Development Of Granulation Tissue Research Articles

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 & 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.

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.

Treatment of methicillin resistant Staphylococcus aureus wound infection usingvancomycin-loaded nanoparticles: Aninvitro 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
 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.
 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%).
 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.

Anastomotic stenosis of bioengineered trachea grafts is driven by transforming growth factor β1-induced signaling, proinflammatory macrophages, and delayed epithelialization

ObjectiveAnastomotic stenosis caused by hypertrophic granulation tissue often develops in response to orthotopically implanted bioengineered tracheal grafts. To determine mechanisms responsible for the development and persistence of this granulation tissue, we looked for changes in gene expression from tissue specimens from the graft-native interface. MethodsRNA was isolated from paraffin-embedded tissue samples of the anastomotic sites of orthotopically implanted bioengineered tracheal grafts of 9 animals. Tissue samples were binned into 3 groups based on degree of stenosis: no stenosis (<5%), mild stenosis (25%-50%), and moderate and severe stenosis (≥75%). Sections of healthy trachea tissue were used as control. The expression levels of ∼200 genes related to wound healing, plus several endogenous controls, were measured with a pathway-focused predesigned primer array. ResultsExpression of ARG2, IL4, RPL13 A, TGFBR3, and EGFR decreased, whereas expression of RUNX2 was increased in stenotic wounds compared with nonstenotic tissue. Based on the cell types present in the trachea and wound healing, this expression profile indicates a lack of M2 anti-inflammatory macrophages, absent epithelial cells, and transforming growth factor β1-induced signaling. ConclusionsThese findings represent a significant step for tracheal tissue engineering by identifying several key mechanisms present in stenotic granulation tissue. Further research must be conducted to determine what modifications of the graft substrate and which coadministered therapeutics can be used to prevent the development of hypertrophic granulation tissue.

Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap

Introduction: Mediastinitis is a rare occurrence following cardiac surgeries; however, it is a significant cause of both mortality and morbidity. Given the significance of mediastinal infections, early diagnosis, and treatment become of paramount importance. The management of this condition necessitates a multidisciplinary approach, involving collaboration and coordination among various medical specialties. Patients and Methods: 21 patients with a diagnosis of deep mediastinal infection who were treated at Eskişehir Osmangazi University Medical Faculty Hospital between January 2015 and May 2021 were included in the study. Broad-spectrum antibiotic therapy, serial debridement, and vacuum-assisted closure were applied to all patients. Among the patients who exhibited negative blood cultures and developed granulation tissue, those with tissue losses that did not extend to the sternum incision sites were assessed for potential flap procedures in conjunction with plastic and reconstructive surgery. In such cases, closure of the wound was achieved using a pectoral muscle flap. All patients were followed for one year. Results: Among the patients, 14 (66.6%) were female and seven (33.3%) were male, with a mean age of 62.7 ± 6.5 (range: 41-76 years). Three of the 21 patients included in the study had type I, two had type II, and 16 had type IIIA mediastinitis. Staphylococcus aureus (S. aureus) was the most commonly isolated microorganism with 11 patients (52.3%). The right pectoralis major muscle was used in four patients (19%), the left pectoralis major muscle in four patients (19%), and the bilateral pectoralis major muscle in 13 patients (62%). There was no need for re-intervention in the follow-up of the patients. No mortality because of infection, surgical muscle flap closure, and/or cardiac causes was observed in any of the patients who were treated. Conclusion: Mediastinitis is a costly treatment, requiring prolonged hospitalization and carrying the risk of mortality. The main objective is to prevent the occurrence of mediastinitis. We believe that this objective should be pursued through a multidisciplinary approach involving cardiovascular surgery, infectious diseases, and plastic and reconstructive surgery units.

Casein fibres for wound healing.

The name casein is given to a family of phosphoproteins which is commonly found in milk. Until recently, this was a constituent of milk that was commonly discarded; however today, it is widely used in health supplements all over the world. In this work, a high loading (50 wt%) of casein is mixed with a solution of polycaprolactone (PCL) to produce bandage-like fibres with an average fibre diameter of 1.4 ± 0.5 µm, which would be used to cover wounds in a series of tests with diabetic rats. Mouse fibroblast cell viability tests show that the casein-loaded fibres had little cytotoxicity with over 90% observed viability. A 14-day in vivo trial involving three groups of rats, used as control (no treatment), pure PCL fibres and casein-loaded fibres, showed that the casein within the fibres contributed to a significantly more extensive healing process. Histological analysis showed increased development of granulation tissue and follicle regrowth for the casein-loaded fibres. Further analysis showed that casein-loaded fibres have significantly lower levels of TNF-α, TGF-β IL-1β, NF-κB and IL-6, contributing to superior healing. The results presented here show an economical and simple approach to advanced wound healing.

The nature of changes in endocrine and immune factors at the initial stage of the formation of chronic wounds

Aim. The work aimed to study the nature of changes in endocrine signals (insulin and cortisol) and bioactive molecules that control inflammation and activation of process synthesis (interleukin-2 (IL-2), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), amino-terminal propeptide of type III procollagen (PIIINP)), at the initial stage of the formation of chronic wounds in the experiment.&#x0D; Materials and methods. The study was conducted in 2 groups of Wistar rats. The first group is represented by intact animals. Animals of the second group were modeled chronic wounds. On the 3rd day of the experiment, all animals were euthanized. The concentration of studied bioactive molecules was measured in blood serum by enzyme immunoassay. Selected areas of the wound were subjected to histological examination.&#x0D; Results. The levels of cortisol, insulin, VEGF, IL-2, and PIIINP in animals with chronic wounds at the stage of inflammation were significantly higher compared to intact animals. A tendency towards a decrease in the expression of IL-8 was shown. Relationships between the levels of bioactive molecules in animals of different groups were studied. According to the results of studies a correlation between the concentrations of IL-8 and cortisol in rats of the intact group was established. In the group of rats on the 3rd day after wound induction, a positive correlation was noted between the levels of IL-8 and IL-2. Wound defects healed under the scab. Microscopic analysis showed that the histoarchitectonics of tissues in the area of damage on the 3rd day corresponded to the classic manifestations of the process of healing wounds at this stage. The main part of the wound was filled with fibrin strands with a predominantly inflammatory cellular component. In some areas, signs of growth and development of young granulation tissue were noted. In the marginal sections, signs of re-epithelialization of the wound defect were observed.&#x0D; Conclusions. Even though in our study, the histoarchitectonics of tissues in the area of damage corresponded to the classical manifestations of the wound healing process at the stage of inflammation, the obtained changes and the relationship between endocrine and immune factors may be harbingers of the formation of the chronic wound in the future.

Digital Image Analysis of Diabetic Foot Ulcer Areas Using ImageJ Software (National Institute of Health, USA) in Patients Treated with Autologous Activated Platelet-rich Plasma Injection

Background: In this cross-sectional study, we investigated three diabetic foot ulcer (DFU) patients. DFU is a serious diabetes complication affecting general health and social life. Autologous regenerative therapies, such as autologous activated platelet-rich plasma (aaPRP), have been proposed for DFU management. However, precise instruments are required to measure the wound size to evaluate wound closure after treatment. Objectives: This study aimed to evaluate the DFU healing process treated by aaPRP through digital image analysis using ImageJ software (National Institute of Health, USA). Methods: The DFU patients were administered aaPRP and followed up on days 7 and 14. The healing process was analyzed through ImageJ software. Paired t-test was used to assess the wound healing process. Results: The results showed that ImageJ was useful for wound area measurement. Granulation and sloughy tissue development can be evaluated and calculated as a part of wound healing progress. Conclusions: We conclude that ImageJ facilitates DFU analysis not only about the size but also on the healing time process through visualization of granulation and sloughy tissue formation, which can represent the healing progress.

Amorphous silicate technology produces good results in equine distal limb wound healing

The objective of this study was to report clinical outcomes of horses with naturally occurring full-thickness skin lacerations treated with an amorphous silicate dressing. We hypothesized that wounds treated with an amorphous silicate dressing would have minimal complications and lesion resolution without formation of exuberant granulation tissue. 11 client-owned horses. Clinical records of 11 horses with distal limb wounds treated with an amorphous silicate dressing were collected from participating veterinarians across the US. Wound healing progression was monitored by the veterinarian and owners. None of the wounds required granulation bed debridement following treatment with topical amorphous silicate dressing. There were no complications associated with the treatment. The size of wounds varied from 5 to 20 cm in length with a median of 10 cm and from 2 to 15 cm in width with a median of 5 cm. Time to resolution varied greatly from 14 to 126 days with a median of 49 days. There was a moderate positive correlation between healing time (days) and area of the wound. All referring veterinarians and owners were satisfied with the healing of the wounds treated with the amorphous silicate dressing. Treatment of equine distal limb wounds with an amorphous silicate dressing may reduce development of exuberant granulation tissue and the need for surgical debridement.

Microcirculation surrounding end-stage human chronic skin wounds is associated with endoglin/CD146/ALK-1 expression, endothelial cell proliferation and an absence of p16Ink4a.

Angiogenesis is an essential part of normal skin healing, re-establishing blood flow in developing granulation tissue. Non-healing skin wounds are associated with impaired angiogenesis and although the role of re-establishing macroscopic blood flow to limbs to prevent wound chronicity is well investigated, less is known about vascular alterations at the microcirculatory level. We hypothesised that significant phenotypic changes would be evident in blood vessels surrounding chronic skin wounds. Wound edge tissue, proximal to wound (2 cm from wound edge) and non-involved skin (>10 cm from wound edge) was harvested under informed consent from 20 patients undergoing elective amputation due to critical limb ischemia. To assess blood vessel structure and viability, tissue was prepared for histological analysis and labelled with antibodies specific for PECAM-1 (CD31), CD146, endoglin, ALK-1, ALK-5, and p16Ink4a as a marker of cellular senescence. Density of microvasculature was significantly increased in wound edge dermis, which was concomitant with increased labelling for endoglin and CD146. The number of CD31 positive vessel density was unchanged in wound edge tissue relative to non-involved tissue. Co-labelling of endoglin with the transforming growth factor receptor ALK-1, and to a lesser extent ALK-5, demonstrated activation of endothelial cells which correlated with PCNA labelling indicative of proliferation. Analysis of p16Ink4a staining showed a complete lack of immunoreactivity in the vasculature and dermis, although staining was evident in sub-populations of keratinocytes. We conclude that the endoglin-ALK-1-endothelial proliferation axis is active in the vasculature at the edge of chronic skin wounds and is not associated with p16Ink4a mediated senescence. This information could be further used to guide treatment of chronic skin wounds and optimise debridement protocols.

Enhanced wound-healing efficacy of electrospun mesoporous hydroxyapatite nanoparticle-loaded chitosan nanofiber developed using pluronic F127

One of the goals of wound repairing is to mimic the function and architecture of the native extracellular matrix (ECM). To this end, for the first time, we used pluronic F127 and mesoporous rod-like hydroxyapatite nanoparticles (mr-HAP NPs) simultaneously to prepare a novel low-diameter electrospun ECM-mimicking wound dressing based on a mixture of chitosan and polyethylene oxide. F127 is used as a surface tension regulator of the polymer solution. In addition, F127 has the special ability to reduce the size of nanofibers. mr-HAP NPs are used as cell proliferation accelerators which also improve the mechanical properties and water uptake capacity of the as-prepared dressing. The average size of nanofibers in the presence of F127 was about 110 nm which was more than 2.5 times lower than nanofibers prepared without F127. The water uptake capacity was evaluated to investigate the wound exudate absorption capacity of the wound dressing. It was observed that the incorporation of mr-HAP NPs into wound dressing structure increases the water uptake capacity by more than 2.5 times. Alongside the evaluation of cytocompatibility through in vitro cell viability assay, the wound healing efficacy was also determined in full-thickness skin wounds in a rat model for 15 days. The cytocompatible wound dressing showed significantly higher wound closure efficacy than the control group so the wounds healed entirely on the last day of the treatment period. As well, the pathology analysis proved better granulation tissue development and greater re-epithelialization. These findings are by virtue of the improved mechanical properties, accelerated cell migration and proliferation, proper environment for oxygen exchange, and enhanced exudate uptake of the wound dressing. These all are due to the presence of F127 and mr-HAP.