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Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic acid, collagen, alginates, and polymers enriched with polyhexamethylene biguanide, chitin, and chitosan derivatives, create a conducive environment for healing, promoting moisture balance, pH regulation, oxygen permeability, and fluid management. Interactive dressings further enhance targeted action by serving as substrates for bioactive agents. The continuous evolution of BDs, with new products introduced annually, underscores the need for updated knowledge in wound care. To facilitate dressing selection, a practical algorithm considers wound exudate, infection probability, and bleeding, guiding clinicians through the process. This algorithm aims to optimize wound care by ensuring the appropriate selection of BDs tailored to individual patient needs, ultimately improving outcomes in wound management. [ABSTRACT FROM AUTHOR]

The reconstruction of patients who possess multi morbid medical histories remains a challenge. With the ever-increasing number of patients with diabetes, infections, and trauma, there is a consistent need for promotion of soft tissue healing and a reliable substrate to assist with every aspect of soft tissue reconstruction, as well as the loss of fascial domain. Several proprietary products filled some of these needs but have failed to fulfill the needs of the clinician when faced with reconstructing multiple soft tissue systems, such as the integument and the musculoskeletal system. In this paper we discuss the use of decellularized human dermis (DermaPure®, Tissue Regenix, Universal City, TX, USA) through which a unique human tissue processing technique (dCELL® technology, Tissue Regenix, Universal City, TX, USA) and the creation of multiple product forms have proven to exhibit versatility in a wide range of clinical needs for successful soft tissue reconstruction. The background of human tissue processing, basic science, and early clinical studies are detailed, which has translated to the rationale for the success of this unique soft tissue substrate in orthoplastic reconstruction, which is also provided here in detail. [ABSTRACT FROM AUTHOR]

Summary: Recognition of the role that biofilms play in the persistence of wounds and lack of response to therapy in horses is increasing. Prevention of biofilm development in the early stages of wound care involves three primary strategies: wound debridement and cleansing to reduce bacterial counts in the wound bed, appropriate use of advanced wound dressings and implementation of topical antimicrobial agents. Once formed, eradication of biofilms requires elimination to improve the wound environment for contraction and epithelialisation while not further harming the native cells integral to the healing process, which is achieved predominantly through repeated lavage and debridement combined with topical antimicrobial therapy. Pseudomonas, Enterococcus and Staphylococcus bacterial species have been most commonly identified in equine wounds with delayed healing. This review will establish why and how biofilms form, how to recognise clinical indications that biofilms have formed in equine wounds and review current diagnostic options and biofilm‐based wound care strategies to eradicate biofilms. Clinical scenarios for cases in which biofilms developed and were successfully treated will be presented. This review will advance practitioners' understanding of the presence and role of biofilms in equine wounds and provide an updated summary of recommended treatment strategies. [ABSTRACT FROM AUTHOR]

Sarah Jane Palmer describes the powerful impact diet can have on the capability of a wound to heal itself. A wide range of nutrients can improve healing, yet malnutrition in everyday diet, regardless of a person's weight, can significantly delay or prevent healing. This article explores wound types, such as chronic wounds and burns, and discusses immunonutrition. [ABSTRACT FROM AUTHOR]

Debridement is a core component of chronic wound management. Although various debridement methods exist, each carries a unique patient risk level. This article discusses the different normal tissue components that are critical to safe debridement practice, various methods of wound debridement for nurses, and the importance of an interprofessional team and consulting a wound specialist. [ABSTRACT FROM AUTHOR]

The concept of macromolecules, which is applied to synthetic and natural polymers, allows for various contemporary polymeric materials and inventive uses. A dynamic structure of macromolecules called the extracellular matrix (ECM) maintains tissues and organs functioning. The cell therapy procedure known as wound healing involves depositing ECM components such as collagen, fibronectin, and laminin. The clinical assessment and management of wounds remain challenging despite the introduction of numerous therapeutic regimens because of their laboriously prolonged treatment requirements and complex wound‐healing mechanisms using macromolecules of a specific type, such as proteins, carbohydrates, lipids, and nucleic acids. Additionally, proteins affect the wound site's mechanical characteristics, such as tensile strength, elasticity, and permeability, which impact the effectiveness and success of wound healing. The main goal of this article is to give a current overview of how therapeutic alternatives have evolved using cutting‐edge innovative techniques for the healing and treatment of wounds. In this article, we have covered different types of macromolecules, how diet affects the wound, what causes wounds, and how macromolecules can help, and how to treat wounds. [ABSTRACT FROM AUTHOR]

Wound healing is a complex process influenced by age, systemic conditions, and local factors. The wound microbiota's crucial role in this process is gaining recognition. This concise review outlines wound microbiota impacts on healing, emphasizing distinct phases like hemostasis, inflammation, and cell proliferation. Inflammatory responses, orchestrated by growth factors and cytokines, recruit neutrophils and monocytes to eliminate pathogens and debris. Notably, microbiota alterations relate to changes in wound healing dynamics. Commensal bacteria influence immune responses, keratinocyte growth, and blood vessel development. For instance, Staphylococcus epidermidis aids keratinocyte progression, while Staphylococcus aureus colonization impedes healing. Other bacteria like Group A Streptococcus spp. And Pseudomonas affect wound healing as well. Clinical applications of microbiota-based wound care are promising, with probiotics and specific bacteria like Acinetobacter baumannii aiding tissue repair through molecule secretion. Understanding microbiota influence on wound healing offers therapeutic avenues. Tailored approaches, including probiotics, prebiotics, and antibiotics, can manipulate the microbiota to enhance immune modulation, tissue repair, and inflammation control. Despite progress, critical questions linger. Determining the ideal microbiota composition for optimal wound healing, elucidating precise influence mechanisms, devising effective manipulation strategies, and comprehending the intricate interplay between the microbiota, host, and other factors require further exploration. [ABSTRACT FROM AUTHOR]

Hard-to-heal wounds can be detrimental to patients' quality of life. Currently, there is scarcity of therapeutic alternatives to mainstay surgical treatment, which uses the principles of tissue debridement, temporary wound coverage, and subsequent tissue reconstruction. Here, a new approach is proposed that harnesses the regenerative power of autologous peripheral blood, through a process termed hypoxia-adjusted in vitro preconditioning. The effectiveness of this method is demonstrated with six cases of surgical wounds, including two cases of large full-thickness dermal wounds that developed as a result of skin necrosis following abdominoplasty and buttock-lift procedures in heavy smokers, as well as a case of extensive inflammatory tissue damage that occurred following breast surgery. While these wounds differed in size (4-160 cm²), geometry and location, all of them could be managed conservatively with topical application of growth factor-enriched hypoxia preconditioned serum derived from the patient's own peripheral blood. This treatment led to complete wound closure by latest 135 days. The finding of complete skin regeneration even in large (>10 cm²), full-thickness wounds, where initially no dermal tissue was available in the wound bed, strongly suggests that the treatment targeted key cellular regenerative mechanisms, including differentiation, angiogenesis, granulation tissue induction, contraction and epithelialization. The method is readily clinically applicable, cost effective, and overcomes limitations of the classic reconstructive approach. [ABSTRACT FROM AUTHOR]

