Development Of Granulation Tissue Research Articles

Natural Product for Wound Healing: Systemic Review

Any injury to the body, including damage to the skin's outer layer and impairment of its normal structure and function, is referred to as a wound. Since the beginning of time, people have recognized the crucial nature of wound healing, and significant resources have been used to create cutting-edge wound dressings made of the best materials possible for quick and effective recovery. A vital part of this healing process is played by medicinal herbs. Many studies conducted recently have focused on developing novel wound dressings that contain infusions from medicinal plants or their purified active components, providing viable substitutes for conventional dressings. Several investigations have looked into how various herbal remedies aid in the healing of wounds. This article intends to explain and examine the molecular components of wound healing that are aided by natural plant-based products. The remedies made from herbs participate in various phases of wound healing and work through a variety of processes. Certain herbal medications also increase the formation of important factors that are involved in re-epithelialization, angiogenesis, granulation tissue development, and collagen fiber deposition, such as transforming growth factor-β (TGF-β) and vascular endothelial growth factor (VEGF). encouraging anti-inflammatory in nature and antioxidant qualities at different stages of the wound-healing process. The field of herbal medicine and other natural products are used in traditional and alternative medicine to treat wounds. These methods have various benefits over conventional treatments, such as enhanced efficacy owing to different ways in which they work action, antibacterial qualities, and long-term safety when using wound dressings.

The Role of Pectin Hydrogel Systems Plus Iodine and Phyto Extract in Second-Degree Burn in Rats.

Skin injuries, such as burns, can result in an open wound that can lead to the deterioration of the skin, which acts as a protective barrier against external agents, and can cause serious health problems. Pectin, a plant-derived polysaccharide, is a suitable candidate for wound care due to its gel-forming ability and biocompatibility. Pectin absorbs wound exudates to form a soft gel and is known for its strong anti-inflammatory efects. Pectin-based hydrogel systems promote wound healing by promoting fibroblast proliferation and keratinocyte migration. In the study, 60 male Wistar albino rats were used, and 6 diferent treatment groups were formed: Healthy control, burn control, silver sulfadiazine, pectin-based hydrogel system, pectin-based hydrogel system+iodine, pectin-based hydrogel system+plant extract. Rats with burn wounds were treated for 21 days, and the wound healing process was evaluated by macroscopic, biochemical, and histopathological analysis. The results showed that the pectin-based hydrogel system, iodine, and plant extracts promoted healing in burn wounds. Especially in the groups treated with silver sulfadiazine and plant extracts, the development of granulation tissue and regeneration of collagen fibers showed significant improvement. Furthermore, the pectin-based hydrogel system is thought to contribute to wound healing by maintaining skin moisturization. Vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β) levels decreased in the treatment groups compared to the burn group, and it was determined that these factors play an important role in wound healing. This study shows that pectin-based hydrogel systems can be an efective alternative in burn treatment, and their healing efects can be enhanced by the addition of iodine and plant extracts.

Evaluation of Full Thickness Wounds Following Application of a Visco-Liquid Hemostat in a Swine Model.

Wound healing is a complex dynamic biomechanical process as the body attempts to restore the integrity of traumatized or devitalized tissues. There are four stages of wound of healing that begins with hemostasis followed by inflammation, proliferation and finally weeks later wound remodeling. Full thickness wounds usually are covered with a dressing material after hemostasis, which allows for controlled hydration. We investigated the potential of a visco-liquid hemostat, polyhedral oligomeric silsesquioxane (POSS), for providing hemostasis and to maintain a microenvironment in the wound bed that would maintain moisture content and promote early re-epithelialization. We hypothesized that the hemostatic agent POSS if left in the wound bed would maintain a protective barrier and accelerate wound healing similar to using saline to irrigate the wound to keep the wound moist. We compared the early phase of wound repair (3-7 days) in a porcine full thickness wound model to evaluate the efficacy of the material. Biopsies were taken after 3 and 7 days to determine the acute response of the POSS hemostat or saline on inflammation, cell migration, concentrations of metalloproteinase (MMPs), and tissue inhibitors of metalloproteinase (TIMPs). Accelerated healing was observed in POSS treated wounds by changes in wound contraction, keratinocyte migration, and development of granulation tissue in comparison to saline treated wounds. Increased concentrations at day 3 of MMP-2, MMP-3, and in MMP-1 at day 7 in POSS treated wounds compared to saline coincide with keratinocyte migration observed in the tissue histology and changes in wound contraction. Tissue concentrations of TIMP-1 and TIMP-2 in POSS treated wounds appear to coordinate the sequence of MMP events in the healing tissue. Matrix metalloproteinase-13, a marker for tissue remodeling, was not upregulated in the early wound healing cascade in either POSS or saline treated wounds at 3 or 7 days. Overall, the data suggests POSS treatment contributed to enhanced early cell migration and wound closure compared to saline treatment.

