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Sample records for nanofibres diabetic wound

  1. Effect of novel blend nanofibrous scaffolds on diabetic wounds healing.

    Science.gov (United States)

    Gholipour-Kanani, Adeleh; Bahrami, S Hajir; Rabbani, Shahram

    2016-02-01

    Chitosan-poly (vinyl alcohol) (Cs: PVA) (2:3) and poly (caprolactone)-chitosan-poly (vinyl alcohol) (PCL: Cs: PVA) (2:1:1.5) nanofibrous blend scaffolds were fabricated using the electrospinning technique in the authors' previous studies. The results of the previous studies confirmed the high biological properties of the scaffolds and their ability in healing of burn and excision wounds on rat model. In the present study, the biological scaffolds were applied on diabetic dorsum skin wounds and diabetic foot wound on rat models (n = 16). Macroscopic and microscopic investigations were carried out using digital images and haematoxylin and eosin (H&E) staining respectively, to measure the wound areas and to track wound healing rate. It was found that at all time points the areas of wounds treated with nanofibrous scaffolds were smaller compared with the controls. Pathological results showed much better healing efficacy for the test samples compared with the control ones. Pathological investigations proved the presence of more pronounced granulation tissues in the scaffold-treated wounds compared with the control ones. At 20 days post excision, the scaffold-treated groups achieved complete repair. The results indicated that Cs: PVA and PCL: Cs: PVA nanofibrous webs could be considered to be promising materials for burn, excision and diabetic wounds healing.

  2. Electrospinning strategies of drug-incorporated nanofibrous mats for wound recovery.

    Science.gov (United States)

    Choi, Ji Suk; Kim, Hye Sung; Yoo, Hyuk Sang

    2015-04-01

    Electrospun nanofibrous mats have recently been employed as drug reservoirs for their unique features, such as high surface-to-volume ratios and easy fabrication process. We describe herein various methods of fabricating drug- and gene-encapsulated nanofibrous meshes, which can be prepared by electrospinning. The electrospinning process of nanofibrous mats is affected by many parameters, including viscosity and ejection speeds of the polymeric solutions and the electrical potential applied to the system. Both single- and dual-nozzle systems are widely employed in the preparation of electrospun nanofibers encapsulating drugs and genes, which are usually incorporated into the electrospun mats either by physical mixing with polymeric solutions before electrospinning or by physical incorporation after electrospinning. Various strategies have been tailored to maintain the bioactivity of proteins for tissue regeneration before and after electrospinning. Nucleic acids, such as DNA and siRNA, are also incorporated into nanofibrous meshes to enhance tissue regeneration by expressing transgenes or silencing domestic genes in specific tissues. Drug- or gene-incorporated nanofibrous meshes can greatly increase tissue regeneration rates and reduce scar formation in normal and diabetic wounds. Hybrid nanofibers, with multiple cell layers or hydrogels, have also been used to improve wound healing efficiency by increasing cell infiltration.

  3. Novel bilayer wound dressing based on electrospun gelatin/keratin nanofibrous mats for skin wound repair.

    Science.gov (United States)

    Yao, Chun-Hsu; Lee, Chia-Yu; Huang, Chiung-Hua; Chen, Yueh-Sheng; Chen, Kuo-Yu

    2017-10-01

    A bilayer membrane (GKU) with a commercial polyurethane wound dressing as an outer layer and electrospun gelatin/keratin nanofibrous mat as an inner layer was fabricated as a novel wound dressing. Scanning electron micrographs showed that gelatin/keratin nanofibers had a uniform morphology and bead-free structure with average fiber diameter of 160.4nm. 3-(4,5-Dimethylthiazolyl)-2,5-diphenyltetrazolium bromide assay using L929 fibroblast cells indicated that the residues released from the gelatin/keratin composite nanofibrous mat accelerated cell proliferation. Cell attachment experiments revealed that adhered cells spread better and migrated deeper into the gelatin/keratin nanofibrous mat than that into the gelatin nanofibrous mat. In animal studies, compared with the bilayer membrane without keratin, gauze and commercial wound dressing, Comfeel®, GKU membrane gave much more number of blood vessels and a greater reduction in wound area at 4days, and better wound repair at 14days with a thicker epidermis and larger number of newly formed hair follicles. GKU membrane, thus, could be a good candidate for wound dressing applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Diabetes and Wound Angiogenesis

    Science.gov (United States)

    Okonkwo, Uzoagu A.; DiPietro, Luisa A.

    2017-01-01

    Diabetes Mellitus Type II (DM2) is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes. PMID:28671607

  5. The Feasibility of a Handheld Electrospinning Device for the Application of Nanofibrous Wound Dressings.

    Science.gov (United States)

    Haik, Josef; Kornhaber, Rachel; Blal, Biader; Harats, Moti

    2017-05-01

    Objectives: The aim of this study was to determine the feasibility of a portable electrospinning device for the application of wound dressings. Approach: Four polymer nanofibers dressings were applied on superficial partial thickness wounds to a porcine model and compared with a traditional paraffin tulle gras dressing. The polymer nanofibrous dressings were applied using a handheld portable electrospinning device activated at a short distance from the wound. The partial thickness donor sites were evaluated on day 2, 7, and 14 when dressings were removed and tissue samples were taken for histological examination. Results: No significant difference was detected between the different electrospun nanofibrous dressings and traditional paraffin tulle gras. Desirable characteristics of the electrospun nanofiber dressing group included nontouch technique, ease of application, adherence and reduction in wound edema and inflammation. There was no delayed wound healing or signs of infection reported in both the electrospun nanofiber and traditional tulle gras dressings. Innovation: Used on partial thickness wounds, polymer electrospun nanofiber dressings provide excellent surface topography and are a nontouch, feasible, and safe method to promote wound healing with the potential to reduce wound infections. Such custom-made nanofibrous dressings have implications for the reduction of pain and trauma, number of dressing changes, scarring, and an added cost benefit. Conclusion: We have demonstrated that this portable handheld electrospinning device can be utilized for different formulations and materials and customized according to the characteristics of the target wound at the various stages of wound healing.

  6. Novel nanofibrous dressings containing rhEGF and Aloe vera for wound healing applications.

    Science.gov (United States)

    Garcia-Orue, Itxaso; Gainza, Garazi; Gutierrez, Franciso Borja; Aguirre, Jose Javier; Evora, Carmen; Pedraz, Jose Luis; Hernandez, Rosa Maria; Delgado, Araceli; Igartua, Manoli

    2017-05-25

    Nanofibrous membranes produced by electrospinning possess a large surface area-to-volume ratio, which mimics the three-dimensional structure of the extracellular matrix. Thus, nanofibrous dressings are a promising alternative for chronic wound healing, since they can replace the natural ECM until it is repaired. Therefore, in this study we have developed a PLGA nanofibrous membrane that contains recombinant human Epidermal Growth Factor (rhEGF) and Aloe vera (AV) extract. Both of them promote wound healing, as EGF is a wound healing mediator and AV stimulates the proliferation and activity of fibroblast. The obtained membranes were composed of uniform and randomly oriented fibers with an average diameter of 356.03±112.05nm, they presented a porosity of 87.92±11.96% and the amount of rhEGF was 9.76±1.75μg/mg. The in vitro viability assay demonstrated that the membranes containing rhEGF and AV improved fibroblast proliferation, revealing the beneficial effect of the combination. Furthermore, these membranes accelerated significantly wound closure and reepithelisation in an in vivo full thickness wound healing assay carried out in db/db mice. Overall, these findings demonstrated the potential of PLGA nanofibers containing rhEGF and AV for the treatment of chronic wounds. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Modern wound care application in diabetic wound management

    OpenAIRE

    . Rohmayanti; Estrin Handayani

    2017-01-01

    Diabetes mellitus is a group of metabolic disease which facilitates diabetic wound foot. To prevent long diabetic wound complication and worse condition it is needed wound care for diabetic patient. Modern bandage has been used for recent wound care technique. The principles of modern wound care product are maintaining and watching over the humid environment of the wound to facilitate the wound healing process, maintaining liquid tissue deprivation and cell decease. This research was aimed to...

  8. Soluplus Graft Copolymer: Potential Novel Carrier Polymer in Electrospinning of Nanofibrous Drug Delivery Systems for Wound Therapy

    Science.gov (United States)

    Tamm, Ingrid; Laidmäe, Ivo; Lust, Andres; Kirsimäe, Kalle

    2014-01-01

    Electrospinning is an effective method in preparing polymeric nanofibrous drug delivery systems (DDSs) for topical wound healing and skin burn therapy applications. The aim of the present study was to investigate a new synthetic graft copolymer (Soluplus) as a hydrophilic carrier polymer in electrospinning of nanofibrous DDSs. Soluplus (polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer (PCL-PVAc-PEG)) was applied in the nonwoven nanomats loaded with piroxicam (PRX) as a poorly water-soluble drug. Raman spectroscopy, X-ray powder diffraction, differential scanning calorimetry, and scanning electron microscopy (SEM) were used in the physical characterization of nanofibrous DDSs. According to the SEM results, the drug-loaded PCL-PVAc-PEG nanofibers were circular in cross-section with an average diameter ranging from 500 nm up to 2 µm. Electrospinning stabilized the amorphous state of PRX. In addition, consistent and sustained-release profile was achieved with the present nanofibrous DDSs at the physiologically relevant temperature and pH applicable in wound healing therapy. In conclusion, electrospinning can be used to prepare nanofibrous DDSs of PCL-PVAc-PEG graft copolymer (Soluplus) and to stabilize the amorphous state of a poorly water-soluble PRX. The use of this synthetic graft copolymer can open new options to formulate nanofibrous DDSs for wound healing. PMID:24575414

  9. An Overview on Application of Natural Substances Incorporated with Electrospun Nanofibrous Scaffolds to Development of Innovative Wound Dressings.

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    Pilehvar-Soltanahmadi, Younes; Dadashpour, Mehdi; Mohajeri, Abbas; Fattahi, Amir; Sheervalilou, Roghayeh; Zarghami, Nosratollah

    2018-02-14

    Conventional dressings are cost-effective and highly absorbent, but not effectual enough to promote hemostasis, adherence and in holding a moist wound bed. Thanks to the developments in the field of nanotechnology and bioengineering, one of the promising current trends is to move progress of innovative wound dressings, merging the application of traditional healing agents and modern products/ practices, such as hydrocolloids, hydrogels, films and nanofibers. This review surveys on potentials of electrospun nanofibrous mats for wound dressing applications. Furthermore, loading of bioactive molecules and therapeutic agents into the nanofibrous mats especially natural compounds with the aim of fabrication novel bioactive electrospun nanofibrous mats for skin substitutes and wound dressings are discussed. Systematic literature search was conducted to review all recent progress toward the potential of natural substances incorporated with electrospun nanofibrous scaffolds for wound dressing applications. The electrospun nanofibers webs can provide the essential parameters require for wound dressing to heal wounds including absorptivity, oxygen permeability, and non-adherence to the healing tissue, barrier to bacteria, bioactivity and occlusivity. The modern wound dressings materials made of electrospun nanofibers contain various traditional healing agents such as plant derived compounds could be beneficial to the healing of wounds. Natural substances have been used in skin wound care for many years because of their therapeutic properties, including antimicrobial, antioxidant, anti-inflammatory and mitogenic activities. A screening of natural substances with plant or animal sources having high wound healer activities and cooperating with electrospun nanofiber are an important step toward producing innovative bioactive wound dressings. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Wound-healing effect of electrospun gelatin nanofibres containing Centella asiatica extract in a rat model.

    Science.gov (United States)

    Yao, Chun-Hsu; Yeh, Jen-Yu; Chen, Yueh-Sheng; Li, Ming-Hsien; Huang, Chiung-Hua

    2017-03-01

    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. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Tibial microdissection for diabetic wounds.

    Science.gov (United States)

    Alexandrescu, V; Vincent, G; Ngongang, C; Ledent, G; Hubermont, G

    2012-02-01

    Few data are available focusing on controlled blunt microdissection during below-the-knee interventions as sole or synchronous technique coupled to subintimal angioplasty, particularly in the management of diabetic critical-ischemic foot wounds. We present two cases of targeted recanalizations in the tibial and pedal trunks for plantar and forefoot diabetic ischemic tissue defects, following an angiosome-model for perfusion.

  12. Advanced nanofibrous textile-based dressing material for treating ...

    Indian Academy of Sciences (India)

    In the present work, an electrospun nanofibrous textile composed of polyurethane (PU), sodium bicarbonate(NaHCO3) and pantothenic acid (PA) is developed for treating chronic wounds. Wounds are a common health problemand in particular, the chronic wounds such as vascular ulcers, diabetic ulcers and pressure ...

  13. Light-activated nanofibre textiles exert antibacterial effects in the setting of chronic wound healing.

    Science.gov (United States)

    Arenbergerova, Monika; Arenberger, Petr; Bednar, Marek; Kubat, Pavel; Mosinger, Jiri

    2012-08-01

    The maintenance of an aseptic environment for chronic wounds is one of the most challenging tasks in the wound-healing process. Furthermore, the emergence of antibiotic-resistant bacterial strains is on the rise, rendering conventional treatments less effective. A new antibacterial material consisting of a polyurethane Tecophilic(™) nanofibre textile (NT) that was prepared by electrospinning and doped by a tetraphenylporphyrin (TPP) photosensitizer activated by visible light was tested for use in wound beds and bandages. In vitro experiments were performed to assess the antibacterial activity of the textile against three bacterial strains. Furthermore, the new textile was tested in 162 patients with chronic leg ulcers. A complete inhibition of in vitro growth of the three tested bacterial strains was observed on the surface of NTs that had been illuminated with visible light and was clinically demonstrated in 89 patients with leg ulcers. The application of the textiles resulted in a 35% decrease in wound size, as assessed via computer-aided wound tracing. Wound-related pain, which was estimated using a visual analogue scale, was reduced by 71%. The results of this trial reveal that the photoinactivation of bacteria through the photosensitized generation of short-lived, highly reactive singlet oxygen O(2) ((1) Δ(g) ) results in relatively superficial antibacterial effects in comparison with standard antiseptic treatment options. Thus, such treatment does not interfere with the normal healing process. This method therefore represents a suitable alternative to the use of topical antibiotics and antiseptics and demonstrates potentially broad applications in medicine. © 2012 John Wiley & Sons A/S.

  14. Diabetic Wound Care

    Science.gov (United States)

    ... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... Tightly controlling blood glucose is of the utmost importance during the treatment of a diabetic foot ulcer. ...

  15. Gelatin/chondroitin sulfate nanofibrous scaffolds for stimulation of wound healing: In-vitro and in-vivo study.

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    Pezeshki-Modaress, Mohamad; Mirzadeh, Hamid; Zandi, Mojgan; Rajabi-Zeleti, Sareh; Sodeifi, Niloofar; Aghdami, Nasser; Mofrad, Mohammad R K

    2017-07-01

    In this research, fabrication of gelatin/chondroitin sulfate (GAG) nanofibrous scaffolds using electrospinning technique for skin tissue engineering was studied. The influence of GAG content on chemical, physical, mechanical and biological properties of the scaffolds were investigated. Human dermal fibroblast (HDF) cells were cultured and bioactivity of electrospun gelatin/GAG scaffolds for skin tissue engineering was assayed. Biological results illustrated that HDF cells attached and spread well on gelatin/GAG nanofibrous scaffolds displaying spindle-like shapes and stretching. MTS assay was performed to evaluate the cell proliferation on electrospun gelatin/GAG scaffolds. The results confirmed the influence of GAG content as well as the nanofibrous structure on cell proliferation and attachment of substrates. The gelatin/GAG nanofibrous scaffolds with the desired thickness for in-vivo evaluations were used on the full-thickness wounds. Pathobiological results showed that cell loaded gelatin/GAG scaffolds significantly accelerated wounds healing. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 2020-2034, 2017. © 2017 Wiley Periodicals, Inc.