Background: Wounds inflict pain and affect human health causing high expenditure on treatment and management. Herbal crude extracts are used in traditional medicine as a treatment for wounds and other illnesses. However, the progress in the use of plants has been deterred due to their poor solubility and poor bioavailability requiring administration at high doses. It has been established that nanoencapsulation of herbal products in nanocarriers (size 1 nm to 100 nm) such as nanofibers, nanoparticles, nanospheres, and nanoliposomes greatly improves their efficacy. Due to their small and large surface area, nanocarriers are more biologically active, improve bioavailability, protect the drug from deterioration, and release it to the targeted site in a sustainable manner. Aim: The review aims to collate and appraise evidence on the efficacy of nano encapsulated herbal extracts in the treatment of induced wounds in animal models. Methods: The review will be protocol-driven and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols (PRISMA-P) and protocol guidelines for systematic review and meta-analysis for animal intervention studies. The final review will be conducted and reported with reference to PRISMA 2020 statement. Studies will be searched in Pub Med, ProQuest, Web of Science, Medline Ovid, EMBASE, and Google Scholar. The PRISMA flow criteria will be followed in screening the articles for inclusion. Data extraction form will be designed in Excel spreadsheet 2013 and data extracted based on the primary and secondary outcomes. Risk of bias assessment will be done using SYRCLE's risk of bias tool for animal studies. Data analysis will be done using narrative and quantitative synthesis. Expected results: We hope to make meaningful comparisons between the effectiveness of the herb-loaded nanomaterials and other interventions (controls) in the selected studies, based on the primary and secondary outcome measures. We expect that these findings to inform clinical practice on whether preclinical studies show enough quality evidence on the efficacy and safety of herbal-loaded nanomaterials that can be translated into clinical trials and further research. Systemic review registration: PROSPERO 330330. The protocol was submitted on the 11th of May 2022. [ABSTRACT FROM AUTHOR]

Aim: The current research aimed to evaluate the potential effect of adding platelet-rich fibrin (PRF) to the decellularized bovine pericardium (DBP) on the distal limb of donkeys' full-thickness cutaneous wounds healing (Equus asinus). Materials and Methods: Healthy male donkeys (n = 12) were used in this study. Under general anesthesia, 6 cm2 full-thickness incisions were made on the middle dorsolateral surface of both forelimbs' metacarpi. The left forelimbs were control wounds, while the right wounds were treated with PRF/DBP. Control wounds were bandaged with a standard dressing after saline irrigation and were evaluated at days 4, 7, 10, 13, 16, 19, 22, 25, and 28 post-wounding. PRF/DBP-treated wounds were dressed with a combination of PRF/DBP at the first, second, and third weeks post-wounding. Clinical and histopathological examinations of the wounds were performed to assess the healing process. Additionally, the immunohistochemical evaluation and gene expression profiles of myofibroblastic and angiogenic genes (transforming growth factor-β1, vascular endothelial growth factor-A, fibroblast growth factor 7 (FGF-7), and collagen type 3α1) were analyzed. Results: PRF/DBP wounds had a significantly faster healing process (61.3 ± 2.6 days) than control wounds (90.3 ± 1.4 days) (p < 0.05). The immunohistochemical examination and gene expression profile revealed significant enrichment in PRF/DBP wounds compared to control wounds. Conclusion: PRF/DBP dressing can be considered a natural and cost-effective biomaterial for enhancing the recovery of donkeys' distal limb injuries. [ABSTRACT FROM AUTHOR]

Background: Necrotizing fasciitis (NF) is a serious infectious disease that can initially place the patient's life in danger and, after successful surgical and antibiotic treatment, leaves extensive wounds with sometimes even exposed bones and tendons. Autologous skin grafts are not always possible or require adequate wound bed preparation. Novel intact fish skin grafts (iFSGs; Kerecis® Omega3 Wound, Kerecis hf, Isafjördur, Iceland) have already shown their potential to promote granulation in many other wound situations. Faster wound healing rates and better functional and cosmetic outcomes were observed due to their additionally postulated anti-inflammatory and analgesic properties. Therefore, iFSGs may also be essential in treating NF. We present our initial experience with iFSGs in treating leg wounds after NF and review the literature for the current spectrum of clinical use of iFSGs. Case Presentations: We present two male patients (aged 60 and 69 years) with chronic or acute postsurgical extensive leg ulcers six weeks and six days after necrotizing fasciitis, respectively. Both suffered from diabetes mellitus without vascular pathologies of the lower limbs. A single application of one pre-meshed (Kerecis® Graftguide) and one self-meshed 300 cm2 iFSG (Kerecis® Surgiclose) was performed in our operation room after extensive surgical debridement and single circles of negative wound pressure therapy. Application and handling were easy. An excellent wound granulation was observed, even in uncovered tibia bone and tendons, accompanied by pain relief in both patients. Neither complications nor allergic reactions occurred. The patients received autologous skin grafting with excellent functional and cosmetic outcomes. Conclusions: iFSGs have the potential to play a significant role in the future treatment of NF due to the fast promotion of wound granulation and pain relief. Our experience may encourage surgeons to use iFSGs in NF patients, although high-quality, large-sized studies are still required to confirm these results. The observed effects of iFSGs on wounds associated with NF may be transferred to other wound etiologies as well. [ABSTRACT FROM AUTHOR]

Wounds are the loss or destruction of part of the body's tissue, if the wound is not treated it will lead to infection and may interfere with livestock production. The faster the healing process occurs, the less likely secondary infections are to develop and become more severe. Clinically, various treatments and medicines, mainly those of chemical origin, have been introduced to facilitate and accelerate the wound healing process, but their use is limited due to side effects or low efficiency. Some substances and active substances are used to accelerate the process, but in this case herbal or medicinal plants can be used as an alternative in treating wounds in livestock, these plants have long been used as herbal medicines for humans and livestock. Moringa leaves contain phytochemicals that have antioxidant, anti-inflammatory and antimicrobial activities that can help the wound healing process. Compounds in Moringa leaves that play a role in wound healing include flavonoids, saponins, tannins, antibacterial, antiseptic, antimicrobial, and polyphenolic compounds. This review discusses and explains Moringa leaves on their medicinal function in livestock. Wound healing is the most important property for organisms and is the process of cell recovery because poor wound healing can cause physical pain, discomfort, and also bring a series of psychological problems to livestock. In addition, wounds that are difficult to heal can cause a further decline in the quality of life of livestock and result in a heavy economic burden. [ABSTRACT FROM AUTHOR]

This study was designed to establish the composition of wound dressing based on poly(2‐hydroxyethylmethacrylate)‐chitosan (PHEM‐CS) hydrogels‐loaded cerium oxide nanoparticle (CeONPs) composites for cutaneous wound healing on nursing care of the chronic wound. The as‐synthesised PHEM‐CS/CeONPs hydrogels nanocomposites were characterised by using UV–visible spectroscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, and thermo gravimetric analysis. The influence of PHEM‐CS/CeONPs hydrogels nanocomposites on the gelation time, swelling ratio, in vitro degradation, and mechanical properties was investigated. The as‐prepared PHEM‐CS/CeONPs hydrogels nanocomposites dressing shows high antimicrobial activity against Staphylococcus aureus and Escherichia coli. Similar trends were observed for the treatment of biofilms where PHEM‐CS/CeONPs hydrogels nanocomposites displayed better efficiency. Furthermore, the biological properties of PHEM‐CS/CeONPs hydrogels nanocomposites had non‐toxic in cell viability and excellent cell adhesion behaviour. After 2 weeks, the wounds treated with the PHEM‐CS/CeONPs hydrogels nanocomposite wound dressing achieved a significant closure to 98.5 ± 4.95% compared with the PHEM‐CS hydrogels with nearly 71 ± 3.55% of wound closure. Hence, this study strongly supports the possibility of using this novel PHEM‐CS/CeONPs hydrogels nanocomposites wound dressing for efficient cutaneous wound healing on chronic wound infection and nursing care. [ABSTRACT FROM AUTHOR]