Effect of hydrocolloid-nitric oxide wound dressings on wound healing in dogs.

To determine the rates of wound healing in surgically created wounds between nitric oxide releasing wound dressings and control wound dressings. Prospective, controlled, randomized experimental study. Purpose-bred, adult, male Beagles (n = 6). Four 2 × 2 cm wounds were surgically created on the trunk of each dog with each wound randomized to treatment with a nitric oxide wound pad (NP), nitric oxide wound gel (NG), plain hydrocolloid wound dressing (HC), or Telfa pad (T). Wound images were taken daily for 8 days then every other day until day 21 with images masked and randomized for evaluation. Total wound area, contraction percentage, and days until granulation were calculated. Time to first appearance of granulation tissue was significantly shorter for NP (3.2 days) than for NG (4 days; p = .023), HC (4.5 days; p = .001), and T (5.2 days; p < .0001). There were significant differences in total wound area and contraction percentage between sites and treatments (p < .001). Total wound area for NG was lower than treatment T (0.7 ± 0.1 cm3; p < .001), HC (0.9 ± 0.1 cm3, p < .001), and NP (0.6 ± 0.1 cm3, p < .001). Use of a nitric oxide wound dressing resulted in faster wound healing as evidenced by lower total wound area and higher contraction in the NG group and faster time to granulation tissue development in the NP group. Nitric oxide wound dressings are innovative and inexpensive products that can significantly decrease the amount of time and cost necessary for open or second intention wound resolution in dogs.

Presentation and Management of Postpartum Granulation Tissue: A Single-Institution Retrospective Study.

Although the development of postpartum granulation tissue (PPGT) is an expected phase of healing of perineal and vaginal lacerations, the persistence of this tissue can result in delayed wound healing, pain, bleeding, and discharge. There is a paucity of information on the efficacy of the treatments used for pathologic PPGT. The objective of this study was to describe characteristics associated with the development of PPGT and the treatment methods currently used for management. This was a retrospective cohort study of 140 patients diagnosed with PPGT within one year of birth from 2012 through 2022 within a single health care system. Patients were identified by International Classification of Diseases and Current Procedural Terminology codes. Demographics, birth characteristics, symptoms, and treatment information were obtained and assessed in frequencies and means. Treatments were compared with 95% CIs and P values. Time to resolution was assessed by the number of weeks and the number of visits. It was the first vaginal birth for 129 (92%) patients in the study cohort. The majority (84.3%) of patients presented with pain. Almost half of all patients (45%) were diagnosed after 6 weeks postpartum. 30.0% of patients were initially treated conservatively. 76.4% of patients were treated with silver nitrate, and 33.6% had an excisional procedure. Successful conservative management had the lowest average number of visits to resolution with 1.39 visits (95% CI, 1.15-1.69), followed by silver nitrate alone with 1.95 visits (95% CI, 1.73-2.19), and excision with or without silver nitrate with 2.40 visits (95% CI, 2.07-2.78). Conservative management was unsuccessful 45% of the time, requiring additional treatment with silver nitrate or excision. 30% of patients treated with silver nitrate or excision continued to report pain even after the resolution of granulation tissue upon examination. PPGT is commonly associated with first vaginal births, often presents beyond 6 weeks postpartum, and frequently requires treatment.

Does The Scientific Evidence Support the Idea of Promoting Sucralfate as The First Aid Topical Management for Burn Wound? A Literature Review

Burn injuries, caused by heat, chemicals, radiation, or electricity, significantly impact morbidity and mortality. Sucralfate, a mucoprotective agent composed of sucrose sulfate and aluminum hydroxide, forms a protective barrier on wounds, reduces pain, stimulates healing, and has anti-inflammatory effects. By stimulating prostaglandin secretion and binding to proteins in the ulcer bed, sucralfate enhances gastrointestinal mucosa defenses and acts locally in injured tissues, minimizing systemic effects. Clinical studies demonstrate its effectiveness in improving wound healing, reducing pain, and promoting tissue regeneration, angiogenesis, and granulation tissue development in burn patients. For optimal burn wound therapy, proper patient selection, formulation techniques, and integration with standard protocols are crucial. Further large-scale randomized controlled trials are necessary to establish guidelines and expand sucralfate's clinical applications.

