Advances in wound care最新文献

{"title":"Bridging the Gap: Contemporary Paradigms in Nerve Scaffolds and Regeneration.","authors":"Charles D Hwang, Seamus P Caragher, Rebekah J Bihun, Kyle R Eberlin","doi":"10.1089/wound.2024.0074","DOIUrl":"https://doi.org/10.1089/wound.2024.0074","url":null,"abstract":"<p><p>Peripheral nerve injuries, especially those with complete transection of major nerves, create significant morbidity including debilitating pain, loss of protective haptic feedback, and impaired volitional control of musculature. The societal burden and cost of medical care for these injuries are enormous, with estimates in the United States alone in excess of $670 million per year. In clinical scenarios with a segmental nerve gap where end-to-end coaptation without tension is not possible, a \"bridge\" or scaffold must be interposed to facilitate communication between the proximal and distal stumps to facilitate organized growth following Wallerian degeneration. A multitude of constructs have been created and studied to facilitate this regeneration. Among the three overall types of bridge employed in contemporary clinical care-conduit/scaffold, allograft, and autograft-each has significant downsides ranging from limited successful nerve ingrowth to donor site morbidity. Despite the tremendous work over the last 150 years in nerve biology and medical technology for the treatment of peripheral nerve injury, the biological processes governing nerve regeneration remain incompletely understood. Especially in cases of long segmental gaps, there remains room for significant improvement. Ongoing studies have identified several promising modalities for nerve scaffolds to facilitate more efficient and effective neuronal outgrowth but still require further investigation. Here, we review contemporary paradigms in the treatment of segmental nerve injuries with interposing scaffolds and reexamine nerve physiology, regulatory programs in nerve regeneration, and strategic targets for neurogenic pathways that may facilitate novel treatment modalities.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603315","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":"Flexible Pressure Sensors for Optimizing Pressure Garment Therapy in Periarticular Scar Treatment: Preclinical and Clinical Applications.","authors":"Jia Xu, Yaxin Xue, Wei Xu, Xin Li, Weijie Su, Jiajun Fan, Yanhong Ma, Dong Han","doi":"10.1089/wound.2024.0139","DOIUrl":"https://doi.org/10.1089/wound.2024.0139","url":null,"abstract":"<p><p><b>Objective:</b> Pressure garment therapy is a common strategy for controlling hypertrophic scars; however, insufficient pressure due to reduced elasticity or joint movement limits its effectiveness around joints. The FlexiForce B201 pressure sensor offers precise pressure measurements, thereby demonstrating a promising solution. <b>Approach:</b> This study used a Bama pig scar model with an untreated group, a pressure garment group, and a pressure monitoring group that was treated with FlexiForce B201 sensors and pressure garments. The therapeutic effects were recorded over 1 month. The clinical research followed the Consolidated Standards of Reporting Trials and was registered as ChiCTR2200064173. Eighty-two patients with peri-joint hypertrophic scars were enrolled. Forty-one patients were randomly assigned to the control group and received conventional pressure garment therapy, whereas the remaining 41 patients were included in the monitoring group. Treatment outcomes were tracked at 3 months and 6 months. <b>Results:</b> The Bama pig scar model demonstrated reduced scar hypertrophy in the monitoring group. In the clinical study, the scar thickness in the monitoring group was 47.76% of the initial thickness after 6 months, thereby representing an additional 11.33% reduction compared to the control group. The Vancouver Scar Scale score of the monitoring group (6.44 ± 1.62) was significantly better than that of the control group (7.33 ± 1.53). <b>Innovation:</b> The FlexiForce B201 pressure sensor is soft and flexible. It provides accurate pressure measurements within the pressure garment and guides physicians in adjusting the pressure distribution. <b>Conclusion:</b> This study revealed that pressure monitoring technology enhances the effectiveness of pressure garments.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603392","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":"Using Three-Dimensional Bioprinting to Generate Realistic Models of Wound Healing.","authors":"Giselle Y Díaz, Victor A da Silva, Farnoosh Kalantarnia, Kali Scheck, Silken A Tschofen, Stephen W Tuffs, Stephanie M Willerth","doi":"10.1089/wound.2024.0138","DOIUrl":"https://doi.org/10.1089/wound.2024.0138","url":null,"abstract":"<p><p><b>Significance:</b> The skin serves as the primary defense against external stimuli, making it vulnerable to damage. Injuries can cause a dysregulated environment, resulting in chronic inflammation and inhibition of cell proliferation and migration, which delays recovery. Innovative approaches, such as three-dimensional (3D) bioprinting, can foster a controlled healing environment by promoting synergy between the skin microbiome and cells. <b>Recent Advances:</b> Traditional approaches to wound healing have focused on fostering an environment conducive to the interplay between cells, extracellular proteins, and growth factors. 