Epidermal growth factor (EGF) can be efficiently used in wound healing process; but the main obstacle of its clinical use is its susceptibility to proteolysis and maintaining its effective concentration in the site of action. In this study, chitosan nanoparticles containing EGF is formulated using a simple method to increase its stability in physiological pH as well as protect its biological activity and effectiveness in wound healing process. Nanoparticles with different ratios of chitosan/EGF were prepared and evaluated in vitro and in vivo. Obtained results showed nanoparticles with 2:1 ratio of chitosan/EGF were able to release 80% of encapsulated protein after 12 h. Cell proliferation study demonstrated that prepared nanoparticles could protect EGF functionality in physiological pH. In vivo results showed that nanoparticles with 2:1 ratio of chitosan/EGF could significantly accelerate the wound closure‐rate, re‐epithelialisation and collagen deposition. In conclusion, the designed nanoparticles in optimal ratio can be considered as a potential vehicle for EGF delivery to wounds with the aim of improving healing process. [ABSTRACT FROM AUTHOR]

While reticulated open cell foam (ROCF) is a well‐established dressing for negative pressure wound therapy (NPWT), there is the known potential for granulation tissue ingrowth if left in place for longer than 72 h. This may cause wound bed disruption, bleeding, and pain upon dressing removal. In addition, any retained foam fragments may elicit an adverse tissue reaction. A novel, easy to use dressing designed to utilise the advantages of ROCF while addressing its challenges has recently been created. This 7 day study investigated the utility of a novel NPWT dressing under longer‐duration wear circumstances while assessing the prevalence of tissue ingrowth and ease of dressing removal in full‐thickness excisional wounds utilising a porcine model. Histopathology and morphometry evaluations indicated thicker granulation tissue with, depending on the parameters assessed, either comparable or better tissue quality for wounds treated with the novel dressing. Greater re‐epithelialization levels were also evident compared with ROCF. Three‐dimensional imaging analysis indicated faster wound fill with a corresponding decrease in wound area with the novel dressing. Furthermore, tissue ingrowth was limited to only ROCF‐treated wounds, which was not unexpected in this longer‐duration wear study. The force required to remove the novel dressing was considerably lower compared with ROCF, correlating to the tissue ingrowth results. Results of this study illustrate that the novel dressing provided more favourable wound healing results compared with traditional ROCF. In addition, reduction in the risk of tissue ingrowth and low dressing peel force may allow it to be used as a longer‐wear dressing. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa can colonize the body when wounds disrupt the skin barrier, compromising immune status, and expressing virulence factors that aid its establishment in the host. Honey is highly medicinal and capable of promoting healing in infected wounds that defy conventional antibiotic therapy. This study assessed the antibacterial activities of honey against multi-drug resistant virulent P. aeruginosa isolates recovered from wounds. Sixty-one P. aeruginosa isolates were recovered, and their virulence factors were determined using phenotypic screening methods. Antibiotic susceptibility testing was evaluated with the Kirby-Bauer disc-diffusion method, while the antibacterial activities of honey were determined by agar-well and disc-diffusion techniques. The components of the honey samples were evaluated using Gas Chromatography-Mass Spectrometry (GC-MS). All isolates were multidrug-resistant (MDR) with 100% resistance to ticarcillin, tigecycline, and nitrofurantoin; the highest susceptibility to piperacillin, meropenem, and imipenem at 4.9%, 6.6%, and 9.8% respectively; and Multiple Antibiotic Resistance Indices (MARI) of = 0.2. All isolates produced hemolysin, but none produced DNase. All the sixty-one isolates extruded multiple virulence factors via phenotypic screening and 96.7% possessed = 50% of virulence determinants analyzed. GC-MS analyses revealed three variants of honey. The isolates exhibited resistance to the honey samples; the most effective honey sample types being H5 and H6. Possession of multiple virulence factors, multi-resistance to antibiotics, and to honey, which is well acclaimed for its wound healing characteristics by isolates raises the probability of invasion to deeper tissues and development of complications, underscoring the necessity to prevent contamination of wounds, a significant cause of morbidity and mortality. [ABSTRACT FROM AUTHOR]

We assessed the efficacy of polydeoxyribonucleotide (PDRN) in accelerating the healing of diabetic wounds in a murine model of streptozotocin (STZ)-induced diabetes. After the creation of diabetic wounds, the mice of the PDRN SC, PDRN IP and PBS groups received a subcutaneous, an intra-peritoneal injection of PDRN and a subcutaneous injection of PBS, respectively. After euthanasia, time-dependent changes in the wound diameter and histologic scores were measured and vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1) and collagen types I and III were assessed for their expression levels. The PDRN SC and the PDRN IP groups showed a significantly smaller diameter of diabetic wounds, significantly higher histologic scores, a significantly greater expression of VEGF, a significantly lower expression of TGF-β1 and a significantly greater expression of collagen types I and III as compared with the PBS group (p < 0.05 or 0.0001). In conclusion, PDRN might be effective in promoting the healing of diabetic wounds in a murine model of STZ-induced diabetes. [ABSTRACT FROM AUTHOR]

The skin serves as the body's first line of defense, guarding against mechanical, chemical, and thermal damage to the interior organs. It includes a highly developed immune response that serves as a barrier against pathogenic infections. Wound healing is a dynamic process underpinned by numerous cellular activities, including homeostasis, inflammation, proliferation, and remodeling, that require proper harmonious integration to effectively repair the damaged tissue. Following cutaneous damage, microorganisms can quickly enter the tissues beneath the skin, which can result in chronic wounds and fatal infections. Natural phytomedicines that possess considerable pharmacological properties have been widely and effectively employed forwound treatment and infection prevention. Since ancient times, phytotherapy has been able to efficiently treat cutaneous wounds, reduce the onset of infections, and minimize the usage of antibiotics that cause critical antibiotic resistance. There are a remarkable number of wound-healing botanicals that have been widely used in the Northern Hemisphere, including Achiella millefolium, Aloe vera, Althaea officinalis, Calendula officinalis, Matricaria chamomilla, Curcuma longa, Eucalyptus, Jojoba, plantain, pine, green tea, pomegranate, and Inula. This review addresses the most often used medicinal plants from the Northern Hemisphere that facilitate the treatment of wounds, and also suggests viable natural alternatives that can be used in the field of wound care. [ABSTRACT FROM AUTHOR]

