Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-resp...Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-responsive drug-releasing microcarriers which were loaded with vascular endothelial growth factor(VEGF)that promotes angiogenesis and actively respond to wound pH for control and prolong VEGF release.The surfaces of the microcarriers were coated with polydopamine which can reduce the silver nanoparticles(AgNPs)in situ,and dynamically crosslink with the polyacrylamide,which forms a stable slow-release system with different release behavior for the VEGF and AgNPs.The hydrogel inhib-ited bacterial formation and accelerated wound healing.With the hydrogel dressing,83.3%±4.29%of the wound heals at day 7,which is 40.9%±8.5%higher than the non-treatment group in defect infected model.The antibacterial properties of hydrogel down-regulate early inflammation-related cytokines,and the release of VEGF in the middle and late phases of wound healing in response to pH changes pro-motes angiogenesis and up-regulate the expression of angiogenesis-associated cytokine.The sequential release of antibacterial agents and pro-vascularizing agents in response to the change in wound microen-vironmental cues facilitate temporally controlled therapy that suites the need of different wound healing phases.Collectively,the hydrogel loaded with multifunctional microcarriers that enable controlled release of AgNPs and VEGF is an effective system for treating infected wounds.展开更多
Infected diabetic wounds represent one of the most severe complications of diabetes mellitus,with complex pathological mechanisms that present significant challenges in clinical management.Ferroptosis,an emerging form...Infected diabetic wounds represent one of the most severe complications of diabetes mellitus,with complex pathological mechanisms that present significant challenges in clinical management.Ferroptosis,an emerging form of iron-dependent programmed cell death driven by excessive lipid peroxidation,plays a critical role in the progression of infected diabetic wounds.This review systematically examines the central mechanisms of ferroptosis in infected diabetic wounds from three key perspectives:dysregulation of iron metabolism,accumulation of lipid peroxidation products,and impairment of the antioxidant defense system.Moreover,it analyzes the impact of ferroptosis on various cell types-fibroblasts,macrophages,vascular endothelial cells,and keratinocytes-during the impaired healing process.Based on these mechanistic insights,the review summarizes recent advances in ferroptosis-targeted therapeutic strategies for wound repair,including ferroptosis inhibitors,cell-based therapies,and innovative hydrogel materials with promising application potential.By integrating current knowledge on the role of ferroptosis in infected diabetic wounds and associated treatment approaches,this article aims to provide new perspectives and a solid theoretical foundation for future research and the comprehensive management of this challenging condition.展开更多
Background:Infected wounds caused by bacteria such as Escherichia coli and Staphylococcus aureus pose significant challenges during the healing process.Hydrogels have emerged as promising materials for the treatment o...Background:Infected wounds caused by bacteria such as Escherichia coli and Staphylococcus aureus pose significant challenges during the healing process.Hydrogels have emerged as promising materials for the treatment of such infections,as they have the potential to deliver therapeutic agents while supporting tissue repair.This study aimed to develop ε-PLL@SA/Gel(PSG)hydrogels by incorporating varying concentrations of ε-poly-L-lysine(ε-PLL)into sodium alginate/gelatin(SA/Gel)using calcium chloride as a crosslinking agent,and to evaluate their antibacterial efficacy.Methods:The mechanical properties,biocompatibility,antibacterial activity of hydrogels were evaluated.Biocompatibility was examined by measuring cell viability and proliferation of human skin fibroblasts in vitro.Antibacterial efficacy against Escherichia coli and Staphylococcus aureus was quantified using bacterial inhibition assays.The wound healing efficacy of the hydrogels were evaluated in mouse models of infected wounds.Results:PSG hydrogels exhibited excellent mechanical strength,injectability,and self-adhesive properties.In vitro,hydrogel treatment resulted in high cell viability and promoted human skin fibroblast proliferation.PSG15 exhibited the highest antibacterial activity and inhibited E.coli and S.aureus by 89.53% and 92.21%,respectively.In vivo,PSG15 significantly accelerated wound healing,enhanced angiogenesis,and regulated macrophage polarization by increasing CD206 expression and decreasing CD80 expression.Additionally,PSG15 modulated the skin microbiota,reduced pathogenic bacterial abundance and maintained microbiota diversity.Conclusions:The PSG15 hydrogel is a promising candidate for the treatment of infected wounds because it inhibits bacterial growth,promotes tissue repair,and modulates the wound microbiota.展开更多
Cold atmospheric plasmas are widely used in biomedicine.Although direct plasma treatments of wounds have been demon-strated,there are still obstacles hampering further clinical adoption,for example,the limited treatme...Cold atmospheric plasmas are widely used in biomedicine.Although direct plasma treatments of wounds have been demon-strated,there are still obstacles hampering further clinical adoption,for example,the limited treatment area,inconsistent ac-tions and risk of thermal injury.In this respect,plasma-activated air(PAA)is proposed and demonstrated for infected wounds treatment as an alternative to the conventional direct plasma treatment.The combination of gliding arc discharge reactor and dielectric barrier discharge reactor produces highly bioactive PAA.In in vitro sterilisation of Staphylococcus aureus,approxi-mately 9-log reduction is achieved after the PAA treatment for 6 min.Bovine serum albumin is added to the S.aureus sus-pension to further simulate the wound exudate to accomplish inactivation of approximately 3-log reduction after 10 min.In vivo experiments show that the PAA treatment of infected wounds significantly reduces the bacterial load and improves the healing rate,revealing an optimal treatment time of 3 min/day.The immunohistochemical and blood biochemical analyses show that the PAA-3 min treatment enhances wound healing by inhibiting the tissue inflammatory response and inducing growth factor production without showing evident systemic toxicity.In conclusion,PAA holds great clinical promise as a safe and effective wound-healing strategy.展开更多
