Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimeti...Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimetic Janus nanofiber membrane as a water diode,which endows with gradient wettability and gradient pore size,offering sustainable unidirectional self-drainage and antibacterial properties for enhanced diabetic wound healing.The Janus membrane is fabricated by depositing a hydrophilic polyacrylonitrile/chlorin e6 layer with smaller pore sizes onto a hydrophobic poly(ε-caprolactone)with larger pore sizes,thereby generating a vertical gradient in both wettability and pore structure.The incorporation of chlorin e6 in the upper layer enables the utilization of external light energy to generate heat for evaporation and produce reactive oxygen species,achieving a high sterilization efficiency of 99%.Meanwhile,the gradient structure of the Janus membrane facilitates continuous antigravity exudate drainage at a rate of 0.95 g cm^(−2) h^(−1).This dual functionality of effective exudate drainage and sterilization significantly reduces inflammatory factors,allows the polarization of macrophages toward the M2 proliferative phenotype,enhances angiogenesis,and accelerates wound healing.Therefore,this study provides a groundbreaking bioinspired strategy for the development of advanced wound dressings tailored for diabetic wound regeneration.展开更多
Plasmonic gold nanoflowers(AuNFs)exhibit considerable potential in wound repair therapy due to their excellent photothermal conversion capability,high surface area,and multi-enzyme activities.However,the intrinsic pro...Plasmonic gold nanoflowers(AuNFs)exhibit considerable potential in wound repair therapy due to their excellent photothermal conversion capability,high surface area,and multi-enzyme activities.However,the intrinsic pro-oxidative properties of AuNFs limit their therapeutic efficacy in diabetic wound treatment.To overcome this limitation,a near-infrared plasmonic Au@CDCe nanohybrid system that can enhance antioxidative performance through the synergistic effects of localized surface plasmon resonance-induced photothermal effect and hot electrons is developed.Specifically,AuNFs serve as near-infrared plasmonic exciters,generating hot electrons that are efficiently transferred to cerium-doped carbon dots(CDCe).Combined with mild photothermal effects,these processes synergistically enhance hydroxyl radical scavenging activity,as well as superoxide dismutase-and catalase-mimicking activities.In vitro experiments demonstrate that Au@CDCe effectively protects cells from oxidative damage,and promotes cell proliferation and migration.In vivo evaluations confirm its ability to modulate the immune microenvironment and accelerate diabetic wound healing.This work establishes a new paradigm for modulating the oxidative stress microenvironment through antioxidant gold-based plasmonic nanozymes and provides novel insights into tuning of prooxidant nanozyme into plasmon-enhanced antioxidant nanozyme.展开更多
Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced ...Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced in rats using streptozotocin,after which full-thickness excisional wounds were created.Piceatannol was administered topically either as a raw hydrogel or formulated into a PIC-SNEDDS,which was prepared using an optimized oil-surfactant mixture and incorporated into a hydrogel for application.Wound healing activity was assessed through measurements of wound contraction,oxidative stress biomarkers,and collagen content,along with histological and immunohistochemical evaluation of inflammatory,angiogenic,and remodeling markers.Results:PIC-SNEDDS markedly enhanced diabetic wound healing by promoting epithelial regeneration,granulation tissue formation,epidermal proliferation,and keratinization.The formulation also reduced the expression of pro-inflammatory markers(interleukin-6,nuclear factor-kappa B,and tumor necrosis factor-α)while increasingα-smooth muscle actin,transforming growth factor-β1,vascular endothelial growth factor-A,and hydroxyproline levels.Additionally,it improved antioxidant status by lowering malondialdehyde levels and boosting superoxide dismutase and catalase activity,along with upregulation of COL1A1 mRNA expression.Conclusions:PIC-SNEDDS promotes the healing of diabetic wounds and exhibits anti-inflammatory,antioxidant,pro-collagen,and angiogenic properties.展开更多
Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the ...Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.展开更多
Diabetic wound healing remains a major clinical challenge,primarily due to excessive inflammation,bacterial infection,and impaired angiogenesis.Although various biomaterial-based strategies have been explored,coordina...Diabetic wound healing remains a major clinical challenge,primarily due to excessive inflammation,bacterial infection,and impaired angiogenesis.Although various biomaterial-based strategies have been explored,coordinating the complex diabetic wound microenvironment remains difficult to achieve.This study proposes a novel multifunctional hydrogel dressing designed to synergistically address multiple issues.Its key innovation lies in dynamically crosslinking deer antler decellularized matrix(dECM)with oxidized dextran via imine bonds,creating a self-healing hydrogel(dECMH).The deer antler dECM,rich in pro-regenerative components,provides a biomimetic scaffold,while Schiff base crosslinking confers mechanical self-healing and injectability.To further address the complexity of diabetic wounds,magnesium gallate metalorganic frameworks(Mg-EGCG)were embedded within the dECMH network,forming Mg-EGCG@dECMH.This innovative combination enables sustained co-delivery of epigallocatechin gallate(EGCG)—possessing antibacterial,anti-inflammatory,and antioxidant properties—alongside magnesium ions that actively promote cell proliferation and vascular regeneration.In vitro analyses confirmed the hydrogel's capacity to enhance endothelial cell proliferation,boost angiogenesis,and mitigate oxidative stress.In vivo evaluations demonstrated accelerated wound healing,manifested by rapid inflammation resolution,ordered collagen deposition,and stimulated neovascularization.Additionally,the material exhibited excellent biocompatibility,hemostatic effects,and antimicrobial activity.This multifunctional dressing synergistically integrates the inherent bioactivity of unique antler decellularized matrix with the multimodal therapeutic effects of metal-organic nanocomposites,offering an innovative and effective strategy for diabetic wound management.展开更多
Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficu...Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.展开更多
