra T Demons
Objective: To better understand Acinetobacter baumannii pathogenesis and to advance drug discovery against this pathogen, we developed a porcine, full-thickness, excisional, monospecies infection wound model. Approach: The research was facilitated with AB5075, a previously characterized, extensively drug-resistant A . baumannii isolate. The model requires cyclophosphamide-induced neutropenia to establish a skin and soft tissue infection (SSTI) that persists beyond 7 days. Multiple, 12-mm-diameter full-thickness wounds were created in the skin overlying the cervical and thoracic dorsum...
January 1, 2019: Advances in Wound Care
Sunil Srivastava, Hiranmayi Kumari, Abhimanyu Singh
Objective: Scar biology is a territory less understood. The search for ideal treatment of keloid continues. The aim of this study was to compare the role of CO2 laser, triamcinolone (TAC), and verapamil in the treatment of keloid. Approach: A randomized parallel-group study was conducted in which 60 patients were randomly allocated to three groups from May 2017 to April 2018. First group received fractional CO2 laser therapy, second group received triamcinolone, and third group received intralesional verapamil...
January 1, 2019: Advances in Wound Care
Simon Lebech Cichosz, Anne-Birgitte Voelsang, Lise Tarnow, John Michael Hasenkam, Jesper Fleischer
Objective: The development of in-hospital acquired pressure ulcers (PUs) is of great concern for both patients and professionals in health care. Based on the hypothesis that identification of patients who are prone to develop PU will enhance preventive measures in this group of patients, we investigated a new tool, Qscale, for in-hospital prediction of PU. Approach: A total of 383 patients were recruited from three departments. The investigations were performed in two steps: 252 patients were used to train the algorithm, and 131 patients were used in the validation...
January 1, 2019: Advances in Wound Care
William J Ennis, Enoch T Huang, Hanna Gordon
Objective: The goal of this research was to identify a population of diabetic foot ulcer patients who demonstrate a significant response to hyperbaric oxygen therapy (HBOT) using a large sample size to provide guidance for clinicians when treating these complicated patients. Approach: The effect of HBOT on diabetic foot ulcers, Wagner grades 3 and 4, was evaluated using a retrospective observational real-world data set. The study reported on the overall healing rate, (74.2%) at the population level, for >2 million wounds...
December 1, 2018: Advances in Wound Care
Linda L Benskin
Objective: Wound management recommendations usually group dressings by base substrate material or reimbursement codes, even when functional differences are vast ( e.g ., honey-containing alginates, super-absorbent hydrogels). Polymeric membrane dressings (PMDs) diverge dramatically from conventional foam dressings in functional attributes, indications, and patient results, providing an opportunity to demonstrate the evidence for categorizing dressings based upon functional differences. Approach: A search of ALL published literature describing the use of PMDs, with no date or language limits, was conducted...
December 1, 2018: Advances in Wound Care
Adrienne M Gilligan
Objective: To provide an overview of comparative effectiveness research (CER) methodology and discuss the challenges of health economics and outcomes research (HEOR) in wound care. Approach: Narrative description of HEOR methodology with supporting references. Results: With the increasing costs of clinical trials, the use of observational studies in a real-world setting will be essential. Wound care clinicians should understand the importance of proper methods for conducting CER studies. Propensity score methods and marginal structural modeling can create a "quasi-randomized" environment for measuring wound closure and can help drive informed decision-making...
November 1, 2018: Advances in Wound Care
Travis A Motley, Joseph M Caporusso, Darrell L Lange, Robert A Eichelkraut, David Innes Cargill, Jaime E Dickerson
Objective: To compare outcomes of diabetic foot ulcers (DFUs) treated with clostridial collagenase ointment (CCO) or silver-containing products, both in combination with sharp debridement as needed. Approach: One hundred two subjects with qualifying DFUs were randomized to daily treatment with either CCO or a silver-containing product for 6 weeks followed by a 4 -week follow-up period. The primary outcome was the mean percent reduction in DFU area. A secondary outcome was the incidence of ulcer infections between groups...
