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Purpose: In pediatric population, large soft tissue defects occur in avulsion injuries. In addition to the challenges of primary surgical therapy, elasticity, appearance and function of the scar in children are of crucial importance, especially in the context of body growth. So far various flaps, plasties, skin grafts and dermal substitutes have become established, although infections and skin shrinkage remain challenging. In 2020, a new skin substitute material—NovoSorb® Biodegradable Temporizing Matrix (BTM)—was introduced in Europe for temporary wound closure and tissue regeneration. The aim of this study was to evaluate the value of BTM in pediatric patients. Methods: The study included all children treated with BTM after traumatic soft tissue defects following limb avulsion injuries between June 2021 and June 2023 at a university hospital. Results: 7 patients with limb avulsion injuries were treated with BTM, 4 boys, 3 girls. Mean age was 6.5 years (2–11 years) at the time of BTM placement. 4/7 had concomitant fractures. BTM was used successfully in all cases, infection did not occur, skin shrinkage was seen in one case. Split thickness skin graft (STSG) after BTM application was performed in average after 33 days (26 to 39 days). Limitations of this study were highlighted. Conclusion: BTM is a promising alternative for reconstruction of complex trauma extremity wounds in children following avulsion injuries, even in cases of concomitant bone injuries. Interpretation may be limited by sample size. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The effective management of bacterial infections that are resistant to multiple drugs remains a substantial clinical challenge. The eradication of drug-resistant bacteria and subsequent promotion of angiogenesis are imperative for the regeneration of the infected wounds. Here, a novel and facile peptide containing injectable hydrogel with sustained antibacterial and angiogenic capabilities is developed. The antibacterial peptide that consists of 11 residues (CM11, WKLFKKILKVL) is loaded onto acrylate-modified gelatin through charge interactions. A vascular endothelial growth factor mimetic peptide KLT (KLTWQELYQLKYKGI) with a GCG (Gly-Cys-Gly) modification at the N-terminal is covalently coupled through a visible light-induced thiol-ene reaction. In this reaction, the acrylate gelatin undergoes cross-linkage within seconds. Based on the physical/chemical double crosslinking strategy, the bioactive peptides achieve sustained and sequential release. The results show that the hydrogel significantly inhibits methicillin-resistant Staphylococcus aureus (MRSA) growth through the rapid release of CM11 peptides at early stage; it forms obvious growth inhibition zones against pathogenic bacterial strains. Moreover, cell counting kit-8 assay and scratch test confirm that the CM11/KLT-functionalized hydrogels promote cell proliferation and migration through the later release of KLT peptides. In a mouse skin wound infected with self-luminous MRSA, the CM11/KLT-functionalized hydrogels enhance wound healing, with rapidly bacterial infection reduction, lower expression of inflammatory factors, and neovascularization promotion. These results suggest that the rationally designed, sustained and sequential release CM11/KLT-functionalized hydrogels have huge potential in promoting the healing of multi-drug resistant bacterial infected wounds. [ABSTRACT FROM AUTHOR]

Objective: Severe soft tissue damage with destruction of the dermis requires plastic reconstructive treatment. For multimorbid patients or patients unable to undergo major reconstructive surgery, use of dermal substitutes, such as a collagen-elastin matrix (CEM) with a split-thickness skin graft (STSG), instead of local or free flap surgery, may be a valid and easy treatment option. We aimed to investigate and compare the outcomes and rate of successful defect reconstruction using CEM plus STSG, using either a one-step approach (simultaneous CEM and STSG) or a two-step approach (CEM and negative wound pressure therapy (NPWT), with secondary STSG transplantation). Method: A single-centre, retrospective follow-up study of patients who had received CEM was conducted. Wounds had been treated with an STSG transplantation covering a CEM (MatriDerm, MedSkin Solutions Dr. Suwelack AG, Germany). Previous attempts at wound closure with conventional methods had failed in the selected patient population, which would usually have resulted in flap surgery. Results: Overall, 46 patients were included (mean age 60.9±20.0 years), with a total of 49 wound sites. We analysed 38 patients with wounds that did not require flap coverage; 18 patients received the one-step approach and 20 patients received the two-step approach. The mean follow-up in these patients was 22±11.5 months, and one patient was lost to follow-up. Overall, 29 (78.4%) wounds remained closed. Wounds which did not successfully heal were related to comorbidities, such as diabetes, alcohol misuse and smoking. Using the one-step approach, long-term defect coverage was achieved in 13 (76.5%) wounds and 16 (80.0%) wounds were closed using the two-step approach. However, there was no statistically significant differences between the one- or two-step approaches regarding the rate of development of a wound healing disorder. Conclusion: Wound closure was achieved in 38 complex wounds using CEM plus STSG, while 11 wounds needed secondary flap coverage. In the flap-free wounds, there were no statistically significant differences between the one-step versus two-step approach. Using a simple defect reconstruction algorithm, we successfully used CEM plus STSG to treat complex wounds. [ABSTRACT FROM AUTHOR]