The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,e...The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,emphasizing its ability to better wound evaluation,hasten healing,alleviate pain,and improve cost-effectiveness.AI-driven technology,including mobile applications and intelligent bandages,provides precise wound assessment,tissue analysis,and continuous monitoring,hence allowing for tailored treatment strategies and prompt intervention.Moreover,AI-driven algorithms forecast wound healing trajectories and find individuals susceptible to chronic wounds,allowing prompt preventative interventions.There are also practical issues with integrating it into clinical practice.Adding AI to current healthcare systems,like electronic medical records(EMRs),needs careful planning and teamwork to make sure that AI-driven insights are used well in real-time clinical decision-making.To make sure AI is used safely,legal frameworks need to be set up to provide clear rules for its use in healthcare.These frameworks should include openness,risk management,and data evaluation.Lastly,clinical validation and acceptance are still big problems.Many AI-powered tools don't have enough clinical validation and aren't widely available,which makes it hard to use them in everyday clinical practice.Solving these problems is important for getting the most out of AI in wound care and making sure it is used safely and effectively.The article combines current advancements and prospective trajectories in AI-assisted wound care,highlighting its revolutionary ability to revolutionize patient outcomes and healthcare delivery.展开更多
Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying com...Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying comorbidities,such as diabetes or vascular diseases,lifestyle factors,and genetic risk profiles which may predispose extremities to local ischemia.Injuries are further exacerbated by bacterial colonization and the formation of biofilms.Infection,consequently,perpetuates a chronic inflammatory microenvironment,preventing the progression and completion of normal wound healing.The current standard of care(SOC)for chronic wounds involves surgical debridement along with localized wound irrigation,which requires inpatient care under general anesthesia.This could be followed by,if necessary,defect coverage via a reconstructive ladder utilizing wound debridement along with skin graft,local,or free flap techniques once the wound conditions are stabilized and adequate blood supply is restored.To promote physiological wound healing,a variety of approaches have been subjected to translational research.Beyond conventional wound healing drugs and devices that currently supplement treatments,cellular and immunotherapies have emerged as promising therapeutics that can behave as tailored therapies with cell-or molecule-specific wound healing properties.However,in contrast to the clinical omnipresence of chronic wound healing disorders,there remains a shortage of studies condensing the current body of evidence on cellular therapies and immunotherapies for chronic wounds.This review provides a comprehensive exploration of current therapies,experimental approaches,and translational studies,offering insights into their efficacy and limitations.Ultimately,we hope this line of research may serve as an evidence-based foundation to guide further experimental and translational approaches and optimize patient care long-term.展开更多
This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indi...This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indications and limits for antiseptics,biofilm-oriented strategies,pain control,and adaptations for high-risk patients and low-resource settings.The aim is to optimize wound bed preparation,protect viable tissue,reduce infection and iatrogenic injury,and standardize outpatient and home-care practice.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide ...BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.展开更多
The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that imm...The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that immunomodulatory hydrogel dressings can facilitate diabetic wound healing.However,current immunomodulatory hydrogels require costly and complex treatments such as cell therapy and cytokines.Herein,a hierarchical hydrogel dressing with continuous biochemical gradient based on glycyrrhizic acid(GA) was constructed to modulate immunomodulatory processes in diabetic wounds.The hydrogels present many desirable features,such as tunable mechanical properties,broad antibacterial ability,outstanding conductive,transparent,and self-adhesive properties.The resultant hydrogel can promote diabetic wound healing by preventing bacterial infection,promoting macrophage polarization,improving the inflammatory microenvironment,and inducing angiogenesis and neurogenesis.Furthermore,electrical stimulation(ES) can further promote the healing of chronic diabetic wounds,providing valuable guidance for relevant clinical practice.展开更多
Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(...Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.展开更多
Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure o...Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure of bee-stingers,we developed a temperature-sensitive,two-stage microneedle-based electro active platform(GP-PPy/PLA-MN)featuring rivet-like micros tructures that integrates intelligent,precise drug-releasing,ES-transmission,and real-time wound-assessment monitoring for comprehensive chronic wound-management and diagnostic therapy.The bionic-design mechanically anchors the microneedle beneath the skin's dermis,while GP-PPy/PLA-MN demonstrates versatile therapeutic characteristics,including outstanding biocompatibility,antimicrobial properties,and antimigratory origins.The GP-PPy/PLA-MN enables the sustained release of insulin at body temperature for up to24 hours through the poly-N-isopropyl acrylamide grafted amidated-gelatin-based thermo-sensitive hydrogel at the needle-tip,thereby providing long-term stable blood glucose control.GP-PPy/PLA-MN indicates its potential as a novel bioelectronics-based patch to record the temperature and humidity during the wound-healing process,realizing significant wound diagnosis and real-time wound assessment,and fundamentally facilitating the therapeutic efficacy by supplying solid data to protect the clinical practice.Extensive in vitro and in vivo studies have demonstrated that GP-PPy/PLA-MN can provide effective ES and sustained drug release,thereby promoting chronic wound healing and increasing the wound healing rate by 20%compared to the control group after 14 days of treatment.This innovative approach combines bioelectronics with intelligent drug delivery and microneedling technology to effectively address the critical challenges of chronic wound management,offering promising prospects for precision diagnostics and therapeutic interventions.展开更多
