Subsequent Wound Research Articles

EP202 - Mesh-Mediated Fascial Traction (MMFT) and Negative Pressure Abdominal Dressing (ABTHERA): Useful in Difficult Open Abdomens?

Abstract Background Challenging abdominal surgical emergencies may require an 'Open Abdomen (OA)' as a life-saving procedure. OA has serious complications: wound infection, fluid and protein loss, catabolic state, loss of abdominal domain, and entero-atmospheric fistula. To assess the efficacy of mesh-mediated fascial traction (MMFT) & Abthera Dressing in achieving definitive abdominal closures. Patients and Method Retrospective analysis of prospectively collected data of 6 patients managed between August and November 23 in a large DGH. Following laparotomy and management of primary pathology, Abthera Dressing combined with bilateral continuous 2-0 PDS suture fixation at 0.5cm gap of macroporous Prolene (Merinium, Meril Life) meshes to each rectus sheath followed by sequential midline mesh traction closure over a time period that allowed subsequent definitive abdominal wound closure. Data collection included patient demographics (age, sex, BMI, ASA), intervention details for OA, wound characteristics, follow-up, and outcome. Results Six included M: F 4:2, age 61* (40-76 ) years, BMI 30* ( 24-35), ASA 3. Three were strangulated incisional hernia, 2 burst abdomens from faecal peritonitis, and 1 necrotizing fasciitis. Initial wound length 25*(20-32) cm, width 12.5* (4-17) cm after management of primary pathology reduced to width 4.5* (0-9) cm through MMFT and Abthera Dressing followed by definitive abdominal closure. Relook surgery required were 4* (1-9) with one full and 4 bridged mesh closures. Length of stay 39* (14-74) days. One death from respiratory failure. Conclusion The study highlights the benefit of MMFT & Abthera Dressing in achieving definitive abdominal closure for challenging OA where primary abdominal closure was not possible. * Median

Lower Extremity Traumatic Wound Management: Relative Significance of Negative Pressure Wound Therapy in the Orthopedic Setting.

Significance: Lower extremity traumatic wounds are associated with numerous perioperative challenges. Their etiologies determine the characteristics and extent of the injury. The timing of subsequent surgical intervention and wound healing optimization after lower extremity trauma are integral to successful perioperative lower extremity wound management. Recent Advances: Managing trauma to the lower extremities uses a multidisciplinary surgical approach. The objective of this review is to summarize lower limb trauma assessment, advancements in lower extremity trauma management, and the clinical applications of advanced wound care in lower limb traumatic wounds. The advent of lower limb reconstruction and the development of advanced wound care modalities have helped to improve the management of these complex injuries. Critical Issues: The extensive involvement of bone, soft tissues, nerves, and blood vessels of severe lower extremity trauma wounds presents a challenge for clinicians in both the acute care setting and during patient rehabilitation. If not properly managed, these injuries may be subject to a decline in limb function and may possibly result in limb loss. To reveal developing limb-threatening conditions, serial examinations should be performed. Future Directions: The majority of lower limb traumatic wound will benefit from the perioperative administration of an appropriate negative pressure wound therapy (NPWT)-based system, which can help to promote granulation tissue and remove wound exudate before definitive closure and/or reconstruction. NPWT should be included as an important adjunct in the surgical management of lower limb traumatic wounds.

Cerebellar Haemorrhage After Corrective Surgery for Scoliosis in a Girl with Arrested Hydrocephalus.

A 14-year-old girl with congenital hydrocephalus and early-onset scoliosis presented with sudden onset of severe headache on the fourth postoperative day of scoliosis correction (definitive fusion). On evaluation, she was found to have cerebellar haemorrhage on computed tomography scan with the findings of obstructive hydrocephalus. Posterior fossa bleed with hydrocephalus contributing to raised ICP was suspected initially. Headache persisted despite treating the patient with analgesics and antioedema measures. There was no history of postural variation of headache. As the drain output was not coming down, even by the sixth postoperative day, low cerebrospinal fluid pressure headache was considered and the drain was removed, which resulted in marked improvement of headache. Subsequent wound exploration revealed grade III dural tear at D10 level, which was repaired and the headache subsided completely. The linear pattern of haemorrhage in the cerebellum is classical of remote cerebellar haemorrhage, which is seen rarely following spinal surgeries with associated dural tear.

Topical ABT-263 treatment reduces aged skin senescence and improves subsequent wound healing.