  16. Preclinical Evaluation of Tegaderm™ Supported Nanofibrous Wound Matrix Dressing on Porcine Wound Healing Model.

    Science.gov (United States)

    Ong, Chee Tian; Zhang, Yanzhong; Lim, Raymond; Samsonraj, Rebekah; Masilamani, Jeyakumar; Phan, Tran Hong Ha; Ramakrishna, Seeram; Lim, Ivor; Kee, Irene; Fahamy, Mohammad; Templonuevo, Vilma; Lim, Chwee Teck; Phan, Toan Thang

    2015-02-01

    Objective: Nanofibers for tissue scaffolding and wound dressings hold great potential in realizing enhanced healing of wounds in comparison with conventional counterparts. Previously, we demonstrated good fibroblast adherence and growth on a newly developed scaffold, Tegaderm™-Nanofiber (TG-NF), made from poly ɛ-caprolactone (PCL)/gelatin nanofibers electrospun onto Tegaderm (TG). The purpose of this study is to evaluate the performance and safety of TG-NF dressings in partial-thickness wound in a pig healing model. Approach: To evaluate the rate of reepithelialization, control TG, human dermal fibroblast-seeded TG-NF(+) and -unseeded TG-NF(-) were randomly dressed onto 80 partial-thickness burns created on four female and four male pigs. Wound inspections and dressings were done after burns on day 7, 14, 21, and 28. On day 28, full-thickness biopsies were taken for histopathological evaluation by Masson-Trichrome staining for collagen and hematoxylin-eosin staining for cell counting. Results: No infection and severe inflammation were recorded. Wounds treated with TG-NF(+) reepithelialized significantly faster than TG-NF(-) and control. Wound site inflammatory responses to study groups were similar as total cell counts on granulation tissues show no significant differences. Most of the wounds completely reepithelialized by day 28, except for two wounds in control and TG-NF(-). A higher collagen coverage was also recorded in the granulation tissues treated with TG-NF(+). Innovation and Conclusion: With better reepithelialization achieved by TG-NF(+) and similar rates of wound closure by TG-NF(-) and control, and the absence of elevated inflammatory responses to TG-NF constructs, TG-NF constructs are safe and demonstrated good healing potentials that are comparable to Tegaderm.

  17. Combination therapy accelerates diabetic wound closure.

    Directory of Open Access Journals (Sweden)

    Robert J Allen

    Full Text Available Non-healing foot ulcers are the most common cause of non-traumatic amputation and hospitalization amongst diabetics in the developed world. Impaired wound neovascularization perpetuates a cycle of dysfunctional tissue repair and regeneration. Evidence implicates defective mobilization of marrow-derived progenitor cells (PCs as a fundamental cause of impaired diabetic neovascularization. Currently, there are no FDA-approved therapies to address this defect. Here we report an endogenous PC strategy to improve diabetic wound neovascularization and closure through a combination therapy of AMD3100, which mobilizes marrow-derived PCs by competitively binding to the cell surface CXCR4 receptor, and PDGF-BB, which is a protein known to enhance cell growth, progenitor cell migration and angiogenesis.Wounded mice were assigned to 1 of 5 experimental arms (n = 8/arm: saline treated wild-type, saline treated diabetic, AMD3100 treated diabetic, PDGF-BB treated diabetic, and AMD3100/PDGF-BB treated diabetic. Circulating PC number and wound vascularity were analyzed for each group (n = 8/group. Cellular function was assessed in the presence of AMD3100. Using a validated preclinical model of type II diabetic wound healing, we show that AMD3100 therapy (10 mg/kg; i.p. daily alone can rescue diabetes-specific defects in PC mobilization, but cannot restore normal wound neovascularization. Through further investigation, we demonstrate an acquired trafficking-defect within AMD3100-treated diabetic PCs that can be rescued by PDGF-BB (2 μg; topical supplementation within the wound environment. Finally, we determine that combination therapy restores diabetic wound neovascularization and accelerates time to wound closure by 40%.Combination AMD3100 and PDGF-BB therapy synergistically improves BM PC mobilization and trafficking, resulting in significantly improved diabetic wound closure and neovascularization. The success of this endogenous, cell-based strategy to

  18. Lidocaine/ketorolac-loaded biodegradable nanofibrous anti-adhesive membranes that offer sustained pain relief for surgical wounds.

    Science.gov (United States)

    Kao, Ching-Wei; Lee, Demei; Wu, Min-Hsuan; Chen, Jan-Kan; He, Hong-Lin; Liu, Shih-Jung

    2017-01-01

    The aim of this study was to develop and evaluate the effectiveness of biodegradable nanofibrous lidocaine/ketorolac-loaded anti-adhesion membranes to sustainably release analgesics on abdominal surgical wounds. The analgesic-eluting membranes with two polymer-to-drug ratios (6:1 and 4:1) were produced via an electrospinning technique. A high-performance liquid chromatography (HPLC) assay was employed to characterize the in vivo and in vitro release behaviors of the pharmaceuticals from the membranes. It was found that all biodegradable anti-adhesion nanofibers released effective concentrations of lidocaine and ketorolac for over 20 days post surgery. In addition, a transverse laparotomy was setup in a rat model for an in vivo assessment of activity of postoperative recovery. No tissue adhesion was observed at 2 weeks post surgery, demonstrating the potential anti-adhesion capability of the drug-eluting nanofibrous membrane. The postoperative activities were recorded for two groups of rats as follows: rats that did not have any membrane implanted (group A) and rats that had the analgesic-eluting membrane implanted (group B). Rats in group B exhibited faster recovery times than those in group A with regard to postoperative activities, confirming the pain relief effectiveness of the lidocaine- and ketorolac-loaded nanofibrous membranes. The experimental results suggested that the anti-adhesion nanofibrous membranes with sustainable elution of lidocaine and ketorolac are adequately effective and durable for the purposes of postoperative pain relief in rats.

  19. Electrospun Chitosan/Polyethylene Oxide Nanofibrous Scaffolds with Potential Antibacterial Wound Dressing Applications

    Directory of Open Access Journals (Sweden)

    Tony T. Yuan

    2016-01-01

    Full Text Available Electrospinning is a simple and versatile technique for the fabrication of nonwoven fibrous materials for biomedical applications. In the present study, chitosan (CS and polyethylene oxide (PEO nanofibrous scaffolds were successfully prepared using three different CS/PEO mass ratios and then evaluated for their physical, chemical, and biological characteristics. Scaffold morphologies were observed by scanning electron microscopy, which showed decreasing fiber diameters with increasing CS content. Higher CS concentrations also correlated with increased tensile strength and decreased elasticity of the scaffold. Degradation studies demonstrated that PEO was solubilized from the scaffold within the first six hours, followed by CS. This profile was unaffected by changes in the CS/PEO ratio or the pH of the media. Only the 2 : 1 CS/PEO scaffold demonstrated superior inhibition of both growth and attachment of Staphylococcus aureus. Finally, all scaffolds exhibited little impact on the proliferation of murine fibroblast monolayers. These data demonstrate that the 2 : 1 CS/PEO scaffold is a promising candidate for wound dressing applications due to its excellent antibacterial characteristics and biocompatibility.

  20. Ibuprofen loaded PLA nanofibrous scaffolds increase proliferation of human skin cells in vitro and promote healing of full thickness incision wounds in vivo.

    Science.gov (United States)

    Mohiti-Asli, M; Saha, S; Murphy, S V; Gracz, H; Pourdeyhimi, B; Atala, A; Loboa, E G

    2017-02-01

    This article presents successful incorporation of ibuprofen in polylactic acid (PLA) nanofibers to create scaffolds for the treatment of both acute and chronic wounds. Nanofibrous PLA scaffolds containing 10, 20, or 30 wt % ibuprofen were created and ibuprofen release profiles quantified. In vitro cytotoxicity to human epidermal keratinocytes (HEK) and human dermal fibroblasts (HDF) of the three scaffolds with varying ibuprofen concentrations were evaluated and compared to pure PLA nanofibrous scaffolds. Thereafter, scaffolds loaded with ibuprofen at the concentration that promoted human skin cell viability and proliferation (20 wt %) were evaluated in vivo in nude mice using a full thickness skin incision model to determine the ability of these scaffolds to promote skin regeneration and/or assist with scarless healing. Both acellular and HEK and HDF cell-seeded 20 wt % ibuprofen loaded nanofibrous bandages reduced wound contraction compared with wounds treated with Tegaderm™ and sterile gauze. Newly regenerated skin on wounds treated with cell-seeded 20 wt % ibuprofen bandages exhibited significantly greater blood vessel formation relative to acellular ibuprofen bandages. We have found that degradable anti-inflammatory scaffolds containing 20 wt % ibuprofen promote human skin cell viability and proliferation in vitro, reduce wound contraction in vivo, and when seeded with skin cells, also enhance new blood vessel formation. The approaches and results reported here hold promise for multiple skin tissue engineering and wound healing applications. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 327-339, 2017. © 2015 Wiley Periodicals, Inc.

  1. Light-activated nanofibre textiles exert antibacterial effects in the setting of chronic wound healing

    Czech Academy of Sciences Publication Activity Database

    Arenbergerová, M.; Arenberger, P.; Bednář, M.; Kubát, Pavel; Mosinger, Jiří

    2012-01-01

    Roč. 21, č. 8 (2012), s. 619-624 ISSN 0906-6705 R&D Projects: GA ČR GAP208/11/2222 Institutional support: RVO:61388955 ; RVO:61388980 Keywords : antibacterial * leg ulcer * light-activated nanofibres Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 3.578, year: 2012

  2. Optimization and integration of nanosilver on polycaprolactone nanofibrous mesh for bacterial inhibition and wound healing in vitro and in vivo

    Directory of Open Access Journals (Sweden)

    Liu M

    2017-09-01

    Full Text Available Menglong Liu,1,2 Gaoxing Luo,1,2 Ying Wang,1,2 Weifeng He,1,2 Tengfei Liu,1,2 Daijun Zhou,1,2 Xiaohong Hu,1,2 Malcolm Xing,1,3 Jun Wu1,2,4 1State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, the Third Military Medical University, 2Department of Burns, Chongqing Key Laboratory for Disease Proteomics, Chongqing, People’s Republic of China; 3Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, Canada; 4Department of Burns, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People’s Republic of China Abstract: Bacterial infection is a major hurdle to wound healing, and the overuse of antibiotics have led to global issue, such as emergence of multidrug-resistant bacteria, even “super bacteria”. On the contrary, nanosilver (NS can kill bacteria without causing resistant bacterial strains. In this study, NS was simply generated in situ on the polycaprolactone (PCL nanofibrous mesh using an environmentally benign and mussel-inspired dopamine (DA. Scanning electron microscopy showed that NS uniformly formed on the nanofibers of PCL mesh. Fourier transform infrared spectroscopy revealed the step-by-step preparation of pristine PCL mesh, including DA coating and NS formation, which were further verified by water contact angle changing from hydrophobic to hydrophilic. To optimize the NS dose, the antibacterial activity of PCL/NS against Staphylococcus aureus, Escherichia coli and Acinetobacter baumannii was detected by bacterial suspension assay, and the cytotoxicity of NS was evaluated using cellular morphology observation and Cell Counting Kit-8 (CCK8 assay. Then, inductively coupled plasma atomic emission spectrometry exhibited that the optimized PCL/NS had a safe and sustained silver release. Moreover, PCL/NS could effectively inhibit bacterial infection in an infectious murine full-thickness skin wound model. As demonstrated by the enhanced level of

  3. Wound Healing Potential of Natural Honey in Diabetic and Non ...

    African Journals Online (AJOL)

    The cutaneous wound healing effects of natural honey were compared in diabetic and non-diabetic rats. Thirty adult male Wistar rats (159g ± 31.5) where randomized into alloxan diabetics (n=15) and non-diabetic (n=15) groups. A 6mm full thickness biopsy punch wound was created on the nape of each rat under 2% ...

  4. Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds

    Science.gov (United States)

    Islam, Md. Asiful; Gan, Siew Hua; Khalil, Md. Ibrahim

    2014-01-01

    Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey's antibacterial activity on diabetic wound-related microorganisms and honey's clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims. PMID:25386217

  5. Morphology, drug release, antibacterial, cell proliferation, and histology studies of chamomile-loaded wound dressing mats based on electrospun nanofibrous poly(ɛ-caprolactone)/polystyrene blends.

    Science.gov (United States)

    Motealleh, Behrooz; Zahedi, Payam; Rezaeian, Iraj; Moghimi, Morvarid; Abdolghaffari, Amir Hossein; Zarandi, Mohammad Amin

    2014-07-01

    For the first time, it has been tried to achieve optimum conditions for electrospun poly(ε-caprolactone)/polystyrene (PCL/PS) nanofibrous samples as active wound dressings containing chamomile via D-optimal design approach. In this work, systematic in vitro and in vivo studies were carried out by drug release rate, antibacterial and antifungal evaluations, cell culture, and rat wound model along with histology observation. The optimized samples were prepared under the following electrospinning conditions: PCL/PS ratio (65/35), PCL concentration 9%(w/v), PS concentration 14%(w/v), distance between the syringe needle tip and the collector 15.5 cm, applied voltage 18 kV, and solution flow rate 0.46 mL h(-1) . The FE-SEM micrographs showed electrospun PCL/PS (65/35) nanofibrous sample containing 15% chamomile had a minimum average diameter (∼175 nm) compared to the neat samples (∼268 nm). The drug released resulted in a gradual and high amount of chamomile from the optimized PCL/PS nanofibrous sample (∼70%) in respect to PCL and PS nanofibers after 48 h. This claim was also confirmed by antibacterial and antifungal evaluations in which an inhibitory zone with a diameter of about 7.6 mm was formed. The rat wound model results also indicated that the samples loaded with 15% chamomile extract were remarkably capable to heal the wounds up to 99 ± 0.5% after 14 days post-treatment periods. The adhesion of mesenchymal stem cells and their viability on the optimized samples were confirmed by MTT analysis. Also, the electrospun nanofibrous mats based on PCL/PS (65/35) showed a high efficiency in the wound closure and healing process compared to the reference sample, PCL/PS nanofibers without chamomile. Finally, the histology analysis revealed that the formation of epithelial tissues, the lack of necrosis and collagen fibers accumulation in the dermis tissues for the above optimized samples. © 2013 Wiley Periodicals, Inc.

  6. Wound healing in diabetes mellitus: traditional treatment modalities.

    Science.gov (United States)

    Laitiff, A A; Teoh, S L; Das, S

    2010-01-01

    The healing of wound is a complex process which requires the interactions of different cells and extracellular molecules. The normal wound healing process can be divided into four overlapping phases i.e. haemostasis, inflammation, proliferation and remodeling. In diseased condition like diabetes mellitus, the wound healing process is grossly impaired, resulting in chronic wounds which fail to heal. In the past decades, several researchers have tested various traditional medicines obtained from the plants for their wound healing properties. Such traditional plants are Aloe vera, Calotropis procera, Portulaca oleracea, Acalypha langiana, Plagiochasma appendiculatum and Momordica charantia. Perhaps one of the most popular and easily available plant is Momordica charantia (bitter gourd). The present article presents an extensive review on the impaired wound healing process in diabetes mellitus and highlights the use of traditional medicines in diabetic wounds.

  7. Evaluation of Punica granatum Peel Against Diabetic Wound Infection

    African Journals Online (AJOL)

    Background: Foot infections are a common and serious problem in diabetic patients. Objectives: To investigate the antibacterial activity of some medicinal plants used by traditional healers for diabetic wounds and to examine in-vivo wound healing activity of active extracts. Materials and Methods: An experimental study in ...

  8. The bacteria profiles of wounds in diabetic patients hospitalized in ...

    African Journals Online (AJOL)

    Diabetic wound infections still remain a health concern such that correct identification of bacteria is essential in monitoring the spread of the infections as well as in the administration of the correct treatment. This study therefore focuses on isolating and identifying bacteria present in diabetic wounds of hospitalized patients in ...

  9. Role of Negative Pressure Wound Therapy in Healing of Diabetic ...

    African Journals Online (AJOL)

    Ulcer area ranging between 50cm2 and 200cm2. -. Diagnosis of diabetes mellitus made by American. Diabetes Association Criteria. Exclusion criteria. -. Age 75 years. -. An obvious septicemia. -. Osteomyelitis. -. Wounds resulting from venous insufficiency. -. Malignant disease in a wound. -. Patients being ...

