Acute Wounds Research Articles

The Effectiveness of Combination of Piper betle L. ethanol Extract and Manuka Honey Spray Gel to Accelerating Acute Wound Healing

Acute wounds are injuries that occur suddenly to tissues that are prone to the risk of being infected. Therefore, acute wound care must be considered carefully. Piper betle leaf contains flavonoids that have a function in the wound healing process, Manuka honey also contains vitamins that can support the healing phase. The combination of Piper betle L. and manuka honey is made into a spray gel preparation because it has advantages over other topical preparations. The purpose of this study is to see how well a combination wound healing spray gel of Piper betle L. and Manuka honey works on an acute wound in mice. This study uses experimental research with a randomized, matched post-test-only control group design. The formulation taken was maceration extraction from Piper betle L. Simplicia powder with 70% ethanol then evaporated to acquire a concentrated concentrate. Spray gel preparations of a combination of Piper betle L extract and manuka honey were made with a concentration of 1% Piper betle L and Manuka honey, 3% Piper betle L and Manuka honey, and 5% Piper betle L and Manuka honey. Balb/c mice that had full-thickness acute wounds were divided into 7 treatment groups, namely SM1, SM2, SM3, M, KP, B, and D. Mice were treated for 14 days and the wound area ratio was calculated and analyzed by ANOVA. The test results showed a significant difference between groups SM3-M, SM5-M, M-SM3, M-SM5, KP-M, B-SM3, and BM with a significance value below 0.05 (p≤0.05) which proves that the spray gel combination of Piper betle L extract and Manuka honey, oxoferin, and base both have activity in accelerating acute wound healing.

CaGA nanozymes with multienzyme activity realize multifunctional repair of acute wounds by alleviating oxidative stress and inhibiting cell apoptosis.

Acute wounds result from damage to the skin barrier, exposing underlying tissues and increasing susceptibility to bacterial and other pathogen infections. Improper wound care increases the risk of exposure and infection, often leading to chronic nonhealing wounds, which cause significant patient suffering. Early wound repair can effectively prevent the development of chronic nonhealing wounds. In this study, Ca-Gallic Acid (CaGA) nanozymes with multienzyme catalytic activity were constructed for treating acute wounds by coordinating Ca ions with gallic acid. CaGA nanozymes exhibit high superoxide dismutase/catalase (SOD/CAT) catalytic activity and good antioxidant performance in vitro. In vitro experiments demonstrated that CaGA nanozymes can effectively promote cell migration, efficiently scavenge ROS, maintain mitochondrial homeostasis, reduce inflammation, and decrease cell apoptosis. In vivo, CaGA nanozymes promoted granulation tissue formation, accelerated collagen fiber deposition, and reconstructed skin appendages, thereby accelerating acute wound healing. CaGA nanozymes have potential clinical application value in wound healing treatment.