The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors...The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors such as bacterial infections,hyperglycemia,and oxidative stress disrupt cellular functions and impair angiogenesis,substantially delaying wound repair.Nanozymes,which are engineered nanoscale materials with enzyme-like activities,offer distinct advantages over conventional enzymes and traditional nanomaterials,making them promising candidates for chronic wound treatment.To enhance their clinical potential,nanozyme-based catalytic systems are currently being optimized through formulation advancements and preclinical studies assessing their biocompatibility,anti-oxidant activity,antibacterial efficacy,and tissue repair capabilities,ensuring their safety and clinical applicability.When integrated into multifunctional wound dressings,nanozymes modulate reactive oxygen species levels,promote tissue regeneration,and simultaneously combat infections and oxidative damage,extending beyond conventional enzyme-like catalysis in chronic wound treatment.The customizable architectures of nanozymes enable precise therapeutic applications,enhancing their effectiveness in managing complex wound conditions.This review provides a comprehensive analysis of the incorporation of nanozymes into wound dressings,detailing fabrication methods and emphasizing their transformative potential in chronic wound management.By identifying and addressing key limitations,we introduce strategic advancements to drive the development of nanozyme-driven dressings,paving the way for next-generation chronic wound treatments.展开更多
BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds pre...BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therape...BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.展开更多
Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problem...Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problems.In this work,monodispersed CeO_(2)@CuS nanocomposites(NCs)were successfully prepared with tannin(TA)as the reductant and linker.Due to abundant oxygen vacancies in CeO_(2)and the polyphenolic structure of TA,the TA-CeO_(2)@CuS NCs exhibited a remarkable antioxidant ability to scavenge excessive reactive oxygen species(ROS),which would likely induce serious inflammation.In addition,the TA-CeO_(2)@CuS NCs demonstrated excellent antibacterial capability with near-infrared ray(NIR)irradiation,and the released copper ions could promote the regeneration of blood vessels.These synergistic effects indicated that the synthesized TA-CeO_(2)@CuS NCs could serve as a promising biomaterial for multimodal wound therapy.展开更多
Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.A...Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.展开更多
Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance ...Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance wearable sensors to offer prompt feedback.Existing devices have limitations in measuring pH and the concentration of pH-dependent electroactive species simultaneously,which is crucial for obtaining a comprehensive understanding of wound status and optimizing biosensors.Therefore,improving materials and analysis system accuracy is essential.This article introduces the first example of a flexible array capable of detecting pyocyanin,a bacterial virulence factor,while correcting dynamic pH fluctuations.We demonstrate that this combined sensor enhances accuracy by mitigating the impact of pH variability on pyocyanin sensor response.Customized screen-printable inks were developed to enhance analytical performance.The analytical performances of two sensitive sensor systems(i.e.,fully-printed porous graphene/multiwalled carbon nanotube(CNT)and polyaniline/CNT composites for pyocyanin and pH sensors)are evaluated.Partial least square regression is employed to analyze nonzero-order data arrays from square wave voltammetric and potentiometric measurements of pyocyanin and pH sensors to establish a predictive model for pyocyanin concentration in complex fluids.This sensitive and effective strategy shows potential for personalized applications due to its affordability,ease of use,and ability to adjust for dynamic pH changes.展开更多
Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomime...Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.展开更多
基金All animal experiments were performed under the protocols approved by the Ethical Committee for Animal Care of Donghua University(DHUEC-NSFC-2019-20)financially supported by the National Key Research and Development Program of China(2021YFA1201304)+3 种基金the National Natural Science Foundation of China(52503082),China Postdoctoral Science Foundation(2024M750402)Postdoctoral Fellowship Program of CPSF(GZC20230419)Shanghai Anticancer Association EYAS PROJECT(SACA-CY23C05)The Fundamental Research Funds for the Central Universities(2232023D-03,2232024Y-01).
文摘Diabetic wounds present challenges in clinical management due to persistent inflammation caused by excessive exudate infiltration.Inspired by the gradient wettability of cactus thorn,this study has devised a biomimetic Janus nanofiber membrane as a water diode,which endows with gradient wettability and gradient pore size,offering sustainable unidirectional self-drainage and antibacterial properties for enhanced diabetic wound healing.The Janus membrane is fabricated by depositing a hydrophilic polyacrylonitrile/chlorin e6 layer with smaller pore sizes onto a hydrophobic poly(ε-caprolactone)with larger pore sizes,thereby generating a vertical gradient in both wettability and pore structure.The incorporation of chlorin e6 in the upper layer enables the utilization of external light energy to generate heat for evaporation and produce reactive oxygen species,achieving a high sterilization efficiency of 99%.Meanwhile,the gradient structure of the Janus membrane facilitates continuous antigravity exudate drainage at a rate of 0.95 g cm^(−2) h^(−1).This dual functionality of effective exudate drainage and sterilization significantly reduces inflammatory factors,allows the polarization of macrophages toward the M2 proliferative phenotype,enhances angiogenesis,and accelerates wound healing.Therefore,this study provides a groundbreaking bioinspired strategy for the development of advanced wound dressings tailored for diabetic wound regeneration.