Acute pulmonary atelectasis in infants and its management

Foreign body aspiration (FBA) is commonly seen in the age group of 1–3years, is a common cause of morbidity and mortality in children worldwide. They are less commonly seen below one year, hence challenging to manage. Aspiration of organic FB (Foreign body) causes severe airway mucosal inflammation. If not promptly removed, chronic inflammation sets in leading to the development of granulation tissue around it, ultimately presenting as a lung infection and collapse. Author is reporting here two rare cases of acute atelectasis in infants and their management.

Topical Fibronectin Improves Wound Healing in Postmastectomy Breast Cancer Radiation Therapy : A Review

Breast cancer is the most common cancer among women worldwide. Breast cancer provides an excellent example of how multidisciplinary management has improved patient outcomes. This paper synthesizes the complex and evolving evidence regarding the role of radiation therapy after mastectomy. Although substantial evidence indicates that radiation therapy can reduce the risk of locoregional failure after mastectomy. This therapy is known as PMRT. Postmastectomy radiotherapy (PMRT) is an essential component of combined therapy for early‐stage, high‐risk breast cancer. Breast reconstruction (BR) is often considered for patients with breast cancer who have undergone mastectomy. There has been a considerable amount of discussion about the optimal approach to combining PMRT with BR in the treatment of breast cancer. PMRT may increase the risk of complications and prevent good aesthetic results after BR, while BR may increase the complexity of PMRT and the radiation dose to surrounding normal tissues. The goal of a PMRT plan is to achieve optimal coverage of the target volume while minimizing the irradiation dose to normal tissues. The purpose of this review is to give a broad overview and summary of the current topical fibronectin improves wound healing in postmastectomy breast cancer radiation therapy. In summary, Exogenous fibronectin diminishes wound progression, by increasing angiogenesis &amp; cell proliferation. This suggests that enhances healing by stimulating the appearance of fibroblasts into the wound site and development of granulation tissue. This acceleration of the repair process may have an important application in the healing of skin chronic wounds.

Comparative study of tissue culture and sensitivity versus swab culture and sensitivity of microorganisms in the healing of diabetic foot ulcers

This prospective observational study, conducted at the Department of General Surgery, SRM Medical College and Hospital, aimed to assess the effectiveness of tissue culture and sensitivity compared to swab culture and sensitivity in the healing of diabetic foot ulcers through antibiotic sensitivity of microorganisms. Between May 2016 and August 2017, 160 subjects with diabetic foot ulcers were randomly assigned treatment based on either swab or tissue culture findings. Patients were followed at 15-day intervals for up to 60 days. Results showed positive swab cultures in 76.88% and positive tissue cultures in 92.50% of the study population. The most prevalent organism in swab cultures was Proteus (14.38%), while Pseudomonas (16.88%) dominated in tissue cultures. The cumulative proportion of subjects developing granulation tissue was faster in the tissue culture group, reaching 57.50% at 15 to 30 days and 99% at 31 to 45 days. The swab culture group exhibited proportions of 48.80%, 75%, and 93.80% at the same intervals. In conclusion, diabetic foot ulcer treatment based on tissue culture showed slightly faster healing rates compared to swab culture. However, both groups achieved good ulcer healing within the 60-day follow-up period. These findings emphasize the importance of choosing an appropriate culture method for effective management of diabetic foot ulcers.

An intrinsically semi-permeable PDMS nanosheet encapsulating adipose tissue-derived stem cells for enhanced angiogenesis.

Cell encapsulation devices are expected to be promising tools that can control the release of therapeutic proteins secreted from transplanted cells. The protein permeability of the device membrane is important because it allows the isolation of transplanted cells while enabling the effectiveness of the device. In this study, we investigated free-standing polymeric ultra-thin films (nanosheets) as an intrinsically semi-permeable membrane made from polydimethylsiloxane (PDMS). The PDMS nanosheet with a thickness of 600 nm showed intrinsic protein permeability, and the device fabricated with the PDMS nanosheet showed that VEGF secreted from implanted adipose tissue-derived stem cells (ASCs) could be released for at least 5 days. The ASC encapsulation device promoted angiogenesis and the development of granulation tissue 1 week after transplantation to the subcutaneous area of a mouse. This cell encapsulation device consisting of PDMS nanosheets provides a new method for pre-vascularization of the subcutaneous area in cell transplantation therapy.

