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
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
Diabetic wounds represent a significant challenge in the medical field,significantly impacting patient quality of life and imposing a heavy burden on healthcare systems.Intelligent hydrogel dressings have attracted si...Diabetic wounds represent a significant challenge in the medical field,significantly impacting patient quality of life and imposing a heavy burden on healthcare systems.Intelligent hydrogel dressings have attracted significant attention in diabetic wound treatment due to their unique properties.This review systematically explores the three main categories of intelligent hydrogels(natural,synthetic,and composite),dissecting their composition,structure,and the mechanisms that enable their intelligent responses.The crucial roles of these dressings in maintaining a moist wound environment,efficiently absorbing exudate,and precisely delivering drugs are expounded.Moreover,their application advantages in combating bacteria and infections,regulating inflammation and immunity,promoting angiogenesis and tissue regeneration,as well as enabling real-time monitoring and personalized treatment,are explored in depth.Additionally,we discuss future research directions and the prospects for personalized precision medicine in diabetic wound care,aiming to inspire innovation and provide a comprehensive theoretical basis for the development of nextgeneration intelligent dressings.展开更多
Chronic diabetic wounds,a common and severe complication of diabetes,are characterized by their inability to heal due to impaired blood and oxygen supply.In addition to glycemic control,various clinical treatments suc...Chronic diabetic wounds,a common and severe complication of diabetes,are characterized by their inability to heal due to impaired blood and oxygen supply.In addition to glycemic control,various clinical treatments such as wound dressings,hyperbaric oxygen therapy,and phototherapy have been employed to manage these wounds.Low-level light therapy has emerged as an effective,noninvasive,and painless therapeutic approach for wound management.However,the bulkiness of traditional light sources and the need for frequent clinic visits have limited its widespread adoption.We have developed a wearable,flexible light-emitting bandage with cyanobacterial impregnation(LEB@Cyan).The bioactive bandage is designed to provide sustained oxygen generation and robust photobiomodulation,promoting keratinocyte migration,fibroblast proliferation,and angiogenesis.This addresses the hypoxic conditions and enhances bioenergetic supply to accelerate the healing process of diabetic wounds.In detail,the wound area of diabetic rats treated with LEB@Cyan showed significant reductions of 74.76%and 96.32%compared with that of LEB-treated diabetic rats and untreated diabetic rats,respectively.Such self-oxygenated wearable light-emitting fabric holds great promise for future clinical and commercial applications,potentially revolutionizing the management of chronic diabetic wounds.展开更多
Diabetic wounds(DWs)are a major complication of diabetes mellitus,characterized by a complex patho-physiological microenvironment that is associated with elevated morbidity and mortality.Conventional management strate...Diabetic wounds(DWs)are a major complication of diabetes mellitus,characterized by a complex patho-physiological microenvironment that is associated with elevated morbidity and mortality.Conventional management strategies often fail to address the multifaceted nature of these wounds effectively.Recent advancements in understanding the mechanisms of DW healing have spurred the development of a plethora of bioactive dressings designed to interact with and modulate the DW microenvironment.These innovations have culminated in the introduction of the“microenvironment-sensitive with on-demand management”paradigm aimed at delivering precision therapy responsive to dynamic changes within DW.Despite these advancements,the current literature lacks a comprehensive review that cate-gorizes and evaluates active,passive,and on-demand approaches that address the DW microenviron-ment.Herein,we describe the unique pathogenic mechanisms and microenvironmental characteristics that distinguish DW from normal acute wounds.This review provides an extensive overview of contem-porary active and passive management strategies incorporating on-demand management principles designed for DW microenvironments.Furthermore,it addresses the principal challenges faced in this therapeutic domain and outlines the potential innovations that can enhance the efficacy and specificity of bioactive dressings.The insights presented here aim to guide further research and development in the on-demand management of DW to improve patient outcomes by aligning personalized therapy modali-ties with the pathophysiological realities of DW.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
The low temperature,high salt content,and bacterial composition of a seawater environment can induce severe infections in open wounds,thus impeding wound healing.To date,numerous wound dressings have been developed fo...The low temperature,high salt content,and bacterial composition of a seawater environment can induce severe infections in open wounds,thus impeding wound healing.To date,numerous wound dressings have been developed for injuries and various antibacterial functions.However,ordinary antibacterial strategies could not provide long-term resistance to infections and could not promote wound healing.Here,we proposed a strategy for enhancing resistance to seawater immersion wound infection by killing bacteria and delivering bacterial antigens in situ.Specifically,MXene-embedded tannin-Eu^(3+)(M@TA-Eu)particles were constructed to effectively alleviate injuries infected through seawater immersion and persistently fight infection by forming in situ bacterial vaccines and immune memory.In the particle,the platform composed of TA and Eu3+exhibited provascularization and antigen presentation effects.MXenes with near-infrared photothermal effect were introduced to kill the bacteria,promote the recruitment of antigen presentation cells,and ultimately enhance vaccination efficacy.Experimental results showed that the particles not only effectively accelerated the healing of injuries by relieving wound inflammation and inhibiting bacteria but also produced a potent vaccination by forming in situ bacterial vaccines.Therefore,the M@TA-Eu particles are novel materials for high-grade anti-infection dressing.展开更多
