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1.
The regional injection of connective tissue growth factor (CTGF) for diabetic wound healing requires multiple components and results in a substantial loss of its biological activity. Acellular dermal matrix (ADM) scaffolds are optimal candidates for delivering these factors to local ischaemic environments. In this study, we explored whether CTGF loaded on ADM scaffolds can enhance fibronectin (FN) expression to accelerate diabetic wound healing via the protein kinase C (PKC) signalling pathway. The performance of CTGF and CTGF + PKC inhibitor, which were loaded on ADM scaffolds to treat dorsal skin wounds in streptozotocin‐induced diabetic mice, was evaluated with naked ADM as a control. Wound closure showed that ADM scaffolds loaded with CTGF induced greater diabetic wound healing in the early stage of the wound in diabetic mice. Moreover, ADM scaffolds loaded with CTGF obviously increased the expression of FN both at the mRNA and protein levels, whereas the expression of FN was significantly reduced in the inhibitor group. Furthermore, the ADM + CTGF group, which produce FN, obviously promoted alpha‐smooth muscle actin and transforming growth factor‐beta expression and enhanced neovasculature and collagen synthesis at the wound sites. ADM scaffolds loaded with CTGF + PKC inhibitor delayed diabetic wound healing, indicating that FN expression was mediated by the PKC signalling pathway. Our findings offer new perspectives for the treatment of diabetic wound healing and suggest a rationale for the clinical evaluation of CTGF use in diabetic wound healing.  相似文献   

2.
Aim. The purpose of this study was to examine the efficacy of silver‐releasing dressings in the management of non‐healing chronic wounds. Background. Non‐healing chronic wounds often have a negative physical impact on patients and place a financial burden on healthcare systems. Silver dressings are wound products designed to control infection and provide a wound environment conducive to healing. However, validation of the clinical efficacy of these dressings is lacking. Design. Systematic review and meta‐analysis. Methods. A systematic search of the major electronic databases PubMed, CINAHL, Cochrane, MEDLINE, British Nursing Index, EBSCO, OCLC and Proquest between 1950–June 2007 was conducted. Hand searches of selected periodicals, textbooks and checking reference lists and contacting experts was also performed. Results. Eight studies were selected from a potentially relevant 1957 references screened. Analysis incorporated data from 1399 participants in the eight randomised control trials. We found that silver dressings significantly improved wound healing (CI95: 0·16–0·39, p < 0·001), reduced odour (CI95: 0·24–0·52, p < 0·001) and pain‐related symptoms (CI95: 0·18–0·47, p < 0·001), decreased wound exudates (CI95: 0·17–0·44, p < 0·001) and had a prolonged dressing wear time (CI95: 0·19–0·48, p = 0·028) when compared with alternative wound management approaches. An analysis of sensitivity in these studies by subgroup analysis generally supported these associations. Furthermore, studies indicated an improvement in quality of life (CI95: 0·04–0·33, p = 0·013) using silver dressings in wound management with no associated severe adverse events. Conclusion. This meta‐analysis confirms the effectiveness of silver dressings in wound healing and improving patients’ quality of life. However, it also highlights the need for additional well‐designed randomised controlled trials to evaluate the effectiveness of silver‐related dressings further. Relevance to clinical practice. The results of this study provide objective data on the effectiveness of silver‐related dressing when applied to non‐healing chronic wounds.  相似文献   

3.
Aims: Studies show that VEGF can promote tissue regeneration in diabetic wounds. The aim of this study was to evaluate the effects of a new composite biomaterial, a collagen scaffold with CBD‐VEGF, for wound healing in a diabetic rat model. Materials and methods: We produced a collagen scaffold loaded with CBD‐VEGF, which allowed VEGF to bind to the collagen scaffold. The diabetic rat model was constructed by injecting streptozocin (STZ) peritoneally and removing a 2 x 2.5 cm thick slice of skin from the back of the animal. Animals were randomly divided into 4 groups: blank control (BC Group, n = 24), collagen scaffold loaded with PBS (PBS Group, n = 24), collagen scaffold loaded with NAT‐VEGF (NAT‐VEGF Group, n = 24), and collagen scaffold loaded with CBD‐VEGF (CBD‐VEGF Group, n = 24). Wounds of the BC Group were covered with gauze and those of the PBS, NAT‐VEGF and CBD‐VEGF Groups were grafted by corresponding collagen scaffolds, respectively. Healing rates were calculated and compared among groups. Wound tissue was evaluated by histologic analysis. Results: The CBD‐VEGF group showed a higher wound healing rate, better vascularization and higher level of VEGF in the granulation tissue wound compared with NAT‐VEGF and PBS groups. Conclusions: The collagen scaffold with CBD‐VEGF promoted wound healing in a diabetic rat model, which could potentially provide better therapeutic options for the treatment of diabetic wounds. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   

