Advances in wound care最新文献

{"title":"Re: \"How Should Clinical Wound Care and Management Translate to Effective Engineering Standard Testing Requirements from Foam Dressings? Mapping the Existing Gaps and Needs\" by Gefen et al.","authors":"Jan Kottner, Michael Clark, Joyce M Black, William V Padula, Peter R Worsley","doi":"10.1089/wound.2022.0087","DOIUrl":"10.1089/wound.2022.0087","url":null,"abstract":"","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 10","pages":"601-602"},"PeriodicalIF":5.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9880745","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":"Vasoconstrictor Agent Administration as a Risk Factor for Pressure Injury Development in Intensive Care Unit Patients: A Systematic Review and Meta-Analysis.","authors":"Wen Tang,&nbsp;Ai-Ping Li,&nbsp;Wan-Qing Zhang,&nbsp;Shi-Qi Hu,&nbsp;Wang-Qin Shen,&nbsp;Hong-Lin Chen","doi":"10.1089/wound.2022.0081","DOIUrl":"10.1089/wound.2022.0081","url":null,"abstract":"<p><p><b>Significance:</b> Pressure injury (PI) is a common critical presentation in intensive care units (ICU) and is an important clinical concern in critical care settings. Some developing data support the vasoconstrictor agent administration as a potential risk factor; however, synthesis of available evidence has not been completed. <b>Recent Advances:</b> Comprehensive tactics were employed to search electronic databases PubMed, Web of Science, and Ovid Embase for data on vasoconstrictor agent administration associated with PI in ICU patients. Extraction was limited to studies that matched the inclusion criteria. The pooled odds ratio and 95% confidence intervals (95% CI) were calculated for dichotomous outcomes. <b>Critical Issues:</b> Twenty-six studies were included, involving 50,192 patients who matched the selection criteria. Around 5.8% of patients (2,523/43,210) got PI in total. PI occurred in 10.9% (1,496/13,675) of the vasoconstrictor agent administration population and 3.5% (1,027/29,503) of the drug-free population. The pooled unadjusted odds ratio was 2.83 (95% CI = 2.21-3.64, <i>p</i> < 0.001). The adjusted odds ratio was 1.83 (95% CI = 1.26-2.68, <i>p</i> = 0.002). Subgroup analysis and meta-regression found that the risk of PI did not vary with research design, time of occurrence, patient age, or male proportion. <b>Future Directions:</b> Vasoconstrictor agent administration raised the risk of PI in critical care patients by nearly twofold. More emphasis should be placed on the timely prevention of PI in patients receiving vasoconstrictor agent administration in the ICU.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 10","pages":"560-573"},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9887742","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":"Artificial Skin Therapies; Strategy for Product Development.","authors":"Nephelie Vaporidou,&nbsp;Federica Peroni,&nbsp;Anna Restelli,&nbsp;M Nauman Jalil,&nbsp;Julian F Dye","doi":"10.1089/wound.2022.0050","DOIUrl":"10.1089/wound.2022.0050","url":null,"abstract":"<p><p><b>Significance:</b> Tissue-engineered artificial skin for clinical reconstruction can be regarded as an established practice. Bi-layered skin equivalents are available as established allogenic or autologous therapy, and various acellular skin replacements can support tissue repair. Moreover, there is considerable commonality between the skin and other soft tissue reconstruction products. This article presents an attempt to create a comprehensive global landscape review of advanced replacement materials and associated strategies for skin and soft tissue reconstruction. <b>Recent Advances:</b> There has been rapid growth in the number of commercial and pre-commercial products over the past decade. In this survey, 263 base products for advanced skin therapy have been identified, across 8 therapeutic categories, giving over 350 products in total. The largest market is in the United States, followed by the E.U. zone. However, despite these advances, and the investment of resources in each product development, there are key issues concerning the clinical efficacy, cost-benefit of products, and clinical impact. Each therapeutic strategy has relative merits and limitations. <b>Critical Issues:</b> A critical consideration in developing and evaluating products is the therapeutic modality, associated regulatory processes, and the potential for clinical adoption geographically, determined by regulatory territory, intellectual property, and commercial distribution factors. The survey identifies an opportunity for developments that improve basic efficacy or cost-benefit. <b>Future Directions:</b> The economic pressures on health care systems, compounded by the demands of our increasingly ageing population, and the imperative to distribute effective health care, create an urgent global need for effective and affordable products.