Mechanism and application of fibrous proteins in diabetic wound healing: a literature review.

Diabetic wounds are more complex than normal chronic wounds because of factors such as hypoxia, reduced local angiogenesis, and prolonged inflammation phase. Fibrous proteins, including collagen, fibrin, laminin, fibronectin, elastin etc., possess excellent inherent properties that make them highly advantageous in the area of wound healing. Accumulating evidence suggests that they contribute to the healing process of diabetic wounds by facilitating the repair and remodel of extracellular matrix, stimulating the development of vascular and granulation tissue, and so on. However, there is currently a lack of a comprehensive review of the application of these proteins in diabetes wounds. An overview of fibrous protein characteristics and the alterations linked to diabetic wounds is given in this article's initial section. Next is a summary of the advanced applications of fibrous proteins in the last five years, including acellular dermal matrix, hydrogel, foam, scaffold, and electrospun nanofibrous membrane. These dressings have the ability to actively promote healing in addition to just covering wounds compared to traditional wound dressings like gauze or bandage. Research on fibrous proteins and their role in diabetic wound healing may result in novel therapeutic modalities that lower the incidence of diabetic wounds and thereby enhance the health of diabetic patients.

Fucoidan-coated cotton dressing functionalized with biomolecules capped silver nanoparticles (LB-Ag NPs–FN–OCG) for rapid healing therapy of infected wounds

The colonization of pathogenic microbes poses a significant clinical barrier that hinders the physiological wound-healing process. Addressing this challenge, we developed a novel wound dressing using a modified cotton gauze dressing coated with fucoidan and functionalized with silver nanoparticles (LB-Ag NPs–FN–OCG) for the rapid treatment of infected wounds. Firstly, phytochemical-capped LB-Ag NPs were synthesized and characterized using high performance liquid chromatography (HPLC), transmission electron microscopy (TEM), and zeta potential analysis. Secondly, different concentrations of LB-Ag NPs (0.1%–1%) were functionalized into FN-OCG to identify appropriate concentrations that were non-toxic with superior antibacterial activities. Screening assays, including antibacterial, hemolysis, chick chorioallantoic membrane (CAM) assay, and cytotoxicity assay, revealed that LB-Ag NPs (0.5%)–FN–OCG were non-toxic and demonstrated greater efficiency in inhibiting bacterial pathogens (Escherichia coli, Salmonella enterica, Staphylococcus aureus, and Listeria monocytogenes) and promoting fibroblast cell (NIH3T3) migration. In vivo assays revealed that LB-Ag NPs (0.5%)–FN–OCG treatment exhibited excellent wound healing activity (99.73 ± 0.01%) compared to other treatments by inhibiting bacterial colonization, maintaining the blood parameters, developing granulation tissue, new blood vessels, and collagen deposition. Overall, this study highlights that LB-Ag NPs (0.5%)–FN–OCG serve as a antibacterial wound dressing for infected wound healing applications.

Trends and Innovation in Negative Pressure Wound Therapy: A Review of Burn Wound Management.

Significance: Burns result in irretrievable cell damage, which can occur upon exposure to hot surfaces, liquids, gases, ultraviolet or ionizing radiation, and through friction. Standard of care in burn management involves protecting the patient, limiting burn progression, and achieving wound closure. Negative pressure wound therapy (NPWT) and NPWT with instillation and dwell time (NPWTi-d) are two wound management options that have been shown to improve outcomes for burn patients in recent years. This work provides a general review of NPWT and NPWTi-d use in burn wound management. A literature search was performed using PubMed and Embase for peer-reviewed publications and conference abstracts written in English and reporting on burn management using NPWT and/or NPWTi-d from a single manufacturer between 2000 and 2021. All burn types were included. Recent Advances: Thirteen studies and 308 patients were available for assessment. Use of NPWT was reported in a majority of studies (n = 11). When conventional NPWT was applied, graft take of >90% was observed and consistent final wound closure was achieved. Two studies described NPWTi-d use for burn wound management. NPWTi-d use promoted granulation tissue development in burn wounds. Critical Issues: Limited high-level prospective evidence exists for use of NPWT and NPWTi-d in burn wound management. Future Directions: Available literature on the use of NPWT and/or NPWTi-d in burn care has reported improved outcomes in wound bed preparation, which can ultimately lead to final wound closure. The use of these modalities should be considered in management of burn care patients.

