Wound Healing Factors Research Articles

Gene Augmentation Techniques to Stimulate Wound Healing Process: Progress and Prospects.

Gene therapy has traditionally been used to treat individuals with late-stage cancers or congenital abnormalities. Numerous prospects for therapeutic genetic modifications have emerged with the discovery that gene therapy applications are far more extensive, particularly in skin and exterior wounds. Cutaneous wound healing is a complex, multistep process involving multiple steps and mediators that operate in a network of activation and inhibition processes. This setting presents a unique obstacle for gene delivery. Many gene delivery strategies have been developed, including liposomal administration, high-pressure injection, viral transfection, and the application of bare DNA. Among several gene transfer techniques, categorical polymers, nanoparticles, and liposomalbased constructs show great promise for non-viral gene transfer in wounds. Clinical experiments have shown that efficient transportation of certain polypeptides to the intended wound location is a crucial factor in wound healing. Genetically engineered cells can be used to produce and control the delivery of specific growth factors, thereby addressing the drawbacks of mechanically administered recombinant growth factors. We have discussed how repair mechanisms are based on molecules and cells, as well as their breakdown, and provided an overview of the methods and research conducted on gene transmission in tissue regeneration.

Intraoperative Hypothermia Versus Normothermia in Breast Reconstruction: A Systematic Review and Meta-Analysis.

Despite advancements in breast reconstruction, the precise impact of intraoperative hypothermia on postoperative complications remains unclear. Recent literature suggests that intraoperative hypothermia is a risk factor for impaired wound healing and increases the incidence of surgical site infections. This study examines the effect of intraoperative hypothermia on postoperative outcomes in breast reconstruction. We searched PubMed, Embase, and Cochrane Library for studies comparing hypothermia with normothermia in breast reconstruction. A meta-analytical method was employed to estimate the risk of postoperative complications among patients undergoing breast reconstruction. Data synthesis employed the random-effects models, presenting the results as risk ratio (RR) with corresponding 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration), and heterogeneity was assessed using I2 statistics. Four studies meeting our inclusion criteria were included in the meta-analysis, comprising 871 participants. The average age and body mass index were 52.98 years and 27.76 kg/m2, with a follow-up duration of 3-6 months. In our analysis, intraoperative hypothermia was associated with an increase in the incidence of wound healing complications in breast reconstruction (RR 1.68; 95% CI 1.24 to 2.27; p = 0.0008). Despite lower incidence of infection, hematoma, seroma, and necrosis in the hypothermia group, no significant differences were observed. Our meta-analysis assessing intraoperative hypothermia in breast reconstruction indicates that hypothermia is a significant risk factor for wound healing complications.

7877 Adipose Depot Differences In Regenerative Properties Of Exosomes Derived From Human Adipose Stem Cells

Abstract Disclosure: M.A. Krause-Hauch: None. R. Patel: None. B. Osborne: None. P. Albear: None. N.A. Patel: None. Many patients struggle with chronic recalcitrant wounds that are the result of delayed healing. Underlying inflammation is one major risk factor for impaired dermal wound healing that may lead to pathologies such as infection and scarring. Adult human adipose stem cells (hASCs) have shown tremendous potential in regenerative medicine. The regenerative potential of hASCs is dependent on secreted bioactive material which is packaged and released in extracellular exosomes. We previously showed that hASC exosomes from the subcutaneous depot (sc) promoted repair in human dermal fibroblasts using in vitro assays. In this study, we evaluated exosomes derived from the omental depot (om) of hASC and compared its efficacy with sc-hASC. Our results show differences in levels of the long noncoding RNA (lncRNA) cargo between om-hASCexo and sc-hASCexo. Next, we evaluated their repair potential in a wound model in vivo. Male and female F344 rats were dorsally wounded via punch biopsy and silicone scaffolding was attached to prevent contraction. The wounds were then either not treated (control) or treated with 50μg om-hASCexo or sc-hASCexo every alternate day when each wound size was measured for 1 week to monitor healing progress. After 7 days, wounds treated with either om-hASCexo and sc-hASCexo closed significantly faster than untreated control wounds. While no difference was observed in closure percentage after 7 days for wounds treated with either om-hASCexo and sc-hASCexo, sc-hASCexo appeared to act faster earlier (1-2 days post wound) in the wound healing process while om-hASCexo acts faster during later stages (2-4 days post wound) of wound healing. The wound tissue was collected for biochemical and histological analysis. qPCR analysis on day 7 revealed that both om-hASCexo and sc-hASCexo treatment resulted in increased levels of Collagen 1 & 3 and MMP9, while levels of TGF-β decreased with treatment. These results indicate that om-hASCexo and sc-hASCexo enhanced the wound healing process while decreasing inflammation of the wound. To determine the differences between om-hASCexo and sc-hASCexo treatments on wound healing pathways, RNAseq was performed. Results show specificity in pathway activation and gene expression between the om-hASCexo and sc-hASCexo treatments. In conclusion, we have demonstrated that the regenerative mechanisms differ between the hASC depots from which exosomes are secreted. At a broader level, this finding may shed light on the body’s organ health and repair processes in normal or disease states. Presentation: 6/3/2024