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 10","pages":"574-600"},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9887770","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":"Cerium Nitrate Stiffens <i>In Vitro</i> Skin Models and Reduces <i>Pseudomonas aeruginosa</i> Pathogenicity and Penetration Through Skin Models.","authors":"Shankar J Evani,&nbsp;Ping Chen,&nbsp;S L Rajasekhar Karna,&nbsp;Peter D'Arpa,&nbsp;Kai Leung","doi":"10.1089/wound.2022.0026","DOIUrl":"10.1089/wound.2022.0026","url":null,"abstract":"<p><p><b>Objective:</b> Cerium nitrate (CeN) plus silver sulfadiazine (SSD) cream has been used for 40-plus years to manage burns. CeN produces a hardened eschar believed to resist bacterial colonization/infection. To evaluate this potential mechanism, we treated <i>in vitro</i> skin models or <i>Pseudomonas aeruginosa</i> with CeN and measured mechanical properties of the models and bacterial virulence, respectively. <b>Approach:</b> We treated three-dimensional-collagen matrix and <i>ex-vivo</i>-burned porcine skin with CeN and evaluated stiffness and <i>P. aeruginosa</i> penetration. In addition, we treated <i>P. aeruginosa</i> with CeN and evaluated the bacteria's motility, skin model penetration, susceptibility to be phagocytized by the human monocytic cell line THP-1, and ability to stimulate this cell line to produce cytokines. <b>Results:</b> CeN treatment of skin models stiffened them and made them resistant to <i>P. aeruginosa</i> penetration. Inversely, CeN treatment of <i>P. aeruginosa</i> reduced their motility, penetration through skin models (<i>ex-vivo</i>-burned porcine skin), and ability to stimulate cytokine production (tumor necrosis factor-α [TNF-α] and interleukin 8 [IL-8]) by THP-1 cells. In addition, CeN-treated <i>Pseudomonas</i> was more readily phagocytized by THP-1 cells. Finally, <i>P. aeruginosa</i> inoculated on CeN-treated <i>ex-vivo</i>-burned porcine skin was more susceptible to killing by a silver dressing. <b>Innovation:</b> <i>In vitro</i> skin models offer a platform for screening drugs that interfere with bacterial penetration into wounded tissue. <b>Conclusion:</b> CeN treatment reduced <i>P. aeruginosa</i> virulence, altered the mechanical properties of <i>ex-vivo</i>-burned porcine skin and collagen matrix, retarded penetration of <i>P. aeruginosa</i> through the skin models, and resulted in increased vulnerability of <i>P. aeruginosa</i> to killing by antimicrobial wound dressings. These data support the use of CeN in burn management.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 10","pages":"546-559"},"PeriodicalIF":4.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9902160","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":"Adipose Tissue in Peripheral Obesity as an Assessment Factor for Pressure Ulcers.","authors":"Madhubari Vathulya,&nbsp;Debarati Chattopadhyay,&nbsp;Pankaj Kandwal,&nbsp;Uttam K Nath,&nbsp;Akshay Kapoor,&nbsp;Mithun Sinha","doi":"10.1089/wound.2020.1275","DOIUrl":"https://doi.org/10.1089/wound.2020.1275","url":null,"abstract":"<p><p><b>Scope and Significance:</b> Pressure ulcers are very difficult to treat and pose an economic burden, just below cancer and cardiovascular illness, at 4.82 billion U.S. dollars. It is important to understand the pathophysiology of the condition, risk stratification, and ways of preventing it. Prevention forms the most important aspect of their management. The authors systematically evaluated the existing risk prediction scales and explored the evidence from literature regarding the role of additional factors including body mass index, obesity, subcutaneous tissue thickness, and skin integrity in pressure ulcers. With this review it is hoped that the future management of pressure