The problem of alimentary dystrophy, which develops due to various reasons, is an urgent problem, especially in patients with tumors of the head and neck. After removal of tumors, patients have large postoperative defects that interfere with proper nutrition. Therefore, to provide the body with the necessary nutrients, enteral nutrition is especially important. In addition, successful wound healing requires adequate blood supply and sufficient levels of nutrients, which depends on the general condition of the body and the patient's diet. However, the degree of reparative processes correlates not only with the number of substrates of anabolism, but also with the proper functioning of the liver. The aim of our study was to investigate the effect of the drug for enteral nutrition and glutargin on the reparative properties of rats’ wounds on the background of partial food deprivation. The study was performed on 60 adult male rats weighing 280±20 grams of the Wistar line, with a mean age of 15 weeks. Prior to the experimental study the regenerative properties of the animals were on partial food deprivation. On the 10th day, a wound with a diameter of 2.0 cm was inflicted. Then the rats were divided into 4 groups: 1 group (control) received food according to physiological needs; Group 2 (food derivation (FD)); Group 3 (FD+enteral nutrition); Group 4 (FD+enteral nutrition +glutargin). Against the background of alimentary dystrophy (20% weight loss) on the first day there was a significant difference in the edges of the wound due to loss of its elasticity. Wound contraction processes up to 14-15 days in all observation groups were quite active, regardless of the factors of malnutrition with cereals or additional therapeutic diet "Peptamen" or in combination with glutargin. Thus, every three days the area of wounds decreased by 30-40 mm2 on an average. Only on the 15th-17th day the difference in the rate of wound contraction becomes visible and statistically significant. Thus, on the 15th day the largest wounds were in the second group on the background of partial food deprivation (p<0.05), at the same time in the first (control) and in the fourth groups the average area was almost equal (p>0.05). The smallest (p<0.05) area of wounds was observed in the first group (control) on the 15th day. On the 17th day wound healing was observed in the fourth group (FD+enteral nutrition+glutargin), despite the expansion of wounds on the first day. A pronounced therapeutic effect correcting alimentary dystrophy was obtained with enteral nutrition (Peptamen) and glutargin at a dose of 50 mg/kg, where the wounds healed simultaneously with those in the first (control) group, ie in animals with a normal diet, indicating a high effectiveness of the proposed method of correction of alimentary dystrophy. Enteral nutrition alone (Peptamen) was also effective, as evidenced by the small size of virtually epithelialized wounds on the 17th day. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the toxicological profile of hyperforin (HP) in silico and to assess it in vivo after topical application of an HP-rich St. John's wort (SJW) extract. The former analysis predicted low toxicity because of HP's inability to bind DNA or proteins, but structural alerts for skin irritation/corrosion, carcinogenicity, and mutagenicity were found. Animal studies involved the treatment of excision wounds in Wistar rats with poloxamer 407/borage oil formulations (bigels; Bs) containing HP-rich SJW extract previously developed by us. The effects of semisolids comprising 'free' extract (B/SJW) or extract loaded in nanostructured lipid carriers (B/NLC-SJW) were compared to positive (commercial herbal product) and negative (untreated) controls after 2-, 7-, 14-, and 21-day applications. Malondialdehyde (MDA) and ABTS assays evaluated the degree of oxidative stress—treatment with bigels did not affect MDA favorably but led to an increased radical-cation scavenging capacity (compared to controls). Gamma-glutamyl transferase (GGT), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), and lactate dehydrogenase (LDH) enzyme levels were measured as indicators for liver/tissue damage. Treatment with both B/SJW and B/NLC-SJW for 21 days resulted in lower GGT and ASAT levels than those in controls. Two-day application of the biphasic semisolids contributed to normalized ALAT levels (lower than in both negative and positive controls), and the same trends were observed in LDH levels after a 7-day treatment. The promising results obtained after the B/NLC-SJW application suggest that this drug delivery system may not only preserve HP in SJW extract effectively but also 'expose' its cyto-/hepatoprotective potential. [ABSTRACT FROM AUTHOR]

Results of an investigation of the wound-healing activity and toxicity parameters of a gel based on guanidine-containing pectin derivatives are presented. It is established that the developed 0.5% pectin guanidine gel exhibits a high rate of wound healing that reaches 82% on the 7th day of treatment. The gel belongs to class VI of relatively harmless compounds, with an LD50 value of >3000 mg/kg for cutaneous application to rats. There were no signs of skin irritation in the form of redness, peeling, or changes in the fur cover in local shaven and adjacent regions in rats. Chronic toxicity studies showed that daily skin application of the pectin guanidine gel for 30 d did not produce any toxic effects on the quantitative composition and morphology of peripheral blood in experimental animals. [ABSTRACT FROM AUTHOR]

Most commercialized wound dressings are polymer-based. Synthetic and natural polymers have been utilized widely for the development of wound dressings. However, the use of natural polymers is limited by their poor mechanical properties, resulting in their combination with synthetic polymers and other materials to enhance their mechanical properties. Natural polymers are mostly affordable, biocompatible, and biodegradable with promising antimicrobial activity. They have been further tailored into unique hybrid wound dressings when combined with synthetic polymers and selected biomaterials. Some important features required in an ideal wound dressing include the capability to prevent bacteria invasion, reduce odor, absorb exudates, be comfortable, facilitate easy application and removal as well as frequent changing, prevent further skin tear and irritation when applied or removed, and provide a moist environment and soothing effect, be permeable to gases, etc. The efficacy of polymers in the design of wound dressings cannot be overemphasized. This review article reports the efficacy of wound dressings prepared from a combination of synthetic and natural polymers. [ABSTRACT FROM AUTHOR]

[Display omitted] Diabetic wounds (DWs) pose a significant health burden worldwide, with their management presenting numerous challenges. Biopolymeric formulations have recently gained attention as promising therapeutic approaches for diabetic wound healing. These formulations, composed of biocompatible and biodegradable polymers, offer unique properties such as controlled drug release, enhanced wound closure, and reduced scarring. In this review, we aim to provide a comprehensive overview of the current state of research and future prospects regarding the application of biopolymeric formulations for diabetic wound healing. The review begins by highlighting the underlying pathophysiology of DWs, including impaired angiogenesis, chronic inflammation, and compromised extracellular matrix (ECM) formation. It further explores the key characteristics of biopolymeric materials, such as their biocompatibility, biodegradability, and tunable physicochemical properties, which make them suitable for diabetic wound healing applications. The discussion further delves into the types of biopolymeric formulations utilized in the treatment of DWs. These include hydrogels, nanoparticles (NP), scaffolds, films, and dressings. Furthermore, the review addresses the challenges associated with biopolymeric formulations for diabetic wound healing. In conclusion, biopolymeric formulations present a promising avenue for diabetic wound healing. Their unique properties and versatility allow for tailored approaches to address the specific challenges associated with DWs. However, further research and developments are required to optimize their therapeutic efficacy, stability, manufacturing processes, and regulatory considerations. With continued advancements in biopolymeric formulations, the future holds great promise for improving the management and outcomes of DWs. [ABSTRACT FROM AUTHOR]

Background: Diabetes-related foot disease (DFD) is a leading cause of the Australian disease burden. The 2011 Australian DFD guidelines were outdated. We aimed to develop methodology for systematically adapting suitable international guidelines to the Australian context to become the new Australian evidence-based guidelines for DFD. Methods: We followed the Australian National Health Medical Research Council (NHMRC) guidelines for adapting guidelines. We systematically searched for all international DFD guideline records. All identified records were independently screened and assessed for eligibility. Those deemed eligible were further assessed and included if scoring at least moderate quality, suitability and currency using AGREE II and NHMRC instruments. The included international guidelines had all recommendations extracted into six sub-fields: prevention, wound classification, peripheral artery disease, infection, offloading and wound healing. Six national panels, each comprising 6–8 multidisciplinary national experts, screened all recommendations within their sub-field for acceptability and applicability in Australia using an ADAPTE form. Where panels were unsure of any acceptability and applicability items, full assessments were undertaken using a GRADE Evidence to Decision tool. Recommendations were adopted, adapted, or excluded, based on the agreement between the panel's and international guideline's judgements. Each panel drafted a guideline that included all their recommendations, rationale, justifications, and implementation considerations. All underwent public consultation, final revision, and approval by national peak bodies. Results: We screened 182 identified records, assessed 24 full text records, and after further quality, suitability, and currency assessment, one record was deemed a suitable international guideline, the International Working Group Diabetic Foot Guidelines (IWGDF guidelines). The six panels collectively assessed 100 IWGDF recommendations, with 71 being adopted, 27 adapted, and two excluded for the Australian context. We received 47 public consultation responses with > 80% (strongly) agreeing that the guidelines should be approved, and ten national peak bodies endorsed the final six guidelines. The six guidelines and this protocol can be found at: https://www.diabetesfeetaustralia.org/new-guidelines/ Conclusion: New Australian evidence-based guidelines for DFD have been developed for the first time in a decade by adapting suitable international guidelines. The methodology developed for adaptation may be useful for other foot-related conditions. These new guidelines will now serve as the national multidisciplinary best practice standards of DFD care in Australia. [ABSTRACT FROM AUTHOR]