Effective Chronic Wound Healing

The adverse impact of chronic wounds is felt worldwide. The concerns for advanced wound care product are progressively increasing due to factors such as value for money spent in wound care products. Acute and Chronic wounds are managed in most health facilities in Ghana with sodium chloride (0.9%) infusion solution and povidone iodine fortified with metronidazole solution. The procedure is usually done by the nurse cleaning the wound with the saline solution wet gauze or cotton and then covered with the povidone iodine wet gauze for acute and chronic wounds. For chronic infected wounds, the wound is usually cleaned with saline solution and covered with wet gauze saline or currently with neomycin wound care spray or powdered antibiotics applied on the wounds. But it is popular as many wounds are covered with povidone iodine after wound cleaning in wound care practices in Ghana. Despite all these efforts, many wounds, especially chronic type wounds take a very long time to heal or sometimes fails to heal which reduce the quality of life of the people suffering from the menace. When it happens in this way, many resort to the use of local remedies to cause the wounds to heal but no avail, especially in Ghana where advanced treatment is scare. It is against this background that focal research in wound care was done in Ghana to come out with an innovative pharmaceutical wound care product effective for chronic and acute wounds healing to improve the quality of life of people as global burden of wounds escalates. In a Blind Observational Study for a period of five years in Ghana to observe the wound care products efficacy to heal wounds especially chronic types, the objective of the study was to examine a new product efficacy in chronic wound healing in the targeted population of patients with wounds. A product that has dual purpose of wound care as a cleaning and application agent, also has unique product pharmaceutical characteristics. A scalable, easy- to- use, multi-purpose, multi-use and cost-effective product, able to address the barriers or problems of wounds healing. The areas of consideration as far as wound care are concerned included: The study also sought to observe the product ability to control wound pains, control wound bleeding, control and prevent wound infection, remove wound debris, remove wound exudates effecting wounds healing at reduced healing time and with minimal scar in varied targeted patients’ population. Again, to observe the product with outcome of which to mitigate the long-term effect of chronic wounds like recurrent hospitalizations, financial burden, amputations, deformity, and frequent visit to hospital for wound care. One product, 9G Wound Solution (a cleaning and application product) manufactured by Pat J Health Company Limited, Ghana, was effective in wounds healing, especially, effective chronic wounds healing. The product was used to subject varied patients’ population with wounds on randomized basis, for wound care, and through observation the direct short, intermedial and long-term outcomes recorded of product effectiveness recorded. The outcome reported included control of wound pains, control of wound odor, control of bleeding, control of wound infection, removal of wounds exudates, removal of wound debris and ultimately reduced wound healing time to prevent wounds complications like amputations. The study was progressively extended across 10 regions in Ghana to cover 500 patient population with varied wounds. Patients’ population included those with Diabetic ulcers, Burns, pressure ulcers, venous ulcers, herpes zoster skin ulcers, Perineum wounds, Surgical abdomen-pelvic wounds, Traumatic wounds, Buruli Ulcers, gas gangrene wounds, and Mouth ulcers. The outcome of using the new wound care product were directly observed for the study period. By this observational study, the new product was observed to be superior to the controls as this product was able to heal 99% patients who had wounds, especially chronic wounds for many years, including 20years-old wound at reduced healing rate with no reoccurrence within the study period. The product scientifically readily released to the wound environment modulators capable to address the problems or barriers of wounds and simultaneously promoting modulators effective for wound healing. The product was not only effective in chronic wound healing at reduced time but also controlled wound pains shortly, controlled wound odor shortly, stopped wound bleeding, fought and controlled wound infection. However, using the product needed change of wound dressing every two days. The long-term effect of the product on target population not conclusively observed within the period of the research. We need to continuously observe the reported long-term effect of the product efficacy.

Versatility in the Use of Cadaveric Skin Grafts for Wound Management

Background. Cadaveric skin grafts were initially used for the management of acute burn wounds. The biological coverage of the wound improves the quality of the wound bed, which prepares it to receive an autologous skin graft. The benefits of cadaveric skin graft in burn wounds have led to its use in the management of acute and chronic wounds of diverse etiologies. Objective. To evaluate the use of cadaveric skin graft and subsequent autologous split-thickness skin graft (STSG) in the management of wounds of diverse etiologies at a single institution. Materials and Methods. A retrospective analysis was performed of patients with wounds of different etiologies managed with cadaveric skin grafts followed by a second procedure in which autologous STSG was performed from May 2017 through May 2022 in the Plastic and Reconstructive Surgery Department of German Hospital, Buenos Aires, Argentina. Results. A total of 25 patients with wounds of different etiologies were included. The mean affected body surface area (BSA) was 1.87%. The mean engraftment percentage of the cadaveric skin graft was 96.6%. The mean engraftment percentage of the STSG was 90.6%. All patients demonstrated improvement in local edema and inflammation, reduced secretions, and reduced pain after treatment. Two patients (8%) had complications, with 1 case of delayed healing of the donor site and 1 case of hypertrophic scarring. Conclusions. Cadaveric skin graft with subsequent STSG is a simple, safe, and effective alternative for the management of complex wounds of diverse etiologies. This technique is particularly useful in patients with multiple comorbidities who are at risk of recurrence and of developing multiple wounds during their lifetime.