3D bioprinting, a manufacturing technology with applications in tissue engineering, deposits biomaterial-based bioink containing living cells to fabricate custom-designed tissue scaffolds in a layer-by-layer fashion. This process controls the architecture and composition of a construct, producing multilayered and complex structures such as skin. <b>Critical Issues:</b> The selection of biomaterials for scaffolds has been a challenge when 3D skin tissue engineering. While prioritizing mechanical properties, current biomaterials often lack the ability to interact with environmental stimuli such as pH, temperature, or oxygen levels. Employing smart biomaterials that integrate bioactive molecules and adapt to external conditions could overcome these limitations. This innovation would enable scaffolds to create a sustainable wound-healing environment, fostering microbiome balance, reducing inflammation, and facilitating cellular recovery and tissue restoration, addressing critical gaps in existing wound care solutions. <b>Future Directions:</b> Novel bioink formulations for skin injury recovery are focused on improving long-term cell viability, proliferation, vascularization, and immune integration. Efficient recovery of the skin microbiome using bioactive molecules has the potential to create microenriched environments that support the recovery of the skin microbiome and restore immune regulation. This promising direction for future research aims to improve patient outcomes in wound care.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555604","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":"Response to Astrada et al. re: \"A Novel Randomized Trial Protocol for Evaluating Wound Healing Interventions\".","authors":"Donna Clements, Keith Harding","doi":"10.1089/wound.2024.0042","DOIUrl":"10.1089/wound.2024.0042","url":null,"abstract":"","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"178-179"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929496","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":"Biomaterial-Based Regenerative Strategies for Volumetric Muscle Loss: Challenges and Solutions.","authors":"Charlene W Cai, Josh A Grey, Dirk Hubmacher, Woojin M Han","doi":"10.1089/wound.2024.0079","DOIUrl":"10.1089/wound.2024.0079","url":null,"abstract":"<p><p><b>Significance:</b> Volumetric muscle loss (VML) is caused by the loss of significant amounts of skeletal muscle tissue. VML cannot be repaired by intrinsic regenerative processes, resulting in permanent loss of muscle function and disability. Current rehabilitative-focused treatment strategies lack efficacy and do not restore muscle function, indicating the need for the development of effective regenerative strategies. <b>Recent Advances:</b> Recent developments implicate biomaterial-based approaches for promoting muscle repair and functional restoration post-VML. Specifically, bioscaffolds transplanted in the injury site have been utilized to mimic endogenous cues of the ablated tissue to promote myogenic pathways, increase neo-myofiber synthesis, and ultimately restore contractile function to the injured unit. <b>Critical Issues:</b> Despite the development and preclinical testing of various biomaterial-based regenerative strategies, effective therapies for patients are not available. The unique challenges posed for biomaterial-based treatments of VML injuries, including its scalability and clinical applicability beyond small-animal models, impede progress. Furthermore, production of tissue-engineered constructs is technically demanding, with reproducibility issues at scale and complexities in achieving vascularization and innervation of large constructs. <b>Future Directions:</b> Biomaterial-based regenerative strategies designed to comprehensively address the pathophysiology of VML are needed. Considerations for clinical translation, including scalability and regulatory compliance, should also be considered when developing such strategies. In addition, an integrated approach that combines regenerative and rehabilitative strategies is essential for ensuring functional improvement.