Delayed healing of traumatic wounds often stems from a dysregulated immune response initiated or exacerbated by existing comorbidities, multiple tissue injury or wound contamination. Over decades, approaches towards alleviating wound inflammation have been centered on interventions capable of a collective dampening of various inflammatory factors and/or cells. However, a progressive understanding of immune physiology has rendered deeper knowledge on the dynamic interplay of secreted factors and effector cells following an acute injury. There is a wide body of literature, both in vitro and in vivo, abstracted on the immunomodulatory approaches to control inflammation. Recently, targeted modulation of the immune response via biotechnological approaches and biomaterials has gained attention as a means to restore the pro-healing phenotype and promote tissue regeneration. In order to fully realize the potential of these approaches in traumatic wounds, a critical and nuanced understanding of the relationships between immune dysregulation and healing outcomes is needed. This review provides an insight on paradigm shift towards interventional approaches to control exacerbated immune response following a traumatic injury from an agonistic to a targeted path. We address such a need by (1) providing a targeted discussion of the wound healing processes to assist in the identification of novel therapeutic targets and (2) highlighting emerging technologies and interventions that utilize an immunoengineering-based approach. In addition, we have underscored the importance of immune engineering as an emerging tool to provide precision medicine as an option to modulate acute immune response following a traumatic injury. Finally, an overview is provided on how an intervention can follow through a successful clinical application and regulatory pathway following laboratory and animal model evaluation. [ABSTRACT FROM AUTHOR]

The primary goal of this systematic review article was to provide an outline of the use of diabetic autologous adipose-derived mesenchymal stem cells (DAAD-MSCs) in the treatment of wounds and ulcers in animal models and patients with diabetes mellitus (DM). The secondary goal was to present the outcomes of pretreatment of diabetic adipose-derived mesenchymal stem cells (DAD-MSCs) with probable different agents in the treatment of diabetic foot ulcers (DFUs) and wounds. In view of possible clinical applications of AD-MSC-mediated cell therapy for DFUs, it is essential to evaluate the influence of DM on AD-MSC functions. Nevertheless, there are conflicting results about the effects of DAAD-MSCs on accelerating wound healing in animals and DM patients. Multistep research of the MEDLINE, PubMed, Embase, Clinicaltrials.gov, Scopus database, and Cochrane databases was conducted for abstracts and full-text scientific papers published between 2000 and 2020. Finally, 5 articles confirmed that the usage of allogeneic or autologous AD-MSCs had encouraging outcomes on diabetic wound healing. One study reported that DM changes AD-MSC function and therapeutic potential, and one article recommended that the pretreatment of diabetic allogeneic adipose-derived mesenchymal stem cells (DAlD-MSCs) was more effective in accelerating diabetic wound healing. Recently, much work has concentrated on evolving innovative healing tactics for hastening the repair of DFUs. While DM alters the intrinsic properties of AD-MSCs and impairs their function, one animal study showed that the pretreatment of DAlD-MSCs in vitro significantly increased the function of DAlD-MSCs compared with DAlD-MSCs without any treatment. Preconditioning diabetic AD-MSCs with pretreatment agents like photobiomodulation (PBM) significantly hastened healing in delayed-healing wounds. It is suggested that further animal and human studies be conducted in order to provide more documentation. Hopefully, these outcomes will help the use of DAAD-MSCs plus PBM as a routine treatment protocol for healing severe DFUs in DM patients. [ABSTRACT FROM AUTHOR]

The Wound Healing Foundation (WHF) recognised a need for an unbiased consensus on the best treatment of chronic wounds. A panel of 13 experts were invited to a virtual meeting which took place on 27 March 2021. The proceedings were organised in the sub‐sections diagnosis, debridement, infection control, dressings, grafting, pain management, oxygen treatment, outcomes and future needs. Eighty percent or better concurrence among the panellists was considered a consensus. A large number of critical questions were discussed and agreed upon. Important takeaways included that wound care needs to be simplified to a point that it can be delivered by the patient or the patient's family. Another one was that telemonitoring, which has proved very useful during the COVID‐19 pandemic, can help reduce the frequency of interventions by a visiting nurse or a wound care center. Defining patient expectations is critical to designing a successful treatment. Patient outcomes might include wound specific outcomes such as time to heal, wound size reduction, as well as improvement in quality of life. For those patients with expectations of healing, an aggressive approach to achieve that goal is recommended. When healing is not an expectation, such as in patients receiving palliative wound care, outcomes might include pain reduction, exudate management, odour management and/or other quality of life benefits to wound care. [ABSTRACT FROM AUTHOR]

Surgical site infection (SSI) increases length of treatment, delays wound healing, increases antibiotic use and causes patient death in severe cases. This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g, a height of 42 cm and a head circumference of 32 cm. Twelve days after birth, he was admitted to hospital where a surgeon removed a sacrococcygeal teratoma. The surgical site became infected, and the infection failed to improve despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy. The authors started treatment using an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month. The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition. This case shows that SSIs can be treated with honey-containing antibacterial wound gel, especially in infants who have weaker immune systems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Tissue-engineered skin has a good application prospect in promoting skin tissue wound repair and scarless healing. OBJECTIVE: To review the current research progress, application and value of tissue-engineered skin in vivo and in vitro. METHODS: A computer was used to search the relevant articles in the CNKI database and PubMed database. The Chinese and English search terms were “mesenchymal stem cells; growth factors; skin; wounds; skin repair; wound healing; regenerative medicine; tissue engineering; scaffolds”. The domestic and foreign related application articles on tissue-engineered skin construction in the treatment of skin tissue injury in recent years were checked, and the research progress of mesenchymal stem cells, growth factors, scaffold materials and dressings for new treatment methods for tissue repair was also summarized. The articles irrelevant to the subject of this article were excluded, and 78 articles were finally included for the result analysis. RESULTS AND CONCLUSION: The construction of tissue-engineered skin involves the selection of seed cells, the application of growth factors, and the combination of multiple elements of scaffold materials. Mesenchymal stem cells are one of the important sources of tissue-engineered skin seed cells. Growth factors optimize the tissue culture environment, and scaffold materials provide appropriate mechanical support. Therefore, how to select appropriate seed cells, growth factors and scaffold materials to construct tissue-engineered skin to treat wounds and speed up repair is the focus and research direction that should be explored in the future. In addition, the development of wound materials is also a new field. [ABSTRACT FROM AUTHOR]

Objective: Cardiac pacemakers must be regularly replaced due to depleted batteries. A possible alternative is proposed by subcutaneous photovoltaic energy harvesting. The body's reaction to an implant can cause device encapsulation. Potential changes in spectral light transmission of skin can influence the performance of subcutaneous photovoltaic cells and has not yet been studied in large animal studies. Methods: Subcutaneous implants measuring changes in the light reaching the implant were developed. Three pigs received those implants and were analyzed for seven weeks. Spectral measurements with known irradiation were performed to identify possible changes in the transparency of the tissues above the implant during the wound healing process. A histological analysis at the end of the trial investigated the skin tissue above the subcutaneous photovoltaic implants. Results: The implants measured decreasing light intensity and shifts in the light's spectrum during the initial wound healing phase. In a later stage of tissue recovery, the implants measured a generally reduced light intensity compared to the healthy tissue after implantation. The spectral distribution of the measured light at the end of the trial was similar to the first measurements. The histological analysis showed subcutaneous granulation tissue formation for all devices. Conclusion: The varying reduction of light intensity reaching the implants means that safety margins must be sufficiently high to ensure the power. At the end of the wound healing process, the spectral distribution of the light reaching the implant is similar to healthy tissue. Significance: Optimizations of spectral sensitivity of photovoltaic cells are possible. [ABSTRACT FROM AUTHOR]

