Reduce Scar Formation Research Articles

Comparative efficacy of silver alginate dressings versus standard gauze in enhancing wound healing post-mastectomy for triple-negative breast cancer: A systematic review and meta-analysis.

This meta-analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post-mastectomy in patients with triple-negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post-mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I2 = 85%; Random: SMD: -7.08, 95% CI: -8.26 to -5.98, p < 0.01), compared to SG. Additionally, long-term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post-mastectomy showed a notable reduction in scar formation (I2 = 95%; Random: SMD: -12.97, 95% CI: -16.20 to -9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post-mastectomy care for triple-negative breast cancer patients but highlight the need for further research on long-term safety and cost-effectiveness.

The effect of dexmedetomidine on postoperative wound healing in neurosurgical patients: A meta-analysis.

This meta-analysis investigates the effect of dexmedetomidine on postoperative wound healing in neurosurgical patients. A thorough literature search resulted in the selection of seven studies from an initial pool of 1546 records. The analysis focused on wound healing outcomes, evaluated by the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale and the Manchester Scar Scale (MSS). Results indicated significant improvements in the dexmedetomidine group: the REEDA scale scores at day seven post-surgery showed a Standardized Mean Difference group (SMD = -16.18, 95% CI: [-22.30, -10.06], p < 0.01), and the MSS scores at 3 months post-operation demonstrated an (SMD = -8.95, 95% CI: [-14.27, -3.62], p < 0.01). These findings suggest that dexmedetomidine may enhance wound healing and reduce scar formation in neurosurgical patients. Bias assessment indicated a low risk of bias across the studies.

Individualized bio-scaffold encapsulating siPTEN-loaded exosomes for promoting neuronal regeneration in spinal cord injury

Biological scaffold implants loaded with exosomes were acknowledged as a promising strategy for the treatment of spinal cord injury. In this study, we constructed an individualized biomimetic scaffold based on combination of multimodal imaging and 3D printing technology, featuring sustained release, biodegradability, and strongly biocompatibility. The scaffold incorporated mesenchymal stem cell-derived exosomes to alleviate inflammatory response in microenvironment and reduce scar formation of ECM molecule deposition. Furthermore, to effectively enhance neuronal repair and regeneration, siRNAs targeting PTEN were introduced into exosomes. The engineered exosomes within scaffold induced endogenous neuronal regeneration and enhanced axonal growth through PTEN/PI3K/AKT/mTOR signaling pathway. Additionally, implantation of scaffold could bridge the severed ends, thus providing spatial signals to modulate the organization of neural cells, facilitating the reconstruction of complex neural networks, and restoring nerve conduction. Collectively, the individualized 3D printed bio-scaffold encapsulated siPTEN-loaded exosomes could offer great promise for the prospective clinical translation in spinal cord injury therapy.

The mechanism of Semen Persicae-Flos Carthami in treating hypertrophic scar: A study based on network pharmacological analysis and invitro experiments.

Traditional medicine believes that hypertrophic scar (HS) falls into the category of "blood stasis". Chinese herbs for promoting blood circulation and removing blood stasis, activating meridians, and relieving pain are usually selected to treat HS by traditional Chinese medicine (TCM). Both Semen Persicae (SP) and Flos Carthami (FC) are confirmed to be effective for HS. Clinically, SP and FC are often used in combination with each other. However, the pharmacodynamic mechanism and molecular target of SP-FC in the treatment of HS are still unclear. Therefore, this study is intended to explore the mechanism and target of SP-FC in the treatment of HS through network pharmacology combined with invitro cell and molecular biology experiments. Target genes of SP-FC were obtained from the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP), and targets of HS-related diseases were searched from databases such as Disgenet and GeneCards. Based on the targets searched and obtained, a Venn diagram was plotted to acquire common targets of SP-FC-HS. Next, STRING 11.0 was employed for protein-protein interaction (PPI) network analysis of common targets; and cytoscape 3.9.0 for connection relationship analysis of PPI and plotting of a "drug-component-target" network diagram. Besides, a modified explant culture method was applied to separate primary hypertrophic scar fibroblasts (HSFs); MTT assay to detect cell viability of HSFs after treatment by SP-FC for 24 h; Annexin V-FITC/PI double staining combined with flow cytometry to test apoptosis; western blot to check the protein expression level of p53; and real-time fluorescence quantitative PCR to determine mRNA level of p53. In the analysis of network pharmacology, 269 pharmacological targets of SP, 449 pharmacological targets of FC, and 2569 targets of HS-related diseases were screened from the databases. After plotting the Venn diagram, 116 common targets of SP-FC-HS were acquired. In vitro experiments showed that the expression of p53 in HSFs was decreased. SP-FC significantly reduces the viability of HSFs, increases p53 levels in HSFs, and promotes apoptosis. SP-FC can reduce scar formation by promoting p53 expression.

