Wound Repair and Regeneration最新文献

{"title":"Residual diabetic foot osteomyelitis after surgery leads to poor clinical outcomes: A systematic review and meta-analysis.","authors":"Mario C Reyes, Mehmet A Suludere, Arthur N Tarricone, Tehreem Sajjad, Tyler L Coye, Matthew J Sideman, Lawrence A Lavery","doi":"10.1111/wrr.13215","DOIUrl":"10.1111/wrr.13215","url":null,"abstract":"<p><p>The aim of this meta-analysis is to compare the clinical outcomes in patients with and without residual osteomyelitis (ROM) after surgical bone resection for diabetic foot osteomyelitis (DFO). We completed a systematic literature search using PubMed, Scopus, and Embase using keywords DFO, Residual OM (ROM), and positive bone margins. The study outcomes included wound healing, antibiotic duration, amputation, and re-infection. Five hundred and thirty patients were included in the analysis; 319 had no residual osteomyelitis (NROM), and 211 had ROM. There was not a significant difference in the proportion of wounds that healed 0.6 (p = 0.1, 95% confidence intervals [95% CI] 0.3-1.3). The risk of infection was 2.0 times higher (OR = 2.0, p = 0.02, 95% CI 1.1-3.4), and the risk of amputation was 4.3 times higher (OR = 4.3, p = 0.0001, 95% CI 2.4-7.6) in patients with ROM. Patients with ROM received antibiotics significantly longer. The mean difference was 16.3 days (p = 0.02, 95% CI 11.1-21.1).</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"872-879"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of biofilm and microbial metrics with healing rate in older adults with chronic venous leg ulcers.","authors":"Philip S Stewart, Junglyun Kim, Garth James, Fan Yi, Joyce Stechmiller, Michael Weaver, Debra L Kelly, Steve Fisher, Gregory Schultz, Debra Lyon","doi":"10.1111/wrr.13230","DOIUrl":"10.1111/wrr.13230","url":null,"abstract":"<p><p>The presence of microbial biofilms in many human chronic wounds led to the hypothesis that biofilms delay healing of these wounds. We tested this hypothesis in a population of 117 older individuals with venous leg ulcers who were receiving standardised therapy, including frequent debridement. Debridement specimens were analysed for the amount of bacterial biomass by two independent methods: a microscopic approach that scored the relative size and number of bacterial aggregates, interpreted as a biofilm metric, and conventional enumeration by agar plating for viable bacteria. The plating protocol yielded three distinct values: the total viable bacterial count, bleach-tolerant bacteria, and the log reduction in viable bacteria upon bleach treatment. Wound healing rates over an 8-week observation period were calculated as the rate of decrease of the equivalent diameter of the wound. There was no statistically significant association between wound healing and the biofilm metric in any of the three analyses performed (p ≥0.15). In all three statistical tests, wound healing was associated with the log reduction caused by bleach treatment (p ≤0.004); wounds that harboured bacteria that were more bleach-susceptible healed more slowly. A refinement of the model of chronic wound infection pathogenesis is proposed in which dormant bacteria constitute a persistent nidus and outgrowth of metabolically active cells impairs healing. This model constitutes a new hypothesis as metabolic activity was not directly measured in this investigation.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"858-871"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11585430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin metabolism in obesity: A narrative review.","authors":"Rubya Pereira Zaccaron, Carolini Mendes, Camila da Costa, Paulo Cesar Lock Silveira, Gislaine Tezza Rezin","doi":"10.1111/wrr.13223","DOIUrl":"10.1111/wrr.13223","url":null,"abstract":"<p><p>Obesity is a complex multifactorial disease in which excess body fat triggers negative health effects. Systemically, obesity causes several changes, such as inflammation, oxidative stress, mitochondrial dysfunction and apoptosis; factors linked to the slow and incomplete epithelial regenerative process. Specifically, in the integumentary system, obesity causes an expansion of the skin's surface area and changes in collagen deposition. Molecular underpinnings of why obesity delays wound healing are still poorly understood. In addition to the primary role of dermal adipocytes in lipid storage and heat insulation, they also promote skin immunity, wound healing and hair follicle cycling. As a consequence of the cellular and dysfunctional adaptations of adipocytes, inflammatory immune alterations, alteration in the expression of proteins genes associated with the blood supply, altered collagen formation through fibroblast senescence and excessive degradation of extracellular matrix proteins are metabolic characteristics of the system in obesity that contribute to sustained inflammation and decreased mechanical resistance of the skin.