BACKGROUND Burn wound management is challenging,and while mesenchymal stem cellderived exosomes show therapeutic potential,optimal delivery methods are unclear.AIM To study chitosan(CS)-αβ-glycerophosphate(CS-αβ-G...BACKGROUND Burn wound management is challenging,and while mesenchymal stem cellderived exosomes show therapeutic potential,optimal delivery methods are unclear.AIM To study chitosan(CS)-αβ-glycerophosphate(CS-αβ-GP)hydrogel crosslinked with adipose-derived stem cell exosomes(ASC-Exos)for healing deep burn injuries.METHODS Rats with deep burn injuries were divided into the CS+ASCs-Exos group,the ASCs-Exos group,the CS group,and the control group.The healing rates on days 4,7,and 14 after treatment were analyzed using ImageJ software.On day 14,the tissues were stained with hematoxylin and eosin staining,Masson’s trichrome staining,and immunohistochemical analysis to evaluate tumor necrosis factorα,interleukin-6(IL-6),IL-1α,IL-10,transforming growth factorβ,and epidermal growth factor.The mRNA levels of IL-1α,CD86,C-C motif chemokine ligand 22,and CD163 were evaluated through quantitative polymerase chain reaction.RESULTS The CS+ASC-Exos group exhibited enhanced healing,reduced lymphocyte infiltration,blood vessels,and muscle fiber distribution.Increased IL-10,transforming growth factorβ,and epidermal growth factor and decreased tumor necrosis factorα,IL-1α,and IL-6 expression were observed.Quantitative polymerase chain reaction revealed reduced IL-1αand CD86 and increased C-C motif chemokine ligand 22 and CD163 expression.Protein analysis showed downregulation of phosphorylated inhibitor of kappa Balpha and P65 in the nuclear factorκB(NF-κB)pathway.ASC-Exos crosslinked with CS-αβ-GP hydrogel demonstrates superior effects in anti-inflammation,wound healing promotion,and promotion of M1 macrophage transformation to M2 macrophage by blocking the NF-κB pathway compared to ASC-Exos alone.CONCLUSION Our research demonstrates that the ASC-Exos cross-linked CS-αβ-GP hydrogel represents an advanced therapeutic approach for treating deep burn wounds.It has anti-inflammatory effects,promotes wound healing,and facilitates the transition of M1 macrophages to M2 macrophages by blocking the NF-κB pathway.展开更多
The skin wound is susceptible to bacterial invasion,which hinders the healing of the wound,especially when infected with multi-drug resistant strains.This demands novel bioactive materials to combat bacterial infectio...The skin wound is susceptible to bacterial invasion,which hinders the healing of the wound,especially when infected with multi-drug resistant strains.This demands novel bioactive materials to combat bacterial infections.In this study,gallium oxide nanoparticles(Ga_(2)O_(3)NPs)were successfully synthesized through high-temperature thermal decomposition,exhibiting excellent biocompatibility and photocatalytic antimicrobial activity.The Ga_(2)O_(3)NPs were crosslinked into chitosan hydrogel to create a light-responsive multilayered 3D porous hydrogel(Ga_(2)O_(3)NPs hydrogel)for use in photocatalytic antimicrobial therapy(PCAT).The prepared Ga_(2)O_(3)NPs hydrogel exhibits broad-spectrum photocatalytic activity and remarkable antibacterial efficacy against E.coli and S.aureus.It effectively eradicates biofilms,promotes reactive oxygen species production,disrupts bacterial cell membranes,and induces nucleic acid leakage,ultimately resulting in bacterial death.Additionally,it exhibits excellent biosafety.Both in vitro pigskin and in vivo mouse wound infection models have confirmed the remarkable efficacy of Ga_(2)O_(3)NPs hydrogel in PCAT.Notably,Ga_(2)O_(3)NPs hydrogel created a moist environment for the wound in an MDR S.aureus-infected mouse wound model,demonstrating significant potential to facilitate wound healing and minimize scar formation.This study introduces a novel hydrogel dressing without antibiotic components for resistant bacterial-infected wounds.展开更多
Different from other orthopaedic diseases, orthopaedic traumatic diseases usually have chronic wounds that are difficult to heal, which will not only aggravate patients' pain, but also increase their psychological...Different from other orthopaedic diseases, orthopaedic traumatic diseases usually have chronic wounds that are difficult to heal, which will not only aggravate patients' pain, but also increase their psychological burden, thus easily hindering the rapid healing of wounds. Therefore, based on the actual situation of patients' wounds, the clinic should establish corresponding personal nursing records, and take a series of humanized nursing measures such as psychological counseling and behavioral intervention for chronic and refractory wounds, so as to keep patients in good physical and mental state, encourage patients to cooperate with the treatment actively, and return to healthy life as soon as possible.展开更多
Objective:To evaluate the activity of selected Ethiopian medicinal plants traditionally used for wound treatment against wound-causing bacteria.Methods:Samples of medicinal plants(Achyranthes aspera,Brucea antidysente...Objective:To evaluate the activity of selected Ethiopian medicinal plants traditionally used for wound treatment against wound-causing bacteria.Methods:Samples of medicinal plants(Achyranthes aspera,Brucea antidysenteriea,Datura stramonium,Croton macrostachyus,Acokanthera xchimperi.,Phytolacca dodecandra,Milhttia ferruginea,and Solanum incanum)were extracted using absolute methanol and water and tested for their antimicrobial activities against clinical isolates and standard strains of wound-causing bacteria using agar well diffusion and micro titer plate methods.Results:Most of the plant extracts had antibacterial activities,among which Acokanthera schimperi and Brucea antidysenteriea inhibited growth of 100%and 35%of the test organisms,respectively.Methanolic extracts had higher activities compared with their corresponding aqueous extracts.The most susceptible organism to the extracts was Streptococcus pyogens while the most resistant were Escherichia coli and Proteus vulgaris.Conclusions:This finding justifies the use of the plants in wound healing and their potential activity against woundcausing bacteria.Their toxicity level and antimicrobial activity with different extraction solvents should further be studied to use them as sources and templates for the synthesis of drugs to control wound and other disease-causing bacteria.展开更多
OBJECTIVE:To investigate the protective effect and possible mechanism of sodium Danshensu(SDSS)against pressure injury caused by ischemia/reperfusion(I/R)injury.METHODS:Sprague-Dawley rats were randomly divided into f...OBJECTIVE:To investigate the protective effect and possible mechanism of sodium Danshensu(SDSS)against pressure injury caused by ischemia/reperfusion(I/R)injury.METHODS:Sprague-Dawley rats were randomly divided into five groups of eight rats each:control group,model group,10 mg/kg SDSS-treated group,20 mg/kg SDSS-treated group,and 40 mg/kg SDSS-treated group.We used two round ferrite magnetic plates of 15 mm diameter and 3 mm thickness to establish stage 2 pressure injury model rats.Each rat was subjected to five cycles of ischemia and reperfusion to induce pressure injury.One cycle consisted of 2 h of ischemia and 0.5 h of reperfusion,which meant that each cycle included2 h of pressure and 0.5 h of pressure relief.The outline of the wound was delineated by butter paper and marker pen,and histopathological changes were observed by hematoxylin and eosin staining.In addition,the number of apoptotic cells and the activity of caspase-3 were assessed by terminal deoxynucleotidyl transferase-mediated nick end labeling and caspase-3 assay kits,respectively.The expression of apoptosis-regulatory proteins and inflammatory mediators was investigated by enzyme-linked immunosorbent assay.RESULTS:Results showed that treatment with SDSS for 7 d after establishing the pressure injury model remarkably improved the healing rate of the wound.SDSS also inhibited the levels of tumor necrosis factor-α,myeloperoxidase,and intercellular cell adhesion molecule-1;decreased the number of apoptotic cells;increased the ratio of B-cell lymphoma-2(Bcl-2)/Bcl-2-associated X(Bax);and regulated the expression and activity of caspase-3.CONCLUSION:Our results suggest that SDSS exhibits a treatment efficacy for pressure injury caused by I/R injury possibly by inhibiting apoptosis and inflammatory response.展开更多
BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic...BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.展开更多
BACKGROUND The impairment of cutaneous wound healing results in chronic,non-healing wounds that are caused by altered wound environment oxygenation,tissue injury,and permissive microbial growth.Current modalities for ...BACKGROUND The impairment of cutaneous wound healing results in chronic,non-healing wounds that are caused by altered wound environment oxygenation,tissue injury,and permissive microbial growth.Current modalities for the treatment of these wounds inadequately address the complex changes involved in chronic wound pathogenesis.Consequently,stem cell therapies have emerged as a potential therapeutic modality to promote cutaneous regeneration through trophic and paracrine activity.AIM To investigate current literature regarding use of stem cell therapies for the clinical treatment of chronic,non-healing wounds.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,and Scopus were queried with combinations of the search terms“mesenchymal stem cells,”“adult stem cells,”“embryonic stem cells,”“erythroid precursor cells,”“stem cell therapies,”and“chronic wounds”in order to find relevant articles published between the years of 2000 and 2019 to review a 20-year experience.Reference lists from the articles were reviewed to identify additional pertinent articles.Retrieved manuscripts(reviews,case reports/series,retrospective/prospective studies,and clinical trials)were evaluated by the authors for their depiction of clinical stem cell therapy use.Data were extracted from the articles using a standardized collection tool.RESULTS A total of 43 articles describing the use of stem cell therapies for the treatment of chronic wounds were included in this review.While stem cell therapies have been explored in in vitro and in vivo applications in the past,recent efforts are geared towards assessing their clinical role.A review of the literature revealed that adipose-derived stem cells,bone marrow-derived stem cells,bone marrowderived mononuclear cells,epidermally-derived mesenchymal stem cells,fibroblast stem cells,keratinocyte stem cells,placental mesenchymal stem cells,and umbilical cord mesenchymal stem cells have all been employed in the treatment of chronic wounds of various etiologies.Most recently,embryonic stem cells have emerged as a novel stem cell therapy with the capacity for multifaceted germ cell layer differentiation.With the capacity for self-renewal and differentiation,stem cells can enrich existing cell populations in chronic wounds in order to overcome barriers impeding the progression of wound healing.Further,stem cell therapies can be utilized to augment cell engraftment,signaling and activity,and resultant patient outcomes.CONCLUSION Assessing observed clinical outcomes,potential for stem cell use,and relevant therapeutic challenges allows wound care stakeholders to make informed decisions regarding optimal treatment approaches for their patients’chronic wounds.展开更多
BACKGROUND Cerebral infarction patients need to be bedridden for long periods of time often resulting in pressure injuries,which may represent a serious threat to patients'life and health.An effective nursing prog...BACKGROUND Cerebral infarction patients need to be bedridden for long periods of time often resulting in pressure injuries,which may represent a serious threat to patients'life and health.An effective nursing program should be adopted for timely intervention in patients with pressure wounds.AIM To explore the value of nursing services based on a multidisciplinary collaborative treatment team in patients with pressure injury wounds following cerebral infarction.METHODS Patients with cerebral infarction pressure injury wounds in our hospital from December 2016 to January 2021 were selected and divided into one study group and one control group based on the simple random number table method.The control group was treated with conventional nursing care(CNC),and the study group was treated with care services based on multidisciplinary collaborative care(MDCC).The Pressure Ulcer Scale for Healing(PUSH),healing effect,Self-Perceived Burden Score(SPBS),and satisfaction with the intervention were calculated before and after 2 and 4 wk of intervention in both groups.RESULTS Sixty-two patients were enrolled,and 31 patients were assigned to each group.The results of the interventions were as follows:(1)There was no significant difference between the PUSH scores of the MDCC group(11.19±2.46)and CNC group(12.01±2.79)before the intervention(P>0.05),and the PUSH scores were lower after 2 and 4 wk of intervention in the MDCC group(6.63±1.97 and 3.11±1.04)than in the CNC group(8.78±2.13 and 4.96±1.35 points)(P<0.05);(2)The rate of wound healing in the MDCC group(96.77%)was higher than that in the CNC group(80.65%)(P<0.05);(3)There was no significant difference between the SPBS scores of emotional factors(21.15±3.11),economic factors(9.88±2.15),and physical factors(8.19±2.23)in the two groups before the intervention.The scores of emotional factors(13.51±1.88),economic factors(6.38±1.44),and physical factors(5.37±1.08)were lower in the MDCC group than in the CNC group(16.89±2.05,7.99±1.68 and 7.06±1.19)after 4 wk of intervention(P<0.05);and(4)Satisfaction with the intervention was higher in the MDCC group(93.55%)than in the CNC group(74.19%)(P<0.05).CONCLUSION Interventions for patients with cerebral infarction pressure wounds based on an MDCC treatment team can effectively reduce patients'self-perceived burden,improve pressure wound conditions,facilitate wound healing,and increase patient satisfaction with the intervention.展开更多
Background:The prevalence of MRSA(Methicillin-resistant Staphylococcus aureus)colonized wounds in home care residents is expected to grow continuously as a result of the substantial proportion of older people requirin...Background:The prevalence of MRSA(Methicillin-resistant Staphylococcus aureus)colonized wounds in home care residents is expected to grow continuously as a result of the substantial proportion of older people requiring institutionalized care due to chronic disease and declining functional status,which contribute to more frequent skin breakdown and wound formation.Tea tree oil has been claimed to have anti-bacterial,analgesic and anti-inflammatory effects that have been suggested in many in-vitro studies to have good efficacy against MRSA.The aims of this study were to evaluate the effectiveness of 10%topical tea tree preparation to eradicateMRSA and to ascertain its influence on wound healing forMRSA-colonized wounds.Methods:It was a randomized controlled trial,single-blind study.Those with stage II or above MRSA-colonized wounds and who had given their informed consent formed the sample.The determined sample sizewasbasedonthe effect size of our previouspilot study,whichwas 0.46.Five outcome measurements were taken for the MRSA bacterial count and wound healing condition at baseline and at 1-week intervals during the 4-week dressing intervention period.Results:Thirty-two participants were recruited from two non-government nursing homes,16 in the control group and 16 in the tea tree oil group.The control group residents received routine saline gauze dressing,while the tea tree oil group residents received the 10%topical tea tree preparation dressing.In the tea tree oil group,all chronic wounds that had previously been delayed in healing were healed within 28 days without adverse reaction.MRSA was also completely eradicated in 14(87.5%)out of 16 wounds in the group receiving the 10%topical tea tree preparation.展开更多