Senescent cells (SnC) accumulate in aging tissues, impairing their ability to undergo repair and regeneration following injury. Previous research has demonstrated that targeting tissue senescence with senolytics can enhance tissue regeneration and repair by selectively eliminating SnCs in specific aged tissues. In this study, we focused on eliminating SnC skin cells in aged mice to assess the effects on subsequent wound healing. We applied ABT-263 directly to the skin of 24-month-old mice over a 5-day period. Following topical ABT-263, aged skin demonstrated decreased gene expression of senescent markers p16 and p21, accompanied by reductions in SA-β-gal and p21-positive cells compared to DMSO controls. However, ABT-263 also triggered a temporary inflammatory response and macrophage infiltration in the skin. Bulk RNA sequencing of ABT-263-treated skin revealed prompt upregulation of genes associated with wound healing pathways, including hemostasis, inflammation, cell proliferation, angiogenesis, collagen synthesis, and extracellular matrix organization. Aged mice skin pre-treated with topical ABT-263 exhibited accelerated wound closure. In conclusion, topical ABT-263 effectively reduced several senescence markers in aged skin, thereby priming the skin for improved subsequent wound healing. This enhancement may be attributed to ABT-263-induced senolysis which in turn stimulates the expression of genes involved in extracellular matrix remodeling and wound repair pathways.

Local Control of Pyoderma Gangrenosum Using Human Amniotic Membrane and Transcriptome Analysis.

Pyoderma gangrenosum (PG) is a rare, chronic, ulcerative disease characterized by non-healing wounds that worsen with debridement, a phenomenon called pathergy. No consensus regarding pathogenesis, diagnosis, or treatment exists for PG. A previous pilot study using dehydrated human amniotic/chorionic membrane (dHACM), following excisional debridement, augmented PG wound healing and allowed for subsequent wound closure through split-thickness skin grafting (STSG). In this clinical trial (NCT05120726), four patients with an established PG diagnosis were enrolled to undergo treatment with dHACM and characterize the pre- and post-treatment transcriptome profiles. RNA sequencing was used to isolate the total RNA from specimens. Genes of particular interest were quantified through real-time quantitative reverse transcription polymerase chain reaction. We observed varied changes to the local expression of inflammatory response, positive regulators of cellular proliferation, and extracellular matrix disassembly cytokines. All PG wounds produced granulation tissue following treatment and were closed using split-thickness skin grafts.

Looking back to look forward: Has the time arrived for active management of obstetricians in placenta accreta spectrum?

Placenta accreta spectrum (PAS) is a relatively new obstetric condition which, until recently, was poorly understood. The true incidence is unknown because of the poor quality and heterogeneous diagnostic criteria. Classification systems have attempted to provide clarity on how to grade and diagnose PAS, but these are no longer reflective of our current understanding of PAS. This is particularly true for placenta percreta, which referred to extrauterine disease, as recent studies have demonstrated that placental villi associated with PAS have minimal potential to invade beyond the uterine serosa. It is accepted that PAS is a direct consequence of previous iatrogenic uterine injury, most commonly a previous cesarean section. Here, we "look back to look forwards"-starting with the primary predisposing factor for PAS, an iatrogenic uterine injury and subsequent wound healing. We then consider the evolution of definitions and diagnostic criteria of PAS from its first description over a century ago to current classifications. Finally, we discuss why modifications to the current classifications are needed to allow accurate diagnosis of this rare but life-threatening complication, while avoiding overdiagnosis and potential patient harm.

Rainfall-induced wind erosion in soils stabilized with alkali-activated waste materials

This study evaluates the efficacy of sustainable erosion control using slag-based alkali-activated cement crusts under varying rainfall and wind conditions. The rainfall intensities ranged from 30 mm/h to 120 mm/h, with durations ranging from 15 min to 90 min, and crust slopes of ∼2° (gentle) and 30° (steep). Wind tunnel experiments were conducted at wind velocities of 14 m/s, 21 m/s, and 28 m/s to investigate post-rainfall wind erodibility, along with changes in crust strength and microstructure analysis. The findings show the development of hydrated cementitious phases in alkali-activated material, which form around and between the particles during the alkaline activation process. Alkali-activated cement crusts significantly reduced erosion caused by rainfall and subsequent wind by several orders of magnitude. At the highest rainfall intensity of 120 mm/h, rainfall erosion was measured to be 1654.81 kg/m2 for untreated samples and 0.89 kg/m2 for treated samples, demonstrating a substantial 99.95% reduction in erosion due to the treatment. Similarly, at the highest wind speed tested, wind erosion was 122.75 kg/m2 for untreated samples and 0.095 kg/m2 for treated samples, indicating a significant 99.92% reduction in erosion due to the formation of an alkali-activated cement crust on the soil surface. However, exposure of the samples to 120 mm/h rainfall for 90 min resulted in a 5.2-fold increase in wind erosion compared to pre-rainfall conditions. Similarly, penetrometer results indicated a 37%–54% reduction in post-rainfall surface strength.