October 1, 2018: Advances in Wound Care
Julie M West, Sumanas W Jordan, Ehud Mendel, Safdar N Khan, Rajiv Y Chandawarkar, Ian L Valerio
Objective: Infection prevention in spinal surgeries involving implantation of hardware is of utmost priority. Furthermore, successful eradication of infection in hardware salvage is likewise critical in maintaining the long-term retention of the spinal hardware construct. Approach: We report a retrospective case series of three cases where the utilization of a VAC with instillation (VACi) in conjunction with surgical debridement aided in infection control and eradication for both preimplantation and hardware salvage spine patients...
October 1, 2018: Advances in Wound Care
Melanie Rodrigues, Clark A Bonham, Caterina P Minniti, Kalpna Gupta, Michael T Longaker, Geoffrey C Gurtner
Objective: Sickle cell ulcers (SCUs) are a devastating comorbidity affecting patients with sickle cell disease (SCD). SCUs form over the medial or lateral malleoli of the lower extremity, are slow to heal, and prone to recidivism. Some SCUs may never heal, leading to chronic pain and foot deformities. There is no specific and effective therapy for SCUs. Systemic deferoxamine (DFO) has been demonstrated to prevent some of the sequelae of SCD by chelating iron. In this study, we tested the ability of DFO delivered via a transdermal delivery system (DFO-TDDS) to accelerate healing in a murine model of SCU...
October 1, 2018: Advances in Wound Care
Anne-Marie Salisbury, Dieter Mayer, Rui Chen, Steven L Percival
Objective: This study was set up to evaluate the efficacy of a concentrated surfactant-based wound dressing (with and without silver sulfadiazine [SSD]) on wound repair, by investigating their ability to enhance human dermal fibroblast proliferation and viability. In addition, the wound dressings were evaluated for their ability to suppress biofilms in a three-dimensional (3D) in vitro wound biofilm model and modulate the inflammatory cytokine interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFα). Approach: Problematic biofilms are well known to affect fibroblast and keratinocyte viability...
September 1, 2018: Advances in Wound Care
Jose A Jaller, Ingrid Herskovitz, Luis J Borda, Joshua Mervis, Evan Darwin, Penelope A Hirt, Hadar Lev-Tov, Robert S Kirsner
Background: Despite the development of numerous wound treatment alternatives, 25% to 50% of leg ulcers and >30% of foot ulcers are not fully healed after 6 months of treatment. Autologous skin grafting is a time-tested therapy for these wounds; however, the creation of a new wound in the donor area yields a considerable limitation to this procedure. Innovation: Fractional autologous full-thickness skin grafting (FFTSG) is a technique wherein multiple small full-thickness skin grafts (FTSGs) are harvested with possibly minor donor-site comorbidities...
September 1, 2018: Advances in Wound Care
Denise R Cooper, Chunyan Wang, Rehka Patel, Andrea Trujillo, Niketa A Patel, Jamie Prather, Lisa J Gould, Mack H Wu
Objective: Chronically ill patients heal recalcitrant ulcerative wounds more slowly. Human adipose-derived stem cells (hADSCs) play an important role in tissue regeneration and exosomes secreted by hADSC contribute to their paracrine signaling. In addition to cytokines, lipids and growth factors, hADSC secrete mRNA, miRNA, and long noncoding (lnc) RNA into exosomes. In this study we examined the role of lncRNA MALAT1 (metastasis-associated lung adenocarcinoma transcript 1), an abundant lncRNA in exosomes from conditioned media (CM), on cell migration and ischemic wound healing...