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"159-175"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074901","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":"Extrusion-Based 3D Bioprinting of Bioactive and Piezoelectric Scaffolds as Potential Therapy for Treating Critical Soft Tissue Wounds.","authors":"Surendrasingh Y Sonaye, Smriti Bohara, Breanne L Welsh, Elif G Ertugral, Chandrasekhar R Kothapalli, Hanz Richter, Koyal Garg, Prabaha Sikder","doi":"10.1089/wound.2024.0073","DOIUrl":"10.1089/wound.2024.0073","url":null,"abstract":"<p><p><b>Objective:</b> This study focuses on developing bioactive piezoelectric scaffolds that could deliver bioelectrical cues to potentially treat injuries to soft tissues such as skeletal muscles and promote active regeneration. <b>Approach:</b> To address the underexplored aspect of bioelectrical cues in skeletal muscle tissue engineering (SMTE), we developed piezoelectric bioink based on natural bioactive materials such as sodium alginate, gelatin, and chitosan. Extrusion-based 3D bioprinting was utilized to develop scaffolds that mimic muscle stiffness and generate electrical stimulation (E-stim) when subjected to forces. The biocompatibility of these scaffolds was tested with the C2C12 muscle cell line. <b>Results:</b> The bioink demonstrated suitable rheological properties for 3D bioprinting, resulting in high-resolution composite sodium alginate-gelatin-chitosan scaffolds with good structural fidelity. The scaffolds exhibited a 42-60 kPa stiffness, similar to muscle. When a controlled force of 5N was applied to the scaffolds at a constant frequency of 4 Hz, they generated electrical fields and impulses (charge), indicating their suitability as a stand-alone scaffold to generate E-stim and instill bioelectrical cues in the wound region. The cell viability and proliferation test results confirm the scaffold's biocompatibility with C2C12s and the benefit of piezoelectricity in promoting muscle cell growth kinetics. Our study indicates that our piezoelectric bioink and scaffolds offer promise as autonomous E-stim-generating regenerative therapy for SMTE. <b>Innovation:</b> A novel approach for treating skeletal muscle wounds was introduced by developing a bioactive electroactive scaffold capable of autonomously generating E-stim without stimulators and electrodes. This scaffold offers a unique approach to enhancing skeletal muscle regeneration through bioelectric cues, addressing a major gap in the SMTE, that is, fibrotic tissue formation due to delayed muscle regeneration. <b>Conclusion:</b> A piezoelectric scaffold was developed, providing a promising solution for promoting skeletal muscle regeneration. This development can potentially address skeletal muscle injuries and offers a unique approach to facilitating skeletal muscle wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"143-158"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603146","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":"Re: \"A Novel Randomized Trial Protocol for Evaluating Wound Healing Interventions\" by Bull <i>et al.</i>","authors":"Adam Astrada, Budi Mulyana, Ratna Dewi","doi":"10.1089/wound.2024.0001","DOIUrl":"10.1089/wound.2024.0001","url":null,"abstract":"","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"176-177"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929495","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":"Prediction Models for Intraoperative Acquired Pressure Injury of Adults: A Systematic Review and Critical Appraisal.","authors":"Yihong Xu, Han Zhao, Shuang Wu, Jianan Wang, Jinyan Zhou, Shanni Ding, Wen Li, Wenjin Wu, Zhichao Yang, Hongxia Xu, Hongying Pan","doi":"10.1089/wound.2024.0238","DOIUrl":"https://doi.org/10.1089/wound.2024.0238","url":null,"abstract":"<p><p><b>Significance:</b> Postoperative Pressure Injuries (PIs) present unique risks, requiring dedicated research for accurate assessment. Despite the increasing number of Intraoperative Acquired Pressure Injury (IAPI) prediction models, their risk of bias and clinical applicability remains unclear. <b>Recent Advances:</b> Adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement requirements, IAPI prediction models of adult inpatients (≥18 years) were systematically retrieved from eight databases. Bias risk and applicability were evaluated using the Prediction model Risk Of Bias Assessment Tool (PROBAST), followed by narrative synthesis. <b>Critical Issues:</b> From 837 studies, 25 were included, covering 32 prediction models. Most studies (88%) were single-center and conducted in China, Korea, the United States, or Singapore, spanning various surgical specialties. Among 26,142 participants, IAPI incidence ranged from 4.1% to 41.75%. Common predictors included surgery duration, age, and diabetes. Areas Under the Curve (AUC) values varied from 0.702 to 0.984, but calibration was underreported. All studies had high bias risk, with 22 models exhibiting applicability concerns. <b>Future Directions:</b> The development of IAPI models requires a clear definition of the timing and personnel responsible for assessing PIs, with a preference for prospective data collection and thorough internal and external validation. Adherence to the critical appraisal and data extraction for systematic reviews of prediction modeling studies checklist and PROBAST guidelines can improve reporting quality. Models should be user-friendly, clinically applicable, and rigorously validated. Precisely defining and rigorously selecting predictors is critical to reducing variability. Future research should adopt more stringent designs to develop high-quality models capable of effectively guiding clinical practice. PROSPERO registration number: CRD42024502726.