Effectively controlling bacterial infections and reducing oxidative stress and inflammatory reactions are important steps in wound healing.However,owing to the improper use of antibiotics and inadequate control of inf...Effectively controlling bacterial infections and reducing oxidative stress and inflammatory reactions are important steps in wound healing.However,owing to the improper use of antibiotics and inadequate control of infections in recent years,the emergence of many broadspectrum drug-resistant strains has exacerbated the threat of infected wounds to human health.Recent studies have shown that bimetallic nanozymes may become an effective means of treating drug-resistant bacterial infections because of their unique physical properties and excellent antibacterial properties.In this study,silver iron bimetallic nanozymes with multiple enzyme activities(peroxidase,glutathione peroxidase,and superoxide dismutase)were successfully synthesized for the treatment of skin wounds.Notably,the prepared V_(o)-AgFeO_(2−x) exhibited different enzyme activities under different pH conditions.In acidic environments,V_(o)-AgFeO_(2−x) can catalyze H2O2 to generate reactive oxygen species(ROS),deplete glutathione(GSH),and kill bacteria.In a neutral environment,V_(o)-AgFeO_(2−x) can eliminate free radicals,control inflammatory reactions,and accelerate wound healing.In vivo experiments have shown that V_(o)-AgFeO_(2−x) can promote the healing of infected wounds and has good biological safety.These findings suggest that it can be used as a safe and efficient antibacterial drug to achieve effective treatment of bacterial infection-induced wounds.展开更多
Uncontrollable non-compressible hemorrhage and traumatic infection have been major causes of mortality and disability in both civilian and military populations.A dressing designed for point-of-care control of noncompr...Uncontrollable non-compressible hemorrhage and traumatic infection have been major causes of mortality and disability in both civilian and military populations.A dressing designed for point-of-care control of noncompressible hemorrhage and prevention of traumatic infections represents an urgent medical need.Here,a novel self-gelling sponge OHN@ε-pL is developed,integrating N-succinimidyl ester oxidized hyaluronic acid(OHN)andε-poly-L-lysine(ε-pL).Upon application to the wound site,the sponge can rapidly absorb interfacial fluids and undergo a phase transition from sponge to gel.The transformed gel facilitates robust tissue adhesion and achieves synergistic hemostasis by enriching coagulation factors within the sponge phase and providing a barrier effect in the gel phase.The in vitro and in vivo studies revealed that the optimized OHN@ε-pL_(3) sponge possesses self-gelling capability,tissue adhesion,enhanced coagulation ability,and exhibits excellent biocompatibility and antibacterial efficacy.In hemostasis,OHN@ε-pL_(3) sponges exhibited reduced blood loss and decreased hemostatic time compared to commercial hemostatic agents,as demonstrated in rat liver,femoral vein,and tail truncation bleeding models.Furthermore,the OHN@ε-pL_(3) sponge exhibited superior performance in accelerating wound closure and healing of S.aureus-infected wounds.Collectively,OHN@ε-pL sponges represent a promising candidate for medical dressings,specifically for managing uncontrollable noncompressible hemorrhage and traumatic infections.展开更多
Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble bec...Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble because of the infection of Vibrio vulnificus.Bdellovibrio bacteriovorus,one kind of natural predatory bacteria,is recognized as a promising biological therapy against intractable bacteria.Here,we prepared a B.bacteriovorus-loaded polyvinyl alcohol/alginate hydrogel for the topical treatment of the seawater immersion wounds infected by V.vulnificus.The B.bacteriovorus-loaded hydrogel(BG)owned highly microporous structures with the mean pore size of 90μm,improving the rapid release of B.bacteriovorus from BG when contacting the aqueous surroundings.BG showed high biosafety with no L929 cell toxicity or hemolysis.More importantly,BG exhibited excellent in vitro anti-V.vulnificus effect.The highly effective infected wound treatment effect of BG was evaluated on mouse models,revealing significant reduction of local V.vulnificus,accelerated wound contraction,and alleviated inflammation.Besides the high bacterial inhibition of BG,BG remarkably reduced inflammatory response,promoted collagen deposition,neovascularization and re-epithelization,contributing to wound healing.BG is a promising topical biological formulation against infected wounds.展开更多
Treating severe burn wounds poses significant challenges,including considerable cell loss,excessive inflammation,and a high susceptibility to bacterial infections.Ideal burn dressings should exhibit excellent antibact...Treating severe burn wounds poses significant challenges,including considerable cell loss,excessive inflammation,and a high susceptibility to bacterial infections.Ideal burn dressings should exhibit excellent antibacterial properties,anti-inflammatory effects,and promote cell proliferation.Additionally,they need facilitate painless dressing changes and be user-friendly.Herein,we synthesized a thermosensitive hydrogel by crosslinking poly(N-isopropylacrylamide-co-allyloxybenzaldehyde)(PNA)and amino-terminated Pluronic F127(APF)through a Schiffbase reaction.It exhibited reversible gelsol transition and spread-ability.By incorporating piezoelectric gold nanoparticle-modified barium titanate(Au@BaTiO3)and cas-cade antioxidant MOF-818,a nanocomposite hydrogel dressing with diverse bioactive functionalities was developed.Results demonstrated that the nanocomposite hydrogel possessed gel-sol transition properties,maintained a stable gel state within a broad temperature range,and desirable self-healing property.Au@BaTiO3 exhibited good piezoelectric properties and ROS generation upon ultrasound stimulation,while MOF-818 displayed highly efficient cascade nanozyme activity.The combination of Au@BaTiO3 and MOF-818 promoted fibroblast proliferation and migration,reduced intracellular ROS levels,and induced anti-inflammatory polarization of macrophages under ultrasound stimulation.In vitro and in vivo antibacterial results disclosed that the nanocomposite hydrogel had excellent antibacterial activity under highintensity ultrasound stimulation.When applied to infected burn wounds,the nanocomposite hydrogel can rapidly sterilize the wound upon initial high-intensity ultrasound,and then reduce inflammation and promote M2 macrophage polarization by the following low-intensity ultrasound stimulation,and thus accelerating the healing by improving granulation tissue formation,angiogenesis,and collagen deposition.展开更多
Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significanc...Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significance.Here,we developed a fresh type of antibacterial cotton dressing through a succinct strategy based on chemically anchoring polyhexamethylene biguanide(PHMB).Intriguingly,after PHMB modification,the cotton dressing exhibited outstanding antibacterial performance which could maintain>99.99%antibacterial rate after several treatments,including washing 50 times,repeated use 10 times,UV irradiation for 7 days,cationic dyes dying,and conditioned under 90℃water bath for 2 h.In addition,the water contact angle of cotton dressing increased dramatically from 0°to 111°,which could facilitate bacterial adhesion,thus further enhance the antibacterial efficiency,and easily remove the bacterial debris.Apart from that,the developed cotton dressing showed good cytocompatibility,promoted blood clotting and expression of platelets,and promoted the wound healing process in the infection intervened skin wound model.Taken together,this antibacterial cotton dressing with desirable blood clotting,sustained protection against bacterial infection and bacterial removal features shows the potential to be a candidate for infected skin wound healing.展开更多
Bacterial infection of wounds is an escalating medical problem,issuing threats to both global public health and personal health.Photothermal antibacterial technology as a novel sterilization strategy has outstanding s...Bacterial infection of wounds is an escalating medical problem,issuing threats to both global public health and personal health.Photothermal antibacterial technology as a novel sterilization strategy has outstanding sterilization efficiency,high safety and low risk of emergence of drug-resistant bacteria.By combining inherent antibacterial activity and light-assisted antibacterial treatment,developing novel multifunctional dressings with synergistic high-efficiency antibacterial effects and also promoting wound healing possesses attractive advantages in the field of treating bacterial wound infections in clinical care.Herein,a multifunctional hydrogel formed by in situ photo-cross linking was designed and prepared by first grafting methacrylic anhydride as a photosensitizer onto chitosan,and then introducing oxidatively synthesized polydopamine(PDA).The physicochemical characterizations of the synthesized hydrogels demonstrated their tunability certainly associated with PDA concentration,including pore size,water swelling,rheological properties and in vitro degradability.In addition,the composite hydrogels exhibited good adhesion,anti-oxidation and photothermal properties due to the existence of PDA.Within 10min upon exposure to 808 nm near-infrared(NIR)light irradiation,this hydrogel system displayed outstanding antibacterial activity against Staphylococcus aureus with almost 100%killing efficiency,of which rapid efficient sterilization plays a significant role in wound healing.Moreover,the hydrogel is capable of cytocompatibility and has low toxicity to murine fibroblasts(L929 and NIH/3T3).In the full-thickness wound defect infection model in mice,the wound closure ratio,inflammatory response,fibroblasts,neovascularization and epithelialization were measured.Animal experiments also reveal that the hydrogel assisted with NIR laser irradiation can inhibit effectively infection at an early stage and accelerate the wound healing process.In summary,this novel multifunctional injectable hydrogel exhibits excellent swelling capacity,bio-adhesion,antioxidant property,photothermal activity,efficient antibacterial property and facilitates skin healing,which has great promising application as a medical dressing biomaterial in infected wound carefields.展开更多
BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting th...BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting the clinical use of autologous platelet-rich plasma(PRP)in treatment of such wounds is becoming increasingly compelling.Mechanisms involved include complex interactions between the patient’s thrombocytes,cytokines,and growth factors.CASE SUMMARY We present a case of a 72-year-old male patient with a long-standing chronic wound and multiple comorbidities.Over the course of more than 7 months,the patient was unsuccessfully treated with all routinely used measures,including different dressing approaches.Multiple antibiotic regimens were administered for wound infection,with repeated evaluation of microbiological swab results.Finally,after three PRP applications,the wound showed clinical improvement with complete restitution of the epithelial layer of the skin.CONCLUSION PRP treatment may be beneficial to reduce healing time in chronic wounds.展开更多
Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical wast...Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.展开更多
BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pa...BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.展开更多
Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance....Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.展开更多
Non-O1/non-O139 Vibrio cholerae(NOVC)has multiple pathogenic pathways in humans.The cause of disease in influenced by the virulence genes carried by the infecting strain and the health condition of the host.[1-2]When ...Non-O1/non-O139 Vibrio cholerae(NOVC)has multiple pathogenic pathways in humans.The cause of disease in influenced by the virulence genes carried by the infecting strain and the health condition of the host.[1-2]When seafood,food and water sources are contaminated with feces,people are prone to gastroenteritis,and direct exposure to contaminated water may cause wound infection.展开更多
AIM: To compare the safety of fast-track rehabilitation protocols (FT) and conventional care strategies (CC), or FT and laparoscopic surgery (LFT) and FT and open surgery (OFT) after gastrointestinal surgery.