ulcers will concentrate on the preventable and alterable factors in its pathophysiology. <b>Translational Relevance:</b> The review focuses on how adipose tissue thickness can predict the occurrence of pressure ulcer. If adequately proved that a definite thickness of peripheral adipose tissue is efficient in prevention of pressure ulcers, then methods of maintaining the thickness of this tissue will be the next effective strategy in the management of this chronic issue. <b>Clinical Relevance:</b> The review addresses the management of pressure ulcers to wound care providers and emphasize on confounding parameters of obesity, subcutaneous tissue thickness, and skin integrity during the treatment regimen of pressure ulcers. <b>Objectives:</b> The main objective of this review is to draw a consensus concerning the role of adipose tissue in pressure ulcers, based on the published research. A review of the various preexisting predictive scales for pressure ulcers is a secondary objective to highlight the shortcomings in ulcer management. This review finally aims in the future at paving a way to refine our prognosticating scales for pressure sores based on these results. Accurate preventative injury risk scales are needed so that preventative resources can be directed to the patients for whom they are the most appropriate.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 9","pages":"513-528"},"PeriodicalIF":4.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9679198","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":"Pulse Capacitive Coupling Electric Field Regulates Cell Migration, Proliferation, Polarization, and Vascularization to Accelerate Wound Healing.","authors":"Ping Li,&nbsp;Junwei Xu,&nbsp;Qiusheng Shi,&nbsp;Jingxi Wang,&nbsp;Wenxin Zhang,&nbsp;Lisha Zheng,&nbsp;Ming Wang,&nbsp;Yubo Fan","doi":"10.1089/wound.2021.0194","DOIUrl":"https://doi.org/10.1089/wound.2021.0194","url":null,"abstract":"<p><p><b>Objectives:</b> Accelerating wound healing using continuous exogenous electrical stimulation is limited due to some serious side effects, including thermal damage. Many previous studies based on direct current contact stimulation may cause chemical burns or blisters, thereby increasing patients suffering. The aim of this study was to develop a safer and more convenient pulse capacitive coupling electrical field (PCCEF) stimulation to accelerate wound healing. <b>Approach:</b> A PCCEF-generating platform was self-designed to facilitate wound healing. The promoting effects and appropriate pulse width were explored by applying PCCEFs (54 mV/mm, 60 Hz) of different pulse widths to various cells involved in wound healing and mouse models for 2 h daily. <b>Results:</b> PCCEFs of ≥10 μs pulse width showed marked promotion of the migration and proliferation of human dermal fibroblasts and HaCaT cells, enhanced the M2-type polarization and YPA/TAZ expression of macrophages, and facilitated the wound healing of mouse models. Comprehensive histological results suggested that PCCEF of 100 μs pulse width exerted the most positive effects. <b>Innovation:</b> A safe and effective PCCEF was developed to promote wound healing, which prevented prolonged stimulation and averted direct contact. <b>Conclusion:</b> PCCEF accelerated wound healing, especially at the optimal 100 μs pulse width, and was expected to be translated to clinical application, helping alleviate patient suffering, while reducing side effects.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 9","pages":"498-512"},"PeriodicalIF":4.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9681555","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":"Electrospun Nanofiber-Based Drug Carrier to Manage Inflammation.","authors":"Gaurav Agrawal, Surabhi Aswath, Anindita Laha, Seeram Ramakrishna","doi":"10.1089/wound.2022.0043","DOIUrl":"10.1089/wound.2022.0043","url":null,"abstract":"<p><p><b>Significance:</b> Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most widely prescribed drugs to treat inflammation and related ailments. In recent years, loading these drugs onto nanodevices like nanoparticles, nanofibers, <i>etc.