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"1022-1027"},"PeriodicalIF":3.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single‐cell RNA‐seq in diabetic foot ulcer wound healing","authors":"Yan Dong, Mengting Wang, Qianqian Wang, Xiaoliang Cao, Peng Chen, Zhenhua Gong","doi":"10.1111/wrr.13218","DOIUrl":"https://doi.org/10.1111/wrr.13218","url":null,"abstract":"Diabetic foot ulcer (DFU) is a chronic and serious complication of diabetes mellitus. It is mainly caused by hyperglycaemia, diabetic peripheral vasculopathy and diabetic peripheral neuropathy. These conditions result in ulceration of foot tissues and chronic wounds. If left untreated, DFU can lead to amputation or even endanger the patient's life. Single‐cell RNA sequencing (scRNA‐seq) is a technique used to identify and characterise transcriptional subpopulations at the single‐cell level. It provides insight into cellular function and the molecular drivers of disease. The objective of this paper is to examine the subpopulations, genes and molecules of cells associated with chronic wounds of diabetic foot by using scRNA‐seq. The paper aims to explore the wound‐healing mechanism of DFU from three aspects: inflammation, angiogenesis and extracellular matrix remodelling. The goal is to gain a better understanding of the mechanism of DFU wound healing and identify possible DFU therapeutic targets, providing new insights for the application of DFU personalised therapy.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the role of wound debridement in pyoderma gangrenosum—A retrospective cohort study","authors":"Danielle Bar, Ilia Beberashvili","doi":"10.1111/wrr.13219","DOIUrl":"https://doi.org/10.1111/wrr.13219","url":null,"abstract":"The role of wound debridement in pyoderma gangrenosum (PG) is controversial, largely due to concerns regarding pathergy. This study sought to evaluate the clinical outcomes and utility of wound debridement in PG management. We conducted a retrospective cohort study of 104 patients diagnosed with PG at a single tertiary referral centre, stratified into two treatment groups: those receiving debridement in conjunction with immunosuppressive therapy (<jats:italic>n</jats:italic> = 38) and those treated with immunosuppression alone (control group, <jats:italic>n</jats:italic> = 66). The primary outcomes measured were remission (absence of active PG lesions without necessitating additional treatment), time to remission and disease progression (new lesions or expansion of existing ones). Remission was achieved by 60.53% (<jats:italic>n</jats:italic> = 23) in the debridement group versus 87.88% (<jats:italic>n</jats:italic> = 58) in the control group (<jats:italic>p</jats:italic> = 0.003). The mean time to remission was 12.3 months for the debridement group versus 8.67 months for the control group (<jats:italic>p</jats:italic> = 0.2). Multivariate Cox regression analysis indicated that debridement significantly decreased the likelihood of disease remission (adjusted hazards ratio [HR]: 0.45, 95% confidence interval [CI]: 0.26–0.78, <jats:italic>p</jats:italic> = 0.005). Disease progression was significantly higher in the debridement group (68.42%, <jats:italic>n</jats:italic> = 26) compared to the control group (15.15%, <jats:italic>n</jats:italic> = 10) (<jats:italic>p</jats:italic> &lt; 0.001). Additionally, 28.95% (<jats:italic>n</jats:italic> = 11) of patients in the debridement group required repeated procedures, and 10.53% (<jats:italic>n</jats:italic> = 4) underwent amputations due to deteriorating conditions. The timing and duration of immunosuppressive therapy relative to the procedure did not mitigate the risk of post‐surgical exacerbations. These findings suggest that debridement is associated with poorer healing outcomes in PG, advocating for its contraindication in the management of this condition.