A large number of apoptotic vesicles(ApoVs)are released during apoptosis,and mesenchymal stem cells(MSCs)-derived ApoVs(MSC-ApoVs)have significant efficacy in the field of tissue regeneration.ApoVs extracted by densit...A large number of apoptotic vesicles(ApoVs)are released during apoptosis,and mesenchymal stem cells(MSCs)-derived ApoVs(MSC-ApoVs)have significant efficacy in the field of tissue regeneration.ApoVs extracted by density gradient centrifugation have a larger volume and wider diameter distribution,high yield and drug loading efficiency,and inherit the apoptotic traces of FasL,phosphatidylserine(PS),ICAM-3,and other parent cells and the ability to target cell membranes.MSC-ApoVs can significantly promote skin wound healing;however,whether they can promote wound healing in the early stages by playing an antibacterial role is unclear.In the present study,human umbilical cord MSC-derived ApoVs(hucMSC-ApoVs)were extracted and prepared.An in vitro antibacterial test confirmed that hucMSC-ApoVs effectively inhibited the growth of bacteria and sterilized bacteria.In vivo experiments revealed that hucMSC-ApoVs can accelerate the healing of infected wounds.Further exploration of the antibacterial mechanism revealed that hucMSC-ApoVs significantly interfered with bacterial catabolic processes.In gram-positive bacteria(MRSA),hucMSC-ApoVs affect the normal metabolic process of bacteria mainly by inhibiting the metabolism of purines,pyrimidines,and other nucleotides of MRSA and arginine biosynthesis,whereas in the gram-negative bacteria E.coli,they affect this process.HucMSC-ApoVs inhibit bacterial metabolic processes such as sulfur,fatty acid,arginine,and proline metabolism;in particular,hucMSC-ApoVs can interfere with the ethanolamine metabolic process in E.coli by regulating a series of ethanolamine genes(Eut)that encode ethanolamine degrading enzymes.These findings suggest that hucMSC-ApoVs are useful natural reagents for inhibiting wound bacterial infection and promoting wound healing.展开更多
BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the ...BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.展开更多
Altered bowel flora is currently thought to play a role in a variety of disease conditions, and the use of Bifidobacterium spp. and Lactobacillus spp. as probiotics has been demonstrated to be health-promoting, even i...Altered bowel flora is currently thought to play a role in a variety of disease conditions, and the use of Bifidobacterium spp. and Lactobacillus spp. as probiotics has been demonstrated to be health-promoting, even if the success of their administration depends on the applied bacterial strain（s） and the targeted disease. In the last few decades, specific probiotics have been shown to be effective in the treatment or the prevention of acute viral gastroenteritis, pediatric post-antibiotic-associated diarrhea, some pediatric allergic disorders, necrotizing enterocolitis in preterm infants, inflammatory bowel diseases and postsurgical pouchitis. The potential application of probiotics is continuously widening, with new evidence accumulating to support their effect on the prevention and treatment of other disease conditions, including several oral diseases, such as dental caries, periodontal diseases and oral malodor, as well as genitourinary and wound infections. Considering the increasingly widespread ability of pathogens to generate persistent biofilm-related infections, an even more attractive proposal is to administer probiotics to prevent or counteract biofilm development.The response of biofilm-based oral, intestinal, vaginal and wound infections to probiotics treatment will be reviewed here in light of the most recent results obtained in this field.展开更多
BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were...BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.展开更多
文摘Bacterial infection causes wound inflammation and makes angiogenesis difficult.It is urgent to develop effectively antibacterial and pro-vascularizing dressings for wound healing.The hydrogel is developed with pH-responsive drug-releasing microcarriers which were loaded with vascular endothelial growth factor(VEGF)that promotes angiogenesis and actively respond to wound pH for control and prolong VEGF release.The surfaces of the microcarriers were coated with polydopamine which can reduce the silver nanoparticles(AgNPs)in situ,and dynamically crosslink with the polyacrylamide,which forms a stable slow-release system with different release behavior for the VEGF and AgNPs.The hydrogel inhib-ited bacterial formation and accelerated wound healing.With the hydrogel dressing,83.3%±4.29%of the wound heals at day 7,which is 40.9%±8.5%higher than the non-treatment group in defect infected model.The antibacterial properties of hydrogel down-regulate early inflammation-related cytokines,and the release of VEGF in the middle and late phases of wound healing in response to pH changes pro-motes angiogenesis and up-regulate the expression of angiogenesis-associated cytokine.The sequential release of antibacterial agents and pro-vascularizing agents in response to the change in wound microen-vironmental cues facilitate temporally controlled therapy that suites the need of different wound healing phases.Collectively,the hydrogel loaded with multifunctional microcarriers that enable controlled release of AgNPs and VEGF is an effective system for treating infected wounds.
基金supported by the Academician Innovation Platform of Hainan Province,National Natural Science Foundation of China(82560446)Natural Science Foundation of Hainan Province(822MS174),(822RC692)the Science and Technology Special Fund of Hainan Province(ZDYF2025SHFZ049).
文摘Infected diabetic wounds represent one of the most severe complications of diabetes mellitus,with complex pathological mechanisms that present significant challenges in clinical management.Ferroptosis,an emerging form of iron-dependent programmed cell death driven by excessive lipid peroxidation,plays a critical role in the progression of infected diabetic wounds.This review systematically examines the central mechanisms of ferroptosis in infected diabetic wounds from three key perspectives:dysregulation of iron metabolism,accumulation of lipid peroxidation products,and impairment of the antioxidant defense system.Moreover,it analyzes the impact of ferroptosis on various cell types-fibroblasts,macrophages,vascular endothelial cells,and keratinocytes-during the impaired healing process.Based on these mechanistic insights,the review summarizes recent advances in ferroptosis-targeted therapeutic strategies for wound repair,including ferroptosis inhibitors,cell-based therapies,and innovative hydrogel materials with promising application potential.By integrating current knowledge on the role of ferroptosis in infected diabetic wounds and associated treatment approaches,this article aims to provide new perspectives and a solid theoretical foundation for future research and the comprehensive management of this challenging condition.