BACKGROUND Patients with keloids who receive radiotherapy(RT)after surgery can develop refractory wounds that cannot be healed by the patient's own repair system.Such chronic wounds are uneven and complex due to p...BACKGROUND Patients with keloids who receive radiotherapy(RT)after surgery can develop refractory wounds that cannot be healed by the patient's own repair system.Such chronic wounds are uneven and complex due to persistent abscess and ulceration.Without external intervention,they can easily result in local tissue necrosis or,in severe cases,large area tissue resection,amputation,and even death.CASE SUMMARY This article describes the use of hydrogen to treat a 42-year-old female patient with a chronic wound on her left shoulder.The patient had a skin graft that involved implanting a dilator under the skin of her left shoulder,and then transferring excess skin from her shoulder onto scar tissue on her chest.The skin grafting was followed by two rounds of RT,after which the shoulder wound had difficulty healing.For six months,the patient was treated with 2 h of hydrogen inhalation(HI)therapy per day,in addition to application of sterile gauze on the wound and periodic debridement.We also performed one deep,large,sharp debridement to enlarge the wound area.The wound healed completely within 6 mo of beginning the HI treatment.CONCLUSION After HI therapy,the patient showed superior progress in reepithelialization and wound repair,with eventual wound closure in 6 mo,in comparison with the previous failures of hyperbaric oxygen and recombinant bovine basic fibroblast growth factor therapies.Our work showed that HI therapy could be a new strategy for wound healing that is cleaner,more convenient,and less expensive than other therapies,as well as easily accessible for further application in clinical wound care.展开更多
Background： Poor healing wounds or postoperative infection after open-heart surgery are most commonly seen, especially in secondary surgery for heart diseases, with an incidence rate of 2.2% after a valve replacement...Background： Poor healing wounds or postoperative infection after open-heart surgery are most commonly seen, especially in secondary surgery for heart diseases, with an incidence rate of 2.2% after a valve replacement surgery. If not treated in time or the infection progresses, it can lead to sternal infection, even mediastinal and pericardial infection, causing a higher mortality rate. It becomes a really troublesome and complicated case when a poor healing occurs in midsternal incision after the heart valve surgery and a higher medical cost may be needed. Methods From January 2009 to February 2013, 162 patients who underwent heart valve surgery through midsternal incision approach and had a poor healing of wound were observed for prospective randomized controlled trial. The patients were randomly assigned to a vacuum sealing drainage group （n = 81） who received vacuum sealing drainage for healing of the wound or a control group （n = 81） who received traditional treating for the infected wound. Their therapeutic effects, healing time and treatment costs, etc were compared. Results Two patients from the vacuum sealing drainage group came back to hospital for repair due to dehiscence of the incision after discharge, and no patient died. Six patients from the control group came back to hospital for repair due to dehiscence of the incision after discharge, two came back to hospital for surgery due to chronic osteomyelitis, and one patient died two weeks later after surgery due to severe chest infection. Wound healing time for vacuum sealing drainage group was 14.6 ± 3.6 days, which was significantly shorter than that of the control group （21.2 ± 7.8 days, P 〈 0.05）, while the medical costs showed no significant difference between the two groups （P 〉 0.05）. Seventy-eight patients （96.29%） in the vacuum sealing drainage group showed a good healing of the wound and sternum after a six-month follow-up. Conclusion The use of vacuum sealing drainage technique in poor-healing wounds after heart valve surgery through midsternal incision approach could achieve good therapeutic efficacy, with shorter wound healing time and similar costs as traditional treatment.展开更多
Diabetic wound takes longer time to heal due to micro and macro-vascular ailment.This longer healing time can lead to infections and other health complications.Foot ulcers are one of the most common diabetic wounds.Th...Diabetic wound takes longer time to heal due to micro and macro-vascular ailment.This longer healing time can lead to infections and other health complications.Foot ulcers are one of the most common diabetic wounds.These are one of the leading cause of amputations.Medical science is continuously striving for improving quality of human life.A recent trend of amalgamation of knowledge,efforts and technological advancement of medical science experts and artificial intelligence researchers,has made tremendous success in diagnosis,prognosis and treatment of a variety of diseases.Diabetic wounds are no exception,as artificial intelligence experts are putting their research efforts to apply latest technological advancements in the field to help medical care personnel to deal with diabetic wounds in more effective manner.The presented study reviews the diagnostic and treatment research under the umbrella of Artificial Intelligence and computational science,for diabetic wound healing.Framework for diabetic wound assessment using artificial intelligence is presented.Moreover,this review is focused on existing and potential contribution of artificial intelligence to improve medical services for diabetic wound patients.The article also discusses the future directions for the betterment of the field that can lead to facilitate both,clinician and patients.展开更多
BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(...BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.展开更多
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.
文摘Diabetic wounds represent a significant challenge in the medical field,significantly impacting patient quality of life and imposing a heavy burden on healthcare systems.Intelligent hydrogel dressings have attracted significant attention in diabetic wound treatment due to their unique properties.This review systematically explores the three main categories of intelligent hydrogels(natural,synthetic,and composite),dissecting their composition,structure,and the mechanisms that enable their intelligent responses.The crucial roles of these dressings in maintaining a moist wound environment,efficiently absorbing exudate,and precisely delivering drugs are expounded.Moreover,their application advantages in combating bacteria and infections,regulating inflammation and immunity,promoting angiogenesis and tissue regeneration,as well as enabling real-time monitoring and personalized treatment,are explored in depth.Additionally,we discuss future research directions and the prospects for personalized precision medicine in diabetic wound care,aiming to inspire innovation and provide a comprehensive theoretical basis for the development of nextgeneration intelligent dressings.