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"393 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A double-blinded randomised control study to compare the effectiveness and safety of intralesional vitamin D3 with intralesional triamcinolone and its correlation with tissue expression of vitamin D receptors in patients with keloid.","authors":"Aman Goyal,Hitaishi Mehta,Tarun Narang,Keshavamurthy Vinay,Seema Chhabra,Shilpa,Hitaishi Kaushik,Manjot Kaur,Naresh Sachdeva,Sunil Dogra","doi":"10.1111/wrr.13209","DOIUrl":"https://doi.org/10.1111/wrr.13209","url":null,"abstract":"Intralesional steroids commonly used for keloid treatment have adverse effects like cutaneous atrophy and telangiectasias. Safer and more effective therapies are needed. Preliminary studies suggest intralesional vitamin D as a potential alternative treatment. The aim of this study was to compare efficacy and safety of intralesional vitamin D with triamcinolone for keloids, and correlate tissue expression of vitamin D receptors (VDRs) with treatment outcomes. Sixty patients were randomly assigned to two groups: Group A (intralesional vitamin D) and Group B (intralesional triamcinolone). Four injections were given at 4-week intervals, with an 8-week follow-up. Biopsies were taken pre- and post-treatment to examine VDR expression levels and treatment response correlation. The primary outcome of interest was the proportion of patients achieving a 50% reduction in Vancouver Scar Scale (VSS). Secondary outcomes included incidence of adverse effects, and changes in VDR expression before and after treatment. Baseline VSS scores were 9.73 ± 1.01 (vitamin D group) and 10.13 ± 1.07 (triamcinolone group). After treatment, mean VSS decreased to 5.17 ± 0.59 (vitamin D group, p < 0.001) and 4.77 ± 0.77 (triamcinolone group, p < 0.001), with significantly better response in latter (p = 0.03). More than 50% reduction in VSS score was higher in the triamcinolone group (76.7% vs. 50%, p = 0.032). No recurrences were noted during the 8-week follow-up. Hypopigmentation (80% vs. 36.7%, p < 0.001) and atrophy (73.3% vs. 40%, p = 0.009) were more common in the triamcinolone group. No significant difference in pre- and post-treatment VDR receptor expression was observed in either group. Both triamcinolone acetonide and vitamin D were effective for keloids. Triamcinolone was more efficacious, whereas vitamin D was safer, suggesting it as a viable alternative for keloid management.","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":"94 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142188542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial/ethnic disparities in chronic wounds: Perspectives on linking upstream factors to health outcomes.","authors":"Jacqueline Cavalcante-Silva, Giamila Fantuzzi, Richard Minshall, Stephanie Wu, Vanessa M Oddo, Timothy J Koh","doi":"10.1111/wrr.13200","DOIUrl":"10.1111/wrr.13200","url":null,"abstract":"<p><p>This review explores the complex relationship between social determinants of health and the biology of chronic wounds associated with diabetes mellitus, with an emphasis on racial/ethnic disparities. Chronic wounds pose significant healthcare challenges, often leading to severe complications for millions of people in the United States, and disproportionally affect African American, Hispanic, and Native American individuals. Social determinants of health, including economic stability, access to healthcare, education, and environmental conditions, likely influence stress, weathering, and nutrition, collectively shaping vulnerability to chronic diseases, such as obesity and DM, and an elevated risk of chronic wounds and subsequent lower extremity amputations. Here, we review these issues and discuss the urgent need for further research focusing on understanding the mechanisms underlying racial/ethnic disparities in chronic wounds, particularly social deprivation, weathering, and nutrition, to inform interventions to address these disparities.