基金supported by the National Natural Science Foundation of China(No.32401110)Hainan Provincial Science and Technology Special Fund(No.ZDYF2025SHFZ020)+3 种基金Hainan Provincial Natural Science Foundation of China(No.525RC703)Scientific Research Project of Hainan University Collaborative Innovation Center(No.XTCX2022STC12)part of a project RENOVATE that has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement(No.101227121)Wellcome Trust-Translational Partnership Award,UCL Regenerative Medicines TIN Pilot Dara Fund(No.214046/Z/18/Z).
文摘Plasmonic gold nanoflowers(AuNFs)exhibit considerable potential in wound repair therapy due to their excellent photothermal conversion capability,high surface area,and multi-enzyme activities.However,the intrinsic pro-oxidative properties of AuNFs limit their therapeutic efficacy in diabetic wound treatment.To overcome this limitation,a near-infrared plasmonic Au@CDCe nanohybrid system that can enhance antioxidative performance through the synergistic effects of localized surface plasmon resonance-induced photothermal effect and hot electrons is developed.Specifically,AuNFs serve as near-infrared plasmonic exciters,generating hot electrons that are efficiently transferred to cerium-doped carbon dots(CDCe).Combined with mild photothermal effects,these processes synergistically enhance hydroxyl radical scavenging activity,as well as superoxide dismutase-and catalase-mimicking activities.In vitro experiments demonstrate that Au@CDCe effectively protects cells from oxidative damage,and promotes cell proliferation and migration.In vivo evaluations confirm its ability to modulate the immune microenvironment and accelerate diabetic wound healing.This work establishes a new paradigm for modulating the oxidative stress microenvironment through antioxidant gold-based plasmonic nanozymes and provides novel insights into tuning of prooxidant nanozyme into plasmon-enhanced antioxidant nanozyme.
基金funded by the Deanship of Scientific Research at King Abdulaziz University,Jeddah,under Grant No.G:534-140-1443.
文摘Objective:To evaluate the effects of a piceatannol-loaded self-nanoemulsifying drug delivery system(PIC-SNEDDS)on wound healing in diabetic rats and its mechanisms of wound healing action.Methods:Diabetes was induced in rats using streptozotocin,after which full-thickness excisional wounds were created.Piceatannol was administered topically either as a raw hydrogel or formulated into a PIC-SNEDDS,which was prepared using an optimized oil-surfactant mixture and incorporated into a hydrogel for application.Wound healing activity was assessed through measurements of wound contraction,oxidative stress biomarkers,and collagen content,along with histological and immunohistochemical evaluation of inflammatory,angiogenic,and remodeling markers.Results:PIC-SNEDDS markedly enhanced diabetic wound healing by promoting epithelial regeneration,granulation tissue formation,epidermal proliferation,and keratinization.The formulation also reduced the expression of pro-inflammatory markers(interleukin-6,nuclear factor-kappa B,and tumor necrosis factor-α)while increasingα-smooth muscle actin,transforming growth factor-β1,vascular endothelial growth factor-A,and hydroxyproline levels.Additionally,it improved antioxidant status by lowering malondialdehyde levels and boosting superoxide dismutase and catalase activity,along with upregulation of COL1A1 mRNA expression.Conclusions:PIC-SNEDDS promotes the healing of diabetic wounds and exhibits anti-inflammatory,antioxidant,pro-collagen,and angiogenic properties.
文摘Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization,increases costs,and undermines patient recovery.In An et al’s recent study,the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters.Among the evaluated algorithms,a decision tree model demonstrated excellent discrimination,achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold.The inclusion of variables such as drainage duration,preoperative white blood cell and neutrophil counts,alongside age and sex,highlights the pragmatic appeal of the model for early postoperative monitoring.Nevertheless,several aspects warrant critical reflection,including the reliance on a postoperative variable(drainage duration),internal validation only,and certain reporting inconsistencies.This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care.We advocate for transparent reporting,external validation,and careful consideration of clinically actionable timepoints before integration into practice.Ultimately,this work represents a valuable step toward precision risk stratification in gastric cancer surgery,and sets the stage for multicenter,prospective evaluations.
基金supported by the National Natural Science Foundation of China(Nos.32300413 and 32371563)the Natural Science Basic Research Program of Shaanxi Province(No.2023-JCQN-0206)+1 种基金the Shaanxi Fundamental Science Research Project for Chemistry&Biology(No.22JHQ037)the National Key R&D Program of China(No.2024YFF1307302).
文摘Diabetic wound healing remains a major clinical challenge,primarily due to excessive inflammation,bacterial infection,and impaired angiogenesis.Although various biomaterial-based strategies have been explored,coordinating the complex diabetic wound microenvironment remains difficult to achieve.This study proposes a novel multifunctional hydrogel dressing designed to synergistically address multiple issues.Its key innovation lies in dynamically crosslinking deer antler decellularized matrix(dECM)with oxidized dextran via imine bonds,creating a self-healing hydrogel(dECMH).The deer antler dECM,rich in pro-regenerative components,provides a biomimetic scaffold,while Schiff base crosslinking confers mechanical self-healing and injectability.To further address the complexity of diabetic wounds,magnesium gallate metalorganic frameworks(Mg-EGCG)were embedded within the dECMH network,forming Mg-EGCG@dECMH.This innovative combination enables sustained co-delivery of epigallocatechin gallate(EGCG)—possessing antibacterial,anti-inflammatory,and antioxidant properties—alongside magnesium ions that actively promote cell proliferation and vascular regeneration.In vitro analyses confirmed the hydrogel's capacity to enhance endothelial cell proliferation,boost angiogenesis,and mitigate oxidative stress.In vivo evaluations demonstrated accelerated wound healing,manifested by rapid inflammation resolution,ordered collagen deposition,and stimulated neovascularization.Additionally,the material exhibited excellent biocompatibility,hemostatic effects,and antimicrobial activity.This multifunctional dressing synergistically integrates the inherent bioactivity of unique antler decellularized matrix with the multimodal therapeutic effects of metal-organic nanocomposites,offering an innovative and effective strategy for diabetic wound management.