基金funded by National Natural Science Foundation of China(82202473,Yudi Han).
文摘Background:Infected wounds caused by bacteria such as Escherichia coli and Staphylococcus aureus pose significant challenges during the healing process.Hydrogels have emerged as promising materials for the treatment of such infections,as they have the potential to deliver therapeutic agents while supporting tissue repair.This study aimed to develop ε-PLL@SA/Gel(PSG)hydrogels by incorporating varying concentrations of ε-poly-L-lysine(ε-PLL)into sodium alginate/gelatin(SA/Gel)using calcium chloride as a crosslinking agent,and to evaluate their antibacterial efficacy.Methods:The mechanical properties,biocompatibility,antibacterial activity of hydrogels were evaluated.Biocompatibility was examined by measuring cell viability and proliferation of human skin fibroblasts in vitro.Antibacterial efficacy against Escherichia coli and Staphylococcus aureus was quantified using bacterial inhibition assays.The wound healing efficacy of the hydrogels were evaluated in mouse models of infected wounds.Results:PSG hydrogels exhibited excellent mechanical strength,injectability,and self-adhesive properties.In vitro,hydrogel treatment resulted in high cell viability and promoted human skin fibroblast proliferation.PSG15 exhibited the highest antibacterial activity and inhibited E.coli and S.aureus by 89.53% and 92.21%,respectively.In vivo,PSG15 significantly accelerated wound healing,enhanced angiogenesis,and regulated macrophage polarization by increasing CD206 expression and decreasing CD80 expression.Additionally,PSG15 modulated the skin microbiota,reduced pathogenic bacterial abundance and maintained microbiota diversity.Conclusions:The PSG15 hydrogel is a promising candidate for the treatment of infected wounds because it inhibits bacterial growth,promotes tissue repair,and modulates the wound microbiota.
基金supported by National Natural Science Foundation of China(Grant 52277231)City University of Hong Kong Donation Research(Grant DON-RMG 9229021)Hong Kong PDFS—RGC Postdoctoral Fellowship Scheme(PDFS2122-1S08).
文摘Cold atmospheric plasmas are widely used in biomedicine.Although direct plasma treatments of wounds have been demon-strated,there are still obstacles hampering further clinical adoption,for example,the limited treatment area,inconsistent ac-tions and risk of thermal injury.In this respect,plasma-activated air(PAA)is proposed and demonstrated for infected wounds treatment as an alternative to the conventional direct plasma treatment.The combination of gliding arc discharge reactor and dielectric barrier discharge reactor produces highly bioactive PAA.In in vitro sterilisation of Staphylococcus aureus,approxi-mately 9-log reduction is achieved after the PAA treatment for 6 min.Bovine serum albumin is added to the S.aureus sus-pension to further simulate the wound exudate to accomplish inactivation of approximately 3-log reduction after 10 min.In vivo experiments show that the PAA treatment of infected wounds significantly reduces the bacterial load and improves the healing rate,revealing an optimal treatment time of 3 min/day.The immunohistochemical and blood biochemical analyses show that the PAA-3 min treatment enhances wound healing by inhibiting the tissue inflammatory response and inducing growth factor production without showing evident systemic toxicity.In conclusion,PAA holds great clinical promise as a safe and effective wound-healing strategy.
基金supported by the Research Fund of the Anhui Institute of Translational Medicine(No.2023zhyx-C51)the Youth Research Project of the Chinese Nursing Association(No.ZHKYQ202213)+1 种基金the Open Project of Engineering Research Center of Biofilm Water Purification and Utilization Technology of Ministry of Education(No.BWPU2020KF03)the Natural Science Research Project of Anhui Higher Education Institution(No.2023AH051127).
文摘Effectively controlling bacterial infections and reducing oxidative stress and inflammatory reactions are important steps in wound healing.However,owing to the improper use of antibiotics and inadequate control of infections in recent years,the emergence of many broadspectrum drug-resistant strains has exacerbated the threat of infected wounds to human health.Recent studies have shown that bimetallic nanozymes may become an effective means of treating drug-resistant bacterial infections because of their unique physical properties and excellent antibacterial properties.In this study,silver iron bimetallic nanozymes with multiple enzyme activities(peroxidase,glutathione peroxidase,and superoxide dismutase)were successfully synthesized for the treatment of skin wounds.Notably,the prepared V_(o)-AgFeO_(2−x) exhibited different enzyme activities under different pH conditions.In acidic environments,V_(o)-AgFeO_(2−x) can catalyze H2O2 to generate reactive oxygen species(ROS),deplete glutathione(GSH),and kill bacteria.In a neutral environment,V_(o)-AgFeO_(2−x) can eliminate free radicals,control inflammatory reactions,and accelerate wound healing.In vivo experiments have shown that V_(o)-AgFeO_(2−x) can promote the healing of infected wounds and has good biological safety.These findings suggest that it can be used as a safe and efficient antibacterial drug to achieve effective treatment of bacterial infection-induced wounds.
基金supported by the China Postdoctoral Science Foundation(Grant No.2023M740626)National Natural Science Foundation of China(Grant No.82102324)Natural Science Foundation of Chongqing(Grant No.CSTB2022BSXM-JCX0028).