Patient-reported outcome survey of user-experiences in the spinal cord injured-community with MPPT for treating wounds and pressure injuries and for controlling soft tissue infection caused by osteomyelitis.

People with spinal cord injury (SCI) are at high risk of developing pressure injuries. Reports in the SCI-community had indicated that a new class of wound treatment, MPPT (micropore-particle-technology), was effective in treating pressure injuries. The British Spinal Injuries Association therefore conducted a survey among MPPT-users to learn from their experiences. Online survey restricted to individuals with spinal cord injury. Participants were requested to identify themselves to permit validation of statement. The survey had 41 respondents reporting on a total of 49 wounds of which the two main categories were wounds (n = 33), primarily pelvic pressure ulcers; and draining fistulas (n = 9) caused by osteomyelitis. All wounds reported had reached full closure. Median duration of MPPT use and time to closure were 3 and 4 weeks for acute wounds (<6 weeks old) and 8 and 10 weeks for chronic wounds, respectively. On draining fistulas, MPPT had been used to reduce wound size, remove soft tissue infection, avoid sepsis, reduce autonomic dysreflexia, improve overall health, and avoid bed rest, whilst waiting for surgery. Comments on MPPT were 84% highly positive, 11% positive, and 0% negative. No adverse events were reported. MPPT achieved a 100% closure rate of acute and chronic wounds, and, in draining fistulas, effectively controlled soft tissue infection resulting from osteomyelitis. MPPT does not require bed rest and is suitable for self-care and telemedicine, promoting independence and higher quality-of-life. The findings strongly agree with a recent clinical study of MPPT.

Injectable multifunctional hydrogel containing Sphingosine 1-phosphate and human acellular amniotic membrane for skin wound healing.

The skin serves as the main defense barrier, protecting against injuries, and preventing infection and water loss. Consequently, wound healing and skin regeneration are crucial aspects of wound management. A novel hydrogel scaffold was developed by incorporating carboxymethyl cellulose (CMC) and gelatin (Gel) hydrogels cross-linked with 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) containing Sphingosine 1-phosphate (S1P). This hydrogel is applied topically to treat acute wounds and is covered with a human acellular amniotic membrane (hAAM) as a secondary dressing. The scaffold was subjected to in vitro cell viability, red blood cell hemolysis, blood clotting index, and in vivo assays. Real-time PCR was implemented to verify the expression of genes involved in skin wounds. The physical and chemical properties of the scaffolds were also tested using weight loss, swelling ratio, scanning electron microscopy (SEM), Fourier transform infrared (FTIR), and mechanical tensile analysis. The synthetic scaffold is biocompatible as evidenced by the high percentage of 3T3 cell viability (127%) after 72 hr. Additionally, excellent hemocompatibility with a low hemolytic effect (2.26%) was observed. Our in vivo wound healing assay demonstrated that CMC/Gel/S1P/hAAM wound dressing led to faster wound healing in treated rats compared to the control group over 14.Also, the mechanical tests showed that the amniotic membrane and the hAAM had very different Young's modulus and elongation at break values. This study demonstrates the effectiveness of the CMC/Gel/EDC hydrogel with S1P as a wound dressing. Additionally, hAAM exhibits excellent characteristics as a protective layer for the treatment of acute wounds.