Aim: One of the technological advances in wound healing is negative pressure wound therapy (NPWT). NPWT is frequently used in acute and chronic wound care. However, few studies in the literature have investigated the effects of NPWT on the graft in patients with diabetic foot ulcers. In this study, we aimed to assess the effects of applying negative pressure wound closure on grafts and its influence on. The healing time indiabetic foot ulcers and thus contribute to the literature by sharing our experience. Materials and Methods: We retrospectively evaluated patients who had received treatment for diabetic foot ulcers in the chronic wound care unit of our hospital between February 2018 and October 2021 and underwent split-thickness skin grafting. The patients were categorized into two groups: those who did and did not receive NPWT to provide support for the graft. The patients were compared in terms of wound healing rates and healing times. Results: The study included 34 men (56.7%) and 26 women (43.3%) (n = 60). The mean age of the patients was 62.07 ± 11.5 years. Supportive NPWT was performed on the graft in 19 (31.7%) patients, whereas 41 (68.3%) patients were treated with grafting and conventional therapy. The treatment duration was shorter in the NPWT group (29.63 ± 19.6 days) than in the non-NPWT group (34.05 ± 17.5 days); however, this difference was not significant (p > 0.05). A significant weak positive correlation (r = 0.28) was observed between the Wagner stage and treatment duration. Conclusion: The treatment of diabetic foot ulcers is affected by several factors, including the presence of infection, vascularization status, wound size, and glycemic control. In this study, we examined a general patient population with diabetic foot ulcers and identified no significant difference in terms of treatment times and healing rates between NPWT and conventional methods as graft-supporting measures. Prospective studies investigating patient populations comprising subgroups may yield varying results, which emphasizes the need for further research in this direction. [ABSTRACT FROM AUTHOR]

Necrotizing fasciitis is one of the most severe soft tissue infections, having substantial fatality rates even in facilities with the highest standards. Typically, it first affects the muscular fascia before spreading to the muscles and subcutaneous tissues. Thus, the therapy for this illness depends on early detection. In this report, we present the case of an 18-year-old male who developed severe necrotizing fasciitis in the right gluteal area following an intramuscular injection of diclofenac sodium. The patient received significant surgical debridement, negative pressure wound therapy (NPWT), and antibiotics as part of their care. A split-thickness skin graft was used for reconstruction. Our results were outstanding as the wound totally healed. Overall, our findings portrayed the importance of taking serious action against soft tissue infections. [ABSTRACT FROM AUTHOR]

Background: Zinc L-carnosine promotes the transition from the inflammatory to the proliferative phase of wound healing by reducing the expression of pro-inflammatory signals and enhancing the expression of anti-inflammatory signals. This prospective cohort study aims to test the effect of a zinc–L-carnosine mouthwash in promoting oral surgical wound healing. Methods: From October 2022 to February 2023, the authors enrolled healthy adult volunteers who needed the extraction of bilateral molars at the Unit of Dentistry of the University of Bari. The authors studied the baseline wound healing of each patient after the first extraction. Three months later, the patients underwent the second extraction and rinsed their mouths with zinc–L-carnosine mouthwash twice per day for the following 28 postoperative days. For a month after each extraction, the patients received weekly follow-up visits by an oral surgeon blinded about the study to record the modified healing index score of the wounds (range 0–6 points). For statistical analysis, we used the one-tailed t-test for paired samples with a significance level set at p < 0.05 to compare the baseline scores with those recorded during the exposure to the zinc–L-carnosine mouthwash. Results: The authors enrolled four women and six men (mean age = 44.60 ± 19.22 years). On the seventh and fourteenth postoperative days, the mean difference between the modified healing index scores obtained by using the zinc–L-carnosine mouthwash and the baseline was not significant. On the twenty-first postoperative day, the mean score obtained by using the mouthwash was 5.2 ± 1.3 points and was significantly higher than the 4.7 ± 1.8 points of the baseline (p = 0.026). On the twenty-eighth postoperative day, the mean difference was significant as well (5.9 ± 0.3 points and 5.4 ± 1.1 points, respectively). Conclusion: The preliminary results of this study showed that the zinc–L-carnosine mouthwash improved the quality of oral surgical wound healing. [ABSTRACT FROM AUTHOR]