Development of multifunctional H2S-releasing gold nanoparticles for chronic wound treatment

Chronic wounds, characterized by prolonged inflammation, require new therapies to improve healing. Hydrogen sulfide (H2S), a key neurotransmitter, supports critical factors in wound healing but is often deficient in chronic wounds. Despite its potential, the toxicity of direct H2S delivery and the unsustainable release from current systems hinder its therapeutic use. This study introduces H2S-releasing gold nanoparticles synthesized by reducing chloroauric acid (HAuCl4) with diallyl trisulfides (DATS), a naturally derived H2S donor. These nanoparticles are hypothesized to be biocompatible and multifunctional, combining H2S release with the beneficial properties of gold. Results show that DATS does not impair H2S release, and higher DATS concentrations enhance H2S output. The sustained H2S release promotes endothelial cell proliferation, migration, and angiogenesis while retaining the antimicrobial properties of gold nanoparticles, making this material promising for chronic wound treatment.

Postoperative Complications in Diabetic type-2 Verses Non-Diabetic Patients Undergoing Appendectomy. A Comparative clinical Study

Background: Diabetes Mellitus (DM) is known to double the risk of postoperative complications because of weak immunity and compromised healing. Objectives: To analyse the rate of postoperative complications among diabetic and non-diabetic patients who have undergone appendectomy to determine whether the level of diabetes management has an impact on wound healing. Methodology: A prospective study was done on n=300 patients who were diagnosed with acute appendicitis and were scheduled to undergo appendectomy; of which n=150 patients had diabetes type-2 and n=150 were non- diabetics. Concerning adverse outcomes, the incidence of surgical site infections (SSIs), prolonged healing of the surgical site, and the number of days spent in the hospital after the operation were identified. Diabetes mellitus was defined based on self-reported diagnosis and glycemic control was evaluated using HbA1c level with the cut-off of >7%. Chi-square and t-tests were used in the analysis of data while multivariate logistic regression was used to assess predictors of complications. p≤0.05 was considered statistically significant. Results: Diabetic patients had a higher incidence of surgical site infections, 15.3% and 5.3%, p= 0.007 for diabetic and non-diabetic patient respectively and delayed wound healing 10.7% and 3. 3%, p = 0.015 for diabetic and non-diabetic patients respectively. Patients with HbA1c > 7% had a higher rate of SSIs of 21. 8 % and delayed healing of 15.4% compared well-controlled diabetics (p = 0.009 and p=0.02 respectively). It was more prolonged in the diabetic patients (6.1 as against 4. 3 days, p<0.001). Diabetes was found to be an independent risk factor for SSIs and slow wound healing. Conclusion: Diabetic patients who have undergone appendectomy were more susceptible to SSIs and slow healing of the wound especially if their blood glucose levels were not well controlled. It is possible that enhanced perioperative glycemic control can decrease postoperative adverse effects.

DNA-Based Nanocarriers for Extended Release of NZ2114 Peptide and Epidermal Growth Factors in Chronic Wound Healing

Chronic wounds, often accompanied by bacterial infection, pose significant clinical challenges. Recognizing this, there has been a growing interest in leveraging nucleic acids as intelligent materials for targeted cargo delivery. Herein, we introduced a pioneering method for encapsulating the anti-S. aureus peptide NZ2114 and epidermal growth factors (EGF) within crosslinked DNA nanomaterials, creating biodegradable and biocompatible antimicrobial agents with high efficacy. Our research validated that the NZ2114-EGF-Gel could exhibit a specific inhibitory effect on S. aureus growth while simultaneously accelerating human dermal fibroblasts’ proliferation. The crosslinked DNA nanostructures demonstrate an enhanced capacity to promote wound therapy rates during in vivo treatment. These findings present a prospective avenue for facilitating therapeutic wound healing.

The effect of absorbable collagen suture for oral implant repair on wound healing and inflammation factors of gingival crevicular fluid

Background: To investigate the clinical value of absorbable collagen suture in the treatment of oral implant restoration. Methods: A prospective, randomized, single-blind trial was conducted in patients undergoing dental implant restoration in our hospital. The patients were divided into an absorbable group (incision closure with absorbable collagen suture) and a conventional group (incision closure with conventional suture). The incision healing time, postoperative pain degree, incision healing grade, patient satisfaction, and the levels of tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8) and interleukin-6 (IL-6) in gingival crevicular fluid were compared between the two groups. Results: The absorbable group had faster incision healing times and lower postoperative pain scores on days 1 and 2, all with significant differences (P<0.05). Wound healing in the absorbable group was notably better, with a Grade A healing rate of 96.88% and a Grade B healing rate of 3.13%. In contrast, the conventional group had a Grade A healing rate of 81.25%, a Grade B healing rate of 17.19%, and a Grade C healing rate of 1.56%. These differences favored the absorbable group significantly (P<0.05).Before surgery, there were no statistically significant differences in the levels of TNF-α, IL-6, and IL-8 in gingival crevicular fluid between the absorbable and conventional groups (P>0.05). However, 3 days after surgery, the absorbable group showed significantly lower levels of TNF-α, IL-6, and IL-8 compared to the conventional group (P<0.05).Patient satisfaction rates for stability, aesthetics, chewing function, and pronunciation were similar between the two groups (P>0.05). However, patients in the absorbable group reported significantly higher comfort levels compared to those in the conventional group (P<0.05). Moreover, the complication rate in the absorbable group was significantly lower at 6.25% compared to 18.75% in the conventional group (P<0.05). Conclusion: Absorbable collagen suture for oral implant prosthesis after suture, beneficial to wound healing and reduce postoperative pain and inflammation.

Insulin-Induced Gene 1-Enhance Secretion of BMSC Exosome Enriched in miR-132-3p Promoting Wound Healing in Diabetic Mice.

Chronic diabetic wounds represent a significant clinical challenge because of impaired healing processes, which require innovative therapeutic strategies. This study explores the therapeutic efficacy of insulin-induced gene 1-induced bone marrow mesenchymal stem cell exosomes (Insig1-exos) in promoting wound healing in diabetic mice. We demonstrated that Insig1 enhanced the secretion of bone marrow mesenchymal stem cell-derived exosomes, which are enriched with miR-132-3p. Through a series of in vitro and in vivo experiments, these exosomes significantly promoted the proliferation, migration, and angiogenesis of dermal fibroblasts under high-glucose conditions. They also regulated key wound-healing factors, including matrix metalloproteinase-9, platelet-derived growth factor, vascular endothelial growth factor, transforming growth factor-β1, and platelet endothelial cell adhesion molecule-1, thereby accelerating wound closure in diabetic mice. Histological analysis showed that Insig1-exos were more effective in promoting epithelialization, enhancing collagen deposition, and reducing inflammation. Additionally, inhibition of miR-132-3p notably diminished these therapeutic effects, underscoring its pivotal role in the wound-healing mechanism facilitated by Insig1-exos. This study elucidates the molecular mechanisms through which Insig1-exos promotes diabetic wound healing, highlighting miR-132-3p as a key mediator. These findings provide new strategies and theoretical foundations for treating diabetes-related skin injuries.

Polydopamine-coated polycaprolactone/carbon nanotube fibrous scaffolds loaded with basic fibroblast growth factor for wound healing

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The impact of angiographic pedal circulation status on wound healing in chronic limb-threatening ischemia after bypass surgery

ObjectiveIn the treatment of chronic limb-threatening ischemia (CLTI), complete wound healing is an important goal. Although foot perfusion status seems to be important for wound healing, the Global Limb Anatomic Staging System (GLASS) of the Global Vascular Guidelines does not include pedal artery status for the staging process due to the lack of sufficient evidence of its importance. This study aimed to clarify the importance of pedal perfusion status after bypass surgery. MethodsAmong the 153 CLTI cases that underwent bypass distal to popliteal arteries from 2014 to 2018, 117 CLTI limbs with wounds and with sufficient pedal angiographic data were enrolled. They were classified into two groups, based on the wound status 6 months postoperatively; early wound healing group (EWG; n = 78), which achieved complete wound healing within 6 months postoperatively, and prolonged healing or unhealed wounds group (PWG; n = 39), which failed to achieve wound healing within 6 months. Various factors associated with wound healing, including the wound, ischemia, and foot infection (WIfI) classification, intraoperative graft flow, and pedal angiographic data, were analyzed. Regarding pedal angiographic data, in addition to the GLASS inframalleolar/pedal disease descriptor (IPD), newly formed classification system of the pedal circulation status in association with the location of wounds was included: pedal circulation status was classified into two groups as visualized arterial perfusion towards wounds (visualized perfusion) and non-visualized arterial perfusion towards wounds (non-visualized perfusion). ResultsUnivariate analysis showed preoperative albumin (Odds ratio [OR], 0.47; 95% confidence interval [CI], 0.24-0.94; P = .027), higher WIfI clinical stage (OR, 3.88; 95% CI, 1.74-10.1; P = .0005), higher IPD (OR, 2.16; 95% CI, 1.16-4.02; P = .012), and non-visualized perfusion to wounds (OR, 5.74: 95% CI, 2.45-14.0; P < .0001) as significant for prolonged wound healing. Multivariate analysis showed higher WIfI stage (OR, 5.04; 95% CI, 1.74-14.6; P = .0029) and non-visualized perfusion to wounds (OR, 4.34; 95% CI, 1.71-11.0; P = .0021) as significant, whereas IPD was not detected as significant. Regarding blood supply to the foot, although graft flow was significantly lower in IPD-P2 than IPD-P0/P1, graft flow was similar regardless of the status of angiographic circulation to wounds, suggesting that distribution of blood supply to the wound would be more important than total amount of blood supply to the foot for wound healing. ConclusionsWIfI clinical stage and pedal circulatory environment were important factors for wound healing after bypass surgery. Pedal anatomical classification system including perfusion status would be important for decision making in CLTI treatment.

Near-Infrared Responsive Nanocomposite Hydrogel Dressing with Anti-Inflammation and Pro-Angiogenesis for Wound Healing.

Anti-inflammatory and angiogenesis are two important factors in wound healing. Wound dressings with anti-inflammation and vascularization are essential to address complex interventions, expensive treatments, and uncontrolled release mechanisms. Based on the above considerations, we designed a near-infrared (NIR)-responsive hydrogel dressing, which is composed of mPDA-DFO@LA nanoparticles (mPDA: dopamine hydrochloride nanoparticles, DFO: deferoxamine, LA: lauric acid), valsartan (abbreviated as Va), and dopamine-hyaluronic acid hydrogel. The hydrogel dressing demonstrated injectability, bioadhesive, and photothermal properties. The results indicated the obtained dressing by releasing Va can appropriately regulate macrophage phenotype transformation from M1 to M2, resulting in an anti-inflammatory environment. In addition, DFO encapsulated by LA can be sustainably released into the wound site by NIR irradiation, which further prevents excessive neovascularization. Notably, the results in vivo indicated the mPDA-DFO@LA/Va hydrogel dressing significantly enhanced wound recovery, achieving a healing rate of up to 96% after 11 days of treatment. Therefore, this NIR-responsive hydrogel dressing with anti-inflammation, vascularization, and on-demand programmed drug release will be a promising wound dressing for wound infection.

Is smoking a risk factor for complications following total ankle arthroplasty? A meta-analysis

BackgroundSmoking has long been recognized as a risk factor for impaired wound and bone healing, particularly in the context of ankle and foot surgery. Despite numerous studies exploring the association between smoking and complications following ankle replacement, there remains significant inconsistency in their findings. Therefore, this meta-analysis study aims to elucidate whether smoking increases the rate of complications after total ankle arthroplasty (TAA), providing valuable insights for clinical management. MethodsA comprehensive systematic search was conducted in the PubMed, Embase, and Wiley databases to identify relevant English studies on the influence of smoking on postoperative complications following ankle replacement without any restrictions on publication dates. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. Random-effect models were used to calculate odds ratios (OR) and 95 % confidence intervals (CI). This study adhered to PRISMA guidelines for transparent reporting and was registered with PROSPERO. ResultsThe analysis incorporated data from 12 retrospective cohort studies, totaling 17331 subjects, 2580 of whom were smokers and 791 complications following TAA. The findings revealed a statistically significant disparity in wound-related complications (OR: 2.26; 95 % CI: 1.13–4.50; P = .02), particularly evident in current smokers with an OR of 3.30 (95 % CI: 2.12–5.14; P < .00001). However, we lacked sufficient evidence to substantiate an association between smoking and complications related to the prosthesis (OR: 1.09; 95 % CI: 0.77–1.53; P = .64) or systemic complications (OR: 1.18; 95 % CI: 0.10–14.13; P = .90) following TAA. ConclusionsSmoking, especially current smoking, is associated with increased wound complication risk post-operation for total ankle arthroplasty. Despite a lack of definitive evidence on the optimal timeframe for smoking cessation before surgery, discontinuing smoking appears to be a prudent measure to mitigate these complications.

Safety of Posterolateral Approach in High-Risk Patients with Trimalleolar Fractures

Aim: Purpose of this study is to compare the outcomes of posterolateral approach (PLA) and minimal-invasive percutaneous anteroposterior (AP) approach for the fixation of posterior malleolar fragment in patients who have risk factors for wound healing. Material and Methods: 66 patients were analyzed in 2 study groups. Group 1: PLA (29 patients), Group 2: AP (37 patients). Patient demographics, risk factors for wound healing, presence of syndesmotic injury, fracture type, postoperative wound-healing complications and American Orthopedic Foot and Ankle Society ankle-hindfoot score (AOFAS) were recorded. Results: There was no difference between the study groups in regard to wound-healing problems. Obese and smokers had significantly more wound-healing problems regardless of the surgical approach. There was no statistically significant difference between the study groups in regard to AOFAS. Conclusion: In trimalleolar fractures, PLA can be safely considered even for the patients who have risk factors for wound-healing problems other than obesity and smoking.

Increased expression levels of PDGF and VEGF magnify the wound healing potential facilitated by biogenic synthesis of silver nanoparticles

Plant extract mediated biogenic synthesis of silver nanoparticles (AgNPs) has garnered considerable attention in nanotechnology due to its promising wound healing properties. This eco-friendly and cost-effective approach utilizes natural sources, such as the ethyl acetate extract of Nigella sativa L. (N. sativa) seeds, as a reducing agent. In this study, AgNPs were synthesized biogenically using N. sativa extract, and their wound healing potential was systematically assessed. Several methods for characterization are employed, incorporating ultraviolet-visible (UV-Vis) spectroscopy, fourier-transform infrared (FTIR) spectrometry, X-ray diffraction (XRD), scanning electron microscope (SEM) and dynamic light scattering (DLS) analysis were utilized to confirm successful synthesis and provide insight into the chemical and physical properties of AgNPs. When compared to a control group, human keratinocytes treated with AgNPs exhibited significantly enhanced proliferation and migration. Additionally, AgNPs were observed to increase the expression of wound-healing factors, (such as platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF)) as evidenced by western blot analysis. As a potent and naturally derived medicine for wound healing, AgNPs synthesized using N. sativa seed extract (ethyl acetate extract) potentially utilize the PDGF and VEGF signaling pathways to induce their therapeutic effects. Nevertheless, additional research is necessary to clarify the underlying mechanisms and assess the long-term safety and efficacy of this environmentally friendly method for producing AgNPs, which demonstrate remarkable wound-healing capabilities.

Polydopamine modified multifunctional carboxymethyl chitosan/pectin hydrogel loaded with recombinant human epidermal growth factor for diabetic wound healing

The development of a multifunctional wound dressing that can adapt to the shape of wounds and provide controlled drug release is crucial for diabetic patients. This study developed a carboxymethyl chitosan-based hydrogel dressing with enhanced mechanical properties and tissue adherence that were achieved by incorporating pectin (PE) and polydopamine (PDA) and loading the hydrogel with recombinant human epidermal growth factor (rhEGF). This EGF@PDA-CMCS-PE hydrogel demonstrated robust tissue adhesion, enhanced mechanical properties, and superior water retention and vapor permeability. It also exhibited significant antioxidant capacity. The results showed that EGF@PDA-CMCS-PE could effectively scavenge 2,2′-Azinobis-(3-ethylbenzthiazoline-6-sulphonate)， (1,1-diphenyl-2-picrylhydrazyl), and superoxide anions and increase superoxide dismutase and catalase levels in vivo. In vitro cytotoxicity and antibacterial assays showed good biocompatibility and antimicrobial properties. The sustained release of EGF by the hydrogel was confirmed, with a gradual release profile over 120 h. In vivo studies in diabetic mice showed that the hydrogel significantly accelerated wound healing, with a wound contraction rate of 97.84% by day 14. Histopathological analysis revealed that the hydrogel promoted fibroblast proliferation, neovascularization, and orderly connective tissue formation, leading to a more uniform and compact wound-healing process. Thus, EGF@PDA-CMCS-PE hydrogel presents a promising tool for managing chronic diabetic wounds, offering a valuable strategy for future clinical applications.

Vascular endothelial growth factor secretion and immunosuppression are distinct potency mechanisms of human bone marrow mesenchymal stromal cells.

Mesenchymal stromal cells (MSCs) are investigated as cellular therapeutics for inflammatory bowel diseases and associated perianal fistula, although consistent efficacy remains a concern. Determining host factors that modulate MSCs' potency including their secretion of angiogenic and wound-healing factors, immunosuppression, and anti-inflammatory properties are important determinants of their functionality. We investigated the mechanisms that regulate the secretion of angiogenic and wound-healing factors and immune suppression of human bone marrow MSCs. Secretory analysis of MSCs focusing on 18 angiogenic and wound-healing secretory molecules identified the most abundancy of vascular endothelial growth factor A (VEGF-A). MSC viability and secretion of other angiogenic factors are not dependent on VEGF-A secretion which exclude the autocrine role of VEGF-A on MSC's fitness. However, the combination of inflammatory cytokines IFNγ and TNFα reduces MSC's VEGF-A secretion. To identify the effect of intestinal microvasculature on MSCs' potency, coculture analysis was performed between human large intestine microvascular endothelial cells (HLMVECs) and human bone marrow-derived MSCs. HLMVECs do not attenuate MSCs' viability despite blocking their VEGF-A secretion. In addition, HLMVECs neither attenuate MSC's IFNγ mediated upregulation of immunosuppressive enzyme indoleamine 2,3-dioxygenase nor abrogate suppression of T-cell proliferation despite the attenuation of VEGF-A secretion. We found that HLMVECs express copious amounts of endothelial nitric oxide synthase and mechanistic analysis showed that pharmacological blocking reverses HLMVEC-mediated attenuation of MSC's VEGF-A secretion. Together these results suggest that secretion of VEGF-A and immunosuppression are separable functions of MSCs which are regulated by distinct mechanisms in the host.

Epidemiological characteristics and factors affecting healing in unintentional pediatric wounds

ObjectiveTo analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.MethodsA retrospective analysis was conducted on data from 1,107 children, aged 0–12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.ResultsAmong the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3–7). Infants and toddlers (0–3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23–1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18–4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86–10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02–22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.ConclusionIn children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.

Liquid‐Metal‐Loaded Hydrogel with Antibacterial Effect and Sustained Release of Growth Factor for Wound Healing

AbstractMultifunctional medical hydrogels play an important role in wound healing because of their excellent biocompatibility, convenient operation, and drug release capacity. So far, many efforts have been exploited to developing new‐generation hydrogels with distinctive capabilities in promoting wound healing. Herein, the liquid‐metal (LM)‐loaded hydrogels are reported with antibacterial effect under an 808 nm near‐infrared laser irradiation for wound healing therapeutic strategies. The addition of LM droplets enables the hydrogel to control the temperature rise and plays an antibacterial effect with the release of gallium3+ under laser irradiation. Benefiting from the porous network structure of hydrogels, the encapsulated growth factors can be released stably at the wound site. Under the synergistic effect of LM and growth factors in the wound tissue, the hydrogel displays antibacterial features and promotes the regeneration of epithelial tissue and neovascularization, thereby further accelerating wound healing. This hydrogel has proven biosafety and low toxicity in vitro and in vivo. With these advantages, such hydrogel is a promising candidate to be developed as a new medical product for future clinical medicine.

SURGICAL OUTCOMES IN INTRAMEDULLARY FIBULAR NAIL FIXATION COMPARED WITH PLATE FIXATION OF DISTAL FIBULAR FRACTURES

IntroductionThe condition of the soft tissues surrounding an ankle fracture influences timing and treatment of injuries. Conventional treatment used an open approach to facilitate anatomical reduction and rigid internal fixation. Intramedullary devices for fibular fractures provide a safe alternative in patients in which the condition of the soft tissue envelope or the patient's co-morbidities may benefit from a less invasive approach. We compared outcomes for patients treated with open reduction internal fixation (ORIF) with those undergoing treatment with fibular nails (FN)Methods13 consecutive patients treated with fibular nails (FN) were compared with 13 age-matched patients that underwent open reduction and internal fixation (ORIF). All patients were followed to union. Study outcomes were time from admission to surgery, length of stay, wound failure, implant failure, revision surgery, OMAS and SF-36ResultsThere was no difference in age or sex distribution between groups. There was no difference in OMAS at 1 year (83 ± 9 in FN group; 80± 21 in ORIF group) and SF-36 (94 ± 11 and 90 ± 20). There were 2 implant failures in the ORIF group and none in the FN group. There was one wound failure in the ORIF group and none in the FN group. Patients treated with FN had a shorter time to surgery (1 day ± 24 hours vs 3 days ± 24 hours) and shorter length of stay (1 day ± 24 hours vs 4 days ± 96 hours)ConclusionFN is a safe method to treat patients with displaced distal fibular fractures that may have a poor soft tissue envelope and risk factors for wound healing. FN reduces the time to surgery and overall length of stay compared with similar patients treated with conventional ORIF.

Unraveling the Significance of Growth Factors (TGF-β, PDGF, KGF, FGF, Pro Collagen, VEGF) in the Dynamic of Wound Healing

The wound healing process is an intricate biological phenomenon that requires various crucial components, including repair cells, proteins, and biological factors. The process of wound healing can be categorized into three interrelated stages: the stage of inflammation, proliferation, and remodeling. Any interruptions during this process can lead to wound healing that deviates from the typical progression. It is crucial to highlight that growth factors have a profoundly influential effect in this particular situation. This study conducts a thorough and analytical literature review to investigate the essential role of growth factors (TGF-β, PDGF, KGF, FGF, Pro Collagen, and VEGF) in wound healing. This study examines the biochemical and molecular mechanisms via which these growth factors impact the wound healing process, including the inflammation, proliferation, and remodeling phases, by analyzing current and authoritative scientific literature. This paper precisely outlines the role of these variables, including the role of the stem cell secretome enriched with growth factors such as TGF-β, PDGF, KGF, FGF, Pro Collagen, VEGF, and exogenous factors, as previously discussed. It explores their impact on tissue regeneration, angiogenesis, and extracellular matrix formation, essential components of the wound healing process. The main objective of this study is to provide a comprehensive summary of the latest research findings, which includes an in-depth analysis of the contributions of stem cell secretomes to wound healing. The findings provide useful insights into potential growth factor-based treatment approaches, highlighting how the components of the stem cell secretome can be leveraged to enhance the wound healing process.