4.
The absorption capacity of cotton dressings is a critical factor in their widespread use where they help absorb wound exudate. Cotton wax dressings, in contrast, are used for wounds where care is taken to avoid adhesion of dressings to sensitive wounds such as burn injuries. Accordingly, we explored the loading of 2‐deoxy‐D‐ribose (2dDR), a small sugar, which stimulates angiogenesis and wound healing in normal and diabetic rats, into both types of dressings and measured the release of it over several days. The results showed that approximately 90% of 2dDR was released between 3 and 5 days when loaded into cotton dressings. For wax‐coated cotton dressings, several methods of loading of 2dDR were explored. A strategy similar to the commercial wax coating methodology was found the best protocol which provided a sustained release over 5 days. Cytotoxicity analysis of 2dDR loaded cotton dressing showed that the dressing stimulated metabolic activity of fibroblasts over 7 days confirming the non‐toxic nature of this sugar‐loaded dressings. The results of the chick chorioallantoic membrane (CAM) assay demonstrated a strong angiogenic response to both 2dDR loaded cotton dressing and to 2dDR loaded cotton wax dressings. Both dressings were found to increase the number of newly formed blood vessels significantly when observed macroscopically and histologically. We conclude this study offers a simple approach to developing affordable wound dressings as both have the potential to be evaluated as pro‐active dressings to stimulate wound healing in wounds where management of exudate or prevention of adherence to the wounds are clinical requirements.  相似文献   

5.
Centella asiatica (CA) is a traditional herbal medicine that has been shown to exert pharmacological effects on wound healing. This study demonstrated that CA extract facilitates the wound‐repair process by promoting fibroblast proliferation and collagen synthesis and exhibits antibacterial activity. Gelatin nanofibres containing C. asiatica extract were fabricated via electrospinning and were shown to exhibit dermal wound‐healing activity in a rat model. The wound areas of rat skin treated with electrospun gelatin membranes containing C. asiatica (EGC) presented the highest recovery rate compared with those treated with gauze, neat gelatin membranes and commercial wound dressings. The results of the histopathological examination support the outcome of the wound models. Contact‐angle and water‐retention measurements confirmed that the addition of C. asiatica extract did not significantly affect the hydrophilicity of the EGC membranes. The measured weight loss revealed that the EGC membranes are biodegradable. The findings suggest that EGC membranes are a promising material for the treatment of skin wounds. Copyright © 2015 John Wiley & Sons, Ltd.  相似文献   

6.
背景:胶原已经被证实能够促进受损组织创面的修复,加速创面愈合。目的:观察凝胶型活性胶原敷料对糖尿病皮肤缺损愈合的影响,以及在促进毛细血管再生方面的作用。方法:取SD大鼠160只,其中40只为正常对照,另120只腹腔注射链脲佐菌素制作糖尿病模型。造模9周后将120只大鼠随机均分为模型组、阳性对照组、实验组,连同正常对照组在大鼠背部制作全层皮肤缺损创面,正常对照组和模型组创面外敷灭菌凡士林,实验组外敷凝胶型胶原敷料,阳性对照组外敷重组人表皮生长因子凝胶,观察各组创面愈合面积及毛细血管新生情况。结果与结论:给药第1周,除正常对照组动物愈合较快外,其余各组动物创面愈合速度差异不大;给药第2周,正常对照组愈合速度最快,阳性对照组、实验组创面未愈合面积小于模型组;给药第3周,正常对照组及实验组创面未愈合面积小于模型组和阳性对照组;给药第4周,正常对照组及阳性对照组未愈合面积小于模型组和实验组;并且实验组给药第2,3周的创面愈合效果好于阳性对照组。实验组给药第1,2,3周的毛细血管数均多于其余3组。结果表明凝胶型胶原敷料可促进糖尿病缺损创面愈合速度并提高愈合质量。  相似文献   