Replantation is widely regarded as the first choice of treatment for finger amputations. However, if the fingertip of a traumatic finger amputation is missing after an injury, the following procedures are often performed to reconstruct this portion: flap surgery, stump surgery, or conservative treatment, including occlusive dressings. To our knowledge, no existing English literature reports using negative-pressure wound therapy (NPWT) to treat traumatic finger amputations. We postulated that NPWT may be applied as a conservative treatment for traumatic finger amputations, promoting the growth of granulation tissue and achieving early epithelialization of the fingertips. Among the case series of five patients, we included six injured fingers comprising two index, two middle, and two ring fingers. The fingertip of each traumatic finger amputation was either missing or highly crushed, making replantation impossible. To preserve finger length with conservative treatment, we adapted an NPWT device for finger amputations. It took an average of 22.7 days for the fingertips to epithelialize. Immediately after epithelialization, there was a slight decrease in sensory perception; however, all patients showed good recovery of sensory perception after 3 months. Range of motion remained unrestricted, with no reduction in grip strength. Patients were highly satisfied with their fingertip appearance. The regenerated nail exhibited slight deformation and shortening. No complications were observed. Our novel study regarding this new conservative treatment and its outcomes revealed that healing was achieved in a relatively short period; therefore, NPWT may serve as a new conservative treatment option in the future. [ABSTRACT FROM AUTHOR]

The rapidly expanding area of regenerative medicine may soon enter a new phase owing to developments in biomaterials and their application in generating new tissues. Chemicals and synthetic drugs are currently the subject of heated debate due to their effects on human health and the environment. Therefore, scientists seek out new products and procedures that are harmless to both the environment and human health concerns. Bio-based materials provide excellent functional qualities with a variety of applications. This study resulted in the development of a film with antimicrobial, hydrophilic, and anti-cancer properties, which is most beneficial in the medical sectors. In this study, we developed a blended biodegradable film containing agar and pectin (AP), with excellent surface functional properties framed through a casting technique. Additionally, the property can be changed by the addition of extract of hemigraphis alternata (HA) extract. The incorporation of extract in AP (APH) can be used for anti-cancer wound care therapy. The fabricated film is biodegradable, biocompatible, and non-toxic. This material is entirely based on a green methodology, and it was prepared in a concise manner without the use of any hazardous solvents. Based on the overall nature of biopolymer, the prepared material is a promising alternative to our society. [ABSTRACT FROM AUTHOR]

Complex and chronic wounds represent a highly prevalent condition worldwide that requires a multimodal and interdisciplinary treatment approach to achieve good functional and aesthetic outcomes. Due to increasing costs of health care, an aging population and an increase in difficult-to-treat microbial colonization of wounds, complex wounds will become a substantial clinical, social and economic challenge in the upcoming years. In plastic reconstructive surgery, a variety of dermal skin substitutes have been established for clinical use. Since its approval as a dermal skin substitute in Germany, NovoSorb® Biodegradable Temporising Matrix (BTM) has become a valuable therapeutic option for the treatment of full-thickness wound defects. The clinical data published to date are limited to case reports and small-scale case series with the main focus on single wounds. The aim of this single-center study was a retrospective analysis of our own patient collective that has received treatment with BTM for complex wounds. Overall, BTM showed to be a reliable and versatile reconstructive option, especially for patients with multiple co-morbidities and microbiologically colonized wounds. Although the preliminary findings have produced promising results, further investigation and research are warranted regarding long-term outcomes and additional clinical applications. [ABSTRACT FROM AUTHOR]