</i> as a drug delivery system has gained momentum due to its desirable properties and advantages. The purpose of this review is to examine the existing research on the potential and novel use of nanofiber-assisted delivery of NSAIDs. <b>Recent Advances:</b> Electrospun nanofibers have recently garnered considerable attention from researchers in a variety of sectors. They have proved to be promising vehicles for drug delivery systems because of their exceptional and favorable features like prolonged drug release, controllable porosity, and high surface area. In this article, various polymers and even combinations of polymers loaded with single or multiple drugs were analyzed to achieve the desired drug release rates (burst, sustained, and biphasic) from the electrospun nanofibers. <b>Critical Issues:</b> The administration of these medications can induce major adverse effects, causing patients discomfort. Thus, encapsulating these drugs within electrospun nanofibers helps to reduce the severity of side effects while also providing additional benefits such as targeted and controlled drug release, reduced toxicity, and long-lasting effects of the drug with lower amounts of administration. <b>Future Directions:</b> This review covers previous research on the delivery of NSAIDs using electrospun nanofibers as the matrix. Also, this study intends to aid in the development of enhanced drug delivery systems for the treatment of inflammation and related issues.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 9","pages":"529-543"},"PeriodicalIF":4.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10038070","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":"Modulation of Lymphangiogenesis in Incisional Murine Diabetic Wound Healing Using Negative Pressure Wound Therapy.","authors":"Mengfan Wu,&nbsp;Dany Y Matar,&nbsp;Zhen Yu,&nbsp;Ziyu Chen,&nbsp;Samuel Knoedler,&nbsp;Brian Ng,&nbsp;Oliver Darwish,&nbsp;Valentin Haug,&nbsp;Leigh Friedman,&nbsp;Dennis Paul Orgill,&nbsp;Adriana Panayi","doi":"10.1089/wound.2022.0074","DOIUrl":"https://doi.org/10.1089/wound.2022.0074","url":null,"abstract":"<p><p><b>Objective:</b> Despite the significant function of lymphatics in wound healing, and frequent clinical use of Negative Pressure Wound Therapy (NPWT), the effect of mechanical force application on lymphangiogenesis remains to be elucidated. We utilize a murine incisional wound healing model to assess the mechanisms of lymphangiogenesis following NPWT. <b>Approach:</b> Dorsal incisional skin wounds were created on diabetic mice (genetically obese leptin receptor-deficient mice [db/db]; <i>n</i> = 30) and covered with an occlusive dressing (Control, <i>n</i> = 15) or NPWT (-125 mmHg, continuous, 24 h for 7 days; NPWT, <i>n</i> = 15). The wounds were macroscopically assessed for 28 days. Tissue was harvested on day 10 for analysis. Qualitative functional analysis of lymphatic drainage was performed on day 28 using Evans Blue staining (<i>n</i> = 2). <b>Results:</b> NPWT increased lymphatic vessel density (40 ± 20 vs. 12 ± 6 podoplanin [PDPN]⁺ and 25 ± 9 vs. 14 ± 8 lymphatic vessel endothelial receptor 1 [LYVE-1]⁺) and vessel diameter (28 ± 9 vs. 12 ± 2 μm). Western blotting verified the upregulation of LYVE-1 with NPWT. Leukocyte presence was higher with NPWT (22% ± 3.7% vs. 9.1% ± 4.1% lymphocyte common antigen [CD45]⁺) and the leukocytes were predominately B cells clustered within vessels (8.8% ± 2.5% vs. 18% ± 3.6% B-lymphocyte antigen CD20 [CD20]⁺). Macrophage presence was lower in the NPWT group. Lymphatic drainage was increased in the NPWT group, which exhibited greater Evans Blue positivity. <b>Innovation:</b> The lymphangiogenic effects take place independent of macrophage infiltration, appearing to correlate with B cell presence. <b>Conclusion:</b> NPWT promotes lymphangiogenesis in incisional wounds, significantly increasing the lymph vessel density and diameter. This study highlights the potential of NPWT to stimulate lymphatic drainage and wound healing of surgical incisions.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 9","pages":"483-497"},"PeriodicalIF":4.