The Observatoire en Ville des Plaies ExSudatives (VIPES) Study: Insight Into the Patient Characteristics, Epidemiology, Previous Management, and Features of Wounds Treated in the French Community Setting

Background. Wounds that become complex and hard-to-heal are a challenge for all health care systems. Identifying and understanding the nature of these wounds is necessary to allow appropriate intervention. Objective. To present the epidemiological outcomes of the VIPES study. Materials and Methods. The prospective, observational VIPES study aimed to describe the use and investigate the performance of 2 wound dressings—a silicone foam and a gelling fiber—in the management of chronic and acute wounds in a community setting in France. Results. Of 407 patients recorded, 285 were included in the analysis. The 184 chronic wounds included ulcers (venous/arterial/mixed, diabetic foot, and pressure) and malignant wounds. The 101 acute wounds included surgical and traumatic wounds. Of all wounds, 98.2% were exuding and 77.9% showed exudate pooling. Unhealthy wound edges and periwound skin were reported in 57.2% and 35.4% of wounds, respectively. Of all wounds, 78.6% were in treatment failure (poor exudate management or stagnant wound). The silicone foam dressing (n = 86) and the gelling fiber (n = 199) were generally used in wounds with low or moderate exudation, or moderate or high exudation, respectively. Conclusions. The VIPES study highlights that wounds can be complex and that community care practices in France warrant improvement. Practical and up-to-date wound management recommendations are needed.

Synthesis and characterization of new electrospun medical scaffold-based modified cellulose nanofiber and bioactive natural propolis for potential wound dressing applications.

Recently, the design of polymer nanofibers using the electrospinning process has attracted much interest. Particularly the use of natural polymers has promoted many advantages in their biomedical applications. However, the combination of multiple natural polymers remains a great challenge in terms of electrospun production and applied performance. From this perspective, the current investigation highlights the study of the preparation of electrospun nanomaterial scaffolds based on combined natural polymers for improved wound healing performance. First, we have synthesized a crosslinked polymer by reacting microcrystalline cellulose (MC) and chitosan (CS) biopolymer via the intermediate of citric acid as a crosslinking agent. Then a natural propolis biomolecule was incorporated into the polymer network. Different MC/CS blend ratios of 90/10 and 70/30 were then used and various machine parameters were optimized to obtain nanofiber scaffolds with excellent strength and structures. SEM, IR, physicochemical, mechanical, and morpho-logical characterization were then performed. SEM evaluation revealed homogeneous and bead-free nanofibrous structures, with well-defined morphology and a random deposition that could accurately mimic the extracellular matrix of native skin. The calculated average nanofiber diameters for the MC/CS blend ratios at 90/10 and 70/30 were 431.4 and 441.2 nm, respectively. The results showed that when the chitosan amount increased, larger nanofibers with narrow diameter distribution appeared. The prepared nanomaterials had a significant and close water vapor permeability of about 1735.12 and 1698.52 g per m per day for the two blend ratios of 90/10 and 70/30, respectively. The examination of swelling behavior revealed a noteworthy enhancement in hydrophilicity, a necessary attribute for improved healing efficacy. FT-IR analysis confirmed the success and the stability of the chemical crosslinking reaction between the two biopolymers before nanofiber conception. Excellent mechanical properties were acquired, based on the chitosan content. Both developed nanofiber scaffolds exhibited high tensile strength and Young's modulus values. The incorporation of 30% chitosan versus 10% results in an increase in tensile strength of 11% and 14% in Young's modulus. Therefore, we could adjust the different mechanical properties simply by varying the mixing rate of the electrospun polymers. Using epithelial HepG2 cells, viability and kinetic cell adhesion assays were assessed to obtain biological evaluation. No cytotoxicity was observed and good cytocompatibility was confirmed. Functionalized nanofiber biomaterials with different MC/CS ratios substantiated significant bactericidal effectiveness against Gram-positive and Gram-negative bacterial culture strains. The novel functional electrospun wound dressing scaffold demonstrated effective and promising biomedical performance, healing both acute and chronic wounds.