The species Jatropha gossypiifolia, popularly known as "pinhão-roxo", is distributed throughout Brazil, is commonly employed for topical or oral administration in treating wounds, inflammations, and snake bites. Given the significant impact of snakebites on public health and the limitations of antivenom, coupled with the diverse molecular composition of this plant species, investigating its healing and antidermonecrotic capacities is relevant. This study aimed to develop a topical nanoemulsion incorporating the hydroethanolic extract of J. gossypiifolia leaves, to evaluate its therapeutic potential, particularly in terms of its efficacy in wound healing and inhibition of dermonecrosis induced by B. erythromelas venom (BeV). The extract of J. gossypiifolia (JgE) leaves was obtained by maceration and remaceration. The phytochemical analysis was conducted and J. gossypiifolia nanoemulsion (JgNe) was obtained, characterized and assessed for stability. The cytotoxicity was determined in normal cells (erythrocytes and 3T3) using hemolytic assay and cell viability assay using crystal violet staining. The antioxidant activity was evaluated by the reduction of ABTS and DPPH radicals. The evaluation of wound healing was conducted in vivo following treatment with JgNe, wherein the percentage of wound closure and inflammatory mediators. The skin irritation test was assessed in vivo by applying JgNe directly to the animal's skin. In vitro , the antivenom capacity was evaluated through enzymatic inhibition assays (phospholipase A 2 and hyaluronidase) of BeV. Additionally, the in vivo antidermonecrotic activity of JgNe was evaluated by measuring the reduction of the dermonecrotic halo. The HPLC-DAD analysis identified flavonoids, specifically vitexin, luteolin derivatives and apigenin derivatives. In addition, 95.08 ± 5.46 mg of gallic acid/g of extract and 137.92 ± 0.99 mg quercetin/g extract, was quantified. JgNe maintained stability over a 4-week period. Moreover, JgE and JgNe demonstrated no cytotoxicity in human erythrocytes and murine fibroblasts at tested concentrations (32.25–250 μg/mL). Additionally, exhibited significant antioxidant activity by reducing ABTS and DPPH radicals. The treatment with JgNe did not induce skin irritation and accelerated wound healing, with significant wound closure observed from 5th day and reduction in nitrite levels, myeloperoxidase activity, and cytokine. Both JgE and JgNe demonstrated in vitro inhibition of the phospholipase and hyaluronidase enzymes of BeV. Moreover, JgNe exhibited antidermonecrotic activity by reducing the dermonecrotic halo caused by BeV after 24 h. JgNe and JgE exhibited no cytotoxicity at the tested concentrations. Additionally, our findings demonstrate that JgNe has the ability to accelerate wound closure and reduce dermonecrosis caused by BeV, indicating to be promising formulation for complementary therapy to antivenom treatment. [Display omitted] [ABSTRACT FROM AUTHOR]

Smart wound dressings aim to enable early diagnosis and treatment of wound infections to accelerate wound healing. This paper summarizes the latest research progress of smart wound dressings, including smart dressings for monitoring different parameters of wounds, smart dressings that can realize wound management, and advanced smart wound dressings that integrate monitoring and treatment into one, and systematically discusses and analyzes them. [Display omitted] • A comprehensive review of the latest developments in intelligent wound dressings. • Explored various wound dressing design concepts and developed applications. • Discussed the future prospects and challenges of intelligent wound dressings. Wound management has long been a significant concern within the healthcare industry. However, conventional passive wound dressings often fail to meet the requirements for effective wound management. As a result, there is a growing emergence of intelligent wound dressings that aim to address this issue. These smart wound dressings incorporate one or more electrochemical or optical sensors, enabling real-time monitoring of wound conditions. Furthermore, they also integrate various stimulation techniques, including photostimulation, electrostimulation, and pharmacological stimulation, in order to facilitate accelerated wound healing. This integration of sensing and stimulation capabilities holds immense potential for personalized wound care. This paper offers a comprehensive review of recent advancements in the field of wearable, novel dressings designed for the purpose of chronic wound monitoring and management. It examines various design concepts and applications that have been developed. Additionally, the paper discusses the future prospects and challenges associated with wearable bioelectronics in wound care, as well as their potential for clinical utilization. Furthermore, it explores the areas in which further development and research are needed, with a focus on establishing the priorities for the next generation of wound dressings. [ABSTRACT FROM AUTHOR]

Chronic wounds are a common and debilitating condition associated with aging populations that impact more than 6.5 million patients in the United States. We have previously demonstrated the efficacy of daily topical 1% valsartan in treating wounds in diabetic mouse and pig models. Despite these promising results, there remains a need to develop an extended‐release formulation that would reduce patient burden by decreasing the frequency of daily applications. Here, we used nanotechnology to self‐assemble valsartan amphiphiles into a filamentous structure (val‐filaments) that would serve as a scaffold in wound beds and allow for steady, localised and tunable release of valsartan amphiphiles over 24 days. Two topical treatments of this peptide‐based hydrogel on full‐thickness wounds in Zucker Diabetic Fatty rats resulted in faster rates of wound closure. By day 23, all val‐filament treated wounds were completely closed, as compared to one wound closed in the placebo group. Mechanistically, we observed enrichment of proteins involved in cell adhesion and energetics pathways, downregulation of Tgf‐β signalling pathway mediators (pSmad2, pSmad3 and Smad4) and increased mitochondrial metabolic pathway intermediates. This study demonstrates the successful synthesis of a sustained‐release valsartan filament hydrogel, its impact on mitochondrial energetics and efficacy in treating diabetic wounds. [ABSTRACT FROM AUTHOR]

Background: Epidermolysis bullosa (EB) patient anecdotes and case reports indicate that cannabinoid-based medicines (CBMs) may alleviate pain and pruritus and improve wound healing. CBM use has not been characterized in the EB patient population.Objectives: To evaluate CBM use among EB patients, including CBM types, effects on symptoms (e.g., pain and pruritus), disease process (e.g., blistering, wounds, and inflammation), well-being (e.g., sleep, appetite) and concomitant medications.Methods: English-speaking EB patients or caregivers completed an online international, anonymous, cross-sectional survey regarding CBM use. Respondents reported the types of CBMs, subsequent effects including perceived EB symptom alteration, changes in medication use, and side effects.Results: Seventy-one EB patients from five continents reported using or having used CBMs to treat their EB. Missing question responses ranged between 0 (0%) and 33 (46%). Most used more than one CBM preparation (mean: 2.4 ± 1.5) and route of administration (mean: 2.1 ± 1.1). Topical and ingested were the most common routes. Pain and pruritus were reported retrospectively to decrease by 3 points (scale: 0-10; p < 0.001 for both) after CBM use. Most reported that CBM use improved their overall EB symptoms (95%), pain (94%), pruritus (91%) and wound healing (81%). Most participants (79%) reported decreased use of pain medications. The most common side-effect was dry mouth (44%).Conclusions: CBMs improve the perception of pain, pruritus, wound healing, and well-being in EB patients and reduced concomitant medication use. Nevertheless, a direct relation between the use of CBMs and reduction of the above-mentioned symptoms cannot be proven by these data. Therefore, future controlled studies using pharmaceutically standardised CBM preparations in EB are warranted to delineate the risks and benefits of CBMs. [ABSTRACT FROM AUTHOR]

Wound bed preparation is the management of a wound in order to optimise healing and/or facilitate other therapeutic measures. It is the most pivotal step in healing wounds. Early referral to a specialist wound clinic can markedly improve the wound healing process. This overview will discuss the techniques involved in the preparation of the wound bed that will effectively accelerate the healing process. The process begins with a correct diagnosis of the wound and optimising the patient's medical condition. The TIMERS framework is discussed. Wound dressings, including the use of negative-pressure wound therapy, are discussed, along with debridement techniques and agents. The timing of wound intervention and evaluating progress will also be discussed, and wound bed preparation strategies will be included. There has been an added challenge of wound care in the community as a result of the COVID-19 pandemic. The present article provides an overview of how to prepare a wound bed in the community. [ABSTRACT FROM AUTHOR]