7.
As a potential alternative to currently available skin substitutes and wound dressings, we explored the use of bioactive scaffolds made of plant‐derived proteins. We hypothesized that ‘green’ materials, derived from renewable and biodegradable natural sources, may confer bioactive properties to enhance wound healing and tissue regeneration. We optimized and characterized fibrous scaffolds electrospun from soy protein isolate (SPI) with addition of 0.05% poly(ethylene oxide) (PEO) dissolved in 1,1,1,3,3,3‐hexafluoro‐2‐propanol, and from corn zein dissolved in glacial acetic acid. Fibrous mats electrospun from either of these plant proteins remained intact without further cross‐linking, possessing a skin‐like pliability. Soy‐derived scaffolds supported the adhesion and proliferation of cultured primary human dermal fibroblasts. Using targeted PCR arrays and qPCR validation, we found similar gene expression profiles of fibroblasts cultured for 2 and 24 h on SPI substrates and on collagen type I at both time points. On both substrates there was a pronounced time‐dependent upregulation of several genes related to ECM deposition remodelling, including MMP‐10, MMP‐1, collagen VII, integrin‐α2 and laminin‐β3, indicating that both plant‐ and animal‐derived materials induce similar responses from the cells after initial adhesion, degrading substrate proteins and depositing extracellular matrix in a ‘normal’ remodelling process. These results suggest that ‘green’ proteins, such as soy and zein, are promising as a platform for organotypic skin equivalent culture, as well as implantable scaffolds for skin regeneration. Future studies will determine specific mechanisms of their interaction with skin cells and their efficacy in wound‐healing applications. Copyright © 2012 John Wiley & Sons, Ltd.  相似文献   

8.
Wound healing is a complicated process that contains a number of overlapping and consecutive phases, disruption in each of which can cause chronic nonhealing wounds. In the current study, we investigated the effects of exosomes as paracrine factors released from menstrual blood‐derived mesenchymal stem cells (MenSCs) on wound‐healing process in diabetic mice. The exosomes were isolated from MenSCs conditioned media using ultracentrifugation and were characterized by scanning electron microscope and western blotting assay. A full thickness excisional wound was created on the dorsal skin of each streptozotocin‐induced diabetic mouse. The mice were divided into three groups as follows: phosphate buffered saline, exosomes, and MenSC groups. We found that MenSC‐derived exosomes can resolve inflammation via induced M1–M2 macrophage polarization. It was observed that exosomes enhance neoangiogenesis through vascular endothelial growth factor A upregulation. Re‐epithelialization accelerated in the exosome‐treated mice, most likely through NF‐κB p65 subunit upregulation and activation of the NF‐κB signaling pathway. The results demonstrated that exosomes possibly cause less scar formation through decreased Col1:Col3 ratio. These notable results showed that the MenSC‐derived exosomes effectively ameliorated cutaneous nonhealing wounds. We suggest that exosomes can be employed in regenerative medicine for skin repair in difficult‐to‐heal conditions such as diabetic foot ulcer.  相似文献   

9.
Aims and objectives. To study the material and nursing costs and outcome of wound care at home comparing two dressing groups (occlusive vs. gauze‐based) in surgical patients after hospital dismissal. Background. The large variety in dressing materials and lack of convincing evidence make the choice for optimum local wound care at home cumbersome. Occlusive wound dressings require a lower change frequency than gauze‐based dressings, which appears especially useful for homecare patients and could save costs. Methods. We investigated a consecutive series of 76 patients with wounds, included in a randomized trial comparing occlusive vs. gauze dressings. Daily dressing change frequency, consumption of dressing materials and need for district nursing visits were recorded until wound closure by means of diaries and at outpatient visits. Costs were expressed as means and 95% confidence intervals (CI) after calculation using non‐parametric bootstrapping. Results. Patient groups were similar regarding age, wound size and aetiology. Dressing change frequency in the occlusive group (median: 0·6/day) was significantly (p = 0·008) lower than in the gauze group (1·1/day). Mean daily material costs of modern dressings were €5·31 vs. €0·71 in the gauze group. Mean difference; €4·60 (95% CI, €2·68–€6·83) while daily total (material plus nursing) costs showed no difference between the groups; mean €2·86 (95% CI, €?6·50–€10·25). Wound healing in the gauze‐treated group tended to be quicker than in the occlusive dressing group (medians: 30 vs. 48 days, respectively; log‐rank p = 0·060). Conclusions. The use of occlusive dressings does not lead to a reduction in costs and wound healing time as compared with gauze dressings for surgical patients receiving wound care at home. Relevance to clinical practice. District nurses should reconsider using gauze‐based dressings, particularly in surgical patients with exudating wounds.  相似文献   