Examining the Clinical Outcomes of a Soft Silicone Multilayer Foam Dressing for Exudate Management in US Hospitals: It Is Time to Optimize Dressing Change Frequency

Background. Acute and chronic wounds in the acute hospital setting are commonly managed with soft silicone multilayer foam dressings (SSMFDs). While many SSMFDs are indicated for wear time of up to 7 days, they are often changed more frequently. Objective. To use real-world data on dressing change practices and clinical outcomes to examine whether a built-in indicator on a proprietary SSMFD could reduce unnecessary dressing changes. Materials and Methods. Health care professionals (HCPs) were screened and recruited from a health care research panel to complete per wound data capture forms. Outcomes reported included dressing wear time, healing rates, dressing change frequency, user satisfaction, and adverse events. Outcomes were reported as an aggregated data set. Results. A total of 53 wounds were analyzed. The mean treatment period was 23.83 days, which included dressing changes every 2 to 3 days on average. Of the 53 cases analyzed, the unique change indicator on the SSMFD was used to guide dressing change frequency 98% of the time. Overall, 21% of wounds completely healed (n = 11), 70% (n = 37) showed improvement, 9% (n = 5) were static, and 0% deteriorated. Conclusion. Real-world data on use of the proprietary SSMFD in an acute setting indicates that the SSMFD can allow for the optimization of dressing change protocols to enable appropriate dressing change frequency, allowing for undisturbed healing and maximizing HCP and dressing resources.

Early short-term hypoxia promotes epidermal cell migration by activating the CCL2-ERK1/2 pathway and epithelial-mesenchymal transition during wound healing.

Due to vasculature injury and increased oxygen consumption, the early wound microenvironment is typically in a hypoxic state. We observed enhanced cell migration ability under early short-term hypoxia. CCL2 belongs to the CC chemokine family and was found to be increased in early hypoxic wounds and enriched in the extracellular signal-regulated kinase (ERK)1/2 pathway in our previous study. However, the underlying mechanism through which the CCL2-ERK1/2 pathway regulates wound healing under early short-term hypoxia remains unclear. Activation of epithelial-mesenchymal transition (EMT) is a key process in cancer cell metastasis, during which epithelial cells acquire the characteristics of mesenchymal cells and enhance cell motility and migration ability. However, the relationship between epithelial cell migration and EMT under early short-term hypoxia has yet to be explored. HaCaT cells were cultured to verify the effect of early short-term hypoxia on migration through cell scratch assays. Lentiviruses with silenced or overexpressed CCL2 were used to explore the relationship between CCL2 and migration under short-term hypoxia. An acute full-thickness cutaneous wound rat model was established with the application of an ERK inhibitor to reveal the hidden role of the ERK1/2 pathway in the early stage of wound healing. The EMT process was verified in all the above experiments through western blotting. In our study, we found that short-term hypoxia promoted cell migration. Mechanistically, hypoxia promoted cell migration through mediating CCL2. Overexpression of CCL2 via lentivirus promoted cell migration, while silencing CCL2 via lentivirus inhibited cell migration and the production of related downstream proteins. In addition, we found that CCL2 was enriched in the ERK1/2 pathway, and the application of an ERK inhibitor in vivo and in vitro verified the upstream and downstream relationships between the CCL2 pathway and ERK1/2. Western blot results both in vivo and in vitro demonstrated that early short-term hypoxia promotes epidermal cell migration by activating the CCL2-ERK1/2 pathway and EMT during wound healing. Our work demonstrated that hypoxia in the early stage serves as a stimulus for triggering wound healing through activating the CCL2-ERK1/2 pathway and EMT, which promote epidermal cell migration and accelerate wound closure. These findings provide additional detailed insights into the mechanism of wound healing and new targets for clinical treatment.

Development of a two-dimensional peptide functionalized-reduced graphene oxide biomaterial for wound care applications.