Regenerative potential of mesenchymal stromal cells in wound healing: unveiling the influence of normoxic and hypoxic environments.

The innate and adaptive immune systems rely on the skin for various purposes, serving as the primary defense against harmful environmental elements. However, skin lesions may lead to undesirable consequences such as scarring, accelerated skin aging, functional impairment, and psychological effects over time. The rising popularity of mesenchymal stromal cells (MSCs) for skin wound treatment is due to their potential as a promising therapeutic option. MSCs offer advantages in terms of differentiation capacity, accessibility, low immunogenicity, and their central role in natural wound-healing processes. To accelerate the healing process, MSCs promote cell migration, angiogenesis, epithelialization, and granulation tissue development. Oxygen plays a critical role in the formation and expansion of mammalian cells. The term "normoxia" refers to the usual oxygen levels, defined at 20.21 percent oxygen (160 mm of mercury), while "hypoxia" denotes oxygen levels of 2.91 percent or less. Notably, the ambient O2 content (20%) in the lab significantly differs from the 2%-9% O2 concentration in their natural habitat. Oxygen regulation of hypoxia-inducible factor-1 (HIF-1) mediated expression of multiple genes plays a crucial role in sustaining stem cell destiny concerning proliferation and differentiation. This study aims to elucidate the impact of normoxia and hypoxia on MSC biology and draw comparisons between the two. The findings suggest that expanding MSC-based regenerative treatments in a hypoxic environment can enhance their growth kinetics, genetic stability, and expression of chemokine receptors, ultimately increasing their effectiveness.

Comparative study between vacuum-assisted closure therapy and tetra-silver nitrate in the management of diabetic foot ulcer

Background Diabetes-related foot ulcers are becoming more common. The percentage range is 15 to 25%. Several procedures and dressing agents have been investigated. In the vacuum-assisted closure technique, sub-atmospheric pressure is employed to accelerate the healing process. Aim and objectives In this study, the healing rates of diabetic foot ulcers (DFUs) treated with tetra-silver nitrate dressing were compared with those treated with negative pressure wound care. Patients and methods More than 30 patients were randomly allocated to one of two study groups by the Vascular Surgery department at Aswan University Medical School. Group A received a vacuum-assisted closure (VAC) dressing for a total of 30 patients, while group B received tetra-silver nitrate. Result After 6 weeks, there was a statistically significant difference in wound-healing rates between the two groups. Conclusion Patients who got VAC developed granulation tissue faster than those who received tetra-silver nitrate. VAC treatment is safe and effective in diabetic foot ulcers. Granulation tissue formation accelerates healing and reduces the risk of problems such as infection or amputation.

Retraction note to: Treatment of methicillin resistant Staphylococcus aureus wound infection using vancomycin-loaded nanoparticles: An in vitro and in vivo study.

Due to the rise of bacteria that are resistant to multiple drugs, treating infections in burn wounds has become a worldwide problem. It is important to find new ways to treat these infections. Lipid-based drug delivery systems have emerged as a promising type of carrier for antibiotics as well as antibacterial agents, such as antimicrobial peptides and nucleic acids, for wound infections. To this end, the current study assessed the antibacterial effects and wound healing properties of vancomycin-loaded solid lipid nanoparticles (SLN) against methicillin-resistant Staphylococcus aureus (MRSA) surgical wound infections. vancomycin-SLN was synthesized by double emulsion solvent evaporation techniques, and then in vitro antibacterial activity was evaluated by well diffusion and broth microdilution methods. A surgical wound was inflicted on 36 male rats; the infection was caused by MRSA, and free vancomycin and vancomycin-SLN were topically applied. Particle size, PDI, zeta potential, drug loading, and encapsulation efficiency of the optimum vancomycin-SLN were 350 ± 24 nm, 0.402 ± 0.014, -16.3 ± 2.5 mV, 13.9 ± 1.4%, and 92.14 ± 3.1%, respectively. In vitro antibacterial assays showed lower MICs for free vancomycin and killed bacteria more efficiently than vancomycin-SLN. However, the synthesized nanoparticles indicated long-term antibacterial activity against MRSA. Animals that were treated with vancomycin-SLN showed the best wound healing procedure. Treatment of rats with vancomycin-SLN increased re-epithelialization and decreased granulation tissue development, as seen by histological analysis. Antibiotic-loaded SLN could not only manage wound infection but also enhance wound healing. Therefore, this kind of treatment should be considered by scientists as an applicable treatment for wounds.