Dynamic prediction of time to wound healing at routine wound care visits.

Objective Having a wound decreases patients' quality of life and brings uncertainty, especially if the wound does not show a healing tendency. The objective of this study was to develop and validate a model to dynamically predict time to wound healing at subsequent routine wound care visits. Approach A dynamic prediction model was developed in a cohort of wounds treated by nurse practitioners between 2017-2022. Potential predictors were selected based on literature, expert opinion, and availability in the routine care setting. To assess performance for future wound care visits, the model was validated in a new cohort of wounds visited in early 2023. Reporting followed TRIPOD guidelines. Results We analyzed data from 92,098 visits, corresponding to 14,248 wounds and 7,221 patients. At external validation, discriminative performance of our developed model was comparable to internal validation (c-statistic = 0.70 [95% CI 0.69, 0.71]) and the model remained well-calibrated. Strong predictors were wound-level characteristics and indicators of the healing process so far (e.g., wound surface area). Innovation Going beyond previous prediction studies in the field, the developed model dynamically predicts the remaining time to wound healing for many wound types at subsequent wound care visits, in line with the dynamic nature of wound care. In addition, the model was externally validated and showed stable performance. Conclusion: The developed model can potentially contribute to patient satisfaction and reduce uncertainty around wound healing times when implemented in practice. When the predicted time of wound healing remains high, practitioners can consider adapting their wound management.

Enhancing Buttock Contours: A Safer Approach to Gluteal Augmentation with Ultrasonic Liposuction, Submuscular Implants, and Ultrasound-Guided Fat Grafting.

Background: The global popularity of gluteal augmentation has risen significantly, driven by the desire for enhanced buttocks size and shape to align with individual patient preferences. This increased demand has prompted extensive research into diverse techniques and their safety. Methods: A retrospective analysis was conducted to evaluate the outcomes of a gluteal augmentation technique involving ultrasound-assisted liposuction, submuscular implants, and ultrasound-guided fat grafting. Our study involved a review of the medical records of 50 consecutive patients who underwent this procedure between February 2020 and July 2023. Results: Data related to patient demographics, the quantity of fat grafts, and any complications were analyzed. Additionally, a brief survey was conducted to evaluate patient satisfaction. The Polytech implants were used in forty-four patients, and Sebbin implants in six. The implant size varied from 285 to 560. Most of the Polytech implants were 390 cc (25/44; 56.8%). Two patients had a minor infection at the incision sites and subsequent wound dehiscence. No revision surgeries were needed. Conclusions: The presented technique incorporates ultrasonic liposuction, submuscular silicone implants, and ultrasound-guided fat grafting to achieve safe and aesthetic gluteal enhancements. This method is especially suitable for patients looking to augment both the central and lateral areas of the buttocks, particularly when they lack adequate fat tissue for augmentation through fat grafting. With the addition of ultrasound guidance, the fat grafting step is significantly safer.

Evaluating antibiotic prophylaxis adherence: Implications for surgical site infections and wound care management

AimThis study aimed to evaluate adherence to an antibiotic prophylaxis protocol and its impact on incidence of surgical site infection (SSI). Materials and methodA prospective observational cohort study was conducted at a teaching hospital in São Paulo, Brazil, from September to November 2015. The population were adults who underwent surgery with surgical antibiotic prophylaxis. The main outcomes measured were incidence of SSI at 30-days postoperatively, protocol adherence and surgical wound complications. STROBE guidelines were followed. ResultsAmong the 527 participants recruited, a 30-day follow-up was completed by 78.7 % (n = 415). Within this cohort, 57.6 % were females aged over 60 years (36.4 %). The incidence of SSI stood at 9.4 % (n = 39), with dehiscence being the most prevalent complication at 64.1 % (n = 25), followed by increased exudate at 51.3 % (n = 20). Notably, full adherence to the antibiotic prophylaxis protocol was low at 1.7 % (n = 7). The study observed a 60 % increased risk of SSI for every protocol mistake made. Alarmingly, 17.8 % (n = 74) of participants received antibiotic treatment exceeding the stipulated protocol duration. The overall mortality rate stood at 13.5 % (n = 56), with 1 % (n = 4) of these deaths attributed to SSI. ConclusionThere is a pressing global necessity to enhance antibiotic management, as underscored by this study's revelation of low adherence to the antibiotic prophylaxis protocol. This lack of adherence correlated with a notable incidence of SSI and subsequent wound complications. Nearly 20 % of participants received prolonged antibiotic treatment. Adhering strictly to the protocol could substantially impact SSI-related outcomes and enhance global antibiotic management.