September 1, 2018: Advances in Wound Care
Lyn M Wise, Gabriella S Stuart, Nicola C Real, Stephen B Fleming, Andrew A Mercer
Objective: Vascular endothelial growth factor (VEGF) family members are critical regulators of tissue repair and depending on their distinct pattern of receptor specificity can also promote inflammation and scarring. This study utilized a receptor-selective VEGF to examine the role of VEGF receptor (VEGFR)-2 in scar tissue (ST) formation. Approach: Cutaneous skin wounds were created in mice using a 4 mm biopsy punch and then treated until closure with purified VEGF-E derived from orf virus stain NZ-2. Tissue samples were harvested to measure gene expression using quantitative PCR and to observe ST formation through histological examination and changes in cell populations by immunofluorescence...
August 1, 2018: Advances in Wound Care
Anna Flattau, Hanna Gordon, Giacomo Vinces, William J Ennis, Caterina P Minniti
Objective: Sickle cell ulcers affect as many as 15% of patients with sickle cell disease in the United States and severely impact quality of life. An understanding of baseline healing patterns is important to inform study design for future trials that test therapies for this disease. Approach: In this study, an electronic wound management system was leveraged to analyze retrospective data on 133 unique sickle cell patients who were treated across 114 wound healing centers, and to describe their characteristics and healing patterns as compared with those of venous ulcer patients...
August 1, 2018: Advances in Wound Care
Michael S Hu, Wan Xing Hong, Michael Januszyk, Graham G Walmsley, Anna Luan, Zeshaan N Maan, Shawn Moshrefi, Ruth Tevlin, Derrick C Wan, Geoffrey C Gurtner, Michael T Longaker, H Peter Lorenz
Objective: In early gestation, fetal wounds heal without fibrosis in a process resembling regeneration. Elucidating this remarkable mechanism can result in tremendous benefits to prevent scarring. Fetal mouse cutaneous wounds before embryonic day (E)18 heal without scar. Herein, we analyze expression profiles of fetal and postnatal wounds utilizing updated gene annotations and pathway analysis to further delineate between repair and regeneration. Approach: Dorsal wounds from time-dated pregnant BALB/c mouse fetuses and adult mice at various time points were collected...
August 1, 2018: Advances in Wound Care
Michael S Hu, Michael T Longaker
No abstract text is available yet for this article.
August 1, 2018: Advances in Wound Care
Lindsay Kalan, Elizabeth A Grice
Significance: Culture-independent methods have revealed the diverse and dynamic bacterial communities that colonize chronic wounds. Only recently have studies begun to examine fungal colonization and interactions with the bacterial component of the microbiome, their relationship with the host, and influence on wound outcomes. Recent Advances: Studies using culture-independent sequencing methods reveal that fungi often go undetected in wounds. Candida spp. and Cladosporidium spp. are the most commonly identified fungi in wounds...
July 1, 2018: Advances in Wound Care
Ulrich Blache, Martin Ehrbar
Significance: Diseases related to vascular malfunction, hyper-vascularization, or lack of vascularization are among the leading causes of morbidity and mortality. Engineered, vascularized tissues as well as angiogenic growth factor-releasing hydrogels could replace defective tissues. Further, treatments and testing of novel vascular therapeutics will benefit significantly from models that allow for the study of vascularized tissues under physiological relevant in vitro conditions. Recent Advances: Inspired by fibrin, the provisional matrix during wound healing, naturally derived and synthetic hydrogel scaffolds have been developed for vascular engineering...
July 1, 2018: Advances in Wound Care
Jacqueline Larouche, Sumit Sheoran, Kenta Maruyama, Mikaël M Martino
Significance: The immune system plays a central role in orchestrating the tissue healing process. Hence, controlling the immune system to promote tissue repair and regeneration is an attractive approach when designing regenerative strategies. This review discusses the pathophysiology of both acute and chronic wounds and possible strategies to control the immune system to accelerate chronic wound closure and promote skin regeneration (scar-less healing) of acute wounds. Recent Advances: Recent studies have revealed the key roles of various immune cells and immune mediators in skin repair...
July 1, 2018: Advances in Wound Care
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