基金supports received from Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)+3 种基金the Natural Science Foundation of Liaoning Province(Grant No.2024-MS-075)the National Natural Science Foundation of China(32201179)National Key R&D Program of China(2023YFC2508200)Liaoning Provincial Natural Science Foundation Joint Fund(General Support Program Project)(2023-MSBA-093).
文摘Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.
文摘The use of artificial intelligence(AI)in wound care has become a crucial instrument in improving the diagnosis,treatment,and management of chronic wounds.This study examines the several functions of AI in wound care,emphasizing its ability to better wound evaluation,hasten healing,alleviate pain,and improve cost-effectiveness.AI-driven technology,including mobile applications and intelligent bandages,provides precise wound assessment,tissue analysis,and continuous monitoring,hence allowing for tailored treatment strategies and prompt intervention.Moreover,AI-driven algorithms forecast wound healing trajectories and find individuals susceptible to chronic wounds,allowing prompt preventative interventions.There are also practical issues with integrating it into clinical practice.Adding AI to current healthcare systems,like electronic medical records(EMRs),needs careful planning and teamwork to make sure that AI-driven insights are used well in real-time clinical decision-making.To make sure AI is used safely,legal frameworks need to be set up to provide clear rules for its use in healthcare.These frameworks should include openness,risk management,and data evaluation.Lastly,clinical validation and acceptance are still big problems.Many AI-powered tools don't have enough clinical validation and aren't widely available,which makes it hard to use them in everyday clinical practice.Solving these problems is important for getting the most out of AI in wound care and making sure it is used safely and effectively.The article combines current advancements and prospective trajectories in AI-assisted wound care,highlighting its revolutionary ability to revolutionize patient outcomes and healthcare delivery.
基金supported by grants from the German Research Foundation (DFG)
文摘Chronic,non-healing wounds represent a significant challenge for healthcare systems worldwide,often requiring significant human and financial resources.Chronic wounds arise from the complex interplay of underlying comorbidities,such as diabetes or vascular diseases,lifestyle factors,and genetic risk profiles which may predispose extremities to local ischemia.Injuries are further exacerbated by bacterial colonization and the formation of biofilms.Infection,consequently,perpetuates a chronic inflammatory microenvironment,preventing the progression and completion of normal wound healing.The current standard of care(SOC)for chronic wounds involves surgical debridement along with localized wound irrigation,which requires inpatient care under general anesthesia.This could be followed by,if necessary,defect coverage via a reconstructive ladder utilizing wound debridement along with skin graft,local,or free flap techniques once the wound conditions are stabilized and adequate blood supply is restored.To promote physiological wound healing,a variety of approaches have been subjected to translational research.Beyond conventional wound healing drugs and devices that currently supplement treatments,cellular and immunotherapies have emerged as promising therapeutics that can behave as tailored therapies with cell-or molecule-specific wound healing properties.However,in contrast to the clinical omnipresence of chronic wound healing disorders,there remains a shortage of studies condensing the current body of evidence on cellular therapies and immunotherapies for chronic wounds.This review provides a comprehensive exploration of current therapies,experimental approaches,and translational studies,offering insights into their efficacy and limitations.Ultimately,we hope this line of research may serve as an evidence-based foundation to guide further experimental and translational approaches and optimize patient care long-term.
文摘This guideline summarizes evidence-based recommendations for cleansing and antisepsis in chronic wounds.It defines target populations,assessment and decision frameworks,preferred cleansing solutions and pressures,indications and limits for antiseptics,biofilm-oriented strategies,pain control,and adaptations for high-risk patients and low-resource settings.The aim is to optimize wound bed preparation,protect viable tissue,reduce infection and iatrogenic injury,and standardize outpatient and home-care practice.
基金Supported by the National Natural Science Foundation of China,No.82202454 and No.81873934the Wang Zhengguo Trauma Medicine Fund(Growth Factor Revival Plan)No.SZYZ-TR-09+1 种基金the Shandong Provincial Natural Science Foundation Youth Fund,No.ZR2020QH168the Jinan Science and Technology Plan Project,No.202225065。
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a significant challenge in diabetic care,and the efficacy of negative pressure wound therapy(NPWT)in treating them remains a subject of continuous investigation.AIM To provide a comprehensive meta-analysis of the role of NPWT in the manage-ment of DFUs.METHODS A systematic review was performed based on Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses guidelines,searching databases like PubMed,Embase,Web of Science,and the Cochrane Library.Randomized clinical trials(RCTs)were included to compare NPWT to other dressings for DFUs.Outcomes measured were wound healing time and rate,granulation tissue formation time,amputation rate,and adverse events.Study quality was evaluated using Coch-rane's risk of bias tool.Analyses utilizedχ2,I2,fixed or random-effects models via Stata v17.RESULTS Of the 1101 identified articles,9 RCTs were selected for meta-analysis.Studies spanned from 2005 to 2020 and originated from countries including the United States,Chile,Pakistan,Italy,India,and Germany.Meta-analysis demonstrated a significant improvement in wound healing rate[risk ratio(RR)=1.46,95%CI:1.22-1.76,P<0.01]and a reduction in amputation rate(RR=0.69,95%CI:0.50-0.96,P=0.006)with NPWT.Furthermore,the time for granulation tissue formation was significantly reduced by an average of 19.54 days.However,the incidence of adverse events did not significantly differ between NPWT and control treatments.CONCLUSION NPWT significantly improves wound healing rates and reduces amputation rates in DFUs.It also hastens the formation of granulation tissue.However,the therapy does not significantly alter the risk of adverse events compared to alternate treatments.