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9672810","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":"Novel Topical Esmolol Hydrochloride (Galnobax) for Diabetic Foot Wound: Phase 1/2, Multicenter, Randomized, Double-Blind, Vehicle-Controlled Parallel-Group Study.","authors":"Ashu Rastogi,&nbsp;Sudhir A Kulkarni,&nbsp;Supreet K Deshpande,&nbsp;Vickie Driver,&nbsp;Hemanga Barman,&nbsp;Arun Bal,&nbsp;Manisha Deshmukh,&nbsp;Harikrishna Nair","doi":"10.1089/wound.2022.0093","DOIUrl":"https://doi.org/10.1089/wound.2022.0093","url":null,"abstract":"<p><p>We aimed to assess safety and dose-finding efficacy of esmolol hydrochloride (Galnobax) for healing of diabetic foot ulcer (DFU). This is phase 1/2 multicenter, randomized, double-blind vehicle-controlled study. Participants having diabetes and noninfected, full-thickness, neuropathic, grade I or II (Wagner classification) DFU, area 1.5-10 cm², and unresponsive to standard wound care (at least 4 weeks) were randomized to receive topical Galnobax 14% twice daily (BID), Galnobax 20% BID, Galnobax 20% once daily (OD)+vehicle, or vehicle BID with standard of care. The primary efficacy end point was the reduction in area and volume of target ulcer from baseline to week 12 or wound closure, whichever was earlier. The wound duration was 12.5 weeks (5-49.1 weeks) and wound area 4.10 ± 2.41 cm² at baseline. The ulcer area reduction was 86.56%, 95.80%, 80.67%, and 82.58% (<i>p</i> = 0.47) in the Galnobax 14%, Galnobax 20%, Galnobax20%+vehicle, and vehicle only groups, respectively. Ulcer volume reduction was 99.40% in the Galnobax14%, 83.36% in Galnobax20%, 55.41% in the Galnobax20%+vehicle, and 84.57% in vehicle group (<i>p</i> = 0.86). The systemic concentration of esmolol was below the quantification limit (10 ng/mL) irrespective of doses of Galnobax (C_max esmolol acid 340 ng/mL for 14% Galnobax, AUC 2.99 ± 4.31 h*μg/mL after single dose). This is the first clinical study of the short acting beta blocker esmolol hydrochloride used as novel formulation for healing of DFU. We found that esmolol when applied topically over wounds had minimal systemic concentration establishing its safety for wound healing in patients with diabetes. Esmolol hydrochloride is a safe novel treatment for DFU.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 8","pages":"429-439"},"PeriodicalIF":4.9,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9523859","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":"Methods and Limitations of Augmenting Mesenchymal Stem Cells for Therapeutic Applications.","authors":"Carlos Theodore Huerta, Yulexi Y Ortiz, Zhao-Jun Liu, Omaida C Velazquez","doi":"10.1089/wound.2022.0107","DOIUrl":"10.1089/wound.2022.0107","url":null,"abstract":"<p><p><b>Significance:</b> Given their capacity for self-renewal, multilineage differentiation, and immunomodulatory potential, mesenchymal stem cells (MSCs) represent a promising modality of clinical therapy for both regenerative medicine and immune diseases. In this study, we review the key approaches and popular methods utilized to boost potency and modify functions of MSCs for clinical purposes as well as their associated limitations. <b>Recent Advances:</b> Several major domains of cell modification strategies are currently employed by investigators to overcome these deficits and augment the therapeutic potential of MSCs. Priming MSCs with soluble factors or pharmacologic agents as well as manipulating oxygen availability in culture have been demonstrated to be effective biochemical methods to augment MSC potential. Distinct genetic and epigenetic methods have emerged in recent years to modify the genetic expression of target proteins and factors thereby modulating MSCs capacity for differentiation, migration, and proliferation. Physical methods utilizing three-dimensional culture methods and alternative cell delivery systems and scaffolds can be used to recapitulate the native MSC niche and augment their engraftment and viability for <i>in vivo</i> models. <b>Critical Issues:</b> Unmodified MSCs have demonstrated only modest benefits in many preclinical and clinical studies due to issues with cell engraftment, viability, heterogeneity, and immunocompatibility between donor and recipient. Furthermore, unmodified MSCs can have low inherent therapeutic potential for which intensive research over the past few decades has been dedicated to improving cell functionality and potency.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"12 8","pages":"467-481"},"PeriodicalIF":5.8,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10254976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594625","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}