文摘Uncontrollable non-compressible hemorrhage and traumatic infection have been major causes of mortality and disability in both civilian and military populations.A dressing designed for point-of-care control of noncompressible hemorrhage and prevention of traumatic infections represents an urgent medical need.Here,a novel self-gelling sponge OHN@ε-pL is developed,integrating N-succinimidyl ester oxidized hyaluronic acid(OHN)andε-poly-L-lysine(ε-pL).Upon application to the wound site,the sponge can rapidly absorb interfacial fluids and undergo a phase transition from sponge to gel.The transformed gel facilitates robust tissue adhesion and achieves synergistic hemostasis by enriching coagulation factors within the sponge phase and providing a barrier effect in the gel phase.The in vitro and in vivo studies revealed that the optimized OHN@ε-pL_(3) sponge possesses self-gelling capability,tissue adhesion,enhanced coagulation ability,and exhibits excellent biocompatibility and antibacterial efficacy.In hemostasis,OHN@ε-pL_(3) sponges exhibited reduced blood loss and decreased hemostatic time compared to commercial hemostatic agents,as demonstrated in rat liver,femoral vein,and tail truncation bleeding models.Furthermore,the OHN@ε-pL_(3) sponge exhibited superior performance in accelerating wound closure and healing of S.aureus-infected wounds.Collectively,OHN@ε-pL sponges represent a promising candidate for medical dressings,specifically for managing uncontrollable noncompressible hemorrhage and traumatic infections.
基金supported by the National Natural Science Foundation of China(82073791)。
文摘Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria.Seawater immersion wounds usually become a mortal trouble because of the infection of Vibrio vulnificus.Bdellovibrio bacteriovorus,one kind of natural predatory bacteria,is recognized as a promising biological therapy against intractable bacteria.Here,we prepared a B.bacteriovorus-loaded polyvinyl alcohol/alginate hydrogel for the topical treatment of the seawater immersion wounds infected by V.vulnificus.The B.bacteriovorus-loaded hydrogel(BG)owned highly microporous structures with the mean pore size of 90μm,improving the rapid release of B.bacteriovorus from BG when contacting the aqueous surroundings.BG showed high biosafety with no L929 cell toxicity or hemolysis.More importantly,BG exhibited excellent in vitro anti-V.vulnificus effect.The highly effective infected wound treatment effect of BG was evaluated on mouse models,revealing significant reduction of local V.vulnificus,accelerated wound contraction,and alleviated inflammation.Besides the high bacterial inhibition of BG,BG remarkably reduced inflammatory response,promoted collagen deposition,neovascularization and re-epithelization,contributing to wound healing.BG is a promising topical biological formulation against infected wounds.
基金the National Key Re-search and Development Project of China(No.2023YFC2412600)National Natural Science Foundation of China(Nos.52003216,82272155, 52403168)+3 种基金the Youth Project of Shaanxi Provin-cial Department of Science and Technology(Nos.2024JC-YBQN-0368,2024JC-YBQN-04502024JC-YBQN-0202)the High-Level Talents Program of Xi’an University of Science and Technology(No.2050122015)the China Postdoctoral Science Foundation(Nos.2022M712506,2024T170717).
文摘Treating severe burn wounds poses significant challenges,including considerable cell loss,excessive inflammation,and a high susceptibility to bacterial infections.Ideal burn dressings should exhibit excellent antibacterial properties,anti-inflammatory effects,and promote cell proliferation.Additionally,they need facilitate painless dressing changes and be user-friendly.Herein,we synthesized a thermosensitive hydrogel by crosslinking poly(N-isopropylacrylamide-co-allyloxybenzaldehyde)(PNA)and amino-terminated Pluronic F127(APF)through a Schiffbase reaction.It exhibited reversible gelsol transition and spread-ability.By incorporating piezoelectric gold nanoparticle-modified barium titanate(Au@BaTiO3)and cas-cade antioxidant MOF-818,a nanocomposite hydrogel dressing with diverse bioactive functionalities was developed.Results demonstrated that the nanocomposite hydrogel possessed gel-sol transition properties,maintained a stable gel state within a broad temperature range,and desirable self-healing property.Au@BaTiO3 exhibited good piezoelectric properties and ROS generation upon ultrasound stimulation,while MOF-818 displayed highly efficient cascade nanozyme activity.The combination of Au@BaTiO3 and MOF-818 promoted fibroblast proliferation and migration,reduced intracellular ROS levels,and induced anti-inflammatory polarization of macrophages under ultrasound stimulation.In vitro and in vivo antibacterial results disclosed that the nanocomposite hydrogel had excellent antibacterial activity under highintensity ultrasound stimulation.When applied to infected burn wounds,the nanocomposite hydrogel can rapidly sterilize the wound upon initial high-intensity ultrasound,and then reduce inflammation and promote M2 macrophage polarization by the following low-intensity ultrasound stimulation,and thus accelerating the healing by improving granulation tissue formation,angiogenesis,and collagen deposition.