基金supported by the National Natural Science Foundation of China[Grant Nos.52375414(L.K.)and 82372121(M.H.)]the Shanghai Science&Technology Committee Innovation Grant[Grant No.23ZR1404200(L.K.)]the Yiwu Research Institute of Fudan University(L.K.),and the Shanghai Rising-Star Program[Grant No.23QA1409500 H.)].
文摘Chronic diabetic wounds,a common and severe complication of diabetes,are characterized by their inability to heal due to impaired blood and oxygen supply.In addition to glycemic control,various clinical treatments such as wound dressings,hyperbaric oxygen therapy,and phototherapy have been employed to manage these wounds.Low-level light therapy has emerged as an effective,noninvasive,and painless therapeutic approach for wound management.However,the bulkiness of traditional light sources and the need for frequent clinic visits have limited its widespread adoption.We have developed a wearable,flexible light-emitting bandage with cyanobacterial impregnation(LEB@Cyan).The bioactive bandage is designed to provide sustained oxygen generation and robust photobiomodulation,promoting keratinocyte migration,fibroblast proliferation,and angiogenesis.This addresses the hypoxic conditions and enhances bioenergetic supply to accelerate the healing process of diabetic wounds.In detail,the wound area of diabetic rats treated with LEB@Cyan showed significant reductions of 74.76%and 96.32%compared with that of LEB-treated diabetic rats and untreated diabetic rats,respectively.Such self-oxygenated wearable light-emitting fabric holds great promise for future clinical and commercial applications,potentially revolutionizing the management of chronic diabetic wounds.
基金supported by the National Natural Science Foundation of China(22408078,82401057,32101170)the Zhejiang Province Postdoctoral Excellence Funding Program-Special Support(ZJ2024004).
文摘Diabetic wounds(DWs)are a major complication of diabetes mellitus,characterized by a complex patho-physiological microenvironment that is associated with elevated morbidity and mortality.Conventional management strategies often fail to address the multifaceted nature of these wounds effectively.Recent advancements in understanding the mechanisms of DW healing have spurred the development of a plethora of bioactive dressings designed to interact with and modulate the DW microenvironment.These innovations have culminated in the introduction of the“microenvironment-sensitive with on-demand management”paradigm aimed at delivering precision therapy responsive to dynamic changes within DW.Despite these advancements,the current literature lacks a comprehensive review that cate-gorizes and evaluates active,passive,and on-demand approaches that address the DW microenviron-ment.Herein,we describe the unique pathogenic mechanisms and microenvironmental characteristics that distinguish DW from normal acute wounds.This review provides an extensive overview of contem-porary active and passive management strategies incorporating on-demand management principles designed for DW microenvironments.Furthermore,it addresses the principal challenges faced in this therapeutic domain and outlines the potential innovations that can enhance the efficacy and specificity of bioactive dressings.The insights presented here aim to guide further research and development in the on-demand management of DW to improve patient outcomes by aligning personalized therapy modali-ties with the pathophysiological realities of DW.
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 the National Key Research and Development Program of China(No.2018YFC0311103)the Project of Science and Technology Innovation Cultivation for University Students of Guangdong Province(No.pdjh202010062)+6 种基金the Science and Technology Project of Guangzhou City(No.2018020100)the General Program of China Postdoctoral Science Foundation(No.2021M701599)the National Natural Science Foundation of China(No.32201083)the Science and Technology Program of Heyuan,China(No.230510171473326)the Science and Technology Program of Guangzhou,China(No.2024A03J0232)the Medical Scientific Research Foundation of Guangdong Province of China(No.A2020548)the Fundamental Research Funds for the Central Universities,China(No.21623403).
文摘The low temperature,high salt content,and bacterial composition of a seawater environment can induce severe infections in open wounds,thus impeding wound healing.To date,numerous wound dressings have been developed for injuries and various antibacterial functions.However,ordinary antibacterial strategies could not provide long-term resistance to infections and could not promote wound healing.Here,we proposed a strategy for enhancing resistance to seawater immersion wound infection by killing bacteria and delivering bacterial antigens in situ.Specifically,MXene-embedded tannin-Eu^(3+)(M@TA-Eu)particles were constructed to effectively alleviate injuries infected through seawater immersion and persistently fight infection by forming in situ bacterial vaccines and immune memory.In the particle,the platform composed of TA and Eu3+exhibited provascularization and antigen presentation effects.MXenes with near-infrared photothermal effect were introduced to kill the bacteria,promote the recruitment of antigen presentation cells,and ultimately enhance vaccination efficacy.Experimental results showed that the particles not only effectively accelerated the healing of injuries by relieving wound inflammation and inhibiting bacteria but also produced a potent vaccination by forming in situ bacterial vaccines.Therefore,the M@TA-Eu particles are novel materials for high-grade anti-infection dressing.
基金the Incubation Program of the General Hospital of the Western Theater Command,No.2021-XZYG-C29 and No.2021-XZYG-B32.
文摘BACKGROUND Burn wound management is challenging,and while mesenchymal stem cellderived exosomes show therapeutic potential,optimal delivery methods are unclear.AIM To study chitosan(CS)-αβ-glycerophosphate(CS-αβ-GP)hydrogel crosslinked with adipose-derived stem cell exosomes(ASC-Exos)for healing deep burn injuries.METHODS Rats with deep burn injuries were divided into the CS+ASCs-Exos group,the ASCs-Exos group,the CS group,and the control group.The healing rates on days 4,7,and 14 after treatment were analyzed using ImageJ software.On day 14,the tissues were stained with hematoxylin and eosin staining,Masson’s trichrome staining,and immunohistochemical analysis to evaluate tumor necrosis factorα,interleukin-6(IL-6),IL-1α,IL-10,transforming growth factorβ,and epidermal growth factor.The mRNA levels of IL-1α,CD86,C-C motif chemokine ligand 22,and CD163 were evaluated through quantitative polymerase chain reaction.RESULTS The CS+ASC-Exos group exhibited enhanced healing,reduced lymphocyte infiltration,blood vessels,and muscle fiber distribution.Increased IL-10,transforming growth factorβ,and epidermal growth factor and decreased tumor necrosis factorα,IL-1α,and IL-6 expression were observed.Quantitative polymerase chain reaction revealed reduced IL-1αand CD86 and increased C-C motif chemokine ligand 22 and CD163 expression.Protein analysis showed downregulation of phosphorylated inhibitor of kappa Balpha and P65 in the nuclear factorκB(NF-κB)pathway.ASC-Exos crosslinked with CS-αβ-GP hydrogel demonstrates superior effects in anti-inflammation,wound healing promotion,and promotion of M1 macrophage transformation to M2 macrophage by blocking the NF-κB pathway compared to ASC-Exos alone.CONCLUSION Our research demonstrates that the ASC-Exos cross-linked CS-αβ-GP hydrogel represents an advanced therapeutic approach for treating deep burn wounds.It has anti-inflammatory effects,promotes wound healing,and facilitates the transition of M1 macrophages to M2 macrophages by blocking the NF-κB pathway.
基金financially supported by the Advanced Fiber Materials Engineering Research Center of Anhui Province(No.2023AFMC20)the Scientific Research Foundation for Advanced Talents of Anhui Polytechnic University(No.2022YQQ072)+5 种基金the Anhui Province Key Research and Development Program(No.2022i01020002)the Key Project Foundation of Anhui Higher Education Institutes of China(No.2023AH050941)the Natural Science Foundation of the Jiangsu Higher Education Institutions of China(No.22KJB180020)the Transversal Project(No.KH10004443),the Anhui Provincial Natural Science Foundation(No.2308085Y45)the Program for Excellent Sci-tech Innovation Teams of Universities in Anhui Province(No.2023AH010073)Wuhu Science and Technology Department project(No.2023jc22).
文摘The skin wound is susceptible to bacterial invasion,which hinders the healing of the wound,especially when infected with multi-drug resistant strains.This demands novel bioactive materials to combat bacterial infections.In this study,gallium oxide nanoparticles(Ga_(2)O_(3)NPs)were successfully synthesized through high-temperature thermal decomposition,exhibiting excellent biocompatibility and photocatalytic antimicrobial activity.The Ga_(2)O_(3)NPs were crosslinked into chitosan hydrogel to create a light-responsive multilayered 3D porous hydrogel(Ga_(2)O_(3)NPs hydrogel)for use in photocatalytic antimicrobial therapy(PCAT).The prepared Ga_(2)O_(3)NPs hydrogel exhibits broad-spectrum photocatalytic activity and remarkable antibacterial efficacy against E.coli and S.aureus.It effectively eradicates biofilms,promotes reactive oxygen species production,disrupts bacterial cell membranes,and induces nucleic acid leakage,ultimately resulting in bacterial death.Additionally,it exhibits excellent biosafety.Both in vitro pigskin and in vivo mouse wound infection models have confirmed the remarkable efficacy of Ga_(2)O_(3)NPs hydrogel in PCAT.Notably,Ga_(2)O_(3)NPs hydrogel created a moist environment for the wound in an MDR S.aureus-infected mouse wound model,demonstrating significant potential to facilitate wound healing and minimize scar formation.This study introduces a novel hydrogel dressing without antibiotic components for resistant bacterial-infected wounds.
文摘Different from other orthopaedic diseases, orthopaedic traumatic diseases usually have chronic wounds that are difficult to heal, which will not only aggravate patients' pain, but also increase their psychological burden, thus easily hindering the rapid healing of wounds. Therefore, based on the actual situation of patients' wounds, the clinic should establish corresponding personal nursing records, and take a series of humanized nursing measures such as psychological counseling and behavioral intervention for chronic and refractory wounds, so as to keep patients in good physical and mental state, encourage patients to cooperate with the treatment actively, and return to healthy life as soon as possible.
基金Supported by Aklilu Lemma Institute of Pathobiology.Addis Ababa University
文摘Objective:To evaluate the activity of selected Ethiopian medicinal plants traditionally used for wound treatment against wound-causing bacteria.Methods:Samples of medicinal plants(Achyranthes aspera,Brucea antidysenteriea,Datura stramonium,Croton macrostachyus,Acokanthera xchimperi.,Phytolacca dodecandra,Milhttia ferruginea,and Solanum incanum)were extracted using absolute methanol and water and tested for their antimicrobial activities against clinical isolates and standard strains of wound-causing bacteria using agar well diffusion and micro titer plate methods.Results:Most of the plant extracts had antibacterial activities,among which Acokanthera schimperi and Brucea antidysenteriea inhibited growth of 100%and 35%of the test organisms,respectively.Methanolic extracts had higher activities compared with their corresponding aqueous extracts.The most susceptible organism to the extracts was Streptococcus pyogens while the most resistant were Escherichia coli and Proteus vulgaris.Conclusions:This finding justifies the use of the plants in wound healing and their potential activity against woundcausing bacteria.Their toxicity level and antimicrobial activity with different extraction solvents should further be studied to use them as sources and templates for the synthesis of drugs to control wound and other disease-causing bacteria.
基金Supported by the Health Commission of Zhejiang Province(Exploring the Mechanism of Danshensu Anti-apoptosis Effect in Rat Models of Stage 2 Pressure Injury Based on PI3K/AKT Pathway,No.2019KY470)。
文摘OBJECTIVE:To investigate the protective effect and possible mechanism of sodium Danshensu(SDSS)against pressure injury caused by ischemia/reperfusion(I/R)injury.METHODS:Sprague-Dawley rats were randomly divided into five groups of eight rats each:control group,model group,10 mg/kg SDSS-treated group,20 mg/kg SDSS-treated group,and 40 mg/kg SDSS-treated group.We used two round ferrite magnetic plates of 15 mm diameter and 3 mm thickness to establish stage 2 pressure injury model rats.Each rat was subjected to five cycles of ischemia and reperfusion to induce pressure injury.One cycle consisted of 2 h of ischemia and 0.5 h of reperfusion,which meant that each cycle included2 h of pressure and 0.5 h of pressure relief.The outline of the wound was delineated by butter paper and marker pen,and histopathological changes were observed by hematoxylin and eosin staining.In addition,the number of apoptotic cells and the activity of caspase-3 were assessed by terminal deoxynucleotidyl transferase-mediated nick end labeling and caspase-3 assay kits,respectively.The expression of apoptosis-regulatory proteins and inflammatory mediators was investigated by enzyme-linked immunosorbent assay.RESULTS:Results showed that treatment with SDSS for 7 d after establishing the pressure injury model remarkably improved the healing rate of the wound.SDSS also inhibited the levels of tumor necrosis factor-α,myeloperoxidase,and intercellular cell adhesion molecule-1;decreased the number of apoptotic cells;increased the ratio of B-cell lymphoma-2(Bcl-2)/Bcl-2-associated X(Bax);and regulated the expression and activity of caspase-3.CONCLUSION:Our results suggest that SDSS exhibits a treatment efficacy for pressure injury caused by I/R injury possibly by inhibiting apoptosis and inflammatory response.
基金Supported by Shenzhen Longhua District Science and Innovation Bureau for Key Laboratory Construction,No.20160919A0410022Shenzhen Longhua District Science and Innovation Bureau Fund for Medical Institutions,No.2020038 and No.2017136。
文摘BACKGROUND Management of chronic refractory wounds is one of the toughest clinical challenges for surgeons.Because of poor blood supply,less tissue coverage,and easy exposure,the lower leg is a common site for chronic refractory wounds.The current therapeutic regimens often lead to prolonged hospital stay and higher healthcare costs.Concentrated growth factor(CGF)is a novel blood extract that contains various growth factors,platelets,and fibrins to promote wound healing process.However,there has been little research reported on the treatment of lower extremity wounds with CGF.CASE SUMMARY A 37-year-old man,without any past medical history,presented an ulcerated chronic wound on his right lower leg.The skin defect exhibited clear boundaries,with a size of 2.0 cm×3.5 cm.The depth of wound was up to the layer of deep fascia.Staphylococcus aureus was detected by bacterial culture.The final diagnosis was right lower extremity ulcers with infection.Cefathiamidine,silver sulfadiazine,and mupirocin cream were applied to control the infection.CGF gel was prepared from the patient’s blood sample,and was used to cover the wound after thorough debridement.The skin wound was successfully healed after three times of CGF treatment.CONCLUSION CGF displays an excellent wound healing promoting effect in patients with lowerextremity chronic refractory wounds.
文摘BACKGROUND The impairment of cutaneous wound healing results in chronic,non-healing wounds that are caused by altered wound environment oxygenation,tissue injury,and permissive microbial growth.Current modalities for the treatment of these wounds inadequately address the complex changes involved in chronic wound pathogenesis.Consequently,stem cell therapies have emerged as a potential therapeutic modality to promote cutaneous regeneration through trophic and paracrine activity.AIM To investigate current literature regarding use of stem cell therapies for the clinical treatment of chronic,non-healing wounds.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,and Scopus were queried with combinations of the search terms“mesenchymal stem cells,”“adult stem cells,”“embryonic stem cells,”“erythroid precursor cells,”“stem cell therapies,”and“chronic wounds”in order to find relevant articles published between the years of 2000 and 2019 to review a 20-year experience.Reference lists from the articles were reviewed to identify additional pertinent articles.Retrieved manuscripts(reviews,case reports/series,retrospective/prospective studies,and clinical trials)were evaluated by the authors for their depiction of clinical stem cell therapy use.Data were extracted from the articles using a standardized collection tool.RESULTS A total of 43 articles describing the use of stem cell therapies for the treatment of chronic wounds were included in this review.While stem cell therapies have been explored in in vitro and in vivo applications in the past,recent efforts are geared towards assessing their clinical role.A review of the literature revealed that adipose-derived stem cells,bone marrow-derived stem cells,bone marrowderived mononuclear cells,epidermally-derived mesenchymal stem cells,fibroblast stem cells,keratinocyte stem cells,placental mesenchymal stem cells,and umbilical cord mesenchymal stem cells have all been employed in the treatment of chronic wounds of various etiologies.Most recently,embryonic stem cells have emerged as a novel stem cell therapy with the capacity for multifaceted germ cell layer differentiation.With the capacity for self-renewal and differentiation,stem cells can enrich existing cell populations in chronic wounds in order to overcome barriers impeding the progression of wound healing.Further,stem cell therapies can be utilized to augment cell engraftment,signaling and activity,and resultant patient outcomes.CONCLUSION Assessing observed clinical outcomes,potential for stem cell use,and relevant therapeutic challenges allows wound care stakeholders to make informed decisions regarding optimal treatment approaches for their patients’chronic wounds.
文摘BACKGROUND Cerebral infarction patients need to be bedridden for long periods of time often resulting in pressure injuries,which may represent a serious threat to patients'life and health.An effective nursing program should be adopted for timely intervention in patients with pressure wounds.AIM To explore the value of nursing services based on a multidisciplinary collaborative treatment team in patients with pressure injury wounds following cerebral infarction.METHODS Patients with cerebral infarction pressure injury wounds in our hospital from December 2016 to January 2021 were selected and divided into one study group and one control group based on the simple random number table method.The control group was treated with conventional nursing care(CNC),and the study group was treated with care services based on multidisciplinary collaborative care(MDCC).The Pressure Ulcer Scale for Healing(PUSH),healing effect,Self-Perceived Burden Score(SPBS),and satisfaction with the intervention were calculated before and after 2 and 4 wk of intervention in both groups.RESULTS Sixty-two patients were enrolled,and 31 patients were assigned to each group.The results of the interventions were as follows:(1)There was no significant difference between the PUSH scores of the MDCC group(11.19±2.46)and CNC group(12.01±2.79)before the intervention(P>0.05),and the PUSH scores were lower after 2 and 4 wk of intervention in the MDCC group(6.63±1.97 and 3.11±1.04)than in the CNC group(8.78±2.13 and 4.96±1.35 points)(P<0.05);(2)The rate of wound healing in the MDCC group(96.77%)was higher than that in the CNC group(80.65%)(P<0.05);(3)There was no significant difference between the SPBS scores of emotional factors(21.15±3.11),economic factors(9.88±2.15),and physical factors(8.19±2.23)in the two groups before the intervention.The scores of emotional factors(13.51±1.88),economic factors(6.38±1.44),and physical factors(5.37±1.08)were lower in the MDCC group than in the CNC group(16.89±2.05,7.99±1.68 and 7.06±1.19)after 4 wk of intervention(P<0.05);and(4)Satisfaction with the intervention was higher in the MDCC group(93.55%)than in the CNC group(74.19%)(P<0.05).CONCLUSION Interventions for patients with cerebral infarction pressure wounds based on an MDCC treatment team can effectively reduce patients'self-perceived burden,improve pressure wound conditions,facilitate wound healing,and increase patient satisfaction with the intervention.