Tracheostomy complications in children: Single center experience

Objective: To evaluate the frequency and the type of complications in children with tracheostomy in our center&#x0D; Materials and Methods: Single-center retrospective study of pediatric patients undergoing tracheostomy between 2017 and 2022. Age, sex, indication of tracheostomy, tracheostomy time, the features of complications and presence of mortality were evaluated.&#x0D; Results: Fifty children (22 girls, 28 boys) were included the study. The mean age of patients 93.5 months. The tracheostomy time was before one year of age for 27 patients. The most common indication for tracheostomy was long-term ventilation. There were 30 complications for 23 patients.(46%) We did not report any early complication. The most common late complication was the development of granulation tissue. The second most common complication was cannula obstruction. Only one patient died due to massive bleeding associated with tracheostomy. We decannulated 7 patients (14%).&#x0D; Conclusion: The rates of complication may vary in the literature. The reason for this differentiation may be related to the different study design and population features.Also socio-economic level of the family and the responsibility awareness of the parents may contribute to these factors. Education of parents and caregivers about the appropriate postoperative management is very important for preventing complications rates.

Predictive factors and clinical efficacy of Chinese medicine Shengji ointment in the treatment of diabetic foot ulcers in the elderly: a prospective study.

Objective: This study aims to investigate the predictive factors and efficacy of traditional Chinese medicine Shengji Ointment in the treatment of diabetic foot ulcers in the elderly population, with the intent of formulating an effective predictive model for deep diabetic foot ulcer healing. The importance of this research lies in its provision of new perspectives and tools for addressing the severe health impact of diabetic foot ulcers in the elderly population, considering the complexity and diversity of its treatment methods. Methods: The study includes 180 elderly patients with Wagner grade 3-4 diabetic foot ulcers that involve the tendon or fascia. The dependent variable is the initiation time of granulation tissue development. Independent variables encompass demographic information, a treatment strategy including Shengji Ointment, pre-treatment trauma assessment data, routine blood count, and biochemical index test results. Lasso regression is employed for variable selection, and Cox regression is utilized for the construction of a prediction model. A nomogram is generated to authenticate the model. Results: The Chinese Medicine treatment approach, ulcer location, creatinine levels, BMI, and haemoglobin levels are identified as independent predictors of granulation tissue development in diabetic foot ulcers. The combined treatment of Chinese herbal Shengji ointment and bromelain positively influenced granulation tissue development. The location of plantar ulcers, impaired renal functionality, obesity, and anaemia are established as independent risk factors that might influence the speed and probability of ulcer healing. The area under the time-dependent ROC curve fluctuates between 0.7 and 0.8, demonstrating substantial discrimination and calibration of the model. Conclusion: The study ascertains that a combined treatment strategy incorporating Shengji Ointment demonstrates greater effectiveness than the use of cleansing gel debridement alone in facilitating the healing of Wagner grade 3 or higher diabetic foot ulcers. Furthermore, the predictive model developed in this research serves as a valuable tool in evaluating the efficacy of Chinese Medicine treatments like Shengji Ointment for diabetic foot ulcers in the elderly. It aids clinicians in effectively assessing and adjusting treatment strategies, thereby proving its significant application value in clinical practice. Clinical Trial Registration: (https://www.chictr.org.cn/hvshowproject.html?id=73862&v=1.5&u_atoken=b403af53-d3b9-41ae-a7e2-db5498609b0c&u_asession=01tNh69p235bMUO4CmHIXcv8Hxirl5-557Duue9QB5lGfl3mf8IvPlcs2kN2zC30voX0KNBwm7Lovlpxjd_P_q4JsKWYrT3W_NKPr8w6oU7K_AyPrQhedMUWBMR2-ZDL_KO0uwDPR9XlF566xraDvT9mBkFo3NEHBv0PZUm6pbxQU&u_asig=05Kd_Q8fjv-24MVbZpOS9ef3xuCCN-tSVH5eUoJKgNLM7E0-n0zMpW6xLq9gh9aUhkKEEA15rdDoCydncF99APBwVSaTPgEG_V_B1iT4wimdCTxV_4ZVbTlDewxyQtE4YgU4-Oza7KPi94RJ64Utel0yZfqg3Tlm-bVxFNOY-zXFP9JS7q8ZD7Xtz2Ly-b0kmuyAKRFSVJkkdwVUnyHAIJzSYJ6SfhFl0WMTCCasZ7zV2I2qfyrp5m-SELPVeREKgX_6yRmLu26qT8kGfcS-Yaeu3h9VXwMyh6PgyDIVSG1W-7D_Sko5YQtpDbs3uvezYkZcUUY4o9-zDPaoYelmMDs8u7I4TPvtCXaPp44YUJcQ9bHr-_RmKA5V8nji3daArhmWspDxyAEEo4kbsryBKb9Q&u_aref=NNH1nHSUCE6pNvCilV%2F1MD0aERs%3D), identifier (ChiCTR2000039327).