  10. A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.

    Science.gov (United States)

    Eginton, Mark T; Brown, Kellie R; Seabrook, Gary R; Towne, Jonathan B; Cambria, Robert A

    2003-11-01

    Optimal treatment for large diabetic foot wounds is ill defined. The purpose of this study was to compare the rate of wound healing with the Vacuum Assisted Closure device trade mark (VAC) to conventional moist dressings in the treatment of large diabetic foot wounds. Diabetics with significant soft tissue defects of the foot were considered for enrollment. Patients were randomized to receive either moist gauze dressings or VAC treatments for 2 weeks, after which they were treated with the alternative dressing for an additional 2 weeks. Wounds were photographed weekly and wound dimensions calculated in a blinded fashion with spatial analysis software. Percent change in wound dimensions were calculated and compared for each weekly assessment and over 2 weeks of therapy with each dressing type. Ten patients were enrolled in the trial, but two were lost to follow-up and two were withdrawn. Complete data were available for analysis on seven wounds in six patients. Average length, width, and depth of the wounds at initiation of the trial was 7.7, 3.5, and 3.1 cm, respectively. Only the wound depth was significantly decreased over the weeks of the trial to 1.2 cm ( p VAC dressings decreased the wound volume and depth significantly more than moist gauze dressings (59% vs. 0% and 49% vs. 8%, respectively). VAC dressings were associated with a decrease in all wound dimensions while wound length and width increased with moist dressings. In summary, over the first several weeks of therapy, VAC dressings decreased wound depth and volume more effectively than moist gauze dressings. Negative-pressure wound treatment may accelerate closure of large foot wounds in the diabetic patient.

  11. Potential of oncostatin M to accelerate diabetic wound healing.

    Science.gov (United States)

    Shin, Soo Hye; Han, Seung-Kyu; Jeong, Seong-Ho; Kim, Woo-Kyung

    2014-08-01

    Oncostatin M (OSM) is a multifunctional cytokine found in a variety of pathologic conditions, which leads to excessive collagen deposition. Current studies demonstrate that OSM is also a mitogen for fibroblasts and has an anti-inflammatory action. It was therefore hypothesised that OSM may play an important role in healing of chronic wounds that usually involve decreased fibroblast function and persist in the inflammatory stage for a long time. In a previous in vitro study, the authors showed that OSM increased wound healing activities of diabetic dermal fibroblasts. However, wound healing in vivo is a complex process involving multiple factors. Thus, the purpose of this study was to evaluate the effect of OSM on diabetic wound healing in vivo. Five diabetic mice were used in this study. Four full-thickness round wounds were created on the back of each mouse (total 20 wounds). OSM was applied on the two left-side wounds (n = 10) and phosphate-buffered saline was applied on the two right-side wounds (n = 10). After 10 days, unhealed wound areas of the OSM and control groups were compared using the stereoimage optical topometer system. Also, epithelialisation, wound contraction and reduction in wound volume in each group were compared. The OSM-treated group showed superior results in all of the tested parameters. In particular, the unhealed wound area and the reduction in wound volume demonstrated statistically significant differences (P healing of diabetic wounds. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  12. Topical fentanyl stimulates healing of ischemic wounds in diabetic rats

    Science.gov (United States)

    FAROOQUI, Mariya; ERICSON, Marna E; GUPTA, Kalpna

    2016-01-01

    Background Topically applied opioids promote angiogenesis and healing of ischemic wounds in rats. We examined if topical fentanyl stimulates wound healing in diabetic rats by stimulating growth-promoting signaling, angiogenesis, lymphangiogenesis and nerve regeneration. Methods We used Zucker diabetic fatty rats that develop obesity and diabetes on a high fat diet due to a mutation in the Leptin receptor. Fentanyl blended with hydrocream was applied topically on ischemic wounds twice daily, and wound closure was analyzed regularly. Wound histology was analyzed by hematoxylin and eosin staining. Angiogenesis, lymphangiogenesis, nerve fibers and phospho-PDGFR-β were visualized by CD31-, lymphatic vessel endothelium-1, protein gene product 9.5- and anti-phospho PDGFR-β-immunoreactivity, respectively. Nitric oxide synthase (NOS) and PDGFR-β signaling were analyzed using Western immunoblotting. Results Fentanyl significantly promoted wound closure as compared to PBS. Histology scores were significantly higher in fentanyl-treated wounds, indicative of increased granulation tissue formation, reduced edema and inflammation, and increased matrix deposition. Fentanyl treatment resulted in increased wound angiogenesis, lymphatic vasculature, nerve fibers, nitric oxide, NOS and PDGFR-β signaling as compared to PBS. Phospho PDGFR-β co-localized with CD31 co-staining for vasculature. Conclusions Topically applied fentanyl promotes closure of ischemic wounds in diabetic rats. Increased angiogenesis, lymphangiogenesis, peripheral nerve regeneration, NO and PDGFR-β signaling are associated with fentanyl-induced tissue remodeling and wound healing. PMID:25266258

  13. Notch Regulates Macrophage-Mediated Inflammation in Diabetic Wound Healing

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    Andrew S. Kimball

    2017-06-01

    Full Text Available Macrophages are essential immune cells necessary for regulated inflammation during wound healing. Recent studies have identified that Notch plays a role in macrophage-mediated inflammation. Thus, we investigated the role of Notch signaling on wound macrophage phenotype and function during normal and diabetic wound healing. We found that Notch receptor and ligand expression are dynamic in wound macrophages during normal healing. Mice with a myeloid-specific Notch signaling defect (DNMAMLfloxedLyz2Cre+ demonstrated delayed early healing (days 1–3 and wound macrophages had decreased inflammatory gene expression. In our physiologic murine model of type 2 diabetes (T2D, Notch receptor expression was significantly increased in wound macrophages on day 6, following the initial inflammatory phase of wound healing, corresponding to increased inflammatory cytokine expression. This increase in Notch1 and Notch2 was also observed in human monocytes from patients with T2D. Further, in prediabetic mice with a genetic Notch signaling defect (DNMAMLfloxedLyz2Cre+ on a high-fat diet, improved wound healing was seen at late time points (days 6–7. These findings suggest that Notch is critical for the early inflammatory phase of wound healing and directs production of macrophage-dependent inflammatory mediators. These results identify that canonical Notch signaling is important in directing macrophage function in wound repair and define a translational target for the treatment of non-healing diabetic wounds.

  14. Modern and Convensional Wound Dressing to Interleukin 1 and Interleukin 6 in Diabetic wound

    Directory of Open Access Journals (Sweden)

    Werna Nontji

    2015-04-01

    Full Text Available Introduction:Holistic wound care is one of the ways to prevent gangrene and amputation, modern wound dressing is more effective than convensional with increasing transforming growth factor and cytokine, especially interleukin. This study aims to identify the effectiveness of Modern and Convensional Wound Dressing to Interleukin 1 (IL-1 and Interleukin 6 (IL-6 in Diabetic wound. Method:A Quasi eksperimental pre-post with control group design was used. The intervention given was modern wound dressing and Control group by convensional wound dressing, This study was conducted in Makassar with 32 samples (16 in intervention group and 16 in control group. Result: The result of Pooled T- test showed that p = 0.00 (p < 0.05, it means that there was signifi cant correlation between modern wound dressing to IL-6 and IL-1 than Convensional wound dressing. Discussion: Process of wound healing was produced growth factor and cytokine (IL-1 and IL-6, it will stimulated by wound dressing, modern wound dressing (Calcium alginat can absorb wound drainage, non oklusive, non adhesif, and autolytic debridement. Keywords: Modern wound dressing, Interleukin 1 (IL-1, Interleukin 6 (IL-6

  15. Diabetes medications: Impact on inflammation and wound healing.

    Science.gov (United States)

    Salazar, Jay J; Ennis, William J; Koh, Timothy J

    2016-01-01

    Chronic wounds are a common complication in patients with diabetes that often lead to amputation. These non-healing wounds are described as being stuck in a persistent inflammatory state characterized by accumulation of pro-inflammatory macrophages, cytokines and proteases. Some medications approved for management of type 2 diabetes have demonstrated anti-inflammatory properties independent of their marketed insulinotropic effects and thus have underappreciated potential to promote wound healing. In this review, the potential for insulin, metformin, specific sulfonylureas, thiazolidinediones, and dipeptidyl peptidase-4 inhibitors to promote healing is evaluated by reviewing human and animal studies on inflammation and wound healing. The available evidence indicates that diabetic medications have potential to prevent wounds from becoming arrested in the inflammatory stage of healing and to promote wound healing by downregulating pro-inflammatory cytokines, upregulating growth factors, lowering matrix metalloproteinases, stimulating angiogenesis, and increasing epithelization. However, no clinical recommendations currently exist on the potential for specific diabetic medications to impact healing of chronic wounds. Thus, we encourage further research that may guide physicians on providing personalized diabetes treatments that achieve glycemic goals while promoting healing in patients with chronic wounds. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Bilayered nanofibrous 3D hierarchy as skin rudiment by emulsion electrospinning for burn wound management.

    Science.gov (United States)

    Pal, Pallabi; Dadhich, Prabhash; Srivas, Pavan Kumar; Das, Bodhisatwa; Maulik, Dhrubajyoti; Dhara, Santanu

    2017-08-22

    Mimicking skin extracellular matrix hierarchy, the present work aims to develop a bilayer skin graft comprising a porous cotton-wool-like 3D layer with membranous structure of PCL-chitosan nanofibers. Emulsion electrospinning with differential stirring periods of PCL-chitosan emulsion results in development of a bilayer 3D structure with varied morphology. The electrospun membrane has fiber diameter ∼274 nm and pore size ∼1.16 μm while fluffy 3D layer has fiber diameter ∼1.62 μm and pore size ∼62 μm. The 3D layer was further coated with collagen I isolated from Cirrhinus cirrhosus fish scales to improve biofunctionality. Surface coating with collagen I resulted in bundling the fibers together, thereby increasing their average diameter to 2.80 μm and decreasing pore size to ∼45 μm. The architecture and composition of the scaffold promotes efficient cellular activity where interconnected porosity with ECM resembling collagen I coating assists cellular adhesion, infiltration, and proliferation from initial days of fibroblast seeding, while keratinocytes migrate on the surface only without infiltrating in the membranous nanofiber layer. Anatomy of the scaffold arising due to variation in pore size distribution at different layers thereby facilitates compartmentalization and prevents initial cellular transmigration. The scaffold also assists in extracellular matrix protein synthesis and keratinocyte stratification in vitro. Further, the scaffold effectively integrates and attaches with third-degree burn wound margins created in rat models and accelerates healing in comparison to standard Tegaderm dressing™. The bilayer scaffold is thus a promising, readily available, cost-effective, off-the-shelf matrix as a skin substitute.

  17. The Effect of Pycnogenol on Wound Healing in Diabetic Rats.

    Science.gov (United States)

    Dogan, Elif; Yanmaz, Latif; Gedikli, Semin; Ersoz, Ugur; Okumus, Zafer

    2017-04-01

    Pycnogenol (PYC), an extract of pine bark, is known to have photoprotective, antimicrobial, antioxidant, and anti-inflammatory properties. An in vivo study was conducted to evaluate the effects of PYC treatment on wound healing in 48 adult male Sprague-Dawley rats, of which 24 were injected with a single dose of alloxan to induce diabetes. Three (3) excisional skin wounds (1.3 cm x 1.3 cm x 2 mm) were created in each healthy and diabetic animal. One (1) wound in each animal was left untreated, 1 was treated daily with a cleanser (ethacridine lactate) and covered with silver sulfadiazine (SSD), and 1 was treated with PYC powder (30 mg). After measuring wound size, 6 animals from both groups were sacrificed on days 3, 7, 14, and 21 and tissue samples were taken for histopathological evaluation of acute and chronic inflammation, granulation tissue, fibroblast maturation, collagen deposition, epithelialization, and neovascularization using a scoring system of 0 = none, 1 = mild, 2 = moderate, and 3 = abundant. Because the wounds created were not uniform in size within and among the animals, healing was expressed as a percentage of the initial wound size for each animal. Data were compared using 2-way analysis of variance; histopathological lesion scores were reported in median values in univariate analysis, with P wound surface area was 1.69 ± 0.44 cm². On day 21, the average reduction in wound size was lower in diabetic than in healthy rats (47.42% versus 50.91%, P wounds (P Wound size reduction was also significantly different between PYC and the cleanser/SSD treatment depending on the rats' health status (P wound size for the healthy rats had decreased more than in the diabetic rats (mean 50.91% versus 47.42%). Although reepithelialization was complete in both groups by day 21, complete neovascularization was evident in the healthy rats but not in the diabetic rats. Overall, compared to the untreated control wounds, treatments with cleanser/SSD and PYC were

  18. Macrophage-Mediated Inflammation in Normal and Diabetic Wound Healing.

    Science.gov (United States)

    Boniakowski, Anna E; Kimball, Andrew S; Jacobs, Benjamin N; Kunkel, Steven L; Gallagher, Katherine A

    2017-07-01

    The healing of cutaneous wounds is dependent on the progression through distinct, yet overlapping phases of wound healing, including hemostasis, inflammation, proliferation, and resolution/remodeling. The failure of these phases to occur in a timely, progressive fashion promotes pathologic wound healing. The macrophage (MΦ) has been demonstrated to play a critical role in the inflammatory phase of tissue repair, where its dynamic plasticity allows this cell to mediate both tissue-destructive and -reparative functions. The ability to understand and control both the initiation and the resolution of inflammation is critical for treating pathologic wound healing. There are now a host of studies demonstrating that metabolic and epigenetic regulation of gene transcription can influence MΦ plasticity in wounds. In this review, we highlight the molecular and epigenetic factors that influence MΦ polarization in both physiologic and pathologic wound healing, with particular attention to diabetic wounds. Copyright © 2017 by The American Association of Immunologists, Inc.

  19. Carnosine enhances diabetic wound healing in the db/db mouse model of type 2 diabetes.

    Science.gov (United States)

    Ansurudeen, Ishrath; Sunkari, Vivekananda Gupta; Grünler, Jacob; Peters, Verena; Schmitt, Claus Peter; Catrina, Sergiu-Bogdan; Brismar, Kerstin; Forsberg, Elisabete Alcantara

    2012-07-01

    Diabetes mellitus (DM) is a progressive disorder with severe late complications. Normal wound healing involves a series of complex and well-orchestrated molecular events dictated by multiple factors. In diabetes, wound healing is grossly impaired due to defective, and dysregulated cellular and molecular events at all phases of wound healing resulting in chronic wounds that fail to heal. Carnosine, a dipeptide of alanine and histidine and an endogenous antioxidant is documented to accelerate healing of wounds and ulcers. However, not much is known about its role in wound healing in diabetes. Therefore, we studied the effect of carnosine in wound healing in db/db mice, a mice model of Type 2 DM. Six millimeter circular wounds were made in db/db mice and analyzed for wound healing every other day. Carnosine (100 mg/kg) was injected (I.P.) every day and also applied locally. Treatment with carnosine enhanced wound healing significantly, and wound tissue analysis showed increased expression of growth factors and cytokines genes involved in wound healing. In vitro studies with human dermal fibroblasts and microvascular-endothelial cells showed that carnosine increases cell viability in presence of high glucose. These effects, in addition to its known role as an antioxidant and a precursor for histamine synthesis, provide evidence for a possible therapeutic use of carnosine in diabetic wound healing.

  20. Effect of systemic insulin treatment on diabetic wound healing.

    Science.gov (United States)

    Vatankhah, Nasibeh; Jahangiri, Younes; Landry, Gregory J; Moneta, Gregory L; Azarbal, Amir F

    2017-04-01

    This study investigates if different diabetic treatment regimens affect diabetic foot ulcer healing. From January 2013 to December 2014, 107 diabetic foot ulcers in 85 patients were followed until wound healing, amputation or development of a nonhealing ulcer at the last follow-up visit. Demographic data, diabetic treatment regimens, presence of peripheral vascular disease, wound characteristics, and outcome were collected. Nonhealing wound was defined as major or minor amputation or those who did not have complete healing until the last observation. Median age was 60.0 years (range: 31.1-90.1 years) and 58 cases (68.2%) were males. Twenty-four cases reached a complete healing (healing rate: 22.4%). The median follow-up period in subjects with classified as having chronic wounds was 6.0 months (range: 0.7-21.8 months). Insulin treatment was a part of diabetes management in 52 (61.2%) cases. Insulin therapy significantly increased the wound healing rate (30.3% [20/66 ulcers] vs. 9.8% [4/41 ulcers]) (p = 0.013). In multivariate random-effect logistic regression model, adjusting for age, gender, smoking status, type of diabetes, hypertension, chronic kidney disease, peripheral arterial disease, oral hypoglycemic use, wound infection, involved side, presence of Charcot's deformity, gangrene, osteomyelitis on x-ray, and serum hemoglobin A1C levels, insulin treatment was associated with a higher chance of complete healing (beta ± SE: 15.2 ± 6.1, p = 0.013). Systemic insulin treatment can improve wound healing in diabetic ulcers after adjusting for multiple confounding covariates. © 2017 by the Wound Healing Society.