Increased incidences of antibiotic resistance have necessitated the development of novel wound disinfection strategies with minimal risk of resistance development. This study aimed at developing a biocompatible wound dressing biomaterial with the potential to treat acute and chronic wounds infected with multidrug-resistant Pseudomonas aeruginosa. A multifunctional antibacterial nanoconjugate was synthesized by covalently coupling a synthetically designed peptide (DP1, i.e., RFGRFLRKILRFLKK) with reduced graphene oxide (rGO). The conjugate displayed antibacterial and antibiofilm activities against multidrug-resistant Pseudomonas aeruginosa. In vitro studies demonstrated 94% hemocompatibility of the nanoconjugate even at concentrations as high as 512 μg mL-1. Cytotoxicity studies on 3T3-L1 cells showed 95% cell viability, signifying biocompatibility. Owing to these properties, the biomedical applicability of the nanoconjugate was assessed as an antibacterial wound dressing agent. rGO-DP1-loaded wound dressing exhibited enhanced reduction in bacterial bioburden (6 log 10 CFU) with potential for wound re-epithelization (77.3%) compared to the uncoated bandage. Moreover, an improvement in the material properties of the bandage was observed in terms of enhanced tensile strength and decreased elongation at break (%). Collectively, these findings suggest that rGO-DP1 is an effective biomaterial that, when loaded on wound dressings, has the potential to be used as a facile, sustainable and progressive agent for bacterial wound disinfection as well as healing.

A Paramount Study in Advancement of Acute and Chronic Wound Repairment using Inorganic Nanoparticles in Veterinary Sphere

A Paramount Study in Advancement of Acute and Chronic Wound Repairment using Inorganic Nanoparticles in Veterinary Sphere

Dilute Povidone-Iodine Solution Soaking Is Ineffective in Improving Outcomes of Necrotizing Fasciitis Caused by Diabetic Foot.

Wound soaking is a physical debridement method that helps reduce bacterial colonization and consequently promotes wound healing. Although soaking in povidone-iodine solution was ineffective in reducing bacterial colonization in acute trauma wounds, there is still a lack of evidence supporting the efficacy of this method in treating severe soft tissue infection. This study aimed to explore the effects of wound soaking in 1% dilute povidone-iodine solution on necrotizing fasciitis caused by diabetic foot ulcers. We retrospectively reviewed and finally included 153 patients who were admitted because of diabetic foot ulcers after undergoing fasciotomy for necrotizing infection from January 2018 to December 2021. Results showed no statistical difference in the outcomes between patients in the soaking and nonsoaking groups. End-stage renal disease (P = 0.029) and high serum C-reactive protein level (P = 0.007) were the only independent factors for below-knee amputation in the univariate and multivariate logistic regression analyses. Therefore, soaking diabetic wounds with severe infection in 1% dilute povidone-iodine solution may not reduce the hospital length of stay, risk of below-knee amputation, and readmission rate.

Efficacy of platelet-rich plasma in alleviating split skin graft morbidities.

Skin grafting is a routinely employed technique to cover the skin defect. Though the skin grafts are technically effortless, they are tiresome because of the prolonged duration of hospital stay, labor-intensive, demanding repeated dressings, and also create a second wound. Platelet-rich plasma (PRP) is one that has a higher concentration of platelets than the blood. Alpha granules of the platelets are rich in growth factors. To assess the effect of PRP on split-thickness skin graft uptake and donor site healing. In a single-center-based prospective study done from August 2018 to June 2020, 60 patients with acute and chronic wounds were divided into two equal groups. Autologous PRP was applied on the recipient wound bed and donor site in PRP group, and conventional methods like staples/sutures were used to anchor the skin grafts and standard of care of the donor site in a control group. Instantaneous graft adhesion was observed in all patients of PRP group. The first graft inspection was delayed. Seroma, hematoma, total number of dressings, and duration of stay in hospital were significantly reduced in the PRP group. Donor site pain in the postoperative period was notably reduced in PRP group. PRP also remarkably hastened the donor site healing. The application of PRP promotes graft take, minimizes complications, enhances donor site wound healing, mitigates donor site pain, and has immense economic benefits due to the reduced number of dressing changes and shorter hospital stay.

Detection of redox potential evolution during the initial stage of an acute wound based on a redox-sensitive SERS-active optical fiber.