10.
Keratin is a cytoskeletal scaffolding protein essential for wound healing and tissue recovery. The aim of the study was to evaluate the potential role of insoluble fur keratin‐derived powder containing silver nanoparticles (FKDP‐AgNP) in the allogenic full‐thickness surgical skin wound model in diabetic mice. The scanning electron microscopy image evidenced that the keratin surface is covered by a single layer of silver nanoparticles. Data obtained from dynamic light scattering and micellar electrokinetic chromatography showed three fractions of silver nanoparticles with an average diameter of 130, 22.5, and 5 nm. Microbiologic results revealed that the designed insoluble FKDP‐AgNP dressing to some extent inhibit the growth of Escherichia coli and Staphylococcus aureus. In vitro assays showed that the FKDP‐AgNP dressing did not inhibit fibroblast growth or induce hemolysis. In vivo studies using a diabetic mice model confirmed biocompatible properties of the insoluble keratin dressings. FKDP‐AgNP significantly accelerated wound closure and epithelization at Days 5 and 8 (p < .05) when compared with controls. Histological examination of the inflammatory response documented that FKDP‐AgNP‐treated wounds contained predominantly macrophages, whereas their untreated variants showed mixed cell infiltrates rich in neutrophils. Wound inflammatory response based on macrophages favors tissue remodeling and healing. In conclusion, the investigated FKDP‐AgNP dressing consisting of an insoluble fraction of keratin, which is biocompatible, significantly accelerated wound healing in a diabetic mouse model.  相似文献   

11.
12.
More and more water-absorbing wound dressings have been studied since moist wound-healing treatment can effectively promote the healing of wounds. In this work, we introduce a novel method to produce improved wound dressings with high-water-absorbance. A high-water-absorbing calcium alginate (Ca-Alg) fibrous scaffold was fabricated simply by microfluidic spinning and centrifugal reprocessing. The structure and physical properties of the scaffold were characterized, and its water-absorbing, cytotoxicity properties and other applicability to wound dressings were comprehensively evaluated. Our results indicate that this material possesses high water-absorbing properties, is biocompatible, and has a 3D structure that mimics the extracellular matrix, while Ca-Alg fibers loaded with silver nanoparticles (AgNPs) exhibit broad-spectrum antibacterial activities; these properties meet the requirements for promoting the healing of chronic wounds and are widely applicable to wound dressings.

More and more water-absorbing wound dressings have been studied since moist wound-healing treatment can effectively promote the healing of wounds.  相似文献   

13.
Wound healing is a complex process that requires the intervention of cytoactive factors. The one‐time application of soluble factors to a wound bed does not maintain a steady, sufficient concentration. Here we investigated the benefits of anchoring a factor in a wound bed via a tether to endogenous collagen. We used a collagen‐mimetic peptide (CMP) as a pylon. The CMP binds to damaged but not intact collagen and thus localizes a pendant cytoactive factor in the regions of a wound bed that require intervention. As a model factor, we chose substance P, a peptide of the tachykinin family that promotes wound healing. Using splinted wounds in db/db mice, we found that the one‐time application of a CMP–substance P conjugate enhances wound healing compared to unconjugated substance P and other controls. Specifically, all 16 wounds treated with the conjugate closed more thoroughly and, did so with extensive re‐epithelialization and mitigated inflammatory activity. These data validate a simple and general strategy for re‐engineering wound beds by the integration of beneficial cytoactive factors. Copyright © 2014 John Wiley & Sons, Ltd.  相似文献   