Surgical incision infection of multidrug-resistant microorganisms (e.g., methicillin-resistant Staphylococcus aureus, MRSA) is a severe cause of poor wound healing, which is prevalent in healthcare facilities and constitutes a huge infectious disease burden in the world. The purpose of this study is to investigate the medical application and possible mechanisms of the cold atmospheric plasma jet on infected wounds. In this article, the New Zealand rabbit in vivo wound infected with MRSA is used as the wound healing animal model. The helium atmospheric-pressure dielectric-barrier-discharge (AP-DBD) plasma jet is employed to treat the wounds infected with MRSA. The wound healing, histological, and cytokine analyses are conducted to evaluate the efficacy of the helium AP-DBD plasma jet on the MRSA-infected wound healing process. The experimental results show that the helium AP-DBD plasma jet treatment on the wounds infected with MRSA can regulate the secretion of the cytokines, limit the inflammatory response and cell excessive proliferation, accelerate the process of re-epithelialization, and consequently, promote the wound healing process and the inactivation of the bacteria. [ABSTRACT FROM AUTHOR]

The treatment and care of human wounds represent an enormous burden on the medical system and patients alike. Chronic or delayed healing wounds are characterized by the inability to form proper granulation tissue, followed by deficiencies in keratinocyte migration and wound re-epithelialization, leading to increased likelihood of infection and poor wound outcomes. Human reticular acellular dermal matrix (HR-ADM) is one type of tissue graft developed to enhance closure of delayed healing wounds that has demonstrated clinical utility through accelerating closure of lower extremity diabetic ulcers, but the mechanisms underlying this clinical success are not well understood. The authors utilized a diabetic murine splinted excisional wound model to investigate the effects of HR-ADM application on wound closure. The authors demonstrate that application of HR-ADM served as a dermal scaffold and promoted rapid re-epithelialization and keratinocyte proliferation, resulting in accelerated wound closure while minimizing granulation tissue formation. HR-ADM-applied wounds also demonstrated evidence of cellular infiltration, neovascularization and collagen remodeling by the host organism. These data suggest that HR-ADM supports epidermal closure in delayed healing wounds and remodeling of the matrix into host tissue, lending further support to the clinical success of HR-ADM described in clinical reports. [ABSTRACT FROM AUTHOR]

Older adults are at high risk of developing chronic wounds due to numerous changes that occur with aging. It is reasonable to consider chronic wounds as a geriatric syndrome—highly prevalent, multifactorial, and associated with substantial morbidity and mortality. Due to the morbidity and cost associated with chronic wounds, prevention, early diagnosis, and treatment are important. The most common chronic wounds presenting in older adults are pressure and vascular wounds, including those associated with diabetes. Atypical wounds are also common and should raise the suspicion for skin malignancy. Diagnosis is primarily clinical and assessment should include documentation of wound characteristics, such as location, size and depth, presence of slough, drainage, odor, and infection. The mainstay of treatment is based on the TIME principle: Tissue debridement, Infection control, Moisture balance, and optimal wound Edges. The use of protein supplements has been shown to improve wound healing in subsets of older adults. In addition to wound care and optimizing nutrition, disease‐specific wound therapy forms an integral part of wound management. Pressure reduction for pressure injury, compression therapy for venous wounds, evaluation of arterial circulation with ABI or arterial Doppler and iCC for diabetic ulcers form the mainstays of therapy. Atypical wounds may present as chronic ulcers and should be biopsied. The goals of treatment should be realistic and for some older adults, palliative wound management may be more appropriate. [ABSTRACT FROM AUTHOR]

Objective: an innovative non−thermal plasma (NTP) system constituted by a radiofrequency (RF) power generator directly coupled to a treatment probe is described and characterized. This system is intended to be applied as a medical device for therapeutic treatments. Methods: electrical characterization of the radiofrequency power generator supplying the treatment probe was performed. Meanwhile, generated NTP was optically analyzed. Obtained data were studied to establish the safety profile of plasma application on heat sensitive matter. Results: the NTP system was validated through bacterial deactivation trials, as well as, of being capable of deactivating carcinogenic cells. Besides promoting and accelerating wound closure in vivo performed in mice, demonstrating faster healing than that done with conventional treatments. Conclusion: the NTP system's characterization is an essential stage to determine the adequate application of the generated plasma over organic media. The therapeutic benefits of the NTP system were proved by the development of in vivo experiences involving laboratory mice. Significance: the generated NTP interacts with surrounding air particles producing reactive oxygen and nitrogen species, which, exhibit bactericidal and antiseptic effects due to their strong biochemical reactivity; functioning like critical mediators in animal physiology and promoting wound healing processes. These properties make the NTP system a feasible technology intended for therapeutic treatments. [ABSTRACT FROM AUTHOR]

Background: Eucheuma Cottonii is a type of red algae obtained from Sabah with main active component, sulfated polysaccharide or k‐carrageenan. Aims: The objective of this research was to evaluate the antioxidant, antibacterial and potential wound‐healing properties in aqueous extraction of E cottonii in order to meet the increasing demand for halal and natural cosmeceutical products. Methods and Results: Aqueous extract of E cottonii was investigated for active compounds by phytochemical screening and IR spectroscopy. Antioxidant activity was carried out using DPPH method, and the IC50 value was 1.99 mg/mL. Antibacterial activity was examined against Staphylococcus Aureus using Kirby‐Bauer disk diffusion method and showed 10.03 ± 0.06 mm zone of inhibition, achieved by 200 mg/mL of extracts. A wound was made by skin excision of area around 100 mm2 on each mouse. Test group was treated with aqueous extract gel (10% w/w); meanwhile, the mice that were treated with honey acted as the positive control group and the untreated mice as negative control group. Results showed that the wound contraction rate inclined to aqueous extracts as compared to untreated group (P <.05). Percentage of wound healing for aqueous extracts and untreated group were 87.7% ± 2.0% and 57.6% ± 5.3%, respectively. Conclusion: Aqueous extract was found to be comparable to the honey in wound healing. [ABSTRACT FROM AUTHOR]

Most acute wounds will heal with good topical care. However, some wounds, especially chronic ones occurring in impaired hosts, are more problematic. To properly manage these types of wounds and optimize healing, there should be an evidence-based approach to wound care in the emergency department. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the effect of topical 1% cannabidiol on second intention wound healing in distal limb wounds of horses. Design: Experimental. Animals: Six Standardbred horses. Methods: A total of five 2.5 cm × 2.5 cm full thickness skin wounds were created on the dorsomedial aspect of the metacarpi of 6 horses. Wounds were contaminated with faeces on the day of wound creation. Each wound was then assigned to a treatment group; compounded 1% cannabidiol in unique manuka factor (UMF) 5 manuka honey, UMF 5 manuka honey, UMF 20 manuka honey or saline. Each treatment was applied topically daily for a total of 42 days. Legs were bandaged and bandages were changed, daily, for 13 days postoperatively. Digital photographs of each wound were taken on day 1 then weekly for 6 weeks. Wound size, daily healing rate and total time to healing were recorded and compared statistically. Results: Irrespective of the treatment, wounds did not retract as expected in the first 7 days after wound creation. There was no difference in wound area, daily healing rate, days to complete healing between treatment groups. Conclusions: This preliminary study failed to demonstrate any difference in wound healing variables between treatment groups in this model of second intention wound healing. This was unexpected due to the established effects of UMF 20 manuka honey on wound healing using the same model. This may be due to systemic effects of cannabidiol and study design. Further research into the use of cannabidiol in equine wounds is warranted. [ABSTRACT FROM AUTHOR]