  1. Targeting connexin 43 in diabetic wound healing: Future perspectives

    Directory of Open Access Journals (Sweden)

    Bajpai S

    2009-01-01

    Full Text Available The unknown mechanisms of impaired tissue repair in diabetes mellitus are making this disease a serious clinical problem for the physicians worldwide. The lacuna in the knowledge of the etiology of diabetic wounds necessitates more focused research in order to develop new targeting tools with higher efficacy for their effective management. Gap-junction proteins, connexins, have shown some promising results in the process of diabetic wound healing. Till now the role of connexins has been implicated in peripheral neuropathy, deafness, skin disorders, cataract, germ cell development and treatment of cancer. Recent findings have revealed that gap junctions play a key role in normal as well as diabetic wound healing. The purpose of this review is to provide the information related to etiology, epidemiology, clinical presentation of diabetic wounds and to analyze the role of connexin 43 (Cx43 in the diabetic wound healing process. The current control strategies and the future research challenges have also been discussed briefly in this review.

  2. Hydrogen sulfide accelerates wound healing in diabetic rats.

    Science.gov (United States)

    Wang, Guoguang; Li, Wei; Chen, Qingying; Jiang, Yuxin; Lu, Xiaohua; Zhao, Xue

    2015-01-01

    The aim of this study was to explore the role of hydrogen sulfide on wound healing in diabetic rats. Experimental diabetes in rats was induced by intraperitoneal injection of streptozotocin (STZ) (in 0.1 mol/L citrate buffer, Ph 4.5) at dose of 70 mg/kg. Diabetic and age-matched non-diabetic rats were randomly assigned to three groups: untreated diabetic controls (UDC), treated diabetic administrations (TDA), and non-diabetic controls (NDC). Wound Healing Model was prepared by making a round incision (2.0 cm in diameter) in full thickness. Rats from TDA receive 2% sodium bisulfide ointment on wound, and animals from UDC and NDC receive control cream. After treatment of 21 days with sodium bisulfide, blood samples were collected for determination of vascular endothelial growth factor (VEGF), intercellular cell adhesion molecule-1 (ICAM-1), antioxidant effects. Granulation tissues from the wound were processed for histological examination and analysis of western blot. The study indicated a significant increase in levels of VEGF and ICAM-1 and a decline in activity of coagulation in diabetic rats treated with sodium bisulfide. Sodium bisulfide treatment raised the activity of superoxide dismutase (SOD) and heme oxygenase-1 (HO-1) protein expression, and decreased tumor necrosis factor α (TNF-α) protein expression in diabetic rats. The findings in present study suggested that hydrogen sulfide accelerates the wound healing in rats with diabetes. The beneficial effect of H2S may be associated with formation of granulation, anti-inflammation, antioxidant, and the increased level of vascular endothelial growth factor (VEGF).

  3. Promising role of ANGPTL4 gene in diabetic wound healing.

    Science.gov (United States)

    Arya, Awadhesh K; Tripathi, Kamlakar; Das, Parimal

    2014-03-01

    Diabetes mellitus (DM) is one of the severe metabolic disorders of carbohydrate metabolism worldwide. Developing countries are at higher risk of DM, and there is significant evidence that it is epidemic in many economically developing and newly industrialized countries. Among all other complications associated with DM, delayed wound healing is a major concern in diabetic patients. Wound healing is a natural healing process that starts immediately after injury. This involves interaction of a complex cascade of cellular events that generates resurfacing, reconstitution, and restoration of the tensile strength of injured skin. There are multiple factors responsible for delayed wound healing among which the contribution of DM has been well documented. The wound healing process is also delayed by the metabolic, vascular, neurological, and inflammatory alterations, which are well known in both type 1 and type 2 diabetes. Keratinocytes are crucial for wound re-epithelialization, and defects in directed migration of keratinocytes due to DM are associated with the delayed wound healing process. Many factors responsible for re-epithelialization have been identified, characterized, and well described; however, the genes responsible for the healing process have only partially been illustrated. This article will therefore focus on the efficacy of ANGPTL4 (angiopoietin-like 4) gene, which plays a novel role in keratinocyte migration during wound healing.

  4. Omental transposition flap for sternal wound reconstruction in diabetic patients.

    Science.gov (United States)

    Stump, Amy; Bedri, Mazen; Goldberg, Nelson H; Slezak, Sheri; Silverman, Ronald P

    2010-08-01

    In 2004, we published our 12-year experience with tissue transfer for deep sternal wound infection after median sternotomy, finding increased rates of reoperation for diabetic patients. Therefore, we decided to alter our treatment approach to diabetic patients to include sternal debridement followed by omental transposition. Eleven diabetic patients underwent omental transposition by our division during the study period. Hospital records were retrospectively reviewed to determine outcomes and complications. We found that diabetic patients treated after implementation of the new treatment approach were 5.4 times less likely to require reoperation for sternal wound management than were patients in the previous series, most of whom had been treated with pectoralis muscle flaps (95% confidence interval, 0.5- 50.5). By altering our treatment approach to use omental transposition as the initial surgical therapy, we were able to demonstrate a trend toward decreased need for flap revision in diabetic patients.

  5. Nerve growth factor accelerates wound healing in diabetic mice.

    Science.gov (United States)

    Muangman, Pornprom; Muffley, Lara A; Anthony, Joanne P; Spenny, Michelle L; Underwood, Robert A; Olerud, John E; Gibran, Nicole S

    2004-01-01

    Patients with diabetic neuropathy have reduced numbers of cutaneous nerves, which may contribute to an increased incidence of nonhealing wounds. Nerve growth factor (NGF) has been reported to augment wound closure. We hypothesized that topical 2.5S NGF, a biologically active subunit of the NGF polymer, would accelerate wound repair, augment nerve regeneration, and increase inflammation in excisional wounds in diabetic mice. A full-thickness 6-mm punch biopsy wound was created on the dorsum of C57BL/6J-m+ Leprdb mice (db/db) and heterozygous (db/-) littermates and treated daily with normal saline or 2.5S NGF (1 microg/day or 10 microg/day) on post-injury days 0-6. Time to closure, wound epithelialization, and degree of inflammation were compared using a Student's t-test. Color subtractive-computer-assisted image analysis was used to quantify immunolocalized nerves in wounds. Non-overlapping (20x) digital images of the wound were analyzed for nerve profile counts, area density (number of protein gene product 9.5 positive profiles per unit dermal area) and area fraction (protein gene product 9.5 positive area per unit dermal area). Healing times in db/db mice decreased from 30 days in normal saline-treated mice to 26 days in mice treated with 1 microg/day NGF (pnerve number, area density, and area fraction were increased in NGF-treated wounds at 14, 21, and 35 days (pnerve regeneration. Further studies to determine the role of nerves in wound repair are warranted.

  6. Wound bed preparation for ischemic diabetic foot ulcer.

    Science.gov (United States)

    Zhang, Zhaoxin; Lv, Lei; Guan, Sheng

    2015-01-01

    This study is to evaluate the effect of allograft skin on wound angiogenesis and wound bed preparation of ischemic diabetic foot ulcer. A total of 60 cases of patients with diabetic foot ulcer were randomly divided into the experimental group (n = 30) and the control group (n = 30). After debridement, in the experimental group, allograft skin was used to cover the wound while in the control group, vaseline and gauze was used to cover the wound. The wound was opened and dressed at 3, 5, 7, 14 days after operation and the growth condition of the granulation tissue was observed and recorded. The wound bed preparation time of the experimental group was 14.37 ± 1.06 days, compared with the control group 25.99 ± 4.03 days, there was statistically significant difference (t = 14.78, P cure time of the experimental group was 32 ± 1.93 days and this time was significantly shortened than the control group 39.73 ± 2.55 days (t = 12.521, P ulcer and shorten the wound bed preparation time and treatment cycle.

  7. Aloe Gel Enhances Angiogenesis in Healing of Diabetic Wound

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    Djanggan Sargowo

    2011-12-01

    Full Text Available BACKGROUND: Diabetic micro and macroangiophathy lead to the incident of diabetic foot ulcers characterized by an increased number of circulating endothelial cells (CECs and decreased function of endothelial progenitor cells (EPCs. This fact is correlated with ischemia and diabetic wound healing failure. Aloe vera gel is known to be able to stimulate vascular endothelial growth factor (VEGF expression and activity by enhancing nitric oxide (NO production as a result of nitric oxide synthase (NOS enzyme activity. Aloe vera is a potential target to enhancing angiogenesis in wound healing. OBJECTIVE: The objective of this study was to explore the major role of Aloe vera gel in wound healing of diabetic ulcers by increasing the level of EPCs, VEGF, and endothelial nitric oxide synthase (eNOS, as well as by reducing the level of CECs involved in angiogenesis process of diabetic ulcers healing. METHODS: The experimental groups was divided into five subgroups consisting of non diabetic wistar rats, diabetic rats without oral administration of aloe gel, and treatment subgroup (diabetic rats with 30, 60 and 120 mg/day of aloe gel doses for 14 days. All subgroups were wounded and daily observation was done on the wounds areas. Measurement of the number of EPCs (CD34, and CECs (CD45 and CD146 was done by flow cytometry, followed by measurement of VEGF and eNOS expression on dermal tissue by immunohistochemical method on day 0 and day 14 after treatment. The quantitative data were analyzed by One-Way ANOVA and Linear Regression, with a confidence interval 5% and significance level (p<0.05 using SPSS 16 software to compare the difference and correlation between wound diameters, number of EPCs and CECs as well as the levels of VEGF and eNOS. RESULTS: The results of this study showed that aloe gel oral treatment in diabetic wistar rats was able to accelerate the wound healing process. It was shown by significant reduction of wound diameter (0.27±0.02; the

  8. Lipopolysaccharides priming mesenchymal stem cells accelerate diabetic wound healing viaexosomes

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    Dong-dong TI

    2016-08-01

    Full Text Available Objective  To study the therapeutic effect of exosome derived from lipopolysaccharides (LPS priming mesenchymal stem cells (MSCs for diabetic wound healing. Methods  Human umbilical cord MSCs were treated with LPS (100ng/ml for 2 days, the supernatant were then collected, and exosomes were harvested by density gradient centrifugation and identified. Diabetic cutaneous wounds were prepared and the animals were divided into the following three groups: control group, untreated MSCs derived exosome (un-exosome treatment group and LPS primed MSCs derived exosome (LPS-exosome treatment group. Exosomes (60μg were injected dispersively into the wound edge daily for 10 days. After treatment, the therapeutic results were evaluated by gross observation of the wounds, the expression levels of inflammation related factors and macrophage subtype markers in the injured sites were detected by qRT-PCR at day 3, 7 and 14 after treatment. Results  Compared with control group, the diabetic wound healing was obviously improved in LPS-exosome treatment group after treatment for 7 and 14 days, with faster wound close, depressed expression of pro-inflammatory factors IL -1, IL -12 and M1 macrophage surface marker iNOS, and up-regulation of anti-inflammatory factors IL-10, TGF-βand M2 macrophage surface marker CD163, the differences were significant (P<0.05. Conclusions  LPS-exosome may balance macrophage plasticity, restrain chronic inflammation and accelerate diabetic cutaneous wound healing. DOI: 10.11855/j.issn.0577-7402.2016.07.02

  9. NEGATIVE PRESSURE WOUND THERAPY (NPWT FOR THE MANAGEMENT OF DIABETIC FOOT WOUND

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    Wesiana Heris Santy

    2015-11-01

    Full Text Available Complications often experienced by people with diabetes are complications in the feet ( 15 % called diabetic foot ( Akhtyo , 2009 . Where the injury to the leg if not treated properly will lead to infections and ultimately need to be amputated .The purpose of writing articles is to review and discuss the evidence-based literature bersadarkanpraktice of Negative Pressure Wound Therapy Effectiveness ( NPWT on the healing of diabetic foot ulcers.One technology that is used to prevent and avoid lower limb amputation is the technique of negative pressure or Negative Pressure Wound Therapy ( NPWT . This negative pressure technique has grown rapidly and now has been widely used in many countries , especially in Western European countries ( Germany and the United States . Negative pressure technique has the advantage that it is relatively cheaper cost than the use of hyperbaric oxygen . Results obtained by several studies that the use of NPWT may improve wound healing process through efforts to create a moist wound environment and decrease edema that becomes optimal wound healing , throw that out of the wound exudate so that the protease enzyme in the exudate also go wasted , this enzyme is known to interfere wound healing process . The other benefit is that it can stimulate cell growth by increasing angiogenesis physically , so that the growth of new cells will be maximal Abstrak : Komplikasi sering dialami pengidap diabetes adalah komplikasi pada kaki (15% disebut kaki diabetes (Akhtyo, 2009.Dimana luka pada kaki jika tidak ditangani dengan baik akan menyebabkan terjadinya infeksi dan akhirnya perlu di amputasi. Tujuan penulisan artikel adalah mengkaji dan membahas literature bersadarkan evidence based praktice  tentang Efektifitas Negative Pressure Wound Therapy (NPWT pada penyembuhan ulkus kaki Diabetik. Salah satu teknologi yang digunakan untuk mencegah dan menghindari amputasi ekstremitas bawah adalah  teknik tekanan negatif atau Negative

  10. Development of poly (1,8 octanediol-co-citrate) and poly (acrylic acid) nanofibrous scaffolds for wound healing applications.

    Science.gov (United States)

    Goins, Allison; Ramaswamy, Vidhya; Dirr, Elliott; Dulany, Krista; Irby, Sean; Webb, Antonio; Allen, Josephine

    2017-10-26

    Wound care is one of the leading health care problems in the United States costing billions of dollars yearly. Annually, millions of acute wounds occur due to surgical procedures or traumas such as burns and abrasions, and these wounds can become non-healing due to bacterial infection or underlying pathologies. Current wound care treatments include the use of bioinert constructs combined with topical administration of anti-bacterial agents and growth factors. However, there is a growing need for the development of bioactive wound dressing materials that are able to promote wound healing and the regeneration of healthy tissue. In this work, we evaluate and report the use of a novel electrospun polymeric scaffold consisting of poly (1,8 octanediol-co-citrate) and poly (acrylic acid) for wound healing applications. The scaffold exhibits intrinsic antibacterial activity, hydrogel-like water uptake abilities, and the ability to deliver physiologically relevant concentrations of growth factor. Additionally, the scaffold shows antibacterial function when tested with bacteria relevant to wound healing applications. Biological characterization of the electrospun scaffold shows excellent cellular adhesion, low cytotoxicity, and enhanced proliferation of skin fibroblasts. This work has potential towards the development of novel bioactive scaffolds for prevention of bacterial infiltration into the wound bed and enhanced healing.

  11. [Advances in the research of treating refractory diabetic wounds with stem cells].

    Science.gov (United States)

    Gong, Jiahong; Lu, Shuliang

    2014-12-01

    With the growth of aging society, China has become the country of population with the highest incidence of diabetes in the world. Diabetes leads to pathological changes in vascular and nervous system, rendering the diabetic skin fragile and hard to heal if wounded; in the end most diabetic wounds tend to become chronic skin ulcers. The refractory diabetic wound is the result of various endogenous and exogenous factors. It is a quite complicated pathophysiologic event which lacks an effective and specific therapeutic method in clinic. The use of stem cells could be a new approach of treating diabetic chronic wounds since they have a potential ability of self-renovation and multi-directional differentiation which will promote angiogenesis and wound healing process, thus be beneficial in the care of ischemia diseases of the lower limb. This article reviews basic theory of treating diabetic wound and the changes in microenvironment, and prompts many successful cases in curing refractory diabetic wounds.

  12. Role of Negative Pressure Wound Therapy in Healing of Diabetic ...

    African Journals Online (AJOL)

    Introduction: Foot disorders such as ulceration, infection and gangrene are the most common, complex and costly sequelae of diabetes mellitus.[1-3] Even for the most superficial wounds, treatment is often difficult with poor healing responses and high rates of complications. The purpose of this study is to compare the rate of ...

  13. The case for evidence in wound care: investigating advanced treatment modalities in healing chronic diabetic lower extremity wounds.

