Wound Healing Outcomes Research Articles

Myrrh sitz bath for wound healing after hemorrhoidectomy: A retrospective study of adverse effects and treatment outcomes.

Hemorrhoids affect 75% of people worldwide. surgical hemorrhoidectomy remains the definitive intervention for severe cases. Postoperative wound care is critical, and alternative treatments, like Myrrh, are of growing interest due to their potential wound-healing properties. This study aimed to compare the safety, efficacy, and treatment outcomes of Myrrh sitz baths with standard clinical care in promoting wound healing after hemorrhoidectomy. A retrospective cohort study was carried out using medical records from Abha Private Hospital for the period of January-December 2022. The data of patients who underwent hemorrhoidectomy were collected and categorized based on postoperative wound care into two groups: Group A for Myrrh-based wound care as a self-medication and Group B for standard wound care. The study included 67 patients who underwent hemorrhoidectomy. Out of these patients, 52 had standard wound care, while 15 used Myrrh-based wound care as self-treatment without medical advice. The Myrrh group patients were significantly older with more comorbidities. The Myrrh group had significant Grade III wound healing outcomes 9/15 (60%) compared to the standard care group 2/52 (3.8%) (p < 0.001). However, despite the better healing outcomes, the Myrrh group had a significantly higher complication rate 7/15(46.7%) than the standard care group 1/52 (1.9%) (p < 0.001). These results indicate that despite the good healing capacity of Myrrh, cautious usage must be considered. Myrrh sitz baths appear more effective than standard wound care in enhancing healing after hemorrhoidectomy. However, increased complications suggest the necessity for comprehensive evaluation and research on its safety profile. These findings can guide future research and clinical practices related to postoperative wound care.

Nanomaterials in Wound Healing: Mechanisms, Applications, and Future Prospects

Background: Poor wound healing poses a significant global health challenge, leading to increased mortality rates and considerable healthcare expenses. Nanotechnology has emerged as a promising approach to address the complexities associated with wound healing, offering potential solutions to enhance the wound microenvironment and promote efficient tissue repair. Aim: This review aims to comprehensively summarize recent advancements in the application of nanomaterials for wound healing, with a focus on their mechanisms of action. The review also explores the prospects and challenges of using nanomaterials in wound dressings, specifically in the context of antimicrobial, anti-inflammatory, and angiogenic effects. Results: The integration of nanomaterials in wound healing has demonstrated significant progress in addressing key challenges, such as providing a suitable environment for cell migration, controlling microbial infections, and managing inflammation. Nanomaterials have been found to stimulate cellular and molecular processes, promoting hemostasis, immune regulation, and tissue proliferation, thereby accelerating wound closure and tissue regeneration. Conclusion: Nanotechnology-based wound healing has shown great promise in revolutionizing wound care. Nanomaterials offer unique physicochemical and biological properties that can be harnessed to develop advanced wound dressings capable of sustained therapeutic agent delivery and targeted bacterial detection and treatment. Despite these promising advancements, challenges such as reproducibility, stability, toxicity, and histocompatibility must be addressed to ensure successful translation from laboratory research to clinical applications. Further research is required to better understand the in-vivo behaviour of nanomaterial-based wound dressings and to explore innovative approaches, such as intelligent wound dressings that detect and treat infections synergistically, to enhance wound healing outcomes. Overall, nanomaterials hold tremendous potential for future wound healing strategies, paving the way for improved patient outcomes and reduced healthcare burdens.

P29 Long-read sequencing provides unprecedented insight into the skin and wound microbial landscape