Objective: To describe the effect of autologous blood patch (3CP, Reapplix, Denmark) treatments as a supplement to standard care among patients with hard-to-heal wounds in an outpatient multidisciplinary wound centre (MWC). Method: The 3CP is an autologous leukocyte- and platelet-rich fibrin patch, which is applied directly into the wound bed. Patients with a wound duration >6 weeks and an unsatisfactory outcome following standard care were considered. Weekly administration of the autologous blood patch was carried out and the wound size was measured using a picture-based area calculation program at three timepoints (first contact with the MWC, initiation of the autologous blood patch treatment and at the end of the autologous blood patch treatment). The effect was followed for one year or until healing. Results: From June 2016 to September 2019, 36 patients were included. The median age was 63.5 years (interquartile range (IQR): 58–70), and 14 patients were female (38.9%) and 22 were male (61.1%). Median wound duration pre-autologous blood patch was 21.5 weeks (IQR: 11.1–50.0) and median treatment time was 3.4 weeks (IQR: 1.6–5.3). Half of the patients (50%, 18/36) healed in <20 weeks, 30.6% (11/36) healed in 20–52 weeks and 19.4% (7/36) did not heal within a year. There was a significant difference between the mean wound area (±standard deviation) at the start of autologous blood patch treatment and the area at the end: 2.85±3.71cm2 versus 1.65±2.37cm2, respectively (p=0.0017). Treatment was stopped prematurely for 5/36 patients (reasons included wound infection, major amputation, procedure discomfort or withdrawal without reason). Conclusion: Among MWC patients with hard-to-heal wounds not responding to standard care, autologous blood patch treatment as a supplement to standard wound care expedited wound healing. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this study, an environment‐friendly, energy‐saving, and useful synthesis of zinc oxide (ZnO) nanoparticles (NPs), titanium oxide (TiO2) NPs, and mixed Zn/TiOx‐NPs was achieved using underwater pulse discharge plasma. The obtained NPs were characterized by UV spectroscopy, X‐ray diffraction, scanning electron microscopy, and transmission electron microscopy. In the discharge cell, the viscose patch is impregnated with ZnO, TiO2, and mixed Zn/TiOx‐NPs in a one‐step process. The adhesive patch is effective against Escherichia coli, Staphylococcus albicans, and Bacillus subtilis. The viscose patch containing 0.22% Zn/TiOx‐NPs demonstrated the highest antimicrobial activity. These antimicrobial patches can be used to treat and cover wounds susceptible to infection. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetic wounds are the most critical complication in patients with diabetes, which often lead to hospitalization and limb amputations. Diabetic foot ulcers (DFU) is characterized by infections, prolonged inflammation, and a delayed wound healing process. Different types of medical procedures including surgical therapy, drug delivery, stem cell therapy, and wound dressings are used to manage DFU. Bioactive dressings such as hydrogels, nanofiber, and collagens are promising materials that can accelerate the healing process. The wound dressing materials can also be loaded with bioactive molecules like nucleic acids. MicroRNAs (miRNAs) are small non-coding RNA molecules that have recently emerged as regulators of impaired wound healing and could be a target for DFU treatment. miRNA therapeutics can be delivered to the wound region using different delivery systems such as exosomes and nanoparticles. These wound dressings have a high potential for treating diabetic wounds by topical delivery of certain miRNAs in a sustained release manner. [ABSTRACT FROM AUTHOR]