    Science.gov (United States)

    Lyon, Karen C

    2008-01-01

    Major complications of diabetes mellitus include lower leg and foot ulcers, which can result in amputation. Further study is needed to determine optimal treatments for these challenging wounds. Growth factor therapy and hyperbaric oxygen (HBO) treatments are 2 advanced therapeutic modalities that hold promise. This descriptive, retrospective review investigated healing rates of patients with diabetes mellitus and lower- extremity ulcers managed by growth factor therapy and HBO as compared to standard wound care. Retrospective review of medical records. We reviewed medical records of 89 patients with diabetes and lower-extremity wounds treated at a major outpatient wound care program in the southwestern United States. Patients were categorized according to 4 treatment modalities: (1) standard wound care, (2) growth factor therapy, (3) standard wound care plus HBO, and (4) growth factor therapy plus HBO. Wounds were measured at the start of the analysis and then weekly for a total of 8 weeks. The change in wound volume from the first to the eighth week was recorded. All patient groups demonstrated healing with the patients who received growth factor therapy alone and those who received growth factor therapy and the HBO treatments demonstrating the greatest decrease in wound volume over the 8 weeks. A 2-by-2 factorial analysis of covariance demonstrated that patients who received HBO as part of their wound care regimen demonstrated significantly greater healing than patients who received only standard wound care or growth factor therapy (P wound healing in this study, it should be noted that the mean size of the wounds in this group was 2.8 times larger than the mean size of the wounds in the other groups. Patients managed in a state-of-the-art wound care center experienced progress toward wound healing, regardless of the treatment modality selected. Those who received HBO as part of their wound care regimen healed faster than those who received standard treatment or

  14. FOXO1 differentially regulates both normal and diabetic wound healing

    Science.gov (United States)

    Zhang, Chenying; Ponugoti, Bhaskar; Tian, Chen; Xu, Fanxing; Tarapore, Rohinton; Batres, Angelika; Alsadun, Sarah; Lim, Jason; Dong, Guangyu

    2015-01-01

    Healing is delayed in diabetic wounds. We previously demonstrated that lineage-specific Foxo1 deletion in keratinocytes interfered with normal wound healing and keratinocyte migration. Surprisingly, the same deletion of Foxo1 in diabetic wounds had the opposite effect, significantly improving the healing response. In normal glucose media, forkhead box O1 (FOXO1) enhanced keratinocyte migration through up-regulating TGFβ1. In high glucose, FOXO1 nuclear localization was induced but FOXO1 did not bind to the TGFβ1 promoter or stimulate TGFβ1 transcription. Instead, in high glucose, FOXO1 enhanced expression of serpin peptidase inhibitor, clade B (ovalbumin), member 2 (SERPINB2), and chemokine (C-C motif) ligand 20 (CCL20). The impact of high glucose on keratinocyte migration was rescued by silencing FOXO1, by reducing SERPINB2 or CCL20, or by insulin treatment. In addition, an advanced glycation end product and tumor necrosis factor had a similar regulatory effect on FOXO1 and its downstream targets and inhibited keratinocyte migration in a FOXO1-dependent manner. Thus, FOXO1 expression can positively or negatively modulate keratinocyte migration and wound healing by its differential effect on downstream targets modulated by factors present in diabetic healing. PMID:25918228

  15. Local medicamentous treatment of wound infection in patients with diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Bugaeva I.O.

    2012-06-01

    Full Text Available The aim of the study was to evaluate the parameters and comparison of wound healing in patients with diabetic foot syndrome using modern dressings and traditional scheme of local treatment of chronic wounds. Materials and methods: Clinical part of the work has been based on the results of a comprehensive investigation of the parameters of wound healing in 154 diabetic foot patients. Results: Optimum results are obtained by treatment of wound infection in patients with neuropathic diabetic foot shape using highly technological dressings. Conclusion: The modern interactive dressings may actively interfere to all phases of wound healing in patients with purulent-necrotic complications of diabetes mellitus

  16. Up-regulation of Hsp72 and keratin16 mediates wound healing in streptozotocin diabetic rats

    Directory of Open Access Journals (Sweden)

    Rasha R. Ahmed

    2015-01-01

    Full Text Available BACKGROUND: Impaired wound healing is a complication of diabetes and a serious problem in clinical practice. We previously found that whey protein (WP was able to regulate wound healing normally in streptozotocin (STZ-dia-betic models. This subsequent study was designed to assess the effect of WP on heat shock protein-72 (Hsp72 and keratin16 (Krt16 expression during wound healing in diabetic rats. METHODS: WP at a dosage of 100 mg/kg of body weight was orally administered daily to wounded normal and STZ-diabetic rats for 8 days. RESULTS: At day 4, the WP-treated diabetic wound was significantly reduced compared to that in the corresponding control. Diabetic wounded rats developed severe inflammatory infiltration and moderate capillary dilatation and regeneration. Treated rats had mild necrotic formation, moderate infiltration, moderate to severe capillary dilatation and regeneration, in addition to moderate epidermal formation. Hsp72 and Krt16 densities showed low and dense activity in diabetic wounded and diabetic wounded treated groups, respectively. At day 8, WP-treatment of diabetic wounded animals revealed great amelioration with complete recovery and closure of the wound. Reactivity of Hsp72 and Krt16 was reversed, showing dense and low, or medium and low, activity in the diabetic wounded and diabetic wounded treated groups, respectively. Hsp72 expression in the pancreas was found to show dense reactivity with WP-treated diabetic wound rats. CONCLUSION: This data provides evidence for the potential impact of WP in the up-regulation of Hsp72 and Krt16 in T1D, resulting in an improved wound healing process in diabetic models.

  17. The efficacy and side effects of oral Centella asiatica extract for wound healing promotion in diabetic wound patients.

    Science.gov (United States)

    Paocharoen, Veeraya

    2010-12-01

    To study clinical efficacy and side effects of the oral Centella asiatica extract capsule in the diabetic wound healing. And to study the side effects of Centella asiatica extract capsule. This prospective randomized control study enrolled two hundred diabetic patients in the department of Surgery, Thammasat University Hospital. The exclusion criterion were low immune patients, oral steroid intake, age more than 80 year and less than 18 yeas, serum albumin less than 3.0 gm/dl, uncorrected peripheral arterial diseased patients, and uncontrolled infective wound. The termination criterion were patient refusal, wound infection, delayed primary sutured wound secondary healing wound. The patients were divided into two groups randomly, groupA was Centella asiatica extract capsule group and group B was placebo group. Centella asiatica extract capsule and placebo were prescribed in each group under the random sheet. The administration was 2 capsules after meal, three times a day (50 mg of extracted asiaticoside / capsule in group A). The general symptoms, wound characteristics, wound size and depth were examined at day 7, day 14 and day 21 by the same investigator. The demographic data of the sample were analyzed by student t test and comparative wound characteristics were analyzed by Pearson Chi-Square test. Wound contraction in the study group is better than placebo group but granulation tissue forming is better in the placebo group. No serious adverse reaction in both groups. Centella asiatica extract capsule is the Thai herb preparation capsule that effective in the wound healing promotion and also suppress the scar in diabetic wound patients. There was no demonstrable serious side effect of the Centella asiatica extract capsule group. Centella asiatica extract capsule can shorten the course of diabetic wound and can be prescribed to the diabetic patients safely.

  18. Effects on Glycemic Control in Impaired Wound Healing in Spontaneously Diabetic Torii (SDT) Fatty Rats.

    Science.gov (United States)

    Katsuhiro, Miyajima; Hui Teoh, Soon; Yamashiro, Hideaki; Shinohara, Masami; Fatchiyah, Fatchiyah; Ohta, Takeshi; Yamada, Takahisa

    2018-02-01

    Impaired diabetic wound healing is an important issue in diabetic complications. The present study aims to evaluate the protective effect on glycemic control against impaired diabetic wound healing using a diabetic rat model. We investigated the wound healing process and effect on the impaired wound repair by glycemic control in the Spontaneously Diabetic Torii (SDT) fatty rat, which is a new animal model of obese type 2 diabetes and may be a good model for study impaired wound healing. Male SDT fatty rats at 15 weeks of age were administered orally with sodium glucose co-transporter (SGLT) 2 inhibitor for 3 weeks. Wounds were induced at 2 weeks after SGLT 2 inhibitor treatment, and the wound areas were periodically examined in morphological and histological analyses. The SDT fatty rats showed a delayed wound healing as compared with the normal rats, but a glycemic control improved the impaired wound healing. In histological analysis in the skin of SDT fatty rats showed severe infiltration of inflammatory cell, hemorrhage and many bacterial masses in the remaining and slight fibrosis of crust on skin tissue . Thought that this results skin performance to be a delay of crust formation and regeneration of epithelium; however, these findings were ameliorated in the SGLT 2 inhibitor treated group. Glycemic control is effective for treatment in diabetic wounds and the SDT fatty rat may be useful to investigate pathophysiological changes in impaired diabetic wound healing.

  19. Antimycotic ciclopirox olamine in the diabetic environment promotes angiogenesis and enhances wound healing.

    Directory of Open Access Journals (Sweden)

    Sae Hee Ko

    Full Text Available Diabetic wounds remain a major medical challenge with often disappointing outcomes despite the best available care. An impaired response to tissue hypoxia and insufficient angiogenesis are major factors responsible for poor healing in diabetic wounds. Here we show that the antimycotic drug ciclopirox olamine (CPX can induce therapeutic angiogenesis in diabetic wounds. Treatment with CPX in vitro led to upregulation of multiple angiogenic genes and increased availability of HIF-1α. Using an excisional wound splinting model in diabetic mice, we showed that serial topical treatment with CPX enhanced wound healing compared to vehicle control treatment, with significantly accelerated wound closure, increased angiogenesis, and increased dermal cellularity. These findings offer a promising new topical pharmacologic therapy for the treatment of diabetic wounds.

  20. Simultaneous dual syringe electrospinning system using benign solvent to fabricate nanofibrous P(3HB-co-4HB)/collagen peptides construct as potential leave-on wound dressing

    Energy Technology Data Exchange (ETDEWEB)

    Vigneswari, S. [Malaysian Institute of Pharmaceuticals and Nutraceuticals, NIBM, MOSTI, 11700 Penang (Malaysia); Institute of Marine Biotechnology, Universiti Malaysia Terengganu, 21030 Kuala Terengganu (Malaysia); Murugaiyah, V. [School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11700 Penang (Malaysia); Kaur, G. [Institute of Research in Molecular Medicine, Universiti Sains Malaysia, 11700 Penang (Malaysia); Abdul Khalil, H.P.S. [School of Industrial Technology, Universiti Sains Malaysia, 11700 Penang (Malaysia); Amirul, A.A., E-mail: amirul@usm.my [Malaysian Institute of Pharmaceuticals and Nutraceuticals, NIBM, MOSTI, 11700 Penang (Malaysia); School of Biological Sciences, Universiti Sains Malaysia, 11800 Penang (Malaysia); Centre of Chemical Biology, Universiti Sains Malaysia, 11900 Penang (Malaysia)

    2016-09-01

    The main focus of this study is the incorporation of collagen peptides to fabricate P(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] nano-fiber construct to further enhance surface wettability and support cell growth while harbouring desired properties for biodegradable wound dressing. Simultaneous electrospinning of nanofiber P(3HB-co-4HB)/collagen peptides construct was carried out using dual syringe system. The wettability of the constructs increased with the increase in 4HB molar fraction from 20 mol% 4HB [53.2°], P(3HB-co-35 mol%4HB)[48.9°], P(3HB-co-50 mol%4HB)[44.5°] and P(3HB-co-82 mol%4HB) [37.7°]. In vitro study carried out using mouse fibroblast cells (L929) grown on nanofiber P(3HB-co-4HB)/collagen peptides construct showed an increase in cell proliferation. In vivo study using animal model (Sprague Dawley rats) showed that nanofibrous P(3HB-co-4HB)/collagen peptides construct had a significant effect on wound contractions with the highest percentage of wound closure of 79%. Hence, P(3HB-co-4HB)/collagen peptides construct suitable for wound dressing have been developed using nano-fabrication technique. - Highlights: • Nano-fiber construct to enhance surface wettability and cell growth, harbouring desired properties as biodegradable wound dressing. • Simultaneous electrospinning of nanofiber P(3HB-co-4HB)/collagen construct using dual syringe system. • Nanofibrous construct accelerated wound healing with efficient cellular organization.

  1. Simultaneous dual syringe electrospinning system using benign solvent to fabricate nanofibrous P(3HB-co-4HB)/collagen peptides construct as potential leave-on wound dressing

    International Nuclear Information System (INIS)

    Vigneswari, S.; Murugaiyah, V.; Kaur, G.; Abdul Khalil, H.P.S.; Amirul, A.A.

    2016-01-01

    The main focus of this study is the incorporation of collagen peptides to fabricate P(3-hydroxybutyrate-co-4-hydroxybutyrate) [P(3HB-co-4HB)] nano-fiber construct to further enhance surface wettability and support cell growth while harbouring desired properties for biodegradable wound dressing. Simultaneous electrospinning of nanofiber P(3HB-co-4HB)/collagen peptides construct was carried out using dual syringe system. The wettability of the constructs increased with the increase in 4HB molar fraction from 20 mol% 4HB [53.2°], P(3HB-co-35 mol%4HB)[48.9°], P(3HB-co-50 mol%4HB)[44.5°] and P(3HB-co-82 mol%4HB) [37.7°]. In vitro study carried out using mouse fibroblast cells (L929) grown on nanofiber P(3HB-co-4HB)/collagen peptides construct showed an increase in cell proliferation. In vivo study using animal model (Sprague Dawley rats) showed that nanofibrous P(3HB-co-4HB)/collagen peptides construct had a significant effect on wound contractions with the highest percentage of wound closure of 79%. Hence, P(3HB-co-4HB)/collagen peptides construct suitable for wound dressing have been developed using nano-fabrication technique. - Highlights: • Nano-fiber construct to enhance surface wettability and cell growth, harbouring desired properties as biodegradable wound dressing. • Simultaneous electrospinning of nanofiber P(3HB-co-4HB)/collagen construct using dual syringe system. • Nanofibrous construct accelerated wound healing with efficient cellular organization.

  2. Macrophage dysfunction impairs resolution of inflammation in the wounds of diabetic mice.

    Directory of Open Access Journals (Sweden)

    Savita Khanna

    2010-03-01

    Full Text Available Chronic inflammation is a characteristic feature of diabetic cutaneous wounds. We sought to delineate novel mechanisms involved in the impairment of resolution of inflammation in diabetic cutaneous wounds. At the wound-site, efficient dead cell clearance (efferocytosis is a pre-requisite for the timely resolution of inflammation and successful healing.Macrophages isolated from wounds of diabetic mice showed significant impairment in efferocytosis. Impaired efferocytosis was associated with significantly higher burden of apoptotic cells in wound tissue as well as higher expression of pro-inflammatory and lower expression of anti-inflammatory cytokines. Observations related to apoptotic cell load at the wound site in mice were validated in the wound tissue of diabetic and non-diabetic patients. Forced Fas ligand driven elevation of apoptotic cell burden at the wound site augmented pro-inflammatory and attenuated anti-inflammatory cytokine response. Furthermore, successful efferocytosis switched wound macrophages from pro-inflammatory to an anti-inflammatory mode.Taken together, this study presents first evidence demonstrating that diabetic wounds suffer from dysfunctional macrophage efferocytosis resulting in increased apoptotic cell burden at the wound site. This burden, in turn, prolongs the inflammatory phase and complicates wound healing.

  3. Pseudomonas aeruginosa uses T3SS to inhibit diabetic wound healing.

    Science.gov (United States)

    Goldufsky, Josef; Wood, Stephen J; Jayaraman, Vijayakumar; Majdobeh, Omar; Chen, Lin; Qin, Shanshan; Zhang, Chunxiang; DiPietro, Luisa A; Shafikhani, Sasha H

    2015-01-01

    Diabetic foot ulcers are responsible for more hospitalizations than any other complication of diabetes. Bacterial infection is recognized as an important factor associated with impaired healing in diabetic ulcers. Pseudomonas aeruginosa is the most frequently detected Gram-negative pathogen in diabetic ulcers. P. aeruginosa infection has been shown to impair healing in diabetic wounds in a manner that correlates with its ability to form biofilm. While the majority of infections in diabetic ulcers are biofilm associated, 33% of infections are nonbiofilm in nature. P. aeruginosa is the most prevalent Gram-negative pathogen in all diabetic wound types, which suggests that the deleterious impact of P. aeruginosa on healing in diabetic wounds goes beyond its ability to form biofilm and likely involves other factors. The Type III Secretion System (T3SS) virulence structure is required for the pathogenesis of all P. aeruginosa clinical isolates, suggesting that it may also play a role in the inhibition of wound repair in diabetic skin ulcers. We evaluated the role of T3SS in mediating P. aeruginosa-induced tissue damage in the wounds of diabetic mice. Our data demonstrate that P. aeruginosa establishes a robust and persistent infection in diabetic wounds independent of its ability to form biofilm and causes severe wound damage in a manner that primarily depends on its T3SS. © 2015 by the Wound Healing Society.