Copper ion/gallic acid MOFs-laden adhesive pomelo peel sponge effectively treats biofilm-infected skin wounds and improves healing quality

Bacterial infection and scar formation remain primary challenges in wound healing. To address these issues, we developed a decellularized pomelo peel (DPP) functionalized with an adhesive PVA-TSPBA hydrogel and antibacterial gallic acid/copper MOFs. The hybrid wound dressing demonstrates favorable biocompatibility. It does not impede the proliferation of fibroblasts or immune cells and can stimulate fibroblast migration, endothelial angiogenesis, and M2 macrophage polarization. Additionally, the dressing can scavenge reactive oxygen species (ROS) and provide antioxidant effects. Furthermore, DPP + MOF@Gel effectively inhibits the viability of S. aureus and E. coli in vitro and in vivo. The histological observations revealed enhanced granulation tissue formation, re-epithelialization, and angiogenesis in the DPP + MOF@Gel group compared to other groups. The local immune response also shifted from a pro-inflammatory to a pro-regenerative status with DPP + MOF@Gel treatment. The skin incision stitching experiment further exhibits DPP + MOF@Gel could reduce scar formation during wound healing. Taken together, the hybrid DPP + MOF@Gel holds great promise for treating bacteria-infected skin wounds and inhibiting scar formation during wound healing.

Bioinspired Adhesive Antibacterial Hydrogel with Self-Healing and On-Demand Removability for Enhanced Full-Thickness Skin Wound Repair.

Adhesive-caused injury is a great threat for extensive full-thickness skin trauma because extra-strong adhesion can incur unbearable pain and exacerbate trauma upon removal. Herein, inspired by the mussel, we designed and fabricated an adhesive antibacterial hydrogel dressing based on dynamic host-guest interaction that enabled on-demand stimuli-triggered removal to effectively care for wounds. In contrast with most hard-to-removable dressing, this adhesive antibacterial hydrogel exhibited strong adhesion property (85 kPa), which could achieve painless and noninvasive on-demand separation within 2 s through a host-guest competition mechanism (amantadine). At the same time, the hydrogel exhibited rapid self-healing properties, and the broken hydrogel could be completely repaired within 5 min. The hydrogel also had excellent protein adsorption properties, mechanical properties, antibacterial properties, and biocompatibility. This on-demand removal was facilitated by the introduction of amantadine as a competitive guest, without any significant adverse effects on cell activity (>90%) or wound healing (98.5%) in vitro. The full-thickness rat-skin defect model and histomorphological evaluation showed that the hydrogel could significantly promote wound healing and reduce scar formation by regulating inflammation, accelerating skin re-epithelialization, and promoting granulation tissue formation. These results indicate that the developed adhesive antibacterial hydrogel offers a promising therapeutic strategy for the healing of extensive full-layer skin injuries.

ROS-scavenging hydrogel to accelerate wound healing and reduce scar formation

ROS-scavenging hydrogel to accelerate wound healing and reduce scar formation

The effects of Shikonin on the hypertrophic scar of rabbit ears via the TLR4/NF-κB signaling pathway.