Purpose: To explore the role of vacuum assisted closure (VAC) therapy versus conventional dressings in the Fournier's gangrene wound therapy. Patients and Methods: This is a retrospective multi-institutional cohort study. Data of 92 patients from nine centers between 2007 and 2018 were retrospectively analyzed. After surgery, patient having a local or a disseminated FG were managed with VAC therapy or with conventional dressings. The 10-weeks wound closure cumulative rate and OS were analyzed. Results: Of the 92 patients, 62 (67.4%) showed local and 30 (32.6%) a disseminated FG. After surgery, 19 patients (20.7%) with local and 14 (15.2%) with disseminated FG underwent to VAC therapy; 43 (46.7%) with local and 16 (17.4%) with disseminated FG were treated using conventional dressings. The multivariable logistic regression analysis demonstrated that the VAC in patients with disseminated FG led to a higher cumulative rate of wound closure than patients treated with no-VAC (OR = 6.5; 95% CI 1.1–37.4, p = 0.036). The Kaplan–Meier survival curves for the OS showed a significant difference between no-VAC patients with local and disseminated FG (OS rate at 90 days 0.90, 95% CI 0.71–0.97 vs 0.55, 95% CI 0.24–0.78, respectively; p = 0.039). Cox regression confirmed that no-VAC patients with disseminated FG showed the lowest OS (hazard ratio adjusted for sex and age HR = 3.4, 95% CI 1.1–10.4; p = 0.033). Conclusions: In this large cohort study, VAC therapy in patients with disseminated FG may offer an advantage in terms of 10-weeks wound closure cumulative rate and OS at 90 days after initial surgery. [ABSTRACT FROM AUTHOR]

Objective: A score to identify local wound infections was developed by a panel of experts from seven European countries. The Therapeutic Index for Local Infections (TILI) score was designed for health professionals who are not specialised in wound care. This study was carried out to test the validity of the TILI score in everyday practice. Method: Content validity was analysed by means of evaluation by a panel of experts, individually and face-to-face, followed by a European multicentred, retrospective, observational study. Participating clinicians sent anonymised copies of completed TILI scores for patients with leg ulcers along with a photograph of the wound for analysis by two blinded reviewers. Concordance (Kappa index) and convergent criterion validity (sensitivity, specificity, accuracy, Youden's J Index and receiver operator characteristic (ROC) or area under the curve (AUC) curve) were calculated to construct validity and reliability. Results: A total of 307 patients with leg ulcers from seven institutions in five European countries were included in this retrospective analysis. It was shown that the diagnosis of local wound infection could be documented well with five of the six clinical criteria included in the TILI score. By summing up these facultative criteria in comparison with any direct criteria that may be present, there would have been an indication for local antiseptic wound therapy in 22% of patients examined. Conclusions: The results show that the TILI score is concordant with the expert assessment of patients and with good diagnostic characteristics. Thus, the easy-to-use TILI score can now be used in the daily routine practice of health professionals to diagnose local wound infections. Declaration of interest: JD has received financial support for lectures, consultations and/or studies from 4M, Coloplast, Convatec, Draco, Engelhardt, Paul Hartmann, KCI, Lohmann&Rauscher, Mölnlycke, SastoMed and Urgo. JVS has received lecture fees and travel-cost reimbursements from Mundipharma, Histocell, Quesper and Urgo. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Gerontologie und Geriatrie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Journal of Wound Management / Leczenie Ran is the property of Evereth Publishing Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Breast surgery complications are important not only due to their morbidity and psychological impact, but also the delays that can occur for adjuvant treatment or the loss of implants in severe cases. There is growing evidence that negative pressure dressing on closed wounds can reduce the complications following surgery. Methods: This study aimed to assess whether negative-pressure dressings reduced complications in patients undergoing bilateral reduction mammoplasty with randomization of a side to negative pressure and standard care, fixation strips, on the contralateral side. This allowed patients to act as their own controls. Results: This study found a significant reduction in the rate of wound complications but used a wide definition for what constituted a wound complication. Discussion: This finding is mirrored in existing work with studies showing that negative-pressure therapy is a cost-effective intervention. Further work is required to validate this finding and targeting those at highest risk may be preferential. [ABSTRACT FROM AUTHOR]

Aim: This case series aims to give insight into the impact of single-use Negative Pressure Wound Therapy (NPWT) (PICO 7) on improving service delivery to patients with complicated diabetic foot ulcers in a UK NHS Trust. Method: Service delivery was modified to utilise the new features available on the single-use NPWT (PICO 7) device. The features of the device and how to use it was explained and demonstrated to all patients and carers involved in the case series. As part of normal, best practice, advice and guidance on deteriorating characteristics of an ulcer as well as emergency symptoms, such as spreading infection, were given. Patients were also given all relevant services' contact details. Discussion/results: Four DFU patients were included in this case series. In all cases, the adoption of single-use NPWT resulted in changes to the treatment pathway, leading to improved efficiency. Patients or their carers were able to self-assess the dressing's status by use of the dressing-full indicator. Contact by phone determined the need for an outpatient clinic visit or a district nurse visit. Consequently, patients only had to attend out-patient clinics when necessary and dressings were only changed when needed. This gave economic benefits associated with a reduced frequency of out-patient clinic visits of 1 to 2 per patient over the treatment period and a reduction in the frequency of district nurse visits from 3-4/week to 1-2/week. Over a 12-week treatment period, this could deliver clinical time and cost savings. Conclusion: Utilisation of the single-use NPWT device gives the potential to improve service delivery in patients with complicated DFUs and infers efficiency savings. [ABSTRACT FROM AUTHOR]