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"770-779"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound Healing Society 2023 update on guidelines for arterial ulcers.","authors":"Daniel G Federman, Alan Dardik, Dag Shapshak, Cristiane M Ueno, Loren Masterson, Harriet W Hopf, Newaj Abdullah, Scott Junkins, Eliot N Mostow","doi":"10.1111/wrr.13204","DOIUrl":"10.1111/wrr.13204","url":null,"abstract":"<p><p>The Wound Healing Society guidelines for the treatment of arterial insufficiency ulcers were originally published in 2006, with the last update in 2014. These guidelines provided recommendations, along with their respective levels of evidence, on seven categories: diagnosis, surgery, infection control, wound bed preparation, dressings, adjuvant therapy and long-term maintenance. Over the last 9 years, additional literature regarding these aspects of arterial ulcer management has been published. An advisory panel comprised of academicians, clinicians and researchers was chosen to update the 2014 guidelines. Members included vascular surgeons, internists, plastic surgeons, anaesthesiologists, emergency medicine physicians and dermatologists, all with expertise in wound healing. The goal of this article is to evaluate relevant new findings upon which an updated version of the guidelines will be based.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"619-629"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring exudate viscosity: A rheological analysis of wound exudates.","authors":"Gianluca Melotto, Avick Sinha, Jaqueline Rachel Forss","doi":"10.1111/wrr.13213","DOIUrl":"10.1111/wrr.13213","url":null,"abstract":"<p><p>Exudate and its viscosity are critical in wound healing. Changes in viscosity can interfere with dressings properties as well as affect the diffusion of immune cells, nutrients, oxygen and bacteria. Current international standards for laboratory testing of wound dressings use a single low-viscosity solution, named as 'Test Solution A', which fails to simulate the diverse range of exudates encountered clinically. This study employs rheological analysis to characterise exudates viscosity, comparing cattle-derived samples to the test solution A. Results reveal non-Newtonian, shear-thinning behaviour in exudates, contrasting with the Newtonian behaviour of the test solution A. Although clinically classified as 'seropurulent', three exudate samples analysed at 37°C present with different viscosity at various shear rates, ranging from 30.8 (±14.7) to 6.5 (±1.9) mPas. Findings show that the current tests on dressings employing Test Solution A are missing the complexity of real exudates.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"671-674"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photoactivated rose bengal mitigates a fibrotic phenotype and improves cutaneous wound healing in full-thickness injuries.","authors":"Jayson W Jay, Alen Palackic, Anesh Prasai, Quincy Seigel, Raima Siddiqui, Isabelle Bergman, Steven E Wolf, Michael G Wilkerson, Amina El Ayadi","doi":"10.1111/wrr.13202","DOIUrl":"10.1111/wrr.13202","url":null,"abstract":"<p><p>Healing of deep cutaneous wounds often results in detrimental sequelae, including painful and debilitating scars. Current therapies for full-thickness injuries that target specific phases of wound healing have moderate success; however, full resolution remains incomplete and negative consequences persist if skin homeostasis is not achieved. Photoactivated molecules can modulate cellular responses by generating reactive oxygen species and may provide a novel therapeutic option to improve wound healing. In the current study, we investigated the effects of Rose bengal (RB) dye in a preclinical model of full-thickness cutaneous injury. Monochromatic green light activates RB to generate ROS in the presence of oxygen, subsequently crosslinking collagen fibrils. In in vitro studies, we show that photoactivated RB is well tolerated by epidermal keratinocytes and dermal fibroblasts and can mitigate fibrotic signalling by downregulating collagen production. In a murine model of full-thickness injury, topically-applied and photoactivated RB closed wounds faster than control and vehicle treatments and showed significantly improved wound healing outcomes, including enhanced early granulation, better collagen organisation and increased vascularity in the presence of protracted tissue ROS. These data support an overall improved cutaneous wound healing profile after RB phototherapy and warrant further investigations into this versatile molecule.</p>","PeriodicalId":23864,"journal":{"name":"Wound Repair and Regeneration","volume":" ","pages":"758-769"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}