14.
背景:各种材料以多种形式制成的创面敷料近年来发展迅速,复合应用或是制成凝胶、药膜的形式是目前研究和应用的热点。目的:评价不同敷料在创面的实验研究或者临床应用。方法:以"敷料;创面;实验;应用"为关键词,对维普数据库2002-01/2011-10的相关文章进行计算机检索,纳入与敷料和创面相关的随机对照实验类文章,排除重复研究或Meta分析类文章,对22篇文献研究的资料结果进行提取、分析。结果与结论:纳米银、聚维酮碘、壳聚糖、康复新等是用于实验动物创面的主要材料,分别与中空活性炭纤维、明胶海绵复合或是制成原位凝胶、药膜形式的材料,能最大程度地发挥抗感染、促进创面愈合的作用。壳聚糖、纳米银或者银离子、猪胶原纤维、生物光素、液超妥藻酸盐、痊愈妥等材料可用于临床患者创面,多是以复合或是制成水凝胶等形式,有利于发挥各自性能,更好地促进不同创面愈合。  相似文献   

15.
Four full-thickness skin wounds made in normal mice led to the significant increase in levels of nerve growth factor (NGF) in sera and in wounded skin tissues. Since sialoadenectomy before the wounds inhibited the rise in serum levels of NGF, the NGF may be released from the salivary gland into the blood stream after the wounds. In contrast, the fact that messenger RNA and protein of NGF were detected in newly formed epithelial cells at the edge of the wound and fibroblasts consistent with the granulation tissue produced in the wound space, suggests that NGF was also produced at the wounded skin site. Topical application of NGF into the wounds accelerated the rate of wound healing in normal mice and in healing-impaired diabetic KK/Ta mice. This clinical effect of NGF was evaluated by histological examination; the increases in the degree of reepithelialization, the thickness of the granulation tissue, and the density of extracellular matrix were observed. NGF also increased the breaking strength of healing linear wounds in normal and diabetic mice. These findings suggested that NGF immediately and constitutively released in response to cutaneous injury may contribute to wound healing through broader biological activities, and NGF improved the diabetic impaired response of wound healing.  相似文献   

16.
OBJECTIVE: The purpose of this study was to assess the feasibility of exposing wounds during low-level laser therapy (LLLT) by transillumination of the wound dressings. BACKGROUND DATA: LLLT has been associated with accelerated wound healing in chronic ulcers. The usual approach is to remove wound dressings prior to exposure and to treat three to five times weekly. Frequent change of wound dressings is time consuming and costly; it disrupts the healing process, increases the risk of wound infection, and may be traumatic for the patient. METHODS: A double integrating sphere setup was employed to quantify the diffuse transmittance and reflectance of various wound dressings. Differences in transmittance for large area sources and point sources were demonstrated through the use of a diode laser and an incoherent light source. RESULTS: There were a number of gels and membrane style wound dressings with diffuse transmittance of more than 50%. Hence, for these dressings the prescribed radiant exposure to the wound surface could be achieved by increasing the exposure duration, while maintaining reasonable overall treatment times. CONCLUSIONS: Although LLLT by transillumination of wound dressings is feasible for a variety of wound dressings without significant commitments in additional treatment time, the specific transmission of products not included in this study needs to be determined at the intended treatment wavelength. A transillumination approach may facilitate a faster rate of wound healing than LLLT applied to exposed wounds by reducing trauma and the risk of infection.  相似文献   

17.
Platelets are a recognised potent source of transforming growth factor‐β1 (TGFβ1), a cytokine known to promote wound healing and regeneration by stimulating dermal fibroblast proliferation and extracellular matrix deposition. Platelet lysate has been advocated as a novel personalised therapeutic to treat persistent wounds, although the precise platelet‐derived growth factors responsible for these beneficial effects have not been fully elucidated. The aim of this study was to investigate the specific role of platelet‐derived TGFβ1 in cutaneous wound healing. Using a transgenic mouse with a targeted deletion of TGFβ1 in megakaryocytes and platelets (TGFβ1fl/fl.PF4‐Cre), we show for the first time that platelet‐derived TGFβ1 contributes to epidermal and dermal thickening and cellular turnover after excisional skin wounding. In vitro studies demonstrate that human dermal fibroblasts stimulated with platelet lysate containing high levels of platelet‐derived TGFβ1 did not exhibit enhanced collagen deposition or proliferation, suggesting that platelet‐derived TGFβ1 is not a key promoter of these wound healing processes. Interestingly, human keratinocytes displayed enhanced TGFβ1‐driven proliferation in response to platelet lysate, reminiscent of our in vivo findings. In summary, our novel findings define and emphasise an important role of platelet‐derived TGFβ1 in epidermal remodelling and regeneration processes during cutaneous wound healing.  相似文献   

18.
The major challenges associated with skin regeneration can include hindered vascularization and an insufficient degree of epithelization. In view of the complexity of these processes and the control signals on which they depend, one possible solution to these limitations could be simulating normal skin development and wound repair via the exogenous delivery of multiple cytokines. Here, we report the use of keratinocyte growth factor (KGF or FGF‐7) and basic fibroblast growth factor (bFGF or FGF‐2) released chemically modified collagen membranes to facilitate skin wound healing. The results from in vitro studies confirmed that this system resulted in higher cellular proliferation and faster cell migration. After transplanting the biomaterial onto an excisional wound healing model, the dual growth factor group, compared with the single growth factor groups and empty control group, showed more highly developed vascular networks and organized epidermal regeneration in the wounds. As a consequence, this experimental group showed mature epidermal coverage. Overall, this novel approach of releasing growth factors from a collagen membrane opens new avenues for fulfilling unmet clinical needs for wound care.  相似文献   

19.
The gelatinases, matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9), have been implicated in different aspects of wound repair. However, little is known about MMP-2 and MMP-9 activity in animal models of impaired wound healing. We sought to compare serial gelatinase activities for 25 days after full-thickness excisional wounds in genetically diabetic healing-impaired mice and their nondiabetic non-healing-impaired littermates. Wound samples were frozen, homogenized, clarified by centrifugation, and analyzed on zymography gels, and MMP bands were quantitated relative to a conditioned media standard from HT-1080 cells. Gelatinase activity in both diabetic mice and nondiabetic mice increased after the mice were wounded. However, levels of latent gelatinases peaked earlier in the diabetic wounds, and there was more active MMP-2 and MMP-9 in the wounds of the diabetic mice than in the wounds of the nondiabetic mice. Because the higher gelatinase activity in the wounds of the diabetic mice was similar to the higher levels of gelatinase reported in difficult-to-heal wounds such as ulcers and burns, this diabetic mouse model may be useful for studies of these proteinases and their inhibitors in impaired wound healing.  相似文献   

20.
Complex skin wounds, such as chronic ulcers and deep burns, require lengthy treatments and cause extensive burdens on healthcare and the economy. Use of biomaterials and cell transplantation may improve traditional treatments and promote the healing of difficult‐to‐treat wounds. In this study, we investigated the use of recombinant human collagen III (rhCol‐III) gel as a delivery vehicle for cultured autologous skin cells (keratinocytes only or keratinocyte–fibroblast mixtures). We examined its effect on the healing of full‐thickness wounds in a porcine wound‐healing model. Two Landrace pigs were used for the study. Fourteen deep dermal wounds were created on the back of each pig with an 8 mm biopsy punch. Syringes containing acellular rhCol‐III gel (n = 8) or rhCol‐III gel with autologous keratinocytes (n = 8) or rhCol‐III gel with autologous keratinocytes and fibroblasts (n = 8) were applied into wounds. Untreated wounds were used as controls for the treatment groups (n = 4). We used rhCol‐III gel to manufacture a cell‐delivery syringe containing autologous skin cells. In a full‐thickness wound‐healing model, we observed that rhCol‐III gel enhances early granulation tissue formation. Interestingly, we found cell type‐dependent differences in the stability of rhCol‐III in vivo. Fibroblast‐containing gel was effectively removed from the wound, whereas gels without cells or with keratinocytes only remained intact. Our results demonstrate that the properties of rhCol‐III gel for skin cell transplantation can be significantly altered in a cell type‐dependent manner. Copyright © 2013 John Wiley & Sons, Ltd.  相似文献   

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