文摘Background:The prevalence of MRSA(Methicillin-resistant Staphylococcus aureus)colonized wounds in home care residents is expected to grow continuously as a result of the substantial proportion of older people requiring institutionalized care due to chronic disease and declining functional status,which contribute to more frequent skin breakdown and wound formation.Tea tree oil has been claimed to have anti-bacterial,analgesic and anti-inflammatory effects that have been suggested in many in-vitro studies to have good efficacy against MRSA.The aims of this study were to evaluate the effectiveness of 10%topical tea tree preparation to eradicateMRSA and to ascertain its influence on wound healing forMRSA-colonized wounds.Methods:It was a randomized controlled trial,single-blind study.Those with stage II or above MRSA-colonized wounds and who had given their informed consent formed the sample.The determined sample sizewasbasedonthe effect size of our previouspilot study,whichwas 0.46.Five outcome measurements were taken for the MRSA bacterial count and wound healing condition at baseline and at 1-week intervals during the 4-week dressing intervention period.Results:Thirty-two participants were recruited from two non-government nursing homes,16 in the control group and 16 in the tea tree oil group.The control group residents received routine saline gauze dressing,while the tea tree oil group residents received the 10%topical tea tree preparation dressing.In the tea tree oil group,all chronic wounds that had previously been delayed in healing were healed within 28 days without adverse reaction.MRSA was also completely eradicated in 14(87.5%)out of 16 wounds in the group receiving the 10%topical tea tree preparation.
基金Supported by National Natural Science Foundation of China,No.81602408Military Logistics Key Open Research Projects,China,No.BHJ17L018.
文摘BACKGROUND Patients with keloids who receive radiotherapy(RT)after surgery can develop refractory wounds that cannot be healed by the patient's own repair system.Such chronic wounds are uneven and complex due to persistent abscess and ulceration.Without external intervention,they can easily result in local tissue necrosis or,in severe cases,large area tissue resection,amputation,and even death.CASE SUMMARY This article describes the use of hydrogen to treat a 42-year-old female patient with a chronic wound on her left shoulder.The patient had a skin graft that involved implanting a dilator under the skin of her left shoulder,and then transferring excess skin from her shoulder onto scar tissue on her chest.The skin grafting was followed by two rounds of RT,after which the shoulder wound had difficulty healing.For six months,the patient was treated with 2 h of hydrogen inhalation(HI)therapy per day,in addition to application of sterile gauze on the wound and periodic debridement.We also performed one deep,large,sharp debridement to enlarge the wound area.The wound healed completely within 6 mo of beginning the HI treatment.CONCLUSION After HI therapy,the patient showed superior progress in reepithelialization and wound repair,with eventual wound closure in 6 mo,in comparison with the previous failures of hyperbaric oxygen and recombinant bovine basic fibroblast growth factor therapies.Our work showed that HI therapy could be a new strategy for wound healing that is cleaner,more convenient,and less expensive than other therapies,as well as easily accessible for further application in clinical wound care.
基金supported by Medical Scientific Research Foundation of Guangdong Province(No. B2013019)grants from Administration of Traditional Chinese Medicine of Guangdong Province (No. 20121258 & No. 20132075)
文摘Background： Poor healing wounds or postoperative infection after open-heart surgery are most commonly seen, especially in secondary surgery for heart diseases, with an incidence rate of 2.2% after a valve replacement surgery. If not treated in time or the infection progresses, it can lead to sternal infection, even mediastinal and pericardial infection, causing a higher mortality rate. It becomes a really troublesome and complicated case when a poor healing occurs in midsternal incision after the heart valve surgery and a higher medical cost may be needed. Methods From January 2009 to February 2013, 162 patients who underwent heart valve surgery through midsternal incision approach and had a poor healing of wound were observed for prospective randomized controlled trial. The patients were randomly assigned to a vacuum sealing drainage group （n = 81） who received vacuum sealing drainage for healing of the wound or a control group （n = 81） who received traditional treating for the infected wound. Their therapeutic effects, healing time and treatment costs, etc were compared. Results Two patients from the vacuum sealing drainage group came back to hospital for repair due to dehiscence of the incision after discharge, and no patient died. Six patients from the control group came back to hospital for repair due to dehiscence of the incision after discharge, two came back to hospital for surgery due to chronic osteomyelitis, and one patient died two weeks later after surgery due to severe chest infection. Wound healing time for vacuum sealing drainage group was 14.6 ± 3.6 days, which was significantly shorter than that of the control group （21.2 ± 7.8 days, P 〈 0.05）, while the medical costs showed no significant difference between the two groups （P 〉 0.05）. Seventy-eight patients （96.29%） in the vacuum sealing drainage group showed a good healing of the wound and sternum after a six-month follow-up. Conclusion The use of vacuum sealing drainage technique in poor-healing wounds after heart valve surgery through midsternal incision approach could achieve good therapeutic efficacy, with shorter wound healing time and similar costs as traditional treatment.
文摘Diabetic wound takes longer time to heal due to micro and macro-vascular ailment.This longer healing time can lead to infections and other health complications.Foot ulcers are one of the most common diabetic wounds.These are one of the leading cause of amputations.Medical science is continuously striving for improving quality of human life.A recent trend of amalgamation of knowledge,efforts and technological advancement of medical science experts and artificial intelligence researchers,has made tremendous success in diagnosis,prognosis and treatment of a variety of diseases.Diabetic wounds are no exception,as artificial intelligence experts are putting their research efforts to apply latest technological advancements in the field to help medical care personnel to deal with diabetic wounds in more effective manner.The presented study reviews the diagnostic and treatment research under the umbrella of Artificial Intelligence and computational science,for diabetic wound healing.Framework for diabetic wound assessment using artificial intelligence is presented.Moreover,this review is focused on existing and potential contribution of artificial intelligence to improve medical services for diabetic wound patients.The article also discusses the future directions for the betterment of the field that can lead to facilitate both,clinician and patients.
基金This observational study was approved by the Ethics Committee of Renmin Hospital of Wuhan University.
文摘BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.