The global market for advanced wound care products is large and growing rapidly. International industry analysts estimate the global wound care market at US$20.3b, and $2.6b in Australia. Growth in the market is robust, estimated at more than 5% annually, attributed not only to demographic changes (that is to say, ageing, diabetes, obesity), but also to rising health care costs. This has led to a plethora of new products, approaches and treatments being trialled and marketed for the treatment of non-healing, chronic wounds. However, this smorgasbord of approaches for wound management brings with it its own issues and challenges as clinicians try to keep abreast of new treatment options and management choices. While some of these advanced wound therapies have been subject to rigorous clinical trials, many have little evidence to support their use in wound care situations. In this review we have focussed on some of the new approaches and therapies which are currently under development or in clinical use for the treatment of chronic wounds and burns. [ABSTRACT FROM AUTHOR]

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Copyright of HeilberufeSCIENCE is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diabetic foot ulceration currently costs around £600--£700 million per year in the NHS alone (Diabetes UK, 2012; NHS Digital, 2016). Both in the UK, and globally, diabetes incidence is increasing apace with costs set to spiral in the coming years. Hyperbaric oxygen therapy was first used in the field of wound care in the 1960s, and the association between oxygen and wound healing has since been investigated further and applied to a range of wounds. This article examines the role of oxygen -- the NATROX® Oxygen Wound Therapy System -- in wound healing, and looks at the impact of increased oxygenation on ulcer healing through a case series where the NATROX system was used in patients with diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Electroceutical Suture Microstructured fiber, reported in article number 2201854 by Louis A. van der Elst, Merve Gokce, and co‐workers, autonomously induces an electric field to a wound, suppressing the proliferation of multiresistant bacteria. The fiber, weaved into gauze, spooled into a sponge, or used as a surgical suture, provides a non‐drug, easy‐to‐produce enhancement to an antibiotic wound treatment. [ABSTRACT FROM AUTHOR]

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Copyright of Trauma und Berufskrankheit is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Heilberufe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ideally, all chronic wounds would be prevented as they can become life threatening complications. The concept that a wound produces a 'current of injury' due to the discontinuity in the electrical field of intact skin provides the basis for the concept that electrical stimulation (ES) may provide an effective treatment for chronic wounds. The optimal stimulation waveform parameters are unknown, limiting the reliability of achieving a successful clinical therapeutic outcome. In order to gain a more thorough understanding of ES for chronic wound therapy, systematic evaluation using a valid in vivo model is required. The focus of the current paper is development of the flexible modular surface stimulation (MSS) device by our group. This device can be programed to deliver a variety of clinically relevant stimulation paradigms and is essential to facilitate systematic in vivo studies. The MSS version 2.0 for small animal use provides all components of a single-channel, programmable current-controlled ES system within a lightweight, flexible, independently-powered portable device. Benchtop testing and validation indicates that custom electronics and control algorithms support the generation of high-voltage, low duty-cycle current pulses in a power-efficient manner, extending battery life and allowing ES therapy to be delivered for up to 7 days without needing to replace or disturb the wound dressing. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The molecular circuitries controlling the process of skin wound healing have gained new significant insights in recent years. This knowledge is built on landmark studies on skin embryogenesis, maturation, and differentiation. Furthermore, the identification, characterization, and elucidation of the biological roles of adult skin epithelial stem cells and their influence in tissue homeostasis have provided the foundation for the overall understanding of the process of skin wound healing and tissue repair. Among numerous signaling pathways associated with epithelial functions, the PI3 K/ Akt/m TOR signaling route has gained substantial attention with the generation of animal models capable of dissecting individual components of the pathway, thereby providing a novel insight into the molecular framework underlying skin homeostasis and tissue regeneration. In this review, we focus on recent findings regarding the mechanisms involved in wound healing associated with the upregulation of the activity of the PI3 K/ Akt/m TOR circuitry. This review highlights critical findings on the molecular mechanisms controlling the activation of mTOR, a downstream component of the PI3 K- PTEN pathway, which is directly involved in epithelial migration and proliferation. We discuss how this emerging information can be exploited for the development of novel pharmacological intervention strategies to accelerate the healing of critical size wounds. [ABSTRACT FROM AUTHOR]