Targeting Anaerobic Respiration in Pseudomonas aeruginosa with Chlorate Improves Healing of Chronic Wounds.

Objective: Pseudomonas aeruginosa is an opportunistic pathogen that can establish chronic infections and form biofilm in wounds. Because the wound environment is largely devoid of oxygen, P. aeruginosa may rely on anaerobic metabolism, such as nitrate respiration, to survive in wounds. While nitrate reductase (Nar) typically reduces nitrate to nitrite, it can also reduce chlorate to chlorite, which is a toxic oxidizing agent. Therefore, chlorate can act as a prodrug to specifically eradicate hypoxic/anoxic, nitrate-respiring P. aeruginosa populations, which are often tolerant to conventional antibiotic treatments. Approach: Using a diabetic mouse model for chronic wounds, we tested the role that anaerobic nitrate respiration plays in supporting chronic P. aeruginosa infections. Results: P. aeruginosa forms biofilm deep within the wound where the environment is anoxic. Daily treatment of P. aeruginosa-infected wounds with chlorate supported wound healing. Chlorate treatment was as effective as a treatment with ciprofloxacin (a conventional antibiotic that targets both oxic and hypoxic/anoxic P. aeruginosa populations). Chlorate-treated wounds showed markers of good-quality wound healing, including well-formed granulation tissue, reepithelialization and microvessel development. Loss- and gain-of-function experiments showed that P. aeruginosa requires nitrate respiration to establish a chronic wound infection and form biofilms. Innovation: We show that the small molecule chlorate, kills the opportunistic pathogen, P. aeruginosa, by targeting a form of anaerobic metabolism called nitrate respiration. Conclusion: Chlorate holds promise as a treatment to combat diverse bacterial infections where oxygen is limiting and/or where pathogens grow as biofilms because many other pathogens possess Nar and survive using anaerobic metabolism.

Mesenchymal Stem Cells (MSCs) Therapy for Pressure Ulcers: A Literature Review

Pressure ulcers or injuries, arise from ischemic damage to soft tissues induced by unrelieved pressure over a bony prominence. They are usually difficult to treat with standard medical therapy and often they recur. Promising alternative methods for treatment are now developing in the search for better treatment choices. Within the field of regenerative medicine, ongoing research on advanced therapies seeks to treat pressure ulcers with mesenchymal stem cells (MSCs). This review was synthesized and obtained from various online databases. Scientific articles were selected based on the inclusion criteria. MSCs have anti-inflammatory capabilities, they are very helpful for treating chronic wounds such as pressure ulcers because they can restart healing infected wounds by moving the wound through a chronic inflammatory state and into the subsequent stage of healing. The research indicates that MSCs produce soluble compounds that promote the proliferative and migratory behavior of the dominant cell types in the wound. MSCs promote wound closure with promoting angiogenesis, granulation tissue production, and faster epithelialization. Additionally, it was discovered that the cells create bioactive chemicals that appear to accelerate the regeneration process. These findings show that MSC therapy affects all stages of wound healing, including inflammation, epithelialization, development of granulation tissue, and tissue remodeling. Although there are many medications to treat pressure ulcers, there are surprisingly new therapies that take use of MSCs' positive benefits and crucial for wounds that are difficult to heal.