  4. Momordica charantia ointment accelerates diabetic wound healing and enhances transforming growth factor-β expression.

    Science.gov (United States)

    Hussan, F; Teoh, S Lin; Muhamad, N; Mazlan, M; Latiff, A A

    2014-08-01

    Transforming growth factor-β (TGF-β) plays an important role in wound healing. Delayed wound healing is a consequence of diabetes, leading to high morbidity and poor quality of life. Momordica charantia (MC) fruit possesses anti-diabetic and wound healing properties. This study aimed to explore the changes in TGF-β expression in diabetic wounds treated with topical MC fruit extract. Fifty-six male Sprague-Dawley rats were divided into a normal control group and five diabetic groups of ten rats each. Intravenous streptozotocin (50mg/kg) was given to induce diabetes in the diabetic groups. Full thickness excision wounds were created on the thoracodorsal region of the animals, and these wounds were then treated with vehicle, MC powder, MC ointment and povidone ointment or ointment base for ten days. Wound healing was determined by the rate of wound closure, total protein content and TGF-β expression in the wounds, and histological observation. Diabetic groups showed delayed wound closure rates compared to the control group. The wound closure rate in the MC ointment group was significantly faster than that of the untreated diabetic group (p<0.05). The MC ointment group also showed intense TGF-β expression and a high level of total protein content. MC ointment has a promising potential for use as an alternative topical medication for diabetic wounds. This work has shown that it accelerates wound healing in diabetic rats, and it is suggested here that this occurs by enhancing TGF-β expression. Further work is recommended to explore this effect.

  5. Nanofibrous electrocatalysts

    Science.gov (United States)

    Liu, Di Jia; Shui, Jianglan; Chen, Chen

    2016-05-24

    A nanofibrous catalyst and method of manufacture. A precursor solution of a transition metal based material is formed into a plurality of interconnected nanofibers by electro-spinning the precursor solution with the nanofibers converted to a catalytically active material by a heat treatment. Selected subsequent treatments can enhance catalytic activity.

  6. Electrospun non-woven nanofibrous hybrid mats based on chitosan and PLA for wound-dressing applications.

    Science.gov (United States)

    Ignatova, Milena; Manolova, Nevena; Markova, Nadya; Rashkov, Iliya

    2009-01-09

    Continuous defect-free nanofibers containing chitosan (Ch) or quaternized chitosan (QCh) were successfully prepared by one-step electrospinning of Ch or QCh solutions mixed with poly[(L-lactide)-co-(D,L-lactide)] in common solvent. XPS revealed the surface chemical composition of the bicomponent electrospun mats. Crosslinked Ch- and QCh-containing nanofibers exhibited higher kill rates against bacteria S. aureus and E. coli than the corresponding solvent-cast films. SEM observations showed that hybrid mats were very effective in suppressing the adhesion of pathogenic bacteria S. aureus. The hybrid nanofibers are promising for wound-healing applications.

  7. Pulsed electromagnetic fields (PEMF) promote early wound healing and myofibroblast proliferation in diabetic rats.

    Science.gov (United States)

    Cheing, Gladys Lai-Ying; Li, Xiaohui; Huang, Lin; Kwan, Rachel Lai-Chu; Cheung, Kwok-Kuen

    2014-04-01

    Reduced collagen deposition possibly leads to slow recovery of tensile strength in the healing process of diabetic cutaneous wounds. Myofibroblasts are transiently present during wound healing and play a key role in wound closure and collagen synthesis. Pulsed electromagnetic fields (PEMF) have been shown to enhance the tensile strength of diabetic wounds. In this study, we examined the effect of PEMF on wound closure and the presence of myofibroblasts in Sprague-Dawley rats after diabetic induction using streptozotocin. A full-thickness square-shaped dermal wound (2 cm × 2 cm) was excised aseptically on the shaved dorsum. The rats were randomly divided into PEMF-treated (5 mT, 25 Hz, 1 h daily) and control groups. The results indicated that there were no significant differences between the groups in blood glucose level and body weight. However, PEMF treatment significantly enhanced wound closure (days 10 and 14 post-wounding) and re-epithelialization (day 10 post-wounding), although these improvements were no longer observed at later stages of the wound healing process. Using immunohistochemistry against α-smooth muscle actin (α-SMA), we demonstrated that significantly more myofibroblasts were detected on days 7 and 10 post-wounding in the PEMF group when compared to the control group. We hypothesized that PEMF would increase the myofibroblast population, contributing to wound closure during diabetic wound healing. © 2014 Wiley Periodicals, Inc.

  8. Shedding Light on a New Treatment for Diabetic Wound Healing: A Review on Phototherapy

    Directory of Open Access Journals (Sweden)

    Nicolette N. Houreld

    2014-01-01

    Full Text Available Impaired wound healing is a common complication associated with diabetes with complex pathophysiological underlying mechanisms and often necessitates amputation. With the advancement in laser technology, irradiation of these wounds with low-intensity laser irradiation (LILI or phototherapy, has shown a vast improvement in wound healing. At the correct laser parameters, LILI has shown to increase migration, viability, and proliferation of diabetic cells in vitro; there is a stimulatory effect on the mitochondria with a resulting increase in adenosine triphosphate (ATP. In addition, LILI also has an anti-inflammatory and protective effect on these cells. In light of the ever present threat of diabetic foot ulcers, infection, and amputation, new improved therapies and the fortification of wound healing research deserves better prioritization. In this review we look at the complications associated with diabetic wound healing and the effect of laser irradiation both in vitro and in vivo in diabetic wound healing.

  9. Acceleration of diabetic wound healing using a novel protease-anti-protease combination therapy.

    Science.gov (United States)

    Gao, Ming; Nguyen, Trung T; Suckow, Mark A; Wolter, William R; Gooyit, Major; Mobashery, Shahriar; Chang, Mayland

    2015-12-08

    Nonhealing chronic wounds are major complications of diabetes resulting in >70,000 annual lower-limb amputations in the United States alone. The reasons the diabetic wound is recalcitrant to healing are not fully understood, and there are limited therapeutic agents that could accelerate or facilitate its repair. We previously identified two active forms of matrix metalloproteinases (MMPs), MMP-8 and MMP-9, in the wounds of db/db mice. We argued that the former might play a role in the body's response to wound healing and that the latter is the pathological consequence of the disease with detrimental effects. Here we demonstrate that the use of compound ND-336, a novel highly selective inhibitor of gelatinases (MMP-2 and MMP-9) and MMP-14, accelerates diabetic wound healing by lowering inflammation and by enhancing angiogenesis and re-epithelialization of the wound, thereby reversing the pathological condition. The detrimental role of MMP-9 in the pathology of diabetic wounds was confirmed further by the study of diabetic MMP-9-knockout mice, which exhibited wounds more prone to healing. Furthermore, topical administration of active recombinant MMP-8 also accelerated diabetic wound healing as a consequence of complete re-epithelialization, diminished inflammation, and enhanced angiogenesis. The combined topical application of ND-336 (a small molecule) and the active recombinant MMP-8 (an enzyme) enhanced healing even more, in a strategy that holds considerable promise in healing of diabetic wounds.

  10. Acceleration of diabetic wound healing using a novel protease–anti-protease combination therapy

    Science.gov (United States)

    Gao, Ming; Nguyen, Trung T.; Suckow, Mark A.; Wolter, William R.; Gooyit, Major; Mobashery, Shahriar; Chang, Mayland

    2015-01-01

    Nonhealing chronic wounds are major complications of diabetes resulting in >70,000 annual lower-limb amputations in the United States alone. The reasons the diabetic wound is recalcitrant to healing are not fully understood, and there are limited therapeutic agents that could accelerate or facilitate its repair. We previously identified two active forms of matrix metalloproteinases (MMPs), MMP-8 and MMP-9, in the wounds of db/db mice. We argued that the former might play a role in the body’s response to wound healing and that the latter is the pathological consequence of the disease with detrimental effects. Here we demonstrate that the use of compound ND-336, a novel highly selective inhibitor of gelatinases (MMP-2 and MMP-9) and MMP-14, accelerates diabetic wound healing by lowering inflammation and by enhancing angiogenesis and re-epithelialization of the wound, thereby reversing the pathological condition. The detrimental role of MMP-9 in the pathology of diabetic wounds was confirmed further by the study of diabetic MMP-9–knockout mice, which exhibited wounds more prone to healing. Furthermore, topical administration of active recombinant MMP-8 also accelerated diabetic wound healing as a consequence of complete re-epithelialization, diminished inflammation, and enhanced angiogenesis. The combined topical application of ND-336 (a small molecule) and the active recombinant MMP-8 (an enzyme) enhanced healing even more, in a strategy that holds considerable promise in healing of diabetic wounds. PMID:26598687

  11. Bitter Melon Extract Promotes Granulation Tissue Growth and Angiogenesis in the Diabetic Wound.

    Science.gov (United States)

    Singh, Rekha; Garcia-Gomez, Ignacio; Gudehithlu, Krishnamurthy P; Singh, Ashok K

    2017-01-01

    Bitter melon is a plant fruit that has been shown to exert a hypoglycemic effect when used systemically in patients with diabetes. This study was designed to investigate the topical effect of bitter melon on diabetic wounds using the wound chamber model in rats. Two bilateral wound chambers were implanted subcutaneously in the thoracic-lumbar region of male Sprague-Dawley rats. Diabetes was induced with streptozotocin 7 days after implantation of wound chambers. After 24 hours of induction of diabetes, aqueous extract of bitter melon was injected into 1 wound chamber, and saline (0.9% sodium chloride solution) was injected into the contralateral chamber once daily for 3 days. Wound fluid was collected on day 4 for analysis, following which rats were euthanized. The granulation tissue encapsulating the wound chamber was removed and processed for histology. Controls included diabetic rats with wound chambers injected with saline (instead of bitter melon) and nondiabetic rats with wound chambers injected with bitter melon. In rats with diabetes, wound granulation tissue treated with bitter melon was well formed, with distinct cellular layers, whereas the saline-treated granulation tissue showed a severe loss of tissue organization and blood vessels. Moreover, the bitter melon treatment increased angiogenesis in the diabetic granulation tissue, marked by abundant microvessels and large blood vessels. In nondiabetic rats, no differences in wound granulation tissues were observed between saline- and bitter melon-treated groups. Bitter melon treatment had no effect on systemic blood glucose levels or insulin receptor substrate 1, suggesting that its stimulatory effect on diabetic granulation tissue was not due to alteration of systemic blood glucose levels. When applied locally to diabetic wounds, bitter melon extract prevents regression of granulation tissue and blood vessels, thus accelerating and improving wound healing.

  12. Detection of RAGE expression and its application to diabetic wound age estimation.

    Science.gov (United States)

    Ji, Xin-Yi; Chen, Yang; Ye, Guang-Hua; Dong, Miao-Wu; Lin, Ke-Zhi; Han, Jun-Ge; Feng, Xiang-Ping; Li, Xing-Biao; Yu, Lin-Sheng; Fan, Yan-Yan

    2017-05-01

    With the prevalence of diabetes, it is becoming important to analyze the diabetic wound age in forensic practice. The present study investigated the time-dependent expression of receptor for advanced glycation end products (RAGE) during diabetic wound healing in mice and its applicability to wound age determination by immunohistochemistry, double immunofluorescence, and Western blotting. After an incision was created in genetically diabetic db/db mice and control mice, mice were killed at posttraumatic intervals ranging from 6 h to 14 days, followed by the sampling of wound margin. Compared with control mice, diabetic mice showed the delayed wound healing. In control and diabetic wound specimens, RAGE immunoreactivity was observed in a small number of polymorphonuclear cells (PMNs), a number of macrophages, and fibroblasts. Morphometrically, the positive ratios of RAGE in macrophages or fibroblasts considerably increased in diabetic wounds during late repair, which exceeded 60% at 7 and 10 days post-injury. There were no control wound specimens to show a ratio of >60% in macrophages or fibroblasts. By Western blotting analysis, the ratios of RAGE to GAPDH were >1.4 in all diabetic wound samples from 7 to 10 days post-injury, which were >1.8 at 10 days after injury. By comparison, no control wound specimens indicated a ratio of >1.4. In conclusion, the expression of RAGE is upregulated and temporally distributed in macrophages and fibroblasts during diabetic wound healing, which might be closely involved in prolonged inflammation and deficient healing. Moreover, RAGE is promising as a useful marker for diabetic wound age determination.

  13. Pseudomonas aeruginosa uses T3SS to inhibit diabetic wound healing

    Science.gov (United States)

    Goldufsky, Josef; Wood, Stephen J.; Jayaraman, Vijayakumar; Majdobeh, Omar; Chen, Lin; Qin, Shanshan; Zhang, Chunxiang; DiPietro, Luisa A.; Shafikhani, Sasha H.

    2015-01-01

    Diabetic foot ulcers are responsible for more hospitalizations than any other complication of diabetes. Bacterial infection is recognized as an important factor associated with impaired healing in diabetic ulcers. Pseudomonas aeruginosa is the most frequently detected Gram-negative pathogen in diabetic ulcers. P. aeruginosa infection has been shown to impair healing in diabetic wounds in a manner that correlates with its ability to form biofilm. While the majority of infections in diabetic ulcers are biofilm associated, 33% of infections are nonbiofilm in nature. P. aeruginosa is the most prevalent Gram-negative pathogen in all diabetic wound types, which suggests that the deleterious impact of P. aeruginosa on healing in diabetic wounds goes beyond its ability to form biofilm and likely involves other factors. The Type III Secretion System (T3SS) virulence structure is required for the pathogenesis of all P. aeruginosa clinical isolates, suggesting that it may also play a role in the inhibition of wound repair in diabetic skin ulcers. We evaluated the role of T3SS in mediating P. aeruginosa–induced tissue damage in the wounds of diabetic mice. Our data demonstrate that P. aeruginosa establishes a robust and persistent infection in diabetic wounds independent of its ability to form biofilm and causes severe wound damage in a manner that primarily depends on its T3SS. PMID:25912785

  14. Evaluation of Topical Tocopherol Cream on Cutaneous Wound Healing in Streptozotocin-Induced Diabetic Rats

    OpenAIRE

    Lin, Teoh Seong; Abd Latiff, Azian; Abd Hamid, Noor Aini; Wan Ngah, Wan Zurinah bt; Mazlan, Musalmah

    2012-01-01

    Diabetes is a common cause of delayed wound healing. The aim of the study was to determine the effect of topical administration of tocopherol cream on the wound healing process in diabetic rats. The study was conducted using 18 male Sprague Dawley rats which were divided into three groups: (I) diabetic rats receiving control cream (n = 6), (II) diabetic rats receiving 0.06% tocopherol cream (n = 6), and (III) diabetic rats receiving 0.29% tocopherol cream (n = 6). Four cutaneous wounds were c...

  15. The Mechanism of Protracted Wound Healing on Oral Mucosa in Diabetes. Review

    Directory of Open Access Journals (Sweden)

    Yoshihiro Abiko

    2010-08-01

    Full Text Available Diabetic patients increase their body’s susceptibility to infection and diabetes is a risk factor for periodontal diseases and oral infection. Although many studies showed the mechanism of impaired wound healing in diabetes, there are still arguments to shed light on what kind of factors, including local and systemic factors are involved in the protracted wound healing. This review article summarizes reports on the wound healing in diabetes and discusses the mechanism of the protracted wound healing of the oral mucosa in diabetes. Delayed vascularization, reduction in blood flow, decline in innate immunity, decreases in growth factor production, and psychological stresses may be involved in the protracted wound healing of the oral mucosa in diabetics.

  16. The SNaP™ Wound Care System: A Case Series Using a Novel Ultraportable Negative Pressure Wound Therapy Device for the Treatment of Diabetic Lower Extremity Wounds

    Science.gov (United States)

    Lerman, Bruce; Oldenbrook, Leslie; Ryu, Justin; Fong, Kenton D.; Schubart, Peter J.