In this study, we investigated whether the nanofibers produced by natural‐synthetic polymers can probably promote the proliferation of co‐cultured adipose‐derived stem cells/human fibroblast cells (ADSs/HFCs) and synthesis of collagen. Nanofiber was fabricated by blending gelatin and poly (L‐lactide co‐ɛ‐caprolactone) (PLCL) polymer nanofiber (Gel/PLCL). Cell morphology and the interaction between cells and Gel/PLCL nanofiber were evaluated by FESEM and fluorescent microscopy. MTS assay and quantitative real‐time polymerase chain reaction were applied to assess the proliferation of co‐cultured ADSs/HFCs and the collagen type I and III synthesis, respectively. The concentrations of two cytokines including fibroblast growth factor‐basic and transforming growth factor‐β1 were also measured in culture medium of co‐cultured ADSs/HDCs using enzyme‐linked immunosorbent assay assay. Actually, nanofibers exhibited proper structural properties in terms of stability in cell proliferation and toxicity analysis processes. Gel/PLCL nanofiber promoted the growth and the adhesion of HFCs. Our results showed in contact co‐culture of ADSs/HFCs on the Gel/PLCL nanofiber increased cellular adhesion and proliferation synergistically compared to non‐coated plate. Also, synthesis of collagen and cytokines secretion of co‐cultured ADSs/HFCs on Gel/PLCL scaffolds is significantly higher than non‐coated plates. To conclude, the results suggest that Gel/PLCL nanofiber can imitate physiological characteristics in vivo and enhance the efficacy of co‐cultured ADSs/HFCs in wound healing process. [ABSTRACT FROM AUTHOR]

Skin acts as a protective barrier of body. It keeps the internal body organs safe from external environmental conditions which can prove harmful for them. So, maintenance of skin integrity is very important for normal functioning of body. In our daily life body of both animals and humans encounter to different types of violence, some of them are of such a severity that they break the skin continuity. This breakage of skin continuity is termed as wound. Whenever, the skin continuity is broken, internal organs of body are exposed. This is a dangerous situation and can be fatal for life. Immediate response of skin after wound is the start of wound healing process which starts automatically. This process can be assisted in a number of ways by keeping the wound free from bacterial contamination, moisture and dirt. For this purpose a variety of antiseptic dressings are available which when applied topically support wound healing process. They prevent wound to be contaminated by any micro-organism and reduce wound healing time. Aloe vera is one of them, it possess significant wound healing properties. Herbs have been integral to both traditional and non-traditional forms of medicine dating back at least 5000 years. Herbal medicines, especially in wound management involve disinfection, debridement and provision of a suitable environment for aiding the natural course of healing. The super focus of this review is to summarize the findings of earlier scientists with authentic concluding verse for utilization of herbal medicines (Aloe vera) being safe, readily available and cheaper. [ABSTRACT FROM AUTHOR]

Chronic wounds are a major complication for diabetes mellitus (DM) patients, which cause discomfort and an increase in medical costs. The purpose of this study is to investigate the medical application and possible mechanisms of a cold atmospheric plasma jet in healing DM chronic wounds. In this paper, the genetic diabetic BKS.DB mice are used as the diabetic wound healing animal model, which have a stable glucose level and can avoid the effects or complications induced by surgical and chemical interventions. The helium atmospheric-pressure dielectric-barrier-discharge (AP-DBD) plasma jet is employed to treat the diabetic mice wounds with the fixed treatment time and distance of 15 s and 20.0 mm, respectively. The wound healing, histological, immunohistochemical, and cytokine analyses are conducted to evaluate the efficacy of the helium AP-DBD plasma jet on the chronic wound healing of the genetic diabetic mice. The experimental results show that the helium AP-DBD plasma jet treatment of wounds of genetic diabetic mice can regulate the secretion of transforming growth factor- $\beta $ (TGF- $\beta$) and fibroblast growth factors (FGFs), limit the inflammatory response and excessive cell proliferation, accelerate the process of re-epithelialization, and consequently, promote the chronic wound healing process. [ABSTRACT FROM AUTHOR]

A plasma jet enhanced oil-based drug, named plasma-activated oil (PAO) is produced in sunflower oil by a single-step, room temperature, energy-efficient, and environment-friendly dry plasma jet enabled process. Plasma jets with two different working gas combinations, argon + air and argon + O2, were generated, namely PAO (air) and PAO (O2), respectively. Several hours of plasma jet treatment substantially increased the hydrogen peroxide and carboxylic acid concentrations in the PAO. Although the electrophilic fatty acid nitroalkenes produced by nitric oxide and nitrite of the argon + air plasma jet increased the acid value of PAO (air), similar sterilization and wound healing effect suggest that PAO (air) and PAO (O2) have similar concentrations of hydrogen peroxide and carboxylic acid. PAO killed the common Gram-positive bacteria [methicillin-resistant staphylococcus aureus (MRSA) and Micrococcus luteus] and Gram-negative bacteria (Pseudomonas aeruginosa and Escherichia coli) efficiently. PAO accelerated the healing of infected wounds by 33%. [ABSTRACT FROM AUTHOR]

Despite the generous blood supply, and resultant healing capacity within the head and neck, complex wounds in this area may be extremely debilitating and present an obstacle to treatment for the reconstructive surgeon. Delayed, incomplete, or otherwise suboptimal wound healing within this anatomical region may lead to both functional and aesthetically displeasing outcomes, resulting in impaired speech or swallowing, social stigma, and, in severe cases, exposure of critical underlying structures. Due to implications, with regard to wound formation following surgical intervention, the facial reconstructive surgeon, in particular, must be familiar with the multitude of treatment modalities available. This article serves as a review of the underlying pathophysiology of wound healing, local and systemic processes that may influence the healing process, and treatments that facilitate tissue restoration while mitigating future complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Since human embryonic stem cells were successfully obtained in 1998, clinicians have been trying to use stem cells in wound healing. Importantly, stem cells can regulate wound inflammation. OBJECTIVE: To investigate the application and prospect of adipose-derived stem cells in wound inflammation. METHODS: The first author searched CNKI and PubMed databases (from 1999 to October 2018) with the retrieval words of “adipose-derived stem cells, wound, inflammation” in Chinese and English, respectively. Literatures regarding adipose-derived stem cells, wound and inflammation were selected. The articles published lately or authoritatively in the same field were preferred. RESULTS AND CONCLUSION: Wound healing is a complex and orderly process, and closely related to wound inflammation. With the development of regenerative medicine, the application of stem cells brings a new approach to wound healing. Adipose-derived stem cells have a promising prospect as characterized by the strong abilities of proliferation and multidirectional differentiation, easy to obtain, and abundant sources. To date, adipose-derived stem cells are still one of the most popular candidates for regulating wound inflammation and promoting wound healing. [ABSTRACT FROM AUTHOR]

• Usnic acid is a lichenic secondary metabolite useful for the treatment of burn wounds. • The poor solubility limits the use of usnic acid in health care products. • Usnic acid was formulated in adhesive polymeric films to improve wounds treatment. • Film F2 is the most effective against usnic acid sensitive bacteria. • Film F2 is safe towards human keratinocytes and fibroblasts. Usnic acid (UA) is a lichenic secondary metabolite useful for the treatment of burn wounds thanks to its antimicrobial activity, particularly toward strains responsible for their infections. However, the poor solubility is the main factor limiting the activity and thus its use in health care products. Adhesive polymeric films were designed to improve UA use by enhancing its bioavailability in the wounded tissues. Three different NaCMC hydrogel films, NaCMC 2% alone (F1), mixed to PVP K90 0.1% (F2) or to Carbopol 971 P 0.1% (F3), were prepared by casting method. Ex vivo experiments performed on pig skin samples showed their suitable adhesion capacity. in vitro release test, performed using the extraction cell, showed that film F2 provides the highest UA concentrations. Differential scanning calorimetry and X-ray analyses performed on the three films highlighted that UA is present in a more soluble form in F2. The in vitro antibacterial activity studies demonstrated that F2 is the most effective film against UA sensitive bacteria S. Epidermidis , E. Faecalis , B. Cereus and S. Pyogenes. In vitro cytotoxicity assays on human keratinocytes and fibroblasts showed that cells viability is not compromised. [ABSTRACT FROM AUTHOR]