A robust microgrid formation method for risk-resistant service restoration considering subsequent contingency

Service restoration (SR) is essential for resilience enhancement of distribution systems (DSs) when natural disasters occur. However, a restored DS may face potential outage risks caused by subsequent contingency during the prolonged event. To improve the risk-resistance of SR strategies, this paper proposes a microgrid-based SR method to continuously supply critical loads when considering subsequent contingency. The microgrids are proactively formed to mitigate the influence of subsequent contingencies, which can effectively reduce the load shedding and wind power curtailment during the SR process. To deal with uncertainties of subsequent contingency and wind power, a two-stage robust model is established. Moreover, an improved uncertainty set is established to further reduce the conservatism of robust optimization. Specially, the line interruption probability is considered when constructing the Shannon entropy-based uncertainty set of subsequent contingencies, and the spatial–temporal correlations of wind power is considered when formulating the budget-constrained uncertainty set. Then, the robust model is solved by column-and-constraint generation algorithm efficiently. Numerical results demonstrate that the proposed SR method can effectively enhance the risk-resistance of SR strategy and reduce the conservatism while ensuring the robustness of solutions.

Commensal Skin Bacteria Exacerbate Inflammation and Delay Skin Barrier Repair

The skin microbiome can both trigger beneficial immune stimulation and pose a potential infection threat. Previous studies have shown that colonization of mouse skin with the model human skin commensal Staphylococcus epidermidis is protective against subsequent excisional wound or pathogen challenge. However, less is known about concurrent skin damage and exposure to commensal microbes, despite growing interest in interventional probiotic therapy. Here, we address this open question by applying commensal skin bacteria at a high dose to abraded skin. While depletion of the skin microbiome via antibiotics delayed repair from damage, probiotic-like application of commensals-- including the mouse commensal Staphylococcus xylosus, three distinct isolates of S. epidermidis, and all other tested human skin commensals-- also significantly delayed barrier repair. Increased inflammation was observed within four hours of S. epidermidis exposure and persisted through day four, at which point the skin displayed a chronic wound-like inflammatory state with increased neutrophil infiltration, increased fibroblast activity, and decreased monocyte differentiation. Transcriptomic analysis suggested that the prolonged upregulation of early canonical proliferative pathways inhibited the progression of barrier repair. These results highlight the nuanced role of members of the skin microbiome in modulating barrier integrity and indicate the need for caution in their development as probiotics.

Homeopathic Pyrogenium Ointment as Adjuvant in Treatment of Traumatic and Infected Myiasis by Cochliomyia Hominivorax (Diptera: Calliphoridae) in Sheep: A Case Series.

The blowfly Cochliomyia hominivorax (Diptera: Calliphoridae) causes traumatic myiasis in farm animals, with deeply embedded larvae that lead to serious tissue damage and sometimes death. Treating this form of myiasis is difficult, often resulting in poor outcomes. As a homeopathic preparation that can mimic traumatic myiasis symptoms, Pyrogenium could potentially supplement treatment. This study aimed to describe the adjuvant effect that a Pyrogenium ointment might have in the treatment of sheep with traumatic myiasis. The study reports a homeopathic adjuvant treatment with Pyrogenium 12cH ointment in six sheep with traumatic and infected myiasis. Daily clinical examinations were performed to monitor the evolution of the health of animals. Pyrogenium 12cH ointment was applied topically on the wounds, after cleaning and mechanical removal of the larvae from the lesion. Blood samples were collected for blood counts, and wound exudate samples were obtained for bacteriological examination before and after wound treatment. The ointment of Pyrogenium 12cH limited the development of parasitic larvae and was associated with the repair of tissue losses resulting from the myiases and with subsequent wound healing, together with control of fever and local inflammation. Homeopathic Pyrogenium 12cH, formulated as an ointment, may be a useful new and adjuvant therapeutic option for treating traumatic and infected myiasis in animals.