As a traditional Chinese medicine, Zihuang Shengji Ointment has obvious effects on promoting postoperative wound healing and reducing scar formation in clinical application. Shikonin is the major phytochemical in Zihuang Shengji Ointment. As a kind of naphquinone compound with anti-tumor, anti-viral, anti-inflammatory, anti-bacterial and other biological activities extracted from Lithospermum erythrorhizon, shikonin exerts an important role in many diseases. Shikonin has impacts on the development of hypertrophic scars (HS), however, these effects are yet mostly unknown. As a result, we created the Newland white rabbit ear HS model, administered shikonin to it, and then assessed scar hypertrophy using HE and VG staining. The degree of scarring is assessed by HI, NA, as well as AA. The expression levels of collagen I, collagen III, as well as α-SMA as well as fibroblast proliferation, are also measured using real-time PCR, immunohistochemistry, and western blot. TUNEL tests are used to assess fibroblast apoptosis. In our work, HE staining and VG staining showed that the shikonin-treated group had normal bundles of collagen fibers and regular fibroblasts. Shikonin suppresses the production of HS, according to histopathological features, HI, NA, and AA measures. Shikonin also causes fibroblast apoptosis and lowers the production of α-SMA, collagen I, as well as collagen III in the HS rat. Notably, we discover that NF-κB activation and TLR4 activity are inhibited by shikonin. Overall, the results show that the signaling pathway of TLR4/NF-κB is modulated by shikonin's inhibitory effect on scar formation, which represses the levels of collagen I, collagen III, α-SMA, as well as fibroblasts.

Therapeutic efficacy of platelet-rich fibrin on surgical site wound healing in patients undergoing oral carcinoma resection: A meta-analysis.

Oral carcinoma, a prevalent malignancy of the oral cavity, often results in surgical site wounds post-resection. The therapeutic efficacy of platelet-rich fibrin (PRF) in wound healing and scar formation has garnered significant attention. This meta-analysis aimed to evaluate the role of PRF in promoting surgical site wound healing and reducing scar formation following oral carcinoma resection. A systematic search, adhering to PRISMA guidelines, was conducted across multiple databases. The primary outcomes assessed were the Landry, Turnbull and Howley (LTH) wound healing index and the Manchester scar scale (MSS). Statistical evaluations were performed using RevMan 5.4 software. Six studies were incorporated, involving 93 patients treated with PRF and 97 in the control group. For the LTH index, significant improvements in wound healing were observed in the PRF group with I2 = 74%, (Random: SMD: 3.70, 95% CIs: 2.66 to 4.75, p < 0.01). The Manchester scar scale assessment, which included 60 PRF-treated patients and 60 controls, indicated a significant reduction in scar formation in the PRF group I2 = 79%, (Random: SMD: 9.13, 95% CIs: 6.06 to 12.20, p < 0.01). PRF demonstrates promising therapeutic potential in enhancing surgical site wound healing and reducing scar formation post oral carcinoma resection. The application of PRF has been associated with improved wound healing metrics and diminished scar severity. However, further high-quality studies are warranted to confirm these findings.

The functions and clinical application potential of exosomes derived from mesenchymal stem cells on wound repair: a review of recent research advances.

Wound repair is a complex problem for both clinical practitioners and scientific investigators. Conventional approaches to wound repair have been associated with several limitations, including prolonged treatment duration, high treatment expenses, and significant economic and psychological strain on patients. Consequently, there is a pressing demand for more efficacious and secure treatment modalities to enhance the existing treatment landscapes. In the field of wound repair, cell-free therapy, particularly the use of mesenchymal stem cell-derived exosomes (MSC-Exos), has made notable advancements in recent years. Exosomes, which are small lipid bilayer vesicles discharged by MSCs, harbor bioactive constituents such as proteins, lipids, microRNA (miRNA), and messenger RNA (mRNA). These constituents facilitate material transfer and information exchange between the cells, thereby regulating their biological functions. This article presents a comprehensive survey of the function and mechanisms of MSC-Exos in the context of wound healing, emphasizing their beneficial impact on each phase of the process, including the regulation of the immune response, inhibition of inflammation, promotion of angiogenesis, advancement of cell proliferation and migration, and reduction of scar formation.

Melatonin, a natural antioxidant therapy in spinal cord injury.