Abstract Introduction and aims It is becoming increasingly evident that the microbial inhabitants of our skin play a key role in cutaneous health and disease. However, our understanding of the contribution of the complex skin microbiome to wound healing outcome remains incomplete. This is, in part, due to the historic challenges around traditional sampling and profiling Methods, which often fail to capture the abundance and diversity of the skin microbiome. Recent advances in microbiome sequencing technologies now enable more comprehensive characterization of skin bacterial composition and host-microbe interactions. Thus, the aim of this study was to utilize a novel long-read sequencing platform to provide species-level microbiome characterization and deliver important insight into the drivers of pathological skin repair. Methods Microbial DNA samples were collected from the skin and wounds of healthy volunteers and patients with chronic wounds (n = 40 per group). Long-read nanopore sequencing was used to profile microbiome samples, while RNA-Seq enabled generation of donor transcriptomic profiles. A multifaceted approach was used to integrate these datasets to investigate the complex interplay between host skin pathology and the microbiome. Results We first identified perturbations in the skin microbiome of patients with chronic wounds, which was significantly less diverse than healthy skin and colonized with key bacteria associated with pathogenicity. These alterations in the skin microbiome also correlated with transcriptomic changes, such as upregulation of genes associated with inflammation, stress and poor healing. Interestingly, long-read sequencing data displayed poor correlation with routine clinical microbiology swabs, while specific clinical characteristics (e.g. glycaemic control and wound duration) were strongly linked to wound microbiome composition. Conclusions Collectively, these data provide crucial new insight into the skin and wound microbial landscape, demonstrating a potential role for specific wound bacteria in modulating pathological skin repair.

Therapeutic Potential of Nanocarrier Mediated Delivery of Peptides for Wound Healing: Current Status, Challenges and Future Prospective.

Wound healing presents a complex physiological process that involves a sequence of events orchestrated by various cellular and molecular mechanisms. In recent years, there has been growing interest in leveraging nanomaterials and peptides to enhance wound healing outcomes. Nanocarriers offer unique properties such as high surface area-to-volume ratio, tunable physicochemical characteristics, and the ability to deliver therapeutic agents in a controlled manner. Similarly, peptides, with their diverse biological activities and low immunogenicity, hold great promise as therapeutics in wound healing applications. In this review, authors explore the potential of peptides as bioactive components in wound healing formulations, focusing on their antimicrobial, anti-inflammatory, and pro-regenerative properties. Despite the significant progress made in this field, several challenges remain, including the need for standardized characterization methods, optimization of biocompatibility and safety profiles, and translation from bench to bedside. Furthermore, developing multifunctional nanomaterial-peptide hybrid systems represents promising avenues for future research. Overall, the integration of nanomaterials made up of natural or synthetic polymers with peptide-based formulations holds tremendous therapeutic potential in advancing the field of wound healing and improving clinical outcomes for patients with acute and chronic wounds.

Biomimetic Materials for Skin Tissue Regeneration and Electronic Skin.

Biomimetic materials have become a promising alternative in the field of tissue engineering and regenerative medicine to address critical challenges in wound healing and skin regeneration. Skin-mimetic materials have enormous potential to improve wound healing outcomes and enable innovative diagnostic and sensor applications. Human skin, with its complex structure and diverse functions, serves as an excellent model for designing biomaterials. Creating effective wound coverings requires mimicking the unique extracellular matrix composition, mechanical properties, and biochemical cues. Additionally, integrating electronic functionality into these materials presents exciting possibilities for real-time monitoring, diagnostics, and personalized healthcare. This review examines biomimetic skin materials and their role in regenerative wound healing, as well as their integration with electronic skin technologies. It discusses recent advances, challenges, and future directions in this rapidly evolving field.

The Utility of Prevena Negative Pressure Wound Therapy on Groin Incisions for Critical Limb-Threatening Ischemia: A Single Institution Experience.

Incisional negative pressure wound therapy (iNPWT) is an adjunctive treatment that uses constant negative pressure suction to facilitate healing. The utility of this treatment modality on vascular operations for critical limb-threatening ischemia (CLTI) has yet to be elucidated. This study compares the incidence of postoperative wound complications between the Prevena Incision Management System, a type of iNPWT, and standard wound dressings for vascular patients who also underwent plastic surgery closure of groin incisions for CLTI. We performed a retrospective cohort study of 40 patients with CLTI who underwent 53 open vascular surgeries with subsequent sartorius muscle flap closure. Patient demographics, intraoperative details, and wound complications were measured from 2015 to 2018 at the University of California San Francisco. Two cohorts were generated based on the modality of postoperative wound management and compared on wound healing outcomes. Of the 53 groin incisions, 29 were managed with standard dressings, and 24 received iNPWT. Patient demographics, comorbidities, and operative characteristics were similar between the 2 groups. Patients who received iNPWT had a significantly lower rate of infection (8.33% vs 31.0%, P = 0.04) and dehiscence (0% vs 41.3%, P < 0.01). Furthermore, the iNPWT group had a significantly lower rate of reoperation (0% vs 17.2%, P = 0.03) for wound complications within 30 days compared with the control group and a moderately reduced rate of readmission (4.17% vs 20.7%, P = 0.08). Rates of infection, reoperation, and dehiscence were significantly reduced in patients whose groin incisions were managed with iNPWT compared with standard wound care. Readmission rates were also decreased, but this difference was not statistically significant. Our results suggest that implementing iNPWT for the management of groin incisions, particularly in patients undergoing vascular operations for CLTI, may significantly improve clinical outcomes.