What can we learn about fish neutrophil and macrophage response to immune challenge from studies in zebrafish

Fish rely, to a high degree, on the innate immune system to protect them against the constant exposure to potential pathogenic invasion from the surrounding water during homeostasis and injury. Zebrafish larvae have emerged as an outstanding model organism for immunity. The cellular component of zebrafish innate immunity is similar to the mammalian innate immune system and has a high degree of sophistication due to the needs of living in an aquatic environment from early embryonic stages of life. Innate immune cells (leukocytes), including neutrophils and macrophages, have major roles in protecting zebrafish against pathogens, as well as being essential for proper wound healing and regeneration. Zebrafish larvae are visually transparent, with unprecedented in vivo microscopy opportunities that, in combination with transgenic immune reporter lines, have permitted visualisation of the functions of these cells when zebrafish are exposed to bacterial, viral and parasitic infections, as well as during injury and healing. Recent findings indicate that leukocytes are even more complex than previously anticipated and are essential for inflammation, infection control, and subsequent wound healing and regeneration.

Optimization of aerodynamic performance by applying the combination of lamellar and 3D wheel deflectors on the SUV model

In the developmental phase of an electric SUV model, optimizing the SUV model’s aerodynamic performance often involves the use of wheel deflectors to control airflow around the front wheels. While lamellar wheel deflectors are a common choice for reducing aerodynamic drag, the automotive industry is increasingly embracing 3D wheel deflectors to enhance drag reduction efforts. This study delves into the flow patterns surrounding the front wheels and the drag reduction mechanisms brought about by wheel deflectors. In this research, we harness the strengths of both lamellar and 3D wheel deflectors to introduce a more effective design approach. The conceived wheel deflectors aim to simultaneously decrease aerodynamic drag and lift, a dual-purpose strategy that extends the SUV’s range and optimizes its stability at high speeds. To validate these optimization effects, comprehensive Computational Fluid Dynamics (CFD) simulations and subsequent wind tunnel testing are conducted. The findings presented in this paper establish a crucial foundation for the design and optimization of wheel deflectors, contributing to advancements in the field.

Precision cardiac targeting: empowering curcumin therapy through smart exosome-mediated drug delivery in myocardial infarction.

Nanoparticle-mediated drug delivery has emerged as a highly promising and effective therapeutic approach for addressing myocardial infarction. However, clinical translation tends to be a failure due to low cardiac retention as well as liver and spleen entrapment in previous therapies. Herein, we report a two-step exosome delivery system, which precludes internalization by the mononuclear phagocyte system before the delivery of therapeutic cardiac targeting exosomes (ExoCTP). Importantly, curcumin released by ExoCTP diminishes reactive oxygen species over-accumulation in ischemic myocardium, as well as serum levels of lactate dehydrogenase, malonyldialdehyde, superoxide dismutase and glutathione, indicating better antioxidant capacity than free curcumin. Finally, our strategy was proven to greatly potentiate the delivery and therapeutic efficacy of curcumin without systemic toxicity. Taken together, our smart exosome-mediated drug delivery strategy can serve either as therapeutics alone or in combination with other drugs for effective heart targeting and subsequent wound healing.

Impact of anisotropic ejecta on jet dynamics and afterglow emission in binary neutron-star mergers

ABSTRACT Binary neutron-stars mergers widely accepted as potential progenitors of short gamma-ray bursts. After the remnant of the merger has collapsed to a black hole, a jet is powered and may breakout from the the matter expelled during the collision and the subsequent wind emission. The interaction of the jet with the ejecta may affect its dynamics and the resulting electromagnetic counterparts. We here examine how an inhomogeneous and anisotropic distribution of ejecta affects such dynamics, dictating the properties of the jet-ejecta cocoon and of the afterglow radiated by the jet upon deceleration. More specifically, we carry out general-relativistic hydrodynamical simulations of relativistic jets launched within a variety of geometrically inhomogeneous and anisotropic distributions of ejected matter. We find that different anisotropies impact the variance of the afterglow light curves as a function of the jet luminosity and ejected mass. A considerable amount of the jet energy is deposited in the cocoon through the jet-ejecta interaction with a small but important dependence on the properties of the ejecta. Furthermore, all configurations show a two-component behaviour for the polar structure of the jet, with a narrow core at large energies and Lorentz factors and a shallow segment at high latitudes from the jet axis. Hence, afterglows measured on off-axis lines of sight could be used to deduce the properties of the ejected matter, but also that the latter need to be properly accounted for when modelling the afterglow signal and the jet-launching mechanisms.