    2010-01-01

    Although there is significant evidence supporting the use of negative pressure wound therapy (NPWT) for the treatment of lower extremity diabetic ulcers, currently available electrically powered NPWT systems are not ideally suited for treating smaller diabetic foot ulcers. The Smart Negative Pressure (SNaP™) Wound Care System is a novel, ultraportable device that delivers NPWT without the use of an electrically powered pump. It was specifically designed to meet the wound care needs of patients with diabetes. The SNaP System is compact, silent, mobile, easy-to-use, and available off-the-shelf. It is fully disposable and may offer other important benefits over electrically powered systems to both the clinician and patient. We review the evidence for use of NPWT for the treatment of diabetic wounds and discuss the potential benefits of this new NPWT technology for patients with diabetes. We also present a case series of four difficult lower extremity diabetic ulcers that were successfully treated with the SNaP System. This study suggests that the SNaP System may be a useful addition to the armamentarium of the diabetic wound care clinician. PMID:20663444

  17. Coacervate delivery of HB-EGF accelerates healing of type 2 diabetic wounds.

    Science.gov (United States)

    Johnson, Noah R; Wang, Yadong

    2015-01-01

    Chronic wounds such as diabetic ulcers pose a significant challenge as a number of underlying deficiencies prevent natural healing. In pursuit of a regenerative wound therapy, we developed a heparin-based coacervate delivery system that provides controlled release of heparin-binding epidermal growth factor (EGF)-like growth factor (HB-EGF) within the wound bed. In this study, we used a polygenic type 2 diabetic mouse model to evaluate the capacity of HB-EGF coacervate to overcome the deficiencies of diabetic wound healing. In full-thickness excisional wounds on NONcNZO10 diabetic mice, HB-EGF coacervate enhanced the proliferation and migration of epidermal keratinocytes, leading to accelerated epithelialization. Furthermore, increased collagen deposition within the wound bed led to faster wound contraction and greater wound vascularization. Additionally, in vitro assays demonstrated that HB-EGF released from the coacervate successfully increased migration of diabetic human keratinocytes. The multifunctional role of HB-EGF in the healing process and its enhanced efficacy when delivered by the coacervate make it a promising therapy for diabetic wounds. © 2015 by the Wound Healing Society.

  18. Evaluation of Topical Tocopherol Cream on Cutaneous Wound Healing in Streptozotocin-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Teoh Seong Lin

    2012-01-01

    Full Text Available Diabetes is a common cause of delayed wound healing. The aim of the study was to determine the effect of topical administration of tocopherol cream on the wound healing process in diabetic rats. The study was conducted using 18 male Sprague Dawley rats which were divided into three groups: (I diabetic rats receiving control cream , (II diabetic rats receiving 0.06% tocopherol cream , and (III diabetic rats receiving 0.29% tocopherol cream . Four cutaneous wounds were created at the dorsal region of the rats. Wound healing was assessed by total protein content, rate of wound closure estimation, and histological studies on the tenth day after wounding. Tocopherol treatment enhanced the wound healing process by increasing rate of wound closure and total protein content significantly compared to the control group. Histological observation also showed better organized epithelium and more collagen fibers in the tocopherol treated groups. Application of tocopherol cream enhances wound healing process in diabetic condition which is known to cause delay in wound healing.

  19. Treating infected diabetic wounds with superoxidized water as anti-septic agent: a preliminary experience

    International Nuclear Information System (INIS)

    Hadi, S.F.; Khaliq, T.; Zubair, M.; Saaiq, M.; Sikandar, I.

    2007-01-01

    To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds. One hundred known diabetic patients were enrolled. Half were randomized to the intervention group (those whose wounds were managed with superoxidized water) and half to the control group (whose wounds were treated with normal saline) using a table of random numbers. The two groups were matched for age, gender, duration of diabetes and category of wound. All patients received appropriate surgical treatment for their wounds as required. Local wound treatment was carried out daily using superoxidized water soaked gauzes on twice daily basis in the intervention group and normal saline in the control group. The treatment was continued until wound healing. The main outcome measures were duration of hospital stay, downgrading of the wound category, wound healing time and need for interventions such as amputation. Statistically significant differences were found in favour of the superoxidized water group with respect to duration of hospital stay, downgrading of the wound category and wound healing time. Although the initial results of employing superoxidized water for the management of infected diabetic wounds are encouraging, further multicentre clinical trials are warranted before this antiseptic is recommended for general use. It may offer an economical alternative to other expensive antiseptics with positive impact on the prevailing infection rates, patient outcomes and patient satisfaction. (author)

  20. Topically Applied Connective Tissue Growth Factor/CCN2 Improves Diabetic Preclinical Cutaneous Wound Healing: Potential Role for CTGF in Human Diabetic Foot Ulcer Healing

    Directory of Open Access Journals (Sweden)

    F. R. Henshaw

    2015-01-01

    Full Text Available Aims/Hypothesis. Topical application of CTGF/CCN2 to rodent diabetic and control wounds was examined. In parallel research, correlation of CTGF wound fluid levels with healing rate in human diabetic foot ulcers was undertaken. Methods. Full thickness cutaneous wounds in diabetic and nondiabetic control rats were treated topically with 1 μg rhCTGF or vehicle alone, on 2 consecutive days. Wound healing rate was observed on day 14 and wound sites were examined for breaking strength and granulation tissue. In the human study across 32 subjects, serial CTGF regulation was analyzed longitudinally in postdebridement diabetic wound fluid. Results. CTGF treated diabetic wounds had an accelerated closure rate compared with vehicle treated diabetic wounds. Healed skin withstood more strain before breaking in CTGF treated rat wounds. Granulation tissue from CTGF treatment in diabetic wounds showed collagen IV accumulation compared with nondiabetic animals. Wound α-smooth muscle actin was increased in CTGF treated diabetic wounds compared with untreated diabetic wounds, as was macrophage infiltration. Endogenous wound fluid CTGF protein rate of increase in human diabetic foot ulcers correlated positively with foot ulcer healing rate (r=0.406; P<0.001. Conclusions/Interpretation. These data collectively increasingly substantiate a functional role for CTGF in human diabetic foot ulcers.

  1. Effect of aqueous extract of Morus nigra on skin wound healing in type 1 diabetic rats

    OpenAIRE

    Mohammad Mahdi Mirjalili; Shiva Faramarzi; Manasour Esmaeilidehaj; Fatemeh Zare Mehrjardi; Mohammad Ebrahim Rezvani

    2017-01-01

    Introduction: Delay in wound healing is one of several complications of type 1 diabetes. It has been reported that the use of various herbal extracts such as Morus nigra increase the  wound healing.  Since,there are no studies on investigation of the effects of Morus nigra on wound healing in diabetics so this study was conducted to determine wound healing effects of Morus nigra in diabetic rats. Methods: In this experimental study, the fresh fruits were blended and pressed. Then...

  2. Differences in cellular infiltrate and extracellular matrix of chronic diabetic and venous ulcers versus acute wounds

    NARCIS (Netherlands)

    Loots, M. A.; Lamme, E. N.; Zeegelaar, J.; Mekkes, J. R.; Bos, J. D.; Middelkoop, E.

    1998-01-01

    In diabetic patients, wound healing is impaired. We studied the pathogenesis behind this clinical observation by characterizing the pattern of deposition of extracellular matrix (ECM) molecules and the cellular infiltrate in chronic (>8 wk) diabetic wounds, compared with chronic venous ulcers and an

  3. Wound-Healing Peptides for Treatment of Chronic Diabetic Foot Ulcers and Other Infected Skin Injuries

    Directory of Open Access Journals (Sweden)

    Ana Gomes

    2017-10-01

    Full Text Available As the incidence of diabetes continues to increase in the western world, the prevalence of chronic wounds related to this condition continues to be a major focus of wound care research. Additionally, over 50% of chronic wounds exhibit signs and symptoms that are consistent with localized bacterial biofilms underlying severe infections that contribute to tissue destruction, delayed wound-healing and other serious complications. Most current biomedical approaches for advanced wound care aim at providing antimicrobial protection to the open wound together with a matrix scaffold (often collagen-based to boost reestablishment of the skin tissue. Therefore, the present review is focused on the efforts that have been made over the past years to find peptides possessing wound-healing properties, towards the development of new and effective wound care treatments for diabetic foot ulcers and other skin and soft tissue infections.

  4. Time Course Study of Delayed Wound Healing in a Biofilm-Challenged Diabetic Mouse Model

    Science.gov (United States)

    Zhao, Ge; Usui, Marcia L.; Underwood, Robert A.; Singh, Pradeep K.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.

    2012-01-01

    Bacterial biofilm has been shown to play a role in delaying wound healing of chronic wounds, a major medical problem that results in significant healthcare burden. A reproducible animal model could be very valuable for studying the mechanism and management of chronic wounds. Our previous work demonstrated that Pseudomonas aeruginosa (PAO1) biofilmchallenge on wounds in diabetic (db/db) mice significantly delayed wound healing. In this wound time course study, we further characterize the bacterial burden, delayed wound healing and certain aspects of the host inflammatory response in the PAO1 biofilm-challenged db/db mouse model. PAO1 biofilms were transferred onto 2 day old wounds created on the dorsal surface of db/db mice. Control wounds without biofilm-challenge healed by 4 weeks, consistent with previous studies; none of the biofilm-challenged wounds healed by 4 weeks; 64% of the biofilm-challenged wounds healed by 6 weeks; and all of the biofilm-challenged wounds healed by 8 weeks. During the wound healing process, P. aeruginosa were gradually cleared from the wounds while the presence of S. aureus (part of the normal mouse skin flora) increased. Scabs from all unhealed wounds contained 107 P. aeruginosa, which was 100 fold higher than the counts isolated from wound beds (i.e. 99% of the P. aeruginosa was in the scab). Histology and genetic analysis showed proliferative epidermis, deficient vascularization and increased inflammatory cytokines. Hypoxia inducible factor (HIF) expression increased 3 fold in 4 week wounds. In summary, our study demonstrates that biofilm-challenged wounds typically heal in approximately 6 weeks, at least 2 weeks longer than non biofilm-challenged normal wounds. These data suggest that this delayed wound healing model enables the in vivo study of bacterial biofilm responses to host defenses and the effects of biofilms on host wound healing pathways. It may also be used to test anti-biofilm strategies the treatment of chronic wounds

  5. Hexane extract of the seeds of Byrsonima crassifolia accelerates wound healing in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Pérez Gutiérrez, Rosa Martha; Muñiz Ramirez, Alethia

    2013-11-16

    To study the effect of seeds of Byrsonima crassifolia in diabetic wound healing. Wound healing potential of hexane extract in the form of simple ointment for the treatment of dermal wounds was studied in streptozotocin-induced diabetic rats on excision wound, incision wound and dead space wound. Various parameters such as epithelization period, scar area, tensile strength, hydroxyproline, total protein, DNA, hexosamine, uronic acid, antioxidant enzymes including superoxide dismutase (SOD) and catalase activity (CAT) were used to evaluate the effect of B. crassifolia on wound healing. Hexane extract in form topical accelerates the wound healing process by decreasing the surface area of the wound with a significant increase in the rate of wound contraction and tensile strength; increase granulation tissue dry weight, hydroxyproline, total protein, DNA and SOD and CAT when compared with diabetic control. B. crassifolia was effective in promoting diabetic wound healing in rats through the processes of tissue regeneration.

  6. Hypoglycemic, Hypolipidemic, and Wound Healing Potential of Quercetin in Streptozotocin-Induced Diabetic Rats.

    Science.gov (United States)

    Ahmad, Mahrukh; Sultana, Mudasir; Raina, Rajinder; Pankaj, Nrip Kishore; Verma, Pawan Kumar; Prawez, Shahid

    2017-10-01

    Among the dietary polyphenolic, quercetin is the most common compound available in vegetables and fruits. The phytochemicals are used to treat diabetic wounds and diabetes, and specifically dietary polyphenols are being extensively studied for their anti-inflammatory and antioxidant abilities. The objective of the study was to assess the hypoglycemic, hypolipidemic, and wound healing potential of quercetin in streptozotocin (STZ)-induced diabetic Wistar rats. Induction of diabetes was done by intraperitoneally administration of STZ at the dose of 55 mg/kg in Wistar rats. An excision wound was created in diabetic rats that were treated with quercetin (100 mg/kg) orally and quercetin ointment topically to evaluate the antidiabetic and wound healing potential of quercetin. Repeated oral administration of quercetin along with topical application of quercetin ointment in diabetic rats normalized the altered blood glucose, hydroxyproline, and glucosamine levels. Topical application of quercetin ointment alone on the excised wound was sufficient enough to heal the wound area in diabetic rats. The result of the present study indicates that quercetin produces hypoglycemic effect in STZ-induced diabetic rats and normalized plasma lipids and protein profiles. Besides, this quercetin also has an excellent wound healing property when applied topically on the wound area in diabetic rats. Quercetin has hypoglycaemic and hypolipidemic potential in streptozotocin induced diabetes in wistar ratsDermal application along with oral administrations of quercetin has more effective in wound healing in diabetic animalsHistopathological studies of pancreas, skin and liver shows significant reduction in archaeological alterations on quercetin administrations in diabetic rats. Abbreviation used: STZ: Streptozotocin; CMC: Carboxy methyl cellulose; HDL: High density lipoproteins; LDL: low density lipoproteins.

  7. Effect of Omegaven on mast cell concentration in diabetic wound healing.

    Science.gov (United States)

    Babaei, Saeid; Ansarihadipour, Hadi; Nakhaei, Mahmoodreza; Darabi, Mohammadreza; Bayat, Parvindokht; Sakhaei, Mohammadhassan; Baazm, Maryam; Mohammadhoseiny, Atefe

    2017-05-01

    Diabetic wound healing is a complicated process. In all over the world 15% of 200 million diabetic people suffer from diabetic foot problems. Mast cells are known to participate in three phases of wound healing: the inflammatory reaction, angiogenesis and extracellular-matrix reabsorption. The inflammatory reaction is mediated by released histamine and arachidonic acid metabolites. Omega-3 fatty acids alter proinflammatory cytokine production during wound healing which affects the presence of inflammatory cells in wound area as well, but how this events specifically influences the presence of mast cells in wound healing is not clearly understood. This study is conducted to determine the effect of Omegaven, eicosapentaenoic (EPA) and docosahexaenoic (DHA) on pattern of presence of mast cells in diabetic wound area. Diabetic male wistar rats were euthanized at 1, 3, 5, 7 and 15 days after the excision was made. To estimate the number of mast cells histological sections were provided from wound area and stained with toluidine blue. In this relation wound area (8400 microscopic field, 45.69 mm 2 ) were examined by stereological methods by light microscope. We found that comparing experimental and control group, omega-3 fatty acids significantly decreased wound area in day 7 and also the number of grade three mast cells in day 3 and 5. We also found that wound strength has significantly increased in experimental group at day 15. Copyright © 2016. Published by Elsevier Ltd.

  8. Evaluation of wound healing potential of Pterocarpus marsupium heart wood extract in normal and diabetic rats

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhal

    2012-01-01

    Full Text Available Aim: The aim of the present study is to evaluate and compare the cutaneous wound healing potential of Pterocarpus marsupium in normal and diabetic rats and make inference for the cutaneous wound healing potential by possible "mode of action" P. marsupium extract. Materials and Methods: The effect of heart wood extract of P. marsupium on wound healing has been studied in diabetic and normal animals. The effect has also been compared with standard (mupirocin ointment application. In the absence of specific animal model for cutaneous diabetic wound healing, we have used common model of wound healing (excision wound model in animals having diabetes (by administration of alloxan monohydrate 120 mg/kg i.p.. Statistics Analysis: Data were analyzed by using one-way ANOVA, followed by Tukey′s post hoc tests, using the Graph Pad Software (5.0 demo version, and P value <0.05 was considered to be significant. Results and Conclusion : Rats treated with 200 mg/kg/day of P. marsupium heart wood extract had high rate of wound contraction, significantly decreased epithelization period, and significant increase in dry weight, wet weight, and hydroxyproline content of the granulation tissue when compared with the diabetic control and normal control groups. Wound contraction together with increased tensile strength and hydroxyproline content support the use of P. marsupium heart wood extract in the management of wound healing in normal and diabetic rats.