'Nutrition has everything to do with wound healing'-health professionals' perceptions of assessment and management of nutrition in individuals with diabetes-related foot ulceration.

Determine how healthcare professionals perceive their role in nutrition assessment and management, and explore barriers and enablers to assessment and management of nutrition in individuals with DFU. Mixed methods including a cross-sectional online survey derived from current international guidelines and theoretical domains framework, and semi-structured interviews with conventional content analysis was performed. One hundred and ninety-one participants completed the survey, with 19 participating in interviews. Many health professionals are not confident in their ability in this area of practice, are uncertain their nutrition advice or management will be effective in assisting wound healing outcomes and are uncertain their intervention would result in adequate behaviour change by the individual with DFU. Major barriers to implementation of nutrition assessment and management were: inadequate time, lack of knowledge and lack of clinical guidance and enablers were as follows: professional development, a standardised clinical pathway and screening tool and a resource addressing wound healing and diabetes management. Nutrition assessment and management in individuals with DFU is not consistently applied. Whilst health professionals believed nutrition was important for wound healing, they lacked confidence in implementing into their practice. Further dissemination of existing guidance and implementation of education programs and resources would help overcome cited barriers.

Examining the Evidence Regarding Smoking and Patient Outcomes for Isolated Meniscus Pathology: A Comprehensive Systematic Review and Meta-Analysis.

Smoking is a well-known cause of impairment in wound healing and postoperative outcomes; however, its effects on treating meniscus issues remain unclear. This study assesses the relationship between smoking and meniscus treatment outcomes. PubMed, Scopus, Cochrane, and CINAHL were searched from inception to 24 December 2023. Inclusion criteria encompassed studies examining smoking's impact on patient outcomes regarding meniscus pathology. A secondary PubMed search targeted randomized controlled trials (RCTs) in the top ten orthopedic journals focusing on meniscus pathology and smoking as a demographic variable. Meta-analysis of six studies (n = 528) assessed meniscus failure rate based on smoking status. Eighteen observational studies (n = 8353 patients; 53.25% male; mean age: 51.35 ± 11.53 years; follow-up: 184.11 ± 117.34 months) were analyzed, covering meniscus repair, meniscectomy, allograft transplant, conservative care, and arthroscopy. Results showed four studies (36.36%) linked smoking with worse meniscus repair outcomes, while seven studies (63.64%) did not find significant associations. Meta-analysis from six studies showed no significant impact of smoking on repair failure (p = 0.118). Regarding meniscectomy, one study (33.33%) identified a significant association with smoking, but two did not. Only one (3.8%) of the RCTs in leading orthopedic journals included smoking as a factor. The evidence on smoking's effect on meniscus treatment is mixed, necessitating further investigation.

A synergistically antimicrobial and antioxidant hyaluronic acid hydrogel for infected wounds

Bacterial infections during wound healing impede the healing process and trigger local or systemic inflammatory reactions. Consequently, there is an urgent need to develop a new material with antimicrobial and antioxidant properties to promote infected wound healing. A synergistically antimicrobial and antioxidant hyaluronic acid hydrogel (HMn) is prepared by employing MnO2 nanosheets into 4ARM-PEG5000-SH crosslinked methacrylated hyaluronic acid (HAMA) network. The coordination between sulfhydryl groups of 4ARM-PEG5000-SH and MnO2 nanosheets ensures entrapment of the nanosheets within the hydrogel, while the interaction between 4ARM-PEG5000-SH and HAMA results in facile gelation through thiol-ene click reaction. MnO2 nanosheets exhibit strong photothermal properties and reactive oxygen species (ROS) scavenging abilities, while hyaluronic acid promotes wound healing. When subjected to near-infrared (NIR) irradiation, the HMn achieves a bactericidal rate of 95.24 % for Staphylococcus aureus and nearly 100 % for Escherichia coli. In animal experiments, treatment with the HMn under NIR irradiation results in the best wound healing outcomes. Both in vitro and vivo biocompatible assays demonstrate that the HMn has rarely cell cytotoxicity and tissue damage. The HMn is easy to prepare and has good biocompatibility as well as efficient antibacterial and antioxidant properties, providing a novel method for the treatment of infected wounds.

Innovative approaches in equine wound management: Addressing challenges and their remedies

Horses are highly susceptible to musculoskeletal wounds due to the demands of their work, whether in transportation or as athletes. These wounds significantly impact the overall performance of horses, emphasizing the importance of effective wound management for optimal functionality. Among equine wounds, distal limb injuries are prevalent, accounting for over 60% of all cases. However, managing wounds in these extremities poses considerable challenges, as poor healing often leads to the formation of exuberant granulation tissue. In equine practice, biofilms are frequently observed in wounds with delayed healing, and there is an alarming rise in the incidence of multi-drug-resistant microbial strains. Consequently, there is an urgent need to implement advanced strategies in wound care management to address these clinical scenarios effectively. Maintaining the soundness of the musculoskeletal system is crucial for horses, particularly those destined for athletic careers. Thus, ongoing trials in equine clinical practice aim to explore innovative approaches for achieving effective wound healing. This article highlights the importance of innovative strategies in equine wound management and emphasizes the need to address challenges such as exuberant granulation tissue formation, biofilm presence, and multi-drug-resistant microbes. By implementing these innovative approaches, equine clinicians can enhance wound healing outcomes and ensure the optimal health and performance of horses.

The Model and Efficacy of Online Nurse-led on the Clinical Outcome of Diabetic Foot Ulcers: A Systematic Review of Randomized Controlled Trials

Background: The most frequent consequence for those with diabetes mellitus is diabetic foot ulcers. Diabetic ulcer treatment must be done properly and on time. The development of online-based intervention by nurses, such as messaging health, may improve the clinical outcome of diabetic foot ulcers by providing easier access, more convenience, and cost-effectiveness, especially for patients in rural areas. Objective: This study aimed to perform a systematic review and meta-analysis the models and efficacy of online nurse-led intervention on clinical outcomes of diabetic foot ulcers. Methods: Randomized Controlled Trials were searched by using PubMed, Scopus, and Google Scholar. The final inclusion study analyzed and synthesized by tabulation, clusterization, contextual and thematic approach, and assessed risk of bias by using RoB 2.0. The study used Mantel Haenszel method. Results: Five randomized controlled trials with 1399 total number of participants were included. There are three studies with some concerns and two studies with low risk of bias. The nurse-led model for diabetic foot ulcer care consists of phone and web-based that conducted by nurse (community nurses and clinical nurses) and doctor specialists are involved in the service. The meta-analysis for amputation outcome showed that telehealth has more favor amputation number with RR 0.6 (95 % CI 0.43 - 0.84; p = 0.003). For healing wounds and mortality outcome, telehealth with RR 1.07 (95% CI 0.99 - 1.16; p = 0.11) and RR 1.37 (95 % CI 0.78 - 2.40; p =0.28), respectively. Conclusions: Phone and web-based may improve clinical outcome of diabetic foot ulcers in terms of amputation outcome, but standard care still more favor in higher wound healing outcome and significantly lower mortality rate.

Pericranial Flap Reconstruction in Pediatric Patients Undergoing Neuromodulatory Surgery: Impact on Wound Healing

Background: Pediatric patients with medically-intractable epilepsy may require modulation of seizure foci to reduce frequency and severity of seizures. These neuromodulatory procedures, which include responsive neurostimulator (RNS) and deep brain stimulator (DBS), involve the implantation of high-profile and long-term cranial hardware, placing patients at risk of wound healing complications, hardware exposure and infection. A multidisciplinary neurosurgical and plastic surgical approach utilizing pericranial flap coverage of hardware may decrease wound healing complications in these cases. This study compares the wound-healing outcomes in patients undergoing RNS/DBS insertion with and without pericranial flap coverage. Methods: A retrospective chart review was conducted of all patients who underwent RNS and DBS insertion with or without pericranial flap coverage at a level 1 pediatric medical center between 2014 and 2022. Wound healing outcomes at 60 days were evaluated. Data were compared using Fisher’s exact test. Results: Twenty-seven patients underwent 29 neuromodulatory epilepsy procedures (14 DBS, 15 RNS). Twenty of the procedures included a pericranial flap to cover hardware. Median length of stay was 2.0 days for both cohorts. Two subjects without pericranial flap reconstruction had a wound healing complication (22.2%), compared to none of the procedures that included a pericranial flap ( P = .09). Conclusion: In pediatric patients undergoing insertion of responsive neurostimulators and deep brain stimulators for medically-intractable epilepsy, a multidisciplinary neurosurgery and plastic surgery approach utilizing pericranial flap reconstruction may reduce the risk of postoperative wound complications.

“Pure Fat Flap”—Perforator-based Adiposal Layer Only Flap for Lateral Ankle Reconstruction

AbstractLateral ankle soft tissue defects pose challenges, especially in cases due to chronic pressure from cross-legged sitting, which usually present with a large dead space, small skin opening that often accompanies an open joint. Traditional reconstruction methods using fasciocutaneous flaps may result in donor site morbidity such as delayed wound healing or nerve injury. In this article, we present a case of diabetes-related lateral ankle defect successfully treated using adiposal layer only flap, also known as pure fat flap. The anatomy and the surgical technique of adiposal layer only flap were reviewed. These flaps preserve the subdermal plexus and deep fascia while obliterating dead space and providing a gliding surface for proper ankle movement. A perforator-based adiposal layer only flap was elevated from the peroneal artery and used to cover the defect. Flap perfusion was confirmed using indocyanine green video angiography and color duplex ultrasound. Patient had a successful recovery with minimal donor site morbidity. The technique expands the reconstructive microsurgeon's options for complex ankle coverage, ensuring optimal wound healing and functional outcomes.

A Review of WIfI Clinical Staging to Predict Outcomes in Patients With Threatened Limbs

The Society for Vascular Surgery Wound, Ischemia, and foot Infection's (WIfI's) threatened limb classification system serves to comprehensively assess the severity of disease in patients with chronic limb-threatening ischemia by identifying and grading the main factors that place the threatened limb at greatest risk: wound severity, ischemic burden, and presence of infection. Each of these 3 factors is graded and the limb placed into a clinical stage, with increasing stage associated with severity of limb threat and predicted risk of major limb amputation at 1 year. Globally, there is a growing body of evidence reported from multiple institutions that has assessed amputation rates and wound-healing outcomes following revascularization in patients with WIfI clinical staging. Risk of major amputation at 1year is low in clinical stage 1, moderate in stages 2 and 3, and high in stage 4. Higher clinical stages are associated with prolonged time to wound healing, while 1-year wound healing rates consistently decrease with increasing clinical stage. Additional avenues of investigation utilizing WIfI as an objective clinical staging tool have yielded new insights into which patients benefit from revascularization, complexity of care, hospital length of stay, quality of life, ethnic and socioeconomic disparities, as well as spurred interest in other modalities of assessing limb perfusion and their possible clinical utility. Ongoing study and refinement of WIfI grading and clinical staging will continue to improve its prognostic utility.

Patterned PCL/PGS Nanofibrous Hyaluronic Acid-Coated Scaffolds Promote Cellular Response and Modulate Gene Expression Profiles.

Chronic wounds impose a significant burden on individuals and healthcare systems, necessitating the development of advanced wound management strategies. Tissue engineering, with its ability to create scaffolds that mimic native tissue structures and promote cellular responses, offers a promising approach. Electrospinning, a widely used technique, can fabricate nanofibrous scaffolds for tissue regeneration. In this study, we developed patterned nanofibrous scaffolds using a blend of poly(ε-caprolactone) (PCL) and poly(glycerol sebacate) (PGS), known for their biocompatibility and biodegradability. By employing a mesh collector, we achieved a unique fiber orientation pattern that emulated the natural tissue architecture. The average fiber diameter of PGS/PCL collected on aluminum foil and on mesh was found to be 665.2 ± 4 and 404.8 ± 16 nm, respectively. To enhance the scaffolds' bioactivity and surface properties, it was coated with hyaluronic acid (HA), a key component of the extracellular matrix known for its wound-healing properties. The HA coating improved the scaffold hydrophilicity and surface wettability, facilitating cell attachment, spreading, and migration. Furthermore, the HA-coated scaffold exhibited enhanced biocompatibility, promoting cell viability and proliferation. High-throughput RNA sequencing was performed to analyze the influence of the fabricated scaffold on the gene expression levels of endothelial cells. The top-upregulated biological processes and pathways include cell cycle regulation and cell proliferation. The results revealed significant alterations in gene expression profiles, indicating the scaffold's ability to modulate cellular functions and promote wound healing processes. The developed scaffold holds great promise for advanced wound management and tissue regeneration applications. By harnessing the advantages of aligned nanofibers, biocompatible polymers, and HA coating, this scaffold represents a potential solution for improving wound healing outcomes and improving the quality of life for individuals suffering from chronic wounds.

Meta-analysis comparing different ultrasound detection methods to accurately assess wound healing and scar formation after caesarean section.

The accurate assessment of wound healing post-caesarean section, especially in twin pregnancies, remains a pivotal concern in obstetrics, given its implications for maternal health and recovery. Traditional methods, including conventional abdominal ultrasonography (CU), have been challenged by the advent of transvaginal ultrasonography (TU), offering potentially enhanced sensitivity and specificity. This meta-analysis directly compares the efficacy of TU and CU in evaluating wound healing and scar formation, crucial for optimizing postoperative care. Results indicate that TU is associated with significantly better outcomes in wound healing, demonstrated by lower REEDA scores (SMD = -20.56, 95% CI: [-27.34.20, -13.77], p < 0.01), and in scar formation reduction, evidenced by lower Manchester Scar Scale scores (SMD = -25.18, 95% CI: [-29.98, -20.39], p < 0.01). These findings underscore the potential of integrating TU into routine post-caesarean evaluation protocols to enhance care quality and patient recovery.

What is slough? Defining the proteomic and microbial composition of slough and its implications for wound healing.

Slough is a well-known feature of non-healing wounds. This pilot study aims to determine the proteomic and microbiologic components of slough as well as interrogate the associations between wound slough components and wound healing. Ten subjects with slow-to-heal wounds and visible slough were enrolled. Aetiologies included venous stasis ulcers, post-surgical site infections and pressure ulcers. Patient co-morbidities and wound healing outcome at 3-months post-sample collection was recorded. Debrided slough was analysed microscopically, through untargeted proteomics, and high-throughput bacterial 16S-ribosomal gene sequencing. Microscopic imaging revealed wound slough to be amorphous in structure and highly variable. 16S-profiling found slough microbial communities to associate with wound aetiology and location on the body. Across all subjects, slough largely consisted of proteins involved in skin structure and formation, blood-clot formation and immune processes. To predict variables associated with wound healing, protein, microbial and clinical datasets were integrated into a supervised discriminant analysis. This analysis revealed that healing wounds were enriched for proteins involved in skin barrier development and negative regulation of immune responses. While wounds that deteriorated over time started off with a higher baseline Bates-Jensen Wound Assessment Score and were enriched for anaerobic bacterial taxa and chronic inflammatory proteins. To our knowledge, this is the first study to integrate clinical, microbiome, and proteomic data to systematically characterise wound slough and integrate it into a single assessment to predict wound healing outcome. Collectively, our findings underscore how slough components can help identify wounds at risk of continued impaired healing and serves as an underutilised biomarker.

Determination of the Effects of Ankaferd Wound Dressing on the Wound Healing Process in Rats.

The effects of a composite nanofiber wound dressing material consisting of a polyvinylidene alcohol and polyvinylidene pyrrolidone polymer mixture with a hemostatic agent doped with Ankaferd Blood Stopper (ABS) on the healing of experimentally induced dermal wounds in rats were examined. Rats were divided into 4 groups (n= 6). Histological material was examined on tissues taken from the wound site, whereas total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) analyses were performed on blood samples taken from the cardia. The material that was produced had hydrophilic properties, and both the ABS-doped and-undoped forms of the material positively affected wound healing. In the histopathological examinations, macroscopic evaluations revealed a statistically significant difference between the groups in terms of wound diameter, reepithelialization, and inflammation formation (p= 0.019). In parallel with wound healing and histological outcomes, TAS values increased in the ABS-doped groups, and TOS and OSI values decreased in the wound dressing groups (p < 0.05). It was concluded that the ABS-dopped dressing did not have a negative effect on wound healing, it accelerated healing, and it could be used effectively and safely to treat skin injuries. However, further studies are needed to evaluate the clinical and histopathological benefits and potential adverse effects of wound dressings produced using ABS-doped polymers on wound healing.

HucMSC-Exo Induced N2 Polarization of Neutrophils: Implications for Angiogenesis and Tissue Restoration in Wound Healing.

Neutrophils rapidly accumulate in large numbers at sites of tissue damage, exhibiting not only their well-known bactericidal capabilities but also playing crucial roles in angiogenesis and tissue repair. While exosomes derived from human umbilical cord mesenchymal stem cells (HucMSC-Exo) have emerged as a promising therapeutic tool, their exact mechanisms of action remain partly elusive. We hypothesize that HucMSC-Exo treatment may modulate neutrophil phenotypes, thereby significantly influencing wound healing outcomes. HucMSC-Exo were isolated via ultracentrifugation and subsequently administered through subcutaneous injection into full-thickness cutaneous wounds in mice. To determine the impact of host neutrophils on the healing effects of HucMSC-Exo in skin injuries, strategies including neutrophil depletion and adoptive transfer were employed. Flow cytometry was used to evaluate the proportion of N2 subtype neutrophils in both normal and diabetic wounds, and the effect of HucMSC-Exo on this proportion was assessed. Furthermore, the mitochondrial metabolic reprogramming driven by HucMSC-Exo during N2 polarization was investigated through JC1 staining, ATP quantification, fatty acid uptake assays, and assessment of FAO-related genes (Cpt1b, Acadm, and Acadl). Depleting host neutrophils strikingly dampened prohealing effect of HucMSC-Exo on skin injury, while adoptive transfer of bone marrow neutrophils rescued this process. During normal healing process, some neutrophils expressed N2 markers, in contrast, diabetic wounds exhibited a reduced expression of N2 markers. After treatment with HucMSC-Exo, most neutrophils increased the phosphorylation of STAT6, leading to mitochondrial metabolic reprogramming and thus acquired an N2 phenotype. These N2 neutrophils, polarized by HucMSC-Exo, boosted the release of proangiogenic factors, particularly BV8, a myeloid cell-derived proangiogenic factor, and induced angiogenesis thereby favoring tissue restoration. This research uniquely demonstrates the identification of N2 neutrophils in skin injury and shows that HucMSC-Exo could skew neutrophils toward N2 phenotype, enhancing our insight into how cells react to HucMSC-Exo.

Efficacy of a Novel Melatonin-Loaded Gelatin Sponge in Palatal Wound Healing

ObjectivesThe aim of this research was to assess both clinically and histologically the effect of a topically applied melatonin-loaded gelatin sponge on palatal wound healing after graft harvesting. MethodsTwenty-six patients for whom free palatal graft procurement was indicated were divided equally into 2 groups. In the test group, the donor site was covered by a melatonin-loaded gelatin sponge, and in the control group the site was covered by a placebo-loaded gelatin sponge. Wound healing was evaluated on the day of surgery and at 7 and 14 days postsurgery using photo-digital planimetry. Histologic specimens were taken to verify healing type and rate. Pain was assessed via Visual Analogue Scale (VAS) for 7 days from the day of the surgery. ResultsAt the 7-day interval, photo-digital planimetry showed a significant decrease in the traced raw area (P = .04) in the test group compared with the control group and a significant increase in the mean area of immature epithelia (P = .04). At the 14-day interval, there was no statistically significant difference in any area of interest. Histologically, the application of melatonin was associated with accelerated healing and superior maturation at all follow-up time points. No significant differences were noted in VAS scores between the 2 groups. ConclusionsMelatonin-treated tissue showed marked clinical improvement in the first week postsurgery, indicating an increased rate of healing. Similarly, histologic analysis revealed significant maturation at both time intervals. A melatonin-loaded gelatin sponge is a novel palatal wound dressing that can be used to improve wound healing outcomes and reduce patient morbidity.