基金the National Natural Science Foundation of China(Nos.51803128,52073186,21802097)Fundamental Research Funds for the Central Universities(No.20826041D4160)+2 种基金Sichuan Science and Technology Programs(Nos.2020KJT0031-2020ZHCG0051,2020KJT0061-2020ZHFP0148)State Key Laboratory of Polymer Materials Engineering(No.sklpme20213–01)Funding of Engineering Characteristic Team,Sichuan University(No.2020SCUNG122)。
文摘Medical cotton dressing is cheap and widely used in diversified fields,but in the application of promoting wound healing,the continuous research of multifunctional medical cotton dressing is still of great significance.Here,we developed a fresh type of antibacterial cotton dressing through a succinct strategy based on chemically anchoring polyhexamethylene biguanide(PHMB).Intriguingly,after PHMB modification,the cotton dressing exhibited outstanding antibacterial performance which could maintain>99.99%antibacterial rate after several treatments,including washing 50 times,repeated use 10 times,UV irradiation for 7 days,cationic dyes dying,and conditioned under 90℃water bath for 2 h.In addition,the water contact angle of cotton dressing increased dramatically from 0°to 111°,which could facilitate bacterial adhesion,thus further enhance the antibacterial efficiency,and easily remove the bacterial debris.Apart from that,the developed cotton dressing showed good cytocompatibility,promoted blood clotting and expression of platelets,and promoted the wound healing process in the infection intervened skin wound model.Taken together,this antibacterial cotton dressing with desirable blood clotting,sustained protection against bacterial infection and bacterial removal features shows the potential to be a candidate for infected skin wound healing.
基金funded by the National Natural Science Foundation of China(Nos.U21A20417 and 31930067)1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYGD18002).
文摘Bacterial infection of wounds is an escalating medical problem,issuing threats to both global public health and personal health.Photothermal antibacterial technology as a novel sterilization strategy has outstanding sterilization efficiency,high safety and low risk of emergence of drug-resistant bacteria.By combining inherent antibacterial activity and light-assisted antibacterial treatment,developing novel multifunctional dressings with synergistic high-efficiency antibacterial effects and also promoting wound healing possesses attractive advantages in the field of treating bacterial wound infections in clinical care.Herein,a multifunctional hydrogel formed by in situ photo-cross linking was designed and prepared by first grafting methacrylic anhydride as a photosensitizer onto chitosan,and then introducing oxidatively synthesized polydopamine(PDA).The physicochemical characterizations of the synthesized hydrogels demonstrated their tunability certainly associated with PDA concentration,including pore size,water swelling,rheological properties and in vitro degradability.In addition,the composite hydrogels exhibited good adhesion,anti-oxidation and photothermal properties due to the existence of PDA.Within 10min upon exposure to 808 nm near-infrared(NIR)light irradiation,this hydrogel system displayed outstanding antibacterial activity against Staphylococcus aureus with almost 100%killing efficiency,of which rapid efficient sterilization plays a significant role in wound healing.Moreover,the hydrogel is capable of cytocompatibility and has low toxicity to murine fibroblasts(L929 and NIH/3T3).In the full-thickness wound defect infection model in mice,the wound closure ratio,inflammatory response,fibroblasts,neovascularization and epithelialization were measured.Animal experiments also reveal that the hydrogel assisted with NIR laser irradiation can inhibit effectively infection at an early stage and accelerate the wound healing process.In summary,this novel multifunctional injectable hydrogel exhibits excellent swelling capacity,bio-adhesion,antioxidant property,photothermal activity,efficient antibacterial property and facilitates skin healing,which has great promising application as a medical dressing biomaterial in infected wound carefields.
文摘BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting the clinical use of autologous platelet-rich plasma(PRP)in treatment of such wounds is becoming increasingly compelling.Mechanisms involved include complex interactions between the patient’s thrombocytes,cytokines,and growth factors.CASE SUMMARY We present a case of a 72-year-old male patient with a long-standing chronic wound and multiple comorbidities.Over the course of more than 7 months,the patient was unsuccessfully treated with all routinely used measures,including different dressing approaches.Multiple antibiotic regimens were administered for wound infection,with repeated evaluation of microbiological swab results.Finally,after three PRP applications,the wound showed clinical improvement with complete restitution of the epithelial layer of the skin.CONCLUSION PRP treatment may be beneficial to reduce healing time in chronic wounds.
基金supported by the National Natural Science Foundation of China(Nos.82370977,52073186)Medical Science and Technology Project of Sichuan Provincial Health Commission(No.21PJ059)+2 种基金Science and Technology Application Fundamental Project of Sichuan Province(No.2022YFS0124)Funding for Distinguished Young Scholars of Sichuan Province(No.23NSFJQ0001)Strategic Cooperation Projects of Yi Bin City and Sichuan University(No.2020CDYB-6)。
文摘Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.
文摘BACKGROUND Acute appendicitis,a common condition with a higher prevalence among men,has shown an increasing incidence in recent years owing to lifestyle changes.It is characterized by right lower quadrant abdominal pain,rebound tenderness,and rapid onset.Its pathogenesis is complex and potentially linked to infection,environment,and genetics.Timely intervention is crucial to prevent complications.While surgery is the primary treatment,it carries risks,including postoperative infections that may necessitate re-operation.Gram-negative bacteria release endotoxin(ETX),which induces inflammation and is recognized by toll-like receptor 4(TLR4).This study evaluated ETX and TLR4 levels in patients with acute appendicitis to assess the risk of postoperative incision infections,aiding in prevention and treatment.AIM To explore ETX and TLR4 expression in the blood of patients with acute appendicitis and its association with in postoperative incision infection.METHODS A total of 153 patients with acute appendicitis treated at our hospital between April 2022 and March 2024(n=153)were included in the study.Patients were categorized into infected(n=36)and uninfected(n=117)groups according to the development of postoperative incision infections.General characteristics and blood levels of ETX and TLR4 were compared,and the factors influencing postoperative infection were identified using multivariate logistic regression.ETX and TLR4 predictive values were analyzed using receiver operating characteristic curves.RESULTS No statistically significant differences were observed between the two groups in terms of sex,age,or other general characteristics(P>0.05).Compared to the uninfected group,the infected group had a higher proportion of patients with suppurative or gangrenous appendicitis,longer surgical times,longer incision lengths,and elevated ETX and TLR4 levels(P<0.05).Multivariate logistic regression analysis identified pathological type,surgical method,surgical time,and incision length as factors influencing postoperative incision infection in acute appendicitis.Receiver operating characteristic curve analysis revealed that both ETX and TLR4 levels were predictive factors for postoperative incision infection,with higher prediction efficiency when combined.CONCLUSION Pathological type,surgical method,surgical time,and incision length significantly influence postoperative incision infection risk in patients with acute appendicitis.Elevated ETX and TLR4 levels serve as valuable predictors of post-appendectomy infections.