To detect redox potential evolution during the initial stage of an acute wound, a redox-sensitive SERS-active optical fiber was fabricated by integrating redox-sensitive SERS probes in a hole of an optical fiber. The redox-sensitive SERS-active optical fibers carried redox-sensitive SERS probes into the inside of a wound to sense its redox potential. The laser was transmitted to the redox-sensitive SERS probes in the body by optical fibers, and the SERS signals of the redox-sensitive SERS probes were transferred out of the body by optical fibers to indicate the redox potentials in the wound. The redox-sensitive SERS probes dynamically sensed the redox potential in vivo, and their SERS signals were collected constantly to indicate the redox potentials. The assessments in vivo and in vitro proved the responsiveness of redox-sensitive SERS-active optical fibers. The redox potential evolution during the initial stage of an acute wound with the treatments of different concentrations of glucose was detected to verify the feasibility of redox-sensitive SERS-active optical fibers to dynamically detect redox potentials in vivo. The redox-sensitive SERS-active optical fiber would be a versatile tool to explore the roles of redox potentials in living organisms.

Clearance of senescent cells enhances skin wound healing in type 2 diabetic mice.

Background: Diabetic foot ulcers (DFUs) pose a substantial healthcare challenge due to their high rates of morbidity, recurrence, disability, and mortality. Current DFU therapeutics continue to grapple with multiple limitations. Senescent cells (SnCs) have been found to have a beneficial effect on acute wound healing, however, their roles in chronic wounds, such as DFU, remain unclear. Methods and results: We collected skin, fat, and muscle samples from clinical patients with DFU and lower limb fractures. RNA-sequencing combined with qPCR analyses on these samples demonstrate a significant accumulation of SnCs at DFU, as indicated by higher senescence markers (e.g., p16 and p21) and a senescence-associated secretory phenotype (SASP). We constructed a type 2 diabetic model of db/db mice, fed with a high-fat diet (Db-HFD), which were wounded using a 6 mm punch to the dorsal skin. HFD slightly affected wound healing in wild-type (WT) mice, but high glucose significantly delayed wound healing in the Db-HFD mice. We injected the mice with a previously developed fluorescent probe (XZ1208), which allows the detection of SnCs in vivo, and observed a strong senescence signal at the wound site of the Db-HFD mice. Contrary to the beneficial effects of SnCs in acute wound healing, our results demonstrated that clearance of SnCs using the senolytic compound ABT263 significantly accelerated wound healing in Db-HFD mice. Conclusion: Collectively, these findings suggest that SnCs critically accumulate at wound sites, delaying the healing process in DFUs. Thus, targeting SnCs with senolytic therapy represents a promising approach for DFU treatment, potentially improving the quality of life for patients with DFUs.

An In Vitro Delayed Scratch Closure Assay with Features of Chronic Wounds.

A scratch assay is a simple wound healing model for assessing cell migration in which a confluent cell layer is scratched to create a scratch zone ("wound") that cells migrate into. Here, we describe a scratch assay exhibiting delayed closure and increased inflammation, which more closely resemble chronic wounds. This delayed scratch closure assay is more relevant for screening compounds and studying delayed wound healing compared with traditional scratch wound assays that more closely resemble acute wounds.

In vitro and in vivo studies of Syzygium cumini-loaded electrospun PLGA/PMMA/collagen nanofibers for accelerating topical wound healing.

This work aims to develop plant extract-loaded electrospun nanofiber as an effective wound dressing scaffolds for topical wound healing. Electrospun nanofibers were fabricated from Syzygium cumini leaf extract (SCLE), poly(lactic-co-glycolic acid) (PLGA), poly(methyl methacrylate) (PMMA), collagen and glycine. Electrospinning conditions were optimized to allow the formation of nanosized and uniform fibers that display smooth surface. Morphology and swelling behavior of the formed nanofibers were studied. In addition, the antibacterial activity of the nanofibers against multidrug-resistant and human pathogens was assessed by agar-well diffusion. Results showed that nanofibers containing Syzygium cumini extract at concentrations of 0.5 and 1% w/v exhibited greater antibacterial activity against the tested Gram-positive (i.e., Staphylococcus aureus, Candida albicans, Candida glabrata and Bacillus cereus) and Gram-negative (i.e., Salmonella paratyphi and Escherichia coli) pathogens compared to the same concentrations of the plain extract. Furthermore, in vivo wound healing was evaluated in Wistar rats over a period of 14 days. In vivo results demonstrated that nanofiber mats containing SCLE and collagen significantly improved wound healing within two weeks, compared to the control untreated group. These findings highlight the potential of fabricated nanofibers in accelerating wound healing and management of topical acute wounds.

