Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence...Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.展开更多
OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty...OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. RESULTS: Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. CONCLUSIONS: Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.展开更多
OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopat...OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn. RESULTS: In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P展开更多
Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a...Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.展开更多
A patch with the capability of avoiding wound infection and promoting tissue remolding is of great value for wound healing.In this paper,we develop a biomass chitosan microneedle array(CSMNA)patch integrated with smar...A patch with the capability of avoiding wound infection and promoting tissue remolding is of great value for wound healing.In this paper,we develop a biomass chitosan microneedle array(CSMNA)patch integrated with smart responsive drug delivery for promoting wound healing.Chitosan possesses many outstanding features such as the natural antibacterial property and has been widely utilized for wound healing.Besides,the microstructure of microneedles enables the effective delivery of loaded drugs into the target area and avoids the excessive adhesion between the skin and the patch.Also,vascular endothelial growth factor(VEGF)is encapsulated in the micropores of CSMNA by temperature sensitive hydrogel.Therefore,the smart release of the drugs can be controllably realized via the temperature rising induced by the inflammation response at the site of wounds.It is demonstrated that the biomass CSMNA patch can promote inflammatory inhibition,collagen deposition,angiogenesis,and tissue regeneration during the wound closure.Thus,this versatile CSMNA patch is potentially valuable for wound healing in clinical applications.展开更多
Cutaneous regeneration at the wound site involves several intricate and dynamic processes which require a series of coordinated interactions implicating various cell types,growth factors,extracellular matrix(ECM),nerv...Cutaneous regeneration at the wound site involves several intricate and dynamic processes which require a series of coordinated interactions implicating various cell types,growth factors,extracellular matrix(ECM),nerves,and blood vessels.Mesenchymal stromal cells(MSCs)take part in all the skin wound healing stages playing active and beneficial roles in animal models and humans.Exosomes,which are among the key products MSCs release,mimic the effects of parental MSCs.They can shuttle various effector proteins,messenger RNA(mRNA)and microRNAs(miRNAs)to modulate the activity of recipient cells,playing important roles in wound healing.Moreover,using exosomes avoids many risks associated with cell transplantation.Therefore,as a novel type of cell-free therapy,MSC-exosome-mediated administration may be safer and more efficient than whole cell.In this review,we provide a comprehensive understanding of the latest studies and observations on the role of MSC-exosome therapy in wound healing and cutaneous regeneration.In addition,we address the hypothesis of MSCs microenvironment extracellular vesicles(MSCs-MEVs)or MSCs microenvironment exosomes(MSCs-MExos)that need to take stock of and solved urgently in the related research about MSC-exosomes therapeutic applications.This review can inspire investigators to explore new research directions of MSC-exosome therapy in cutaneous repair and regeneration.展开更多
基金Supported by Health Research Institute,Diabetes Research Center,Ahvaz Jundishapur University of Medical Sciences,Ahvaz,Iran
文摘Diabetic foot ulcer(DFU) is the most costly and devastating complication of diabetes mellitus, which affect 15% of diabetic patients during their lifetime.Based on National Institute for Health and Clinical Excellence strategies, early effective management of DFU can reduce the severity of complications such as preventable amputations and possible mortality, and also can improve overall quality of life. The management of DFU should be optimized by using a multidisciplinary team, due to a holistic approach to wound management is required. Based on studies, blood sugar control, wound debridement, advanced dressings and offloading modalities should always be a part of DFU management. Furthermore, surgery to heal chronic ulcer and prevent recurrence should be considered as an essential component of management in some cases. Also, hyperbaric oxygen therapy, electrical stimulation, negative pressure wound therapy, bio-engineered skin and growth factors could be used as adjunct therapies for rapid healing of DFU. So, it's suggested that with appropriate patient education encourages them to regular foot care in order to prevent DFU and its complications.
基金supported partially by the National Grant for Outstanding Young Researchers (No．39525024) the Major State Basic Development Program (No．G1999054204)．
文摘OBJECTIVE: To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. METHODS: Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. RESULTS: Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. CONCLUSIONS: Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.
基金supported by the Major State Basic Research Development Program of China(No．Gl999054205)．
文摘OBJECTIVE: To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds. METHODS: Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn. RESULTS: In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P
文摘Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.
基金supported by the National Natural Science Foundation of China(grants 61927805 , 51522302)the NSAF Foundation of China(grant U1530260)+2 种基金the Natural Science Foundation of Jiangsu(Grant no.BE2018707)the Special Fund for Military Medical Science(grants BWS16J007 , AWS17J009)the China Postdoctoral Science Foundation funded project(2019M663090).
文摘A patch with the capability of avoiding wound infection and promoting tissue remolding is of great value for wound healing.In this paper,we develop a biomass chitosan microneedle array(CSMNA)patch integrated with smart responsive drug delivery for promoting wound healing.Chitosan possesses many outstanding features such as the natural antibacterial property and has been widely utilized for wound healing.Besides,the microstructure of microneedles enables the effective delivery of loaded drugs into the target area and avoids the excessive adhesion between the skin and the patch.Also,vascular endothelial growth factor(VEGF)is encapsulated in the micropores of CSMNA by temperature sensitive hydrogel.Therefore,the smart release of the drugs can be controllably realized via the temperature rising induced by the inflammation response at the site of wounds.It is demonstrated that the biomass CSMNA patch can promote inflammatory inhibition,collagen deposition,angiogenesis,and tissue regeneration during the wound closure.Thus,this versatile CSMNA patch is potentially valuable for wound healing in clinical applications.
基金funded by National Natural Science Foundation of China(81871570,81560313).
文摘Cutaneous regeneration at the wound site involves several intricate and dynamic processes which require a series of coordinated interactions implicating various cell types,growth factors,extracellular matrix(ECM),nerves,and blood vessels.Mesenchymal stromal cells(MSCs)take part in all the skin wound healing stages playing active and beneficial roles in animal models and humans.Exosomes,which are among the key products MSCs release,mimic the effects of parental MSCs.They can shuttle various effector proteins,messenger RNA(mRNA)and microRNAs(miRNAs)to modulate the activity of recipient cells,playing important roles in wound healing.Moreover,using exosomes avoids many risks associated with cell transplantation.Therefore,as a novel type of cell-free therapy,MSC-exosome-mediated administration may be safer and more efficient than whole cell.In this review,we provide a comprehensive understanding of the latest studies and observations on the role of MSC-exosome therapy in wound healing and cutaneous regeneration.In addition,we address the hypothesis of MSCs microenvironment extracellular vesicles(MSCs-MEVs)or MSCs microenvironment exosomes(MSCs-MExos)that need to take stock of and solved urgently in the related research about MSC-exosomes therapeutic applications.This review can inspire investigators to explore new research directions of MSC-exosome therapy in cutaneous repair and regeneration.