Inflammation in Myocardial Ischemia/Reperfusion Injury: Underlying Mechanisms and Therapeutic Potential.

Acute myocardial infarction (MI) occurs when blood flow to the myocardium is restricted, leading to cardiac damage and massive loss of viable cardiomyocytes. Timely restoration of coronary flow is considered the gold standard treatment for MI patients and limits infarct size; however, this intervention, known as reperfusion, initiates a complex pathological process that somewhat paradoxically also contributes to cardiac injury. Despite being a sterile environment, ischemia/reperfusion (I/R) injury triggers inflammation, which contributes to infarct expansion and subsequent cardiac remodeling and wound healing. The immune response is comprised of subsets of both myeloid and lymphoid-derived cells that act in concert to modulate the pathogenesis and resolution of I/R injury. Multiple mechanisms, including altered metabolic status, regulate immune cell activation and function in the setting of acute MI, yet our understanding remains incomplete. While numerous studies demonstrated cardiac benefit following strategies that target inflammation in preclinical models, therapeutic attempts to mitigate I/R injury in patients were less successful. Therefore, further investigation leveraging emerging technologies is needed to better characterize this intricate inflammatory response and elucidate its influence on cardiac injury and the progression to heart failure.

Gelatinase-responsive biodegradable targeted microneedle patch for abscess wound treatment of S. aureus infection

Abscess wound caused by bacterial infection is usually difficult to heal, thus greatly affect people's quality of life. In this study, a biodegradable drug-loaded microneedle patch (MN) is designed for targeted eradication of S. aureus infection and repair of abscess wound. Firstly, the bacterial responsive composite nanoparticle (Ce6@GNP-Van) with a size of about 182.6 nm is constructed by loading the photosensitizer Ce6 into gelatin nanoparticle (GNP) and coupling vancomycin (Van), which can specifically target S. aureus and effectively shield the phototoxicity of photosensitizer during delivery. When Ce6@GNP-Van is targeted and enriched in the infected regions, the gelatinase secreted by the bacteria can degrade GNP in situ and release Ce6, which can kill the bacteria by generating ROS under laser irradiation. In vivo experiments show that the microneedle is basically degraded in 10 min after inserting into skin, and the abscess wound is completely healed within 13 d after applying Ce6@GNP-Van-loaded MN patch to the abscess wound of the bacterial infected mice with laser irradiation, which can simultaneously achieve the eradication of biofilm and subsequent wound healing cascade activation, showing excellent synergistic antibacterial effect. In conclusion, this work establishes a synergistic treatment strategy to facilitate the repair of chronic abscess wound.

Wound-triggered shape change microgels for the development of enhanced biomimetic function platelet-like particles.

Platelets play a pivotal role in hemostasis and wound healing and conditional shape change is an important component of platelet functionality. In normal circumstances, platelets travel through the circulatory system in an inactive rounded state, which enables platelets to easily move to vessel walls for attachment. When an injury occurs, platelets are prompted by molecules, such as thrombin, to shift into a stellate shape and increase exposure of fibrin-binding receptors. When active, platelets promote hemostasis and clot retraction, which enhances clot stability and promotes healing. However, in conditions where platelets are depleted or hyporeactive, these functions are diminished and lead to inhibited hemostasis and healing. To treat platelet depletion, our group developed platelet-like particles (PLPs) which consist of highly deformable microgels coupled to fibrin binding motif. However, first generation PLPs do not exhibit wound-triggered shape change like native platelets. Thus, the objective of these studies was to develop a PLP formulation that changes shape when prompted by thrombin. To create thrombin-sensitive PLPs (TS-PLPs), we incorporated a thrombin-cleavable peptide into the microgel body and then evaluated PLP properties before and after exposure to thrombin including morphology, size, and in vitro clot retraction. Once thrombin-prompted shape change ability was confirmed, the TS-PLPs were tested in vivo for hemostatic ability and subsequent wound healing outcomes in a murine liver trauma model. We found that TS-PLPs exhibit a wound-triggered shape change, induce significant clot retraction following exposure to thrombin and promote hemostasis and healing in vivo after trauma.