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490365","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":"An Open-Label, Interventional, Prospective, Real-World Evidence Study to Evaluate a Multimodal Wound Matrix in Patients with Refractory Wounds.","authors":"Yadwinder Dhillon, Gerit Mulder, Keyur Patel, Luis Moya, Gerard Boghossian, David Swain, Robert McLafferty, Kelly Perez, Jessica Nguyen, Natalie Wilkinson, Jessica Arragon, Lillia Contreras, Donna Geiger, Ryan Cummings, Brenda LaVigne, Desmond Bell, Suzanne Bakewell","doi":"10.1089/wound.2024.0189","DOIUrl":"https://doi.org/10.1089/wound.2024.0189","url":null,"abstract":"<p><p><b>Objective:</b> The objective of this open-label, interventional, prospective clinical study was to evaluate the effectiveness of a multimodal wound matrix (MWM) in moving chronic, nonhealing wounds that had failed prior therapies onto a healing trajectory. The overall response rate was the proportion of subjects who had greater than 40% reduction in size after 4 weeks of treatment. Secondary objectives included the percentage area reduction (PAR) after 4 and 12 weeks, incidence of ulcer closing, and changes in quality of life. <b>Approach:</b> An open-label, interventional, prospective cohort, real-world evidence study was conducted following the STROBE criteria. Criteria included chronic nonhealing wounds of multiple etiologies in subjects with extensive comorbidities. Results were compared with data from the U.S. Wound Registry. <b>Results:</b> A total of 111 subjects entered the screening phase and 64 were treated. Fifty-three wounds were eligible for the dataset that included 18 diabetic foot ulcers, 19 venous leg ulcers, 2 pressure injuries, 1 surgical, 1 lower extremity wound, and 12 unclassified etiologies. The objective response rate was 42%. The 4-week PAR was 34%. The 12-week PAR was 66%. Eighteen wounds closed by week 12. <b>Innovation:</b> MWM is a formulation technology developed to address the major obstacles that prevent healing. Results were evaluated in a patient population with extensive comorbidities that had failed prior treatments and would be generally excluded from controlled trials. <b>Conclusion:</b> The results from this study support the contention that MWM achieves substantial clinical improvement in a complex patient population not enrolled in clinical trials and demonstrates an advancement in wound management.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143397756","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":"Prevalent Types of Peristomal Skin Damage During Chemoradiotherapy and Their Risk Factors.","authors":"Yi Chen, Yan Lu, LiJuan Zhang, LaiJuan Li","doi":"10.1089/wound.2023.0215","DOIUrl":"https://doi.org/10.1089/wound.2023.0215","url":null,"abstract":"<p><p><b>Significance:</b> Colorectal cancer is currently ranked third in terms of the global cancer incidence. Enterostomy, a common surgical procedure for colorectal cancer treatment, creates a temporary or permanent stoma in the abdominal wall for waste excretion. Cancer itself and the associated treatments, such as chemotherapy and radiation therapy, increase the likelihood of various types of peristomal skin damage. <b>Recent Advances:</b> Recent research has focused on developing more targeted treatment approaches for peristomal moisture-associated skin damage (P-MASD). In addition, studies are investigating the potential of novel wound care products and therapies to enhance healing and reduce the risk of complications. There is also growing interest in understanding the different types except P-MASD during chemoradiotherapy. Different types match the varied treatments. Thus, we aimed to comprehensively review the most prevalent types of peristomal skin damage during chemoradiotherapy and their associated risk factors. <b>Critical Issues:</b> The five prevalent types of peristomal skin damage that occur during chemoradiotherapy are peristomal radiodermatitis, P-MASD, peristomal acneiform rash, peristomal pyoderma gangrenosum, and peristomal abscess/infection/fistula. The risk factors vary depending on the type; however, they include the radiation dose, ileostomy surgery, chemoradiotherapy-associated diarrhea, use of epidermal growth factor receptor inhibitors, inflammatory bowel disease, and unclear factors. <b>Future Directions:</b> This review guides the clinical identification of peristomal skin damage during chemoradiotherapy, laying a solid foundation for developing effective strategies to prevent this condition.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254520","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}