Effect of Thumari Malahara in The Management of Post-debridement Wound of Fournier’s Gangrene

Background: Despite improvements in surgical techniques, suture materials, and peri-operative care, acute wound failure or dehiscence remains a dreaded surgical complication. Factors contributing to wound failure include inadequate closure, local factors like infection, advanced age, obesity, malnutrition, and local surgical site infection or hematoma. Case details: A 59-year-old patient referred from Civil hospital to Shalya Tantra OPD seeking management of post debridement wound, on 15th day after secondary suture on debrided wound of Fournier’s Gangrene. Material and Methods: Sutures from the dehisced wound (8×4×2 cm³) were removed and wound management was done by daily dressing with Normal Saline and packed with Thumari Malahara until complete healing. Triphala Guggulu 1gram three times daily and Isabgol husk 2 tablespoonsful at bedtime with lukewarm water was given for one month. The assessment was done on every 7th day on subjective criteria like Varna (Colour of margin &amp; surrounding skin), Srava (Discharge), Vedana (Pain) and granulation tissue and objective criteria as Unit Healing Time (UHT). Results and discussion: Unit healing time was 0.437 days/cm³ with significant decrease in amount of discharge, pain etc. The wound healed completely within 4 weeks of treatment. During follow up for 60 days, no recurrence was noticed. Thumari known as Securinega leucopyrus is a potential drug for wound healing. Thumari in a Malahara formulation further aids in wound healing by maintaining moist environment in wound and penetrating drugs to deeper tissue. Conclusion: This case demonstrates the significant wound healing effect of Thumari Malahara along with adjuvant Ayurveda medicines in the management of post debridement wound of Fournier’s Gangrene.

The Use of Custom-Made Negative Pressure Wound Therapy to Manage Acute Wound Infections: A Retrospective Outcomes Study

Background. NPWT has been used to treat various wounds. Scant evidence exists on the use of custom-made NPWT for infected wounds. NPWT dressings promote wound healing by increasing local blood flow and antibiotic concentration, and by removing exudates from the wound. Objective. To report the use of custom-made NPWT dressings to manage complex infected wounds of the lower limb. Materials and Methods. The authors retrospectively reviewed the records of 43 patients with complex infected wounds of the lower limb treated with debridement and low-cost, custom-made NPWT dressing connected to wall suction from January 1, 2018 to December 31, 2020, at PSG Medical College Hospital, Coimbatore, India. Results. A total of 43 patients with infected wounds of the lower limb were treated with the custom-made NPWT dressings. Second-look debridement was required in 5 patients. An average of 5 dressing changes were required for optimal wound granulation, with 23% of patients (n = 10) requiring secondary suturing and 62% (n = 27) requiring STSG for definitive coverage of the wound. Healing by secondary intention was achieved in 6 patients. The average duration from the start of therapy until the wound was ready for coverage (STSG or secondary suturing) was 2.5 weeks (range, 1–5 weeks), with an average time to complete wound healing of 5 weeks (range, 3–7 weeks). The most common wound isolate was Staphylococcus aureus (60%). No complications occurred. Conclusions. Custom-made NPWT dressings are safe to use in complex infected lower limb wounds. These dressings keep the wound dry and promote healing. Wound debridement followed by NPWT combined with antibiotic therapy can act synergistically to promote wound healing and control infection.