Spinal cord injury (SCI) is a sudden onset of disruption to the spinal neural tissue, leading to loss of motor control and sensory function of the body. Oxidative stress is considered a hallmark in SCI followed by a series of events, including inflammation and cellular apoptosis. Melatonin was originally discovered as a hormone produced by the pineal gland. The subcellular localization of melatonin has been identified in mitochondria, exhibiting specific onsite protection to excess mitochondrial reactive oxygen species and working as an antioxidant in diseases. The recent discovery regarding the molecular basis of ligand selectivity for melatonin receptors and the constant efforts on finding synthetic melatonin alternatives have drawn researchers' attention back to melatonin. This review outlines the application of melatonin in SCI, including 1) the relationship between the melatonin rhythm and SCI in clinic; 2) the neuroprotective role of melatonin in experimental traumatic and ischemia/reperfusion SCI, i.e., exhibiting anti-oxidative, anti-inflammatory, and anti-apoptosis effects, facilitating the integrity of the blood-spinal cord barrier, ameliorating edema, preventing neural death, reducing scar formation, and promoting axon regeneration and neuroplasticity; 3) protecting gut microbiota and peripheral organs; 4) synergizing with drugs, rehabilitation training, stem cell therapy, and biomedical material engineering; and 5) the potential side effects. This comprehensive review provides new insights on melatonin as a natural antioxidant therapy in facilitating rehabilitation in SCI.

The effect of GelDex-S58 hydrogel on anti-conjunctival scarring after glaucoma filtration surgery

Excessive scarring is the main cause of surgical failure in glaucoma filtration surgery. S58 has been shown to have an excellent antifibrotic effect but its duration of action is not sufficient to achieve the desired antiscarring effect. In this study, a light-cured bioadhesive hydrogel composed of GelMA and oxidized dextran (ODex), namely, GelDex, was used to load S58 (GelDex-S58). The microscopic morphology of GelDex-S58 appeared to be a porous structure with good slow-release properties and suitable degradation time. Cell Counting Kit-8, cell scratch and transwell assays showed that GelDex-S58 significantly reduced TGF-β-induced fibroblast proliferation, increased migration and invasion ability. In invivo studies, GelDex-S58 treatment prolonged follicular retention, reduced mean intraocular pressure, and significantly reduced collagen deposition and α-SMA expression levels in the conjunctival tissue compared to treatment with S58 alone. In conclusion, GelDex-S58 could reduce scar formation after glaucoma filtration surgery.

A modified Park's technique for creating a natural-looking double eyelid.

This study aimed to evaluate an improved park's technique to create a natural double eyelid and reduce scar formation. The levator aponeurosis, orbicularis oculi muscle, and dermis were fixed using subcutaneous intermittent sutures, and then the skin and the levator aponeurosis were sutured. Postoperative evaluation included double-eyelid stability, symmetry, double-eyelid curve, scar formation, and patient satisfaction. Between January 2021 and August 2021, a total of 89 patients (178 eyes) underwent double-eyelid blepharoplasty by the same surgeon using this improved technique. The mean follow-up period was 15.5 months (range 10 to 18 months). Seventy-six patients were very satisfied with this surgical method, six patients were rather satisfied, and seven patients were dissatisfied. The overall satisfaction rate was 92.1%. This new blepharoplasty method generates a stable, natural double-eyelid line with minimal scarring.

Aligned lovastatin-loaded electrospun nanofibers regulate collagen organization and reduce scar formation.

Excessive scar formation caused by cutaneous injury leads to pruritus, pain, contracture, dyskinesia, and unpleasant appearance. Functional wound dressings are designed to accelerate wound healing and reduce scar formation. In this study, we fabricated aligned or random polycaprolactone/silk fibroin electrospun nanofiber membranes with or without lovastatin loading, and then evaluated their scar-inhibitory effects on wounds under a specific tension direction. The nanofiber membranes exhibited good controlled-release performance, mechanical properties, hydrophilicity, and biocompatibility. Furthermore, nanofibers' perpendicular placement to the tension direction of the wound most effectively reduced scar formation (the scar area decreased by 66.9%) and promotedskin regeneration in vivo. The mechanism was associated with aligned nanofibers regulated collagen organization in the early stage of wound healing. Moreover, lovastatin-loaded nanofibers inhibited myofibroblast differentiation and migration. Both tension direction-perpendicular topographical cues and lovastatin synergistically inhibited mechanical transduction and fibrosis progression, further reducing scar formation. In summary, our study may provide an effective scar prevention strategy in which individualized dressings can be designed according to the local mechanical force direction of patients' wounds, and the addition of lovastatin can further inhibit scar formation. STATEMENT OF SIGNIFICANCE: In vivo, cells and collagen are always arranged parallel to the tension direction. However, the aligned topographic cues themselves promote myofibroblast differentiation and exacerbate scar formation. Electrospun nanofibers' perpendicular placement to the tension direction of the wound most effectively reduces scar formation and promotes skin regeneration in vivo. The mechanism is associated with tension direction-perpendicular nanofibers reregulate collagen organization in the early stage of wound healing. In addition, tension direction-perpendicular topographical cue and lovastatin could inhibit mechanical transduction and fibrosis progression synergistically, further reducing scar formation. This study proves that combining topographical cues of wound dressing and drugs would be a promising therapy for clinical scar management.

Polymer-Based Wound Dressings Loaded with Ginsenoside Rg3.

The skin, the largest organ in the human body, mainly plays a protective role. Once damaged, it can lead to acute or chronic wounds. Wound healing involves a series of complex physiological processes that require ideal wound dressings to promote it. The current wound dressings have characteristics such as high porosity and moderate water vapor permeability, but they are limited in antibacterial properties and cannot protect wounds from microbial infections, which can delay wound healing. In addition, several dressings contain antibiotics, which may have bad impacts on patients. Natural active substances have good biocompatibility; for example, ginsenoside Rg3 has anti-inflammatory, antibacterial, antioxidant, and other biological activities, which can effectively promote wound healing. Some researchers have developed various polymer wound dressings loaded with ginsenoside Rg3 that have good biocompatibility and can effectively promote wound healing and reduce scar formation. This article will focus on the application and mechanism of ginsenoside Rg3-loaded dressings in wounds.

Self-Assembled Sulfated Hyaluronan Coating Modulates Transforming Growth Factor-Beta1 Penetration for Corneal Scarring Alleviation.

Corneal scarring caused by epithelial-stromal injury impairs corneal transparency and visual acuity. Excess secretion of transforming growth factor-beta 1 (TGF-β1), which promotes wound closure, penetrates the corneal stroma via defects in the epithelial basement membrane and induces the differentiation of corneal fibroblasts to myofibroblasts, leading to scar formation. Modulating TGF-β1 penetration might alleviate corneal scar formation and restore transparency. In this study, sulfated hyaluronan (sHA) coatings were self-assembled above wounded corneal stroma to modulate TGF-β1 penetration, and their ability to alleviate corneal scarring was investigated. The formation of sHA coatings was rapid (within 30 s), and the high-sulfated hyaluronan coating efficiently blocked penetration by TGF-β1 and reduced the concentration of TGF-β1 in the corneal stroma. Further investigation showed that the ability of TGF-β1 to induce differentiation of corneal fibroblasts into myofibroblasts was inhibited by sHA binding. Evaluation of corneal scarring with sHA coating in a rabbit model of lamellar resection indicated that a sHA (high sulfation) coating effectively reduced scar formation. Immunohistochemical staining of α-smooth muscle actin and optical coherence tomography of the anterior segment showed minimal scar tissue formation in the sHA group. This work presents a promising alternative to alleviate scarring in corneal epithelial-stromal injury.

Role of Onion Extract in Post Electrical Burn Scar

An imbalance of collagen synthesis and degradation is the most common cause of scarring. Onion extract inhibits fibroblast activity, which helps to reduce scar formation. Despite the fact that onion extract is used in a variety of commercial products, the precise molecular mechanisms by which onion extract reduces scar development in the skin are yet unknown. The aim of this study is to evaluate the effectiveness of onion extract gel in improving the post electrical burn scar.

Therapeutic Potential of Extracellular Vesicles from Different Stem Cells in Chronic Wound Healing.

Wound healing has long been a complex problem, especially in chronic wounds. Although debridement, skin grafting, and antimicrobial dressings have been used to treat chronic wounds, their treatment period is long, expensive, and has specific rejection reactions. The poor treatment results of traditional methods have caused psychological stress to patients and a substantial economic burden to society. Extracellular vesicles (EVs) are nanoscale vesicles secreted by cells. They play an essential role in intercellular communication. Numerous studies have confirmed that stem cell-derived extracellular vesicles (SC-EVs) can inhibit overactive inflammation, induce angiogenesis, promote re-epithelization, and reduce scar formation. Therefore, SC-EVs are expected to be a novel cell-free strategy for chronic wound treatment. We first summarize the pathological factors that hinder wound healing and discuss how SC-EVs accelerate chronic wound repair. And then, we also compare the advantages and disadvantages of different SC-EVs for chronic wound treatment. Finally, we discuss the limitations of SC-EVs usage and provide new thoughts for future SC-EVs research in chronic wound treatment.

Efficacy of bioabsorbable dressing combined with antibacterial spray for treatment of third-degree burns.

To evaluate the clinical efficacy of a bioabsorbable dressing in combination with antibacterial spray in treating third-degree burns. Patients with third-degree burns in our hospital from February 2019 to February 2020 were enrolled and divided into an experimental group and a control group. In all patients, two wound repair surgeries were performed. During the first surgery, bioabsorbable dressing (PELNAC, Gunze Medical Equipment (Shenzhen) Co. Ltd., China) was used for wound treatment. During the second surgery, autologous split-thickness skin graft was performed. For patients in the experimental group, bioabsorbable dressings (PELNAC) were uniformly applied with antibacterial spray during the operation and during postoperative dressing. For patients in the control group, antibacterial spray was not used. A total of 68 patients took part in the study (experimental group n=36; control group n=32). Infection rate in the experimental group was significantly lower than that in the control group (2.8% versus 21.9%, respectively; p<0.05). The mean wound healing time in the experimental group was shorter by 3.2 days and the wound healing rate of the experimental group was significantly higher than that in the control group (p<0.05). Vancouver Scar Scale (VSS) scores at specific postoperative time intervals were significantly reduced in the experimental group compared with those in the control group (p<0.05). Bioabsorbable dressing combined with antibacterial spray could reduce infection rate, shorten wound healing time and reduce scar formation in repairing third-degree burns.

Ultrapulse Fractional CO2 Laser With Different Fluences and Densities in the Prevention of Periorbital Laceration Scars: A Split-Scar, Evaluator-Blinded Study.

Periorbital laceration can result in complex, permanent scars, and even lead to serious complications such as cicatricial ectropion. Early intervention with laser devices has been suggested as a novel modality to reduce scar formation. However, no consensus exists regarding the optimal treatment parameters for scar management. This study evaluated the efficacy and safety of ultrapulse fractional CO2 laser (UFCL) with different fluences and densities in preventing periorbital surgical scars. To assess the efficacy and safety of UFCL with different fluences and densities in the prevention of periorbital laceration scars. A prospective, randomized, blinded study was conducted on 90 patients with periorbital laceration scars of 2 weeks old. Four treatment sessions of UFCL were administered to each half of the scar at 4-week intervals, with halves treated with high fluences with low density versus low fluences with low-density treatment. Vancouver Scar Scale was used to assess the 2 portions of each individual scar at baseline, final treatment, and 6 months. The patient's 4-point satisfaction scale was used to evaluate the patient's satisfaction at baseline and 6 months. Safety was evaluated by registration of adverse events. Eighty-two of 90 patients completed the clinical trial and follow-up. There was no significant difference in Vancouver Scar Scale and satisfaction score between different laser settings between the two groups (P > 0.05). Adverse events were minor and no long-term side effects were noted. Early application of UFCL is a safe, strategy to significantly improve the final traumatic periorbital scar appearance. Objective evaluation of scars did not identify differences in scar appearance between high fluences with low density versus low fluences with low density of UFCL treatment. Level III.