Copyright of Der Hautarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vacuum assisted closure (VAC) is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Materials and Methods: Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days during the study period. Patient satisfaction and formation of granulation tissue were also assessed. Results: Improvement of the wound in the form of reducing the diameter and depth and increasing proliferation of granulation tissue was significant in most of the patients of the VAC group after two weeks. Satisfaction of patients in the VAC group was evaluated as excellent as no amputation was done in this group. Wagner score was reduced in both the study groups, although this decrement was not significant in the moist dressing group. Conclusion: VAC appears to be as safe as and more efficacious than moist dressing for the treatment of diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Chitosan is currently proposed to be one of the most promising polymers in wound dressing development. Our research focuses on its potential as a vehicle for nano-delivery systems destined for burn therapy. One of the most important features of wound dressing is its bioadhesion to the wounded site. We compared the bioadhesive properties of chitosan with those of Carbopol, a synthetic origin polymer. Chitosan-based hydrogels of different molecular weights were first analyzed by texture analysis for gel cohesiveness, adhesiveness and hardness. In vitro release studies showed no difference in release of model antimicrobial drug from the different hydrogel formulations. Bioadhesion tests were performed on pig ear skin and the detachment force, necessary to remove the die from the skin, and the amount of remaining formulation on the skin were determined. Although no significant difference regarding detachment force could be seen between Carbopol-based and chitosan-based formulations, almost double the amount of chitosan formulation remained on the skin as compared to Carbopol formulations. The findings confirmed the great potential of chitosan-based delivery systems in advanced wound therapy. Moreover, results suggest that formulation retention on the ex vivo skin samples could provide deeper insight on formulation bioadhesiveness than the determination of detachment force. [ABSTRACT FROM AUTHOR]

Vascular insufficiency is a major reason for the development and perpetuation of chronic wounds. It is plausible that agents that cause vasodilation may promote wound healing. The OPAL process is where ripened fruit is treated by homogenisation, heat treatment, alkalisation and filtration of the pulp. OPAL 001 uses papaw and peach fruits mixed 10: 1 by volume. This article presents four cases of non-healing ulcers that provide clinical observational support for the hypothesis that OPAL products facilitates healing by causing vasodilation of the blood vessels around the wound. [ABSTRACT FROM AUTHOR]

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Background: An ideal topical formulation for wound therapy does not exist. The aim of this study was to develop a novel improved therapeutic option for the treatment of acute and chronic wounds. Methods: A transparent wound gel which is in a liquid state below and in a gel state at or above room temperature was developed. Forty-four patients were included in this open randomized controlled single-center study. Flammazine™ served as control in the treatment of skin graft donor sites. Wounds were assessed for time of dressing change and overall satisfaction of patients and health care providers. The data were analyzed using the nonparametric Mann-Whitney test. Results: The wound gel proved to be superior in comparison with Flammazine with respect to wound assessment (p = 0.002), staining (p = 0.007), leaking (p = 0.032) and smell (p = 0.034). Flammazine showed favorable results regarding the parameters dehydration of the dressings (p = 0.012) and wound adherence (p = 0.005). The evaluation of the overall dressing change process showed no significant differences. Conclusion: The thermoreversible wound gel containing polyhexanide allows for good handling and wound assessment. This study demonstrated a high satisfaction level of patient and health care providers, and the wound gel proved an effective alternative to commonly used treatments. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Hyaluronan is a natural polymer that was introduced to wound therapy. Formulations based on synthetic polymers such as methylcellulose (MC) and polyacrylic acid (PA) containing hyaluronan (HA) were proposed for the development of prospective wound-healing preparations. The formulations of different carrier concentrations containing a fixed amount of HA were prepared, and their viscosity was measured. The HA release was evaluated by employing the apparatus paddle over a disc. The hydrogels were introduced to the donor chamber, and HA was released to the pH = 7.4 buffer. The amount of HA released was obtained using the ELISA test. The release was analyzed on the basis of different kinetic models: zero-, first-, and second-order kinetics, as well as Higuchi and Korsmeyer–Peppas equations. The release rate constants and the half release time were calculated from these equations. According to the value of the coefficient of the determination, the best model describing the observed process was selected. The comparison between the dissolution profiles was carried out by calculating the difference factor f1 and the similarity factor f2. The interaction between the hydrogel components was investigated by Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) measurements. The study revealed that the zero-order equation best described the release of HA from the formulations studied. The FTIR research and the DSC study showed the intermolecular interaction between HA chains in MC-based compositions, as well as between HA and the synthetic polymer in the PA-based formulations. The study revealed that the formulation with a higher concentration of synthetic polymer may prolong the release of HA. The obtained results indicated that the proposed hydrogels have potential for wound healing and may accelerate skin regeneration. [ABSTRACT FROM AUTHOR]

Copyright of Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The morbidity and mortality from chronic wounds of varying etiology present a significant health care problem. Multiple local disturbances and systemic disease can impair wound healing. Recently, experiments with tissue cultures and animal models have revolutionized the understanding of wound healing and the pathophysiological processes involved. In cooperation with clinicians and industrial partners novel therapeutic concepts including the topical application of growth factors and cell therapies have been developed. Cytokines that have been tested in clinical studies include epidermal growth factor, platelet-derived growth factor and fibroblast growth factor. These studies showed that an important aspect of the growth factor wound healing paradigm is the effective delivery of these polypeptides to the wound site. Current drug delivery strategies suffer from the inherent loss of drug activity due to the combined effects of physical inhibition and biological degradation. A molecular genetic approach in which genetically modified cells synthesize and deliver the desired growth factor in a time-regulated manner is a powerful means to overcome the limitations associated with the topical application of recombinant growth factor proteins.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The German S3- guideline on local therapy of leg ulcers and diabetic foot ulcers is in the process of being updated. Major goals are to improve the guidelines' applicability and to take steps towards a living guideline according to current methodological standards. The aim of this article is to describe the main measures to achieve these goals. Methods: The context of the guideline in the field of local wound care and the stakeholder requirements are briefly described. Based on a derived framework, the project team adjusted the methods for the guideline. Results: Main adjustments are more specific inclusion criteria, online consensus meetings and the use of an authoring and publication platform to provide information in a multi-layered format. A new set of practice-oriented key questions were defined by the guideline panel to foster the formulation of action-oriented recommendations. Conclusions: The set of new key questions addressing practical problems and patients' preferences as well as the adjustments made to improve not only the guidelines' applicability, but also the feasibility of the further dynamic updating processes in the sense of a living guideline, should be steps in the right direction. [ABSTRACT FROM AUTHOR]

A liposomes-in-hydrogel system as an advanced wound dressing for dermal delivery of curcumin was proposed for improved chronic wound therapy. Curcumin, a multitargeting poorly soluble active substance with known beneficial properties for improved wound healing, was incorporated in deformable liposomes to overcome its poor solubility. Chitosan hydrogel served as a vehicle providing superior wound healing properties. The novel system should assure sustained skin delivery of curcumin, and increase its retention at the skin site, utilizing both curcumin and chitosan to improve the therapy outcome. To optimize the properties of the formulation and determine the effect of the liposomal charge on the hydrogel properties, curcumin-containing deformable liposomes (DLs) with neutral (NDLs), cationic (CDLs), and anionic (ADLs) surface properties were incorporated in chitosan hydrogel. The charged DLs affected the hydrogel's hardness, cohesiveness, and adhesiveness. Importantly, the incorporation of DLs, regardless of their surface charge, in chitosan hydrogel did not decrease the system's bioadhesion to human skin. Stability testing revealed that the incorporation of CDLs in hydrogel preserved hydrogel´s bioadhesiveness to a higher degree than both NDLs and ADLs. In addition, CDLs-in-hydrogel enabled the most sustained skin penetration of curcumin. The proposed formulation should be further evaluated in a chronic wound model. [ABSTRACT FROM AUTHOR]