基金Supported by the Ministry of Health of the Czech Republic,Grant/Award Number:NU22-05-00475 and NV19-05-00214。
文摘Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.
基金supported by the National Natural Science Foundation(82372206)the Jiangsu Provincial Health Commission(H2023107)the project of basic and clinical research on cardiac arrest in the Emergency and Critical Care Department of the Second Affiliated Hospital of Soochow University(XKTJ-XK202408-2).
文摘Non-O1/non-O139 Vibrio cholerae(NOVC)has multiple pathogenic pathways in humans.The cause of disease in influenced by the virulence genes carried by the infecting strain and the health condition of the host.[1-2]When seafood,food and water sources are contaminated with feces,people are prone to gastroenteritis,and direct exposure to contaminated water may cause wound infection.
基金Supported by The National Natural Science Foundation of China,No.81172279
文摘AIM: To compare the safety of fast-track rehabilitation protocols (FT) and conventional care strategies (CC), or FT and laparoscopic surgery (LFT) and FT and open surgery (OFT) after gastrointestinal surgery.
基金supported by the National Natural Science Foundation of China(Nos.82372552 and 82303775)the Excellent Youth of Natural Science Research Projects in Anhui Province Universities(No.2023AH030060)+2 种基金Anhui Provincial Natural Science Foundation(No.2408085Y016)Anhui Province Excellent Research and Innovation Team Project(No.2024AH010013)the Anhui Medical University Research Fund Youth Project(No.2023xkj018).
文摘A large number of apoptotic vesicles(ApoVs)are released during apoptosis,and mesenchymal stem cells(MSCs)-derived ApoVs(MSC-ApoVs)have significant efficacy in the field of tissue regeneration.ApoVs extracted by density gradient centrifugation have a larger volume and wider diameter distribution,high yield and drug loading efficiency,and inherit the apoptotic traces of FasL,phosphatidylserine(PS),ICAM-3,and other parent cells and the ability to target cell membranes.MSC-ApoVs can significantly promote skin wound healing;however,whether they can promote wound healing in the early stages by playing an antibacterial role is unclear.In the present study,human umbilical cord MSC-derived ApoVs(hucMSC-ApoVs)were extracted and prepared.An in vitro antibacterial test confirmed that hucMSC-ApoVs effectively inhibited the growth of bacteria and sterilized bacteria.In vivo experiments revealed that hucMSC-ApoVs can accelerate the healing of infected wounds.Further exploration of the antibacterial mechanism revealed that hucMSC-ApoVs significantly interfered with bacterial catabolic processes.In gram-positive bacteria(MRSA),hucMSC-ApoVs affect the normal metabolic process of bacteria mainly by inhibiting the metabolism of purines,pyrimidines,and other nucleotides of MRSA and arginine biosynthesis,whereas in the gram-negative bacteria E.coli,they affect this process.HucMSC-ApoVs inhibit bacterial metabolic processes such as sulfur,fatty acid,arginine,and proline metabolism;in particular,hucMSC-ApoVs can interfere with the ethanolamine metabolic process in E.coli by regulating a series of ethanolamine genes(Eut)that encode ethanolamine degrading enzymes.These findings suggest that hucMSC-ApoVs are useful natural reagents for inhibiting wound bacterial infection and promoting wound healing.
基金the Natural Science Foundation of Shandong Province,No.ZR2020MH257。
文摘BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.
文摘Altered bowel flora is currently thought to play a role in a variety of disease conditions, and the use of Bifidobacterium spp. and Lactobacillus spp. as probiotics has been demonstrated to be health-promoting, even if the success of their administration depends on the applied bacterial strain（s） and the targeted disease. In the last few decades, specific probiotics have been shown to be effective in the treatment or the prevention of acute viral gastroenteritis, pediatric post-antibiotic-associated diarrhea, some pediatric allergic disorders, necrotizing enterocolitis in preterm infants, inflammatory bowel diseases and postsurgical pouchitis. The potential application of probiotics is continuously widening, with new evidence accumulating to support their effect on the prevention and treatment of other disease conditions, including several oral diseases, such as dental caries, periodontal diseases and oral malodor, as well as genitourinary and wound infections. Considering the increasingly widespread ability of pathogens to generate persistent biofilm-related infections, an even more attractive proposal is to administer probiotics to prevent or counteract biofilm development.The response of biofilm-based oral, intestinal, vaginal and wound infections to probiotics treatment will be reviewed here in light of the most recent results obtained in this field.
基金in part was funded by a medical student grant($2500)by the Emergency Medicine Foundation
文摘BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration(SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not.METHODS: The study was performed at two urban hospitals enrolling 125 emergency department(ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit(10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals(CI).RESULTS: In the 125 patients with SHL [median age: 28(18, 43); range: 1–102 years old; 36% female], 44(35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients(4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection(P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7%(3/44), 95% CI: 2%–10% vs. 4%(3/81), 95% CI: 1%–11%, P=0.66]. Patient's satisfaction with appearance ofinfected and non-infected wounds were significantly different [7.5(6, 8) vs. 9(8, 10), P=0.01].CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk ofinfection.