基金supported by Natural Science Foundation of Jilin Province(No.SKL202302002)。
文摘The healing of diabetic wounds poses a significant healthcare burden due to persistent inflammation,M1 macrophage aggregation,and high glucose levels in the microenvironment.Previous studies have demonstrated that immunomodulatory hydrogel dressings can facilitate diabetic wound healing.However,current immunomodulatory hydrogels require costly and complex treatments such as cell therapy and cytokines.Herein,a hierarchical hydrogel dressing with continuous biochemical gradient based on glycyrrhizic acid(GA) was constructed to modulate immunomodulatory processes in diabetic wounds.The hydrogels present many desirable features,such as tunable mechanical properties,broad antibacterial ability,outstanding conductive,transparent,and self-adhesive properties.The resultant hydrogel can promote diabetic wound healing by preventing bacterial infection,promoting macrophage polarization,improving the inflammatory microenvironment,and inducing angiogenesis and neurogenesis.Furthermore,electrical stimulation(ES) can further promote the healing of chronic diabetic wounds,providing valuable guidance for relevant clinical practice.
基金Supported by Henan Province Key Research and Development Program,No.231111311000Henan Provincial Science and Technology Research Project,No.232102310411+2 种基金Henan Province Medical Science and Technology Key Project,No.LHGJ20220566 and No.LHGJ20240365Henan Province Medical Education Research Project,No.WJLX2023079Zhengzhou Medical and Health Technology Innovation Guidance Program,No.2024YLZDJH022.
文摘Necrotizing fasciitis(NF)is a rapidly progressing,life-threatening soft tissue infection,with upper limb NF posing a particularly serious threat to patient survival and quality of life.Negative pressure wound therapy(NPWT)has shown considerable advantages in accelerating wound healing and mitigating functional impairment.A retrospective study by Lipatov et al.demonstrated that NPWT significantly reduced the time needed for wound closure preparation while enhancing the success rate of local repair.Despite its benefits,certain limitations highlight the need for further optimization.This paper investigates the potential for personalized dynamic regulation of NPWT,its integration with adjunctive therapies,and the role of multidisciplinary collaboration.Furthermore,it explores the incorporation of advanced technologies such as artificial intelligence,imaging modalities,and biomaterials,presenting novel pathways for the personalized management and global standardization of NF treatment.
基金financially supported by the National Natural Science Foun-dation of China(22278257)the Key R&D Program of Shaanxi Province(2024SF-YBXM-586)the Project of Innovation Capability Support Program in Shaanxi Province(2024ZC-KJXX-005)。
文摘Rapidly-advancing microneedle-based bioelectronics integrated with electrical stimulation(ES)therapy exhibit significant potential for improving chronic wound management.Herein,bio-inspired by the serrated structure of bee-stingers,we developed a temperature-sensitive,two-stage microneedle-based electro active platform(GP-PPy/PLA-MN)featuring rivet-like micros tructures that integrates intelligent,precise drug-releasing,ES-transmission,and real-time wound-assessment monitoring for comprehensive chronic wound-management and diagnostic therapy.The bionic-design mechanically anchors the microneedle beneath the skin's dermis,while GP-PPy/PLA-MN demonstrates versatile therapeutic characteristics,including outstanding biocompatibility,antimicrobial properties,and antimigratory origins.The GP-PPy/PLA-MN enables the sustained release of insulin at body temperature for up to24 hours through the poly-N-isopropyl acrylamide grafted amidated-gelatin-based thermo-sensitive hydrogel at the needle-tip,thereby providing long-term stable blood glucose control.GP-PPy/PLA-MN indicates its potential as a novel bioelectronics-based patch to record the temperature and humidity during the wound-healing process,realizing significant wound diagnosis and real-time wound assessment,and fundamentally facilitating the therapeutic efficacy by supplying solid data to protect the clinical practice.Extensive in vitro and in vivo studies have demonstrated that GP-PPy/PLA-MN can provide effective ES and sustained drug release,thereby promoting chronic wound healing and increasing the wound healing rate by 20%compared to the control group after 14 days of treatment.This innovative approach combines bioelectronics with intelligent drug delivery and microneedling technology to effectively address the critical challenges of chronic wound management,offering promising prospects for precision diagnostics and therapeutic interventions.
基金supported by the Key Project of the Joint Fund for Regional Innovation and Development of the National Natural Science Foundation of China(U23A20686)the National Natural Science Foundation of China(81901979)+2 种基金the Peking University People’s Hospital Scientific Research Development Funds(RDJP2022-07)the Joint Funds for the Innovation of Science and Technology,Fujian Province(2023Y9226)the Introduced High-Level Talent Team Project of Quanzhou City(2023CT008).