  9. The effect of diabetes on the wound healing potential of adipose-tissue derived stem cells.

    Science.gov (United States)

    Kim, Sue Min; Kim, Yun Ho; Jun, Young Joon; Yoo, Gyeol; Rhie, Jong Won

    2016-03-01

    To investigate whether diabetes mellitus affects the wound-healing-promoting potential of adipose tissue-derived stem cells, we designed a wound-healing model using diabetic mice. We compared the degree of wound healing between wounds treated with normal adipose tissue-derived stem cells and wounds treated with diabetic adipose tissue-derived stem cells. We evaluated the wound-healing rate, the epithelial tongue distance, the area of granulation tissue, the number of capillary and the number of Ki-67-stained cells. The wound-healing rate was significantly higher in the normal adipose tissue-derived stem cells group than in the diabetic adipose tissue-derived stem cells group; it was also significantly higher in the normal adipose tissue-derived stem cells group than in the control group. Although the diabetic adipose tissue-derived stem cells group showed a better wound-healing rate than the control group, the difference was not statistically significant. Similar trends were observed for the other parameters examined: re-epithelisation and keratinocyte proliferation; granulation tissue formation; and dermal regeneration. However, with regard to the number of capillary, diabetic adipose tissue-derived stem cells retained their ability to promote neovasculisation and angiogenesis. These results reflect the general impairment of the therapeutic potential of diabetic adipose tissue-derived stem cells in vivo. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  10. Advanced nanofibrous textile-based dressing material for treating ...

    Indian Academy of Sciences (India)

    2018-02-02

    Feb 2, 2018 ... Abstract. In the present work, an electrospun nanofibrous textile composed of polyurethane (PU), sodium bicarbonate. (NaHCO3) and pantothenic acid (PA) is developed for treating chronic wounds. Wounds are a common health problem and in particular, the chronic wounds such as vascular ulcers, ...

  11. Delayed Wound Healing in Diabetic (db/db) Mice with Pseudomonas aeruginosa Biofilm Challenge – A Model for the Study of Chronic Wounds

    Science.gov (United States)

    Zhao, Ge; Hochwalt, Phillip C.; Usui, Marcia L.; Underwood, Robert A.; Singh, Pradeep K.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.

    2010-01-01

    Chronic wounds are a major clinical problem that leads to considerable morbidity and mortality. We hypothesized that an important factor in the failure of chronic wounds to heal was the presence of microbial biofilm resistant to antibiotics and protected from host defenses. A major difficulty in studying chronic wounds is the absence of suitable animal models. The goal of this study was to create a reproducible chronic wound model in diabetic mice by application of bacterial biofilm. Six millimeter punch biopsy wounds were created on the dorsal surface of diabetic (db/db) mice, subsequently challenged with Pseudomonas aeruginosa (PAO1) biofilms two days post-wounding, and covered with semi-occlusive dressings for two weeks. Most of the control wounds were epithelialized by 28 days post-wounding. In contrast, none of biofilm challenged wounds were closed. Histological analysis showed extensive inflammatory cell infiltration, tissue necrosis and epidermal hyperplasia adjacent to challenged wounds- all indicators of an inflammatory non-healing wound. Quantitative cultures and transmission electron microscopy demonstrated that the majority of bacteria were in the scab above the wound bed rather than in the wound tissue. The model was reproducible, allowed localized cutaneous wound infections without high mortality and demonstrated delayed wound healing following biofilm challenge. This model may provide an approach to study the role of microbial biofilms in chronic wounds as well as the effect of specific biofilm therapy on wound healing. PMID:20731798

  12. Abnormal Cell Responses and Role of TNF-α in Impaired Diabetic Wound Healing

    Science.gov (United States)

    Xu, Fanxing; Zhang, Chenying; Graves, Dana T.

    2013-01-01

    Impaired diabetic wound healing constitutes a major health problem. The impaired healing is caused by complex factors such as abnormal keratinocyte and fibroblast migration, proliferation, differentiation, and apoptosis, abnormal macrophage polarization, impaired recruitment of mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs), and decreased vascularization. Diabetes-enhanced and prolonged expression of TNF-α also contributes to impaired healing. In this paper, we discuss the abnormal cell responses in diabetic wound healing and the contribution of TNF-α. PMID:23484152

  13. The Extract of Lycium depressum Stocks Enhances Wound Healing in Streptozotocin-Induced Diabetic Rats.

    Science.gov (United States)

    Naji, Siamak; Zarei, Leila; Pourjabali, Masoumeh; Mohammadi, Rahim

    2017-06-01

    In diabetes, impaired wound healing and other tissue abnormalities are considered major concerns. The aim of the present study was to assess the wound-healing activity of methanolic extracts of the extract of Lycium depressum leaves. A total of 60 healthy male Wistar diabetic rats weighing approximately 160 to 180 g and 7 weeks of age were randomized into 10 groups for incision and excision wound models: sham surgery group (SHAM), including creation of wounds and no treatment; base formulation group (FG) with creation of wounds and application of base formulation ointment; treatment group 1 (TG1) with 1 g of powder extract of the plant material in ointment; treatment group 2 (TG2) with 2 g; and treatment group 4 (TG3) with 4 g of powder extract of the plant material in ointment. A wound was induced by an excision- and incision-based wound model in male rats. The mature green leaves of L depressum were collected and authenticated. Extractions of dried leaves were carried out. For wound-healing activity, the extracts were applied topically in the form of ointment and compared with control groups. The healing of the wound was assessed based on excision, incision, hydroxyproline estimation, and biomechanical and biochemical studies. The extract of L depressum leaves enhanced wound contraction, decreased epithelialization time, increased hydroxyproline content, and improved mechanical indices and histological characteristics in treatment groups compared with SHAM and FG ( P wound healing in a diabetes induced model.

  14. Investigation on the effects of the atmospheric pressure plasma on wound healing in diabetic rats

    Science.gov (United States)

    Fathollah, Sara; Mirpour, Shahriar; Mansouri, Parvin; Dehpour, Ahmad Reza; Ghoranneviss, Mahmood; Rahimi, Nastaran; Safaie Naraghi, Zahra; Chalangari, Reza; Chalangari, Katalin Martits

    2016-02-01

    It is estimated that 15 percent of individuals with diabetes mellitus suffer from diabetic ulcers worldwide. The aim of this study is to present a non-thermal atmospheric plasma treatment as a novel therapy for diabetic wounds. The plasma consists of ionized helium gas that is produced by a high-voltage (8 kV) and high-frequency (6 kHz) power supply. Diabetes was induced in rats via an intravascular injection of streptozotocin. The plasma was then introduced to artificial xerograph wounds in the rats for 10 minutes. Immunohistochemistry assays was performed to determine the level of transforming growth factor (TGF-β1) cytokine. The results showed a low healing rate in the diabetic wounds compared with the wound-healing rate in non-diabetic animals (P diabetic rats (P treatment compared with untreated diabetic wounds (P treatment also resulted in the release of TGF-β1 cytokine from cells in the tissue medium. The findings of this study demonstrate the effect of plasma treatment for wound healing in diabetic rats.

  15. Cultured fibroblasts from chronic diabetic wounds on the lower extremity (non-insulin-dependent diabetes mellitus) show disturbed proliferation

    NARCIS (Netherlands)

    Loots, M. A.; Lamme, E. N.; Mekkes, J. R.; Bos, J. D.; Middelkoop, E.

    1999-01-01

    Patients with diabetes mellitus experience impaired wound healing often resulting in chronic foot ulcers. Hospital discharge data indicate that 6-20% of all diabetic individuals hospitalized (mostly with type 2 diabetes) have a lower extremity ulcer. Maintaining glucose levels at acceptable levels

  16. A concomitant review of the effects of diabetes mellitus and hypothyroidism in wound healing

    Science.gov (United States)

    Ekmektzoglou, Konstantinos A; Zografos, Georgios C

    2006-01-01

    This paper reviews the negative impact of diabetes mellitus or hypothyroidism on wound healing, both in experimental and clinical settings. Since both are metabolic disorders of great clinical importance, special attention is given, not only to their pathophysiology, but also to their biochemical and histological effects on tissue integrity and regeneration. Also, special focus is awarded on wound healing of the gastrointestinal tract, i.e. in intestinal anastomosis, and how these disorders can lead to wound dehiscence. Since diabetes mellitus and hypothyroidism can coexist in clinical settings, more research must be directed on their influence on wound healing, considering them as one clinical entity. PMID:16718759

  17. Syndecan-4 enhances PDGF-BB activity in diabetic wound healing.

    Science.gov (United States)

    Das, Subhamoy; Majid, Marjan; Baker, Aaron B

    2016-09-15

    Non-healing ulcers are a common consequence of long-term diabetes and severe peripheral vascular disease. These non-healing wounds are a major source of morbidity in patients with diabetes and place a heavy financial burden on the healthcare system. Growth factor therapies are an attractive strategy for enhancing wound closure in non-healing wounds but have only achieved mixed results in clinical trials. Platelet derived growth factor-BB (PDGF-BB) is the only currently approved growth factor therapy for non-healing wounds. However, PDGF-BB therapy is not effective in many patients and requires high doses that increase the potential for side effects. In this work, we demonstrate that syndecan-4 delivered in a proteoliposomal formulation enhances PDGF-BB activity in diabetic wound healing. In particular, syndecan-4 proteoliposomes enhance the migration of keratinocytes derived from patients with diabetes. In addition, syndecan-4 proteoliposomes sensitize keratinocytes to PDGF-BB stimulation, enhancing the intracellular signaling response to PDGF-BB. We further demonstrated that co-therapy with syndecan-4 proteoliposomes enhanced wound closure in diabetic, hyperlipidemic ob/ob mice. Wounds treated with both syndecan-4 proteoliposomes and PDGF-BB had increased re-epithelization and angiogenesis in comparison to wounds treated with PDGF-BB alone. Moreover, the wounds treated with syndecan-4 proteoliposomes and PDGF-BB also had increased M2 macrophages and reduced M1 macrophages, suggesting syndecan-4 delivery induces immunomodulation within the healing wounds. Together our findings support that syndecan-4 proteoliposomes markedly improve PDGF-BB efficacy for wound healing and may be useful in enhancing treatments for non-healing wounds. Non-healing wounds are major healthcare issue for patients with diabetes and peripheral vascular disease. Growth factor therapies have potential for healing chronic wounds but have not been effective for many patients. PDGF-BB is

  18. Prediction of Wound Healing in Diabetic Foot Ulcers: an Observational Study in Tertiary Hospital in Indonesia

    Directory of Open Access Journals (Sweden)

    Pradana Soewondo

    2017-04-01

    Full Text Available Aim: to evaluate the role of clinical characteristics, functional markers of vasodilation, inflammatory response, and atherosclerosis in predicting wound healing in diabetic foot ulcer. Methods: a cohort study (February – October 2010 was conducted from 40 subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each subject underwent at least two variable measurements, i.e. during inflammatory phase and proliferation phase. The studied variables were clinical characteristics, complete peripheral blood count (CBC and differential count, levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG, marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA, endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery, and marker of vascular calcification (osteoprotegerin/OPG. Results: median of time achieving 50% granulation tissue in our study was 21 days. There were nine factors that contribute in the development of 50% granulation tissue, i.e. family history of diabetes mellitus (DM, previous history of wound, wound area, duration of existing wound, captopril and simvastatin medications, levels of ADMA, ET-1, and OPG. There were three out of the nine factors that significantly correlated with wound healing, i.e. wound area, OPG levels, and simvastatin medications. Conclusion: in acute diabetic foot ulcers, wound area and OPG levels had positive correlation with wound healing, whereas simvastatin medications had negative correlation with wound healing.

  19. Sympathetic Denervation Accelerates Wound Contraction but Inhibits Reepithelialization and Pericyte Proliferation in Diabetic Mice

    Directory of Open Access Journals (Sweden)

    Zhifang Zheng

    2017-01-01

    Full Text Available Previous studies focused on the effects of sympathetic denervation with 6-hydroxydopamine (6-OHDA on nondiabetic wounds, but the effects of 6-OHDA on diabetic wounds have not been previously reported. In this study, treated mice received intraperitoneal 6-OHDA, and control mice received intraperitoneal injections of normal saline. Full-thickness wounds were established on the backs of mice. The wounds were sectioned (four mice per group for analysis at 2, 5, 7, 10, 14, 17, and 21 days after injury. The wound areas in the control group were larger than those in the treatment group. Histological scores for epidermal and dermal regeneration were reduced in the 6-OHDA-treated group on day 21. The mast cells (MCs in each field decreased after sympathectomy on days 17 and 21. The expression levels of norepinephrine, epidermal growth factor (EGF, interleukin-1 beta, NG2 proteoglycan, and desmin in the treatment group were less than those in the control group. In conclusion, 6-OHDA delays reepithelialization during wound healing in diabetic mice by decreasing EGF, but increases wound contraction by reducing IL-1β levels and the number of MCs. Besides, 6-OHDA led to reduced pericyte proliferation in diabetic wounds, which might explain the vascular dysfunction after sympathetic nerve loss in diabetic wounds.

  20. Polydeoxyribonucleotide stimulates angiogenesis and wound healing in the genetically diabetic mouse.

    Science.gov (United States)

    Galeano, Mariarosaria; Bitto, Alessandra; Altavilla, Domenica; Minutoli, Letteria; Polito, Francesca; Calò, Margherita; Lo Cascio, Patrizia; Stagno d'Alcontres, Francesco; Squadrito, Francesco

    2008-01-01

    Healing of diabetic wounds still remains a critical medical problem. Polydeoxyribonucleotide (PDRN), a compound having a mixture of deoxyribonucleotide polymers, stimulates the A2 purinergic receptor with no toxic or adverse effect. We studied the effects of PDRN in diabetes-related healing defect using an incisional skin-wound model produced on the back of female diabetic mice (db+/db+) and their normal littermates (db+/+m). Animals were treated daily for 12 days with PDRN (8 mg/kg/ip) or its vehicle (100 muL 0.9%NaCl). Mice were killed 3, 6, and 12 days after skin injury to measure vascular endothelial growth factor (VEGF) mRNA expression and protein synthesis, to assay angiogenesis and tissue remodeling through histological evaluation, and to study CD31, Angiopoietin-1 and Transglutaminase-II. Furthermore, we measured wound breaking strength at day 12. PDRN injection in diabetic mice resulted in an increased VEGF message (vehicle=1.0+/-0.2 n-fold vs. beta-actin; PDRN=1.5+/-0.09 n-fold vs. beta-actin) and protein wound content on day 6 (vehicle=0.3+/-0.07 pg/wound; PDRN=0.9+/-0.1 pg/wound). PDRN injection improved the impaired wound healing and increased the wound-breaking strength in diabetic mice. PDRN also caused a marked increase in CD31 immunostaining and induced Transglutaminase-II and Angiopoietin-1 expression. Furthermore, the concomitant administration of 3,7-dimethyl-1-propargilxanthine, a selective adenosine A2A receptor antagonist, abolished PDRN positive effects on healing. However, 3,7-dimethyl-1-propargilxanthine alone did not affect wound healing in both diabetic mice and normal littermates. These results suggest that PDRN might be useful in wound disorders associated with diabetes.

  1. Poly-ADP-ribose polymerase inhibition enhances ischemic and diabetic wound healing by promoting angiogenesis.

    Science.gov (United States)

    Zhou, Xin; Patel, Darshan; Sen, Sabyasachi; Shanmugam, Victoria; Sidawy, Anton; Mishra, Lopa; Nguyen, Bao-Ngoc

    2017-04-01

    Chronic nonhealing wounds are a major health problem for patients in the United States and worldwide. Diabetes and ischemia are two major risk factors behind impaired healing of chronic lower extremity wounds. Poly-ADP-ribose polymerase (PARP) is found to be overactivated with both ischemic and diabetic conditions. This study seeks a better understanding of the role of PARP in ischemic and diabetic wound healing, with a specific focus on angiogenesis and vasculogenesis. Ischemic and diabetic wounds were created in FVB/NJ mice and an in vitro scratch wound model. PARP inhibitor PJ34 was delivered to the animals at 10 mg/kg/d through implanted osmotic pumps or added to the culture medium, respectively. Animal wound healing was assessed by daily digital photographs. Animal wound tissues, peripheral blood, and bone marrow cells were collected at different time points for further analysis with Western blot and flow cytometry. Scratch wound migration and invasion angiogenesis assays were performed using human umbilical vein endothelial cells (HUVECs). Measurements were reported as mean ± standard deviation. Continuous measurements were compared by t-test. P < .05 was considered statistically significant. A significant increase in PARP activity was observed under ischemic and diabetic conditions that correlