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The pathogenesis of chronic wounds (CW) involves a multifaceted interplay of biochemical, immunological, hematological, and microbiological interactions. Biofilm development is a significant virulence trait which enhances microbial survival and pathogenicity and has various implications on the development and management of CW. Biofilms induce a prolonged suboptimal inflammation in the wound microenvironment, associated with delayed healing. The composition of wound fluid (WF) adds more complexity to the subject, with proven pro-inflammatory properties and an intricate crosstalk among cytokines, chemokines, microRNAs, proteases, growth factors, and ECM components. One approach to achieve information on the mechanisms of disease progression and therapeutic response is the use of multiple high-throughput 'OMIC' modalities (genomic, proteomic, lipidomic, metabolomic assays), facilitating the discovery of potential biomarkers for wound healing, which may represent a breakthrough in this field and a major help in addressing delayed wound healing. In this review article, we aim to summarize the current progress achieved in host-microbiome crosstalk in the spectrum of CW healing and highlight future innovative strategies to boost the host immune response against infections, focusing on the interaction between pathogens and their hosts (for instance, by harnessing microorganisms like probiotics), which may serve as the prospective advancement of vaccines and treatments against infections.

Chronic lower limb ulcers are defined by a longstanding evolution, with no tendency to heal after three months of proper treatment or still not completely healed after twelve months Chronic wounds may be classified as typical and atypical. The majority of the typical chronic ulcers are localized on the lower limbs and are caused by chronic venous insufficiency, followed infrequency by other wound types arterial, of mixed etiology-arterial and venous, pressure, neuropathic and diabetic foot ulcers. Standard therapy of chronic ulcers begins with a few general principles which are applicable regardless of the lesions' cause: tissue debridement, control of the infection, moisture balance and management of the edges of the wound Negative pressure wound therapy is an alternative method shown to be effective in the treatment of wounds of various etiologies The appropriate negative pressure therapy type is chosen according to the clinical situation of the patient, the characteristics of the wound and the objective of the treatment. We aim to review the applications of negative pressure wound therapy in the management of typical chronic lower limb ulcers its impact on skin healing its adverse reactions as well as to provide information from our experience with this device. [ABSTRACT FROM AUTHOR]

Systemic sclerosis is a chronic autoimmune condition of the connective tissue characterized by the appearance of inflammatory changes vascular abnormalities and fibrosis often with a multisystemic involvement. The ongoing vasculopathy, along with functional vasoconstriction and tissular damage, predisposes to ischemia, necrosis and skin ulcers There is little information in the scientific literature regarding the benefits of negative pressure therapy in the healing process of skin ulcers in patients with systemic sclerosis. We report the case of' a 49-year-old female patient, who presented in our dermatology department for painful bilateral plantar ulcers the first one progressing for 9 months with local signs of infection and a recent rapid unfavorable evolution The presence of Raynaud's phenomenon, sclerodactyly and post-ulcerative digital scar lesions on both hands specific facial skin changes, specific autoimmune positive tests (positive antinuclear antibodies positive Anti-SCL-70 antibodies), histopathological examination and investigations to assess disease extension (cardiovascular, pulmonary and others confirmed the diagnosis of severe systemic sclerosis with vascular, lung and skin involvement. Arterial and venous Doppler ultrasound examination of the lower limbs revealed the presence of femoral vascular axes stenosis and the presence of distal popliteal and interdigital flows The bacteriological examination revealed an infection of skin ulcers with Staphylococcus aureus and Streptococcus agalactiae. Therapeutic management was complex by merging systemic treatment (antibiotic therapy according to antibiogram results, alprostadil vasodilator treatment) with local therapy (surgical debridement, topical antiseptics topical application of skin-neutral ointment dressing in adittion to negative pressure wound therapy). The evolution was favorable with complete wound healing within 3 weeks. In conclusion negative pressure therapy has proven to be beneficial in healing plantar ulcers in a systemic sclerosis patient by: diminishing pain, removing the exudate, stimulating the development of granulation tissue and maintaining a sterile optimal local environment throughout the whole healing process. [ABSTRACT FROM AUTHOR]

Aim: To report the case of a 49-year-old female patient diagnosed with systemic scleroderma, with healing of bilateral plantar ulcerations by the use of negative pressure therapy. Methods: The anamnesis and clinical examination revealed chronic bilateral, intensely painful plantar ulcerations, with local signs of infection, progressing for 9 months, with a recent rapid extension in size and depth. The presence of Raynaud's phenomenon, sclerodactyly, and post-ulcerative digital cicatricial lesions on the hands, Mauskopf facies, positivity of anti-SCL70+ antibodies, and histopathological examination established the diagnosis of systemic scleroderma. Arterial and venous Doppler ultrasound examination of the lower limbs revealed femoral vascular axes stenosis and the presence of distal popliteal and interdigital flows. Wound bacteriological examination was positive for Staphylococcus aureus and Streptococcus agalactiae. Results/ Discussion: Therapeutic management was complex by systemic treatment (antibiotics, alprostadil as vasodilator) and local therapy (surgical debridement, topical antiseptics, modern dressings, negative pressure wound therapy). The evolution was favorable with complete wound healing within 3 weeks. Conclusion: Negative pressure therapy has proven to be beneficial in healing plantar chronic ulcers in a systemic sclerosis patient by: diminishing pain, removing the exudate, stimulating the development of granulation tissue, and maintaining a sterile optimal local environment throughout the whole healing process. There is little information in the scientific literature about the usefulness of negative pressure therapy in healing skin ulcers in patients with systemic scleroderma. This work was supported by a grant of the Ministry of Research, Innovation and Digitization, CNCS/CCCDI -- UEFISCDI, project number PN-III-P1-1.1-PD-2019-1225, within PNCDI III. [ABSTRACT FROM AUTHOR]