文摘The treatment of chronic wounds presents significant challenges due to the necessity of accelerating healing within complex microenvironments characterized by persistent inflammation and biochemical imbalances.Factors such as bacterial infections,hyperglycemia,and oxidative stress disrupt cellular functions and impair angiogenesis,substantially delaying wound repair.Nanozymes,which are engineered nanoscale materials with enzyme-like activities,offer distinct advantages over conventional enzymes and traditional nanomaterials,making them promising candidates for chronic wound treatment.To enhance their clinical potential,nanozyme-based catalytic systems are currently being optimized through formulation advancements and preclinical studies assessing their biocompatibility,anti-oxidant activity,antibacterial efficacy,and tissue repair capabilities,ensuring their safety and clinical applicability.When integrated into multifunctional wound dressings,nanozymes modulate reactive oxygen species levels,promote tissue regeneration,and simultaneously combat infections and oxidative damage,extending beyond conventional enzyme-like catalysis in chronic wound treatment.The customizable architectures of nanozymes enable precise therapeutic applications,enhancing their effectiveness in managing complex wound conditions.This review provides a comprehensive analysis of the incorporation of nanozymes into wound dressings,detailing fabrication methods and emphasizing their transformative potential in chronic wound management.By identifying and addressing key limitations,we introduce strategic advancements to drive the development of nanozyme-driven dressings,paving the way for next-generation chronic wound treatments.
基金National Natural Science Foundation of China,No.81873934and Jinan Science and Technology Planning Project,No.202225065.
文摘BACKGROUND Mesenchymal stem cells,found in various tissues,possess significant healing and immunomodulatory properties,influencing macrophage polarization,which is essential for wound repair.However,chronic wounds present significant therapeutic challenges,requiring novel strategies to improve healing outcomes.AIM To investigate the potential of fetal dermal mesenchymal stem cells(FDMSCs)in enhancing wound healing through modulation of macrophage polarization,specifically by promoting the M2 phenotype to address inflammatory responses in chronic wounds.METHODS FDMSCs were isolated from BalB/C mice and co-cultured with RAW264.7 macrophages to assess their effects on macrophage polarization.Flow cytometry,quantitative reverse transcriptase polymerase chain reaction,and histological analyses were employed to evaluate shifts in macrophage phenotype and wound healing in a mouse model.Statistical analysis was performed using GraphPad Prism.RESULTS FDMSCs induced macrophage polarization from the M1 to M2 phenotype,as demonstrated by a reduction in proinflammatory markers(inducible nitric oxide synthase,interleukin-6)and an increase in anti-inflammatory markers[mannose receptor(CD206),arginase-1]in co-cultured RAW264.7 macrophages.These shifts were confirmed by flow cytometry.In an acute skin wound model,FDMSC-treated mice exhibited faster wound healing,enhanced collagen deposition,and improved vascular regeneration compared to controls.Significantly higher expression of arginase-1 further indicated an enriched M2 macrophage environment.CONCLUSION FDMSCs effectively modulate macrophage polarization from M1 to M2,reduce inflammation,and enhance tissue repair,demonstrating their potential as an immunomodulatory strategy in wound healing.These findings highlight the promising therapeutic application of FDMSCs in managing chronic wounds.
基金Hubei Province Top Medical Youth Talent Program,Wuhan Knowledge Innovation Special Basic Research Project,No.2023020201020558Clinical Research Project of Affiliated Hospital of Guangdong Medical University,No.LCYJ2021B004 and No.LCYJ2019B010Science and Technology Plan Project of Zhanjiang,No.2022A01191.
文摘BACKGROUND Diabetic foot ulcers(DFUs)present a significant clinical challenge due to their high prevalence and profound impact on morbidity.Ultrasound-assisted wound debridement(UAWD)has emerged as a potential therapeutic modality to improve healing outcomes in DFU management.AIM To evaluate the efficacy of UAWD in treating DFUs on wound closure rates,treatment duration,and quality of life outcomes.METHODS This systematic review and meta-analysis followed PRISMA guidelines,systematically searching PubMed,Embase,Web of Science,and the Cochrane Library with no date restrictions.Randomized controlled trials(RCTs)that evaluated the efficacy of UAWD in DFU treatment were included.Data were independently extracted by two reviewers,with discrepancies resolved through consensus or third-party consultation.The risk of bias was assessed using the Cochrane tool.χ2 and I2 statistics assessed heterogeneity,informing the use of fixed or random-effects models for meta-analysis,supplemented by sensitivity analysis and publication bias assessment through funnel plots and Egger's test.RESULTS From 1255 articles,seven RCTs met the inclusion criteria.The studies demonstrated that UAWD significantly reduced DFU healing time(standardized mean difference=-0.78,95%CI:-0.97 to-0.60,P<0.001)and increased healing rates(odds ratio=9.96,95%CI:5.99 to 16.56,P<0.001)compared to standard care.Sensitivity analysis confirmed the stability of these results,and no significant publication bias was detected.CONCLUSION UAWD is a promising adjunctive treatment for DFUs,significantly reducing healing times and increasing healing rates.These findings advocate for the integration of UAWD into standard DFU care protocols.
基金supported by Key Scientific and Technological Project of Henan Province(No.242102231060)Doctoral Scientific Research Foundation of Zhoukou Normal University(No.ZKNUC2021041)the Program of Innovative Research Team(in Science and Technology)in University of Henan Province(No.23IRTSTHN008)。
文摘Bacterial infection,insufficient angiogenesis,and oxidative damage are generally regarded as key issues that impede wound healing,making it necessary to prepare new biomaterials to simultaneously address these problems.In this work,monodispersed CeO_(2)@CuS nanocomposites(NCs)were successfully prepared with tannin(TA)as the reductant and linker.Due to abundant oxygen vacancies in CeO_(2)and the polyphenolic structure of TA,the TA-CeO_(2)@CuS NCs exhibited a remarkable antioxidant ability to scavenge excessive reactive oxygen species(ROS),which would likely induce serious inflammation.In addition,the TA-CeO_(2)@CuS NCs demonstrated excellent antibacterial capability with near-infrared ray(NIR)irradiation,and the released copper ions could promote the regeneration of blood vessels.These synergistic effects indicated that the synthesized TA-CeO_(2)@CuS NCs could serve as a promising biomaterial for multimodal wound therapy.
基金supported in part by the National Nature Science Foundation of China(92268206,81830064)the CAMS Innovation Fund for Medical Sciences(CIFMS,2019-I2M-5-059)+4 种基金the Military Medical Research Projects(145AKJ260015000X,2022-JCJQ-ZB-09600)the Military Key Basic Research of Foundational Strengthening Program(2020-JCJQ-ZD-256-021)the Science Foundation of National Defense Science and Technology for Excellent Young(2022-JCJQ-ZQ-017)the Military Medical Research and Development Projects(AWS17J005,2019-126)the Specific Research Fund of The Innovation Platform for Academicians of Hainan Province(YSPTZX202317).
文摘Scar formation resulting from burns or severe trauma can significantly compromise the structural integrity of skin and lead to permanent loss of skin appendages,ultimately impairing its normal physiological function.Accumulating evidence underscores the potential of targeted modulation of mechanical cues to enhance skin regeneration,promoting scarless repair by influencing the extracellular microenvironment and driving the phenotypic transitions.The field of skin repair and skin appendage regeneration has witnessed remarkable advancements in the utilization of biomaterials with distinct physical properties.However,a comprehensive understanding of the underlying mechanisms remains somewhat elusive,limiting the broader application of these innovations.In this review,we present two promising biomaterial-based mechanical approaches aimed at bolstering the regenerative capacity of compromised skin.The first approach involves leveraging biomaterials with specific biophysical properties to create an optimal scarless environment that supports cellular activities essential for regeneration.The second approach centers on harnessing mechanical forces exerted by biomaterials to enhance cellular plasticity,facilitating efficient cellular reprogramming and,consequently,promoting the regeneration of skin appendages.In summary,the manipulation of mechanical cues using biomaterial-based strategies holds significant promise as a supplementary approach for achieving scarless wound healing,coupled with the restoration of multiple skin appendage functions.
基金the Talent Management Project of Prince of Songkla University
文摘Wearable sensing systems have been designed to monitor health conditions in real-time by detecting analytes in human biofluids.Wound diagnosis remains challenging,necessitating suitable materials for high-performance wearable sensors to offer prompt feedback.Existing devices have limitations in measuring pH and the concentration of pH-dependent electroactive species simultaneously,which is crucial for obtaining a comprehensive understanding of wound status and optimizing biosensors.Therefore,improving materials and analysis system accuracy is essential.This article introduces the first example of a flexible array capable of detecting pyocyanin,a bacterial virulence factor,while correcting dynamic pH fluctuations.We demonstrate that this combined sensor enhances accuracy by mitigating the impact of pH variability on pyocyanin sensor response.Customized screen-printable inks were developed to enhance analytical performance.The analytical performances of two sensitive sensor systems(i.e.,fully-printed porous graphene/multiwalled carbon nanotube(CNT)and polyaniline/CNT composites for pyocyanin and pH sensors)are evaluated.Partial least square regression is employed to analyze nonzero-order data arrays from square wave voltammetric and potentiometric measurements of pyocyanin and pH sensors to establish a predictive model for pyocyanin concentration in complex fluids.This sensitive and effective strategy shows potential for personalized applications due to its affordability,ease of use,and ability to adjust for dynamic pH changes.
基金supported by the National Natural Science Foundation of China(No.82272297).
文摘Abnormal wound scarring often leads to functional impairments and cosmetic deformities,primarily driven by the prolonged activation of the TGF-β/Smad signaling pathway.Addressing this challenge,we developed a biomimetic scaffold aimed at facilitating rapid and scarless wound healing.This highly in-tegrated 3D-printed dermal scaffold comprised modified recombinant human type III collagen(rhCOLIII-MA),gelatin methacrylate(GelMA),and liposomes encapsulating SB431542 to target TGF-β1(Lip@SB).The rhCOLIII-MA/GelMA(CG)scaffold retained inherent biomaterial characteristics,exhibited tailored physicochemical properties,and demonstrated favorable biocompatibility.Moreover,the Lip@SB-loaded CG scaffold(CGL)effectively promoted in vitro wound healing,while enabling controlled release of SB431542 to inhibit pathological collagen deposition.In a full-thickness skin defect rat model,the CGL dermal scaffold combined with split-thickness skin graft(STSG)minimized scar contraction,stimulated functional neovascularization,and enhanced graft aesthetics comparable to normal skin.Remarkably,the performance of the CGL scaffold surpassed that of commercially available anti-scarring alternatives.This innovative strategy presents a straightforward approach toward scarless skin regeneration and holds promise in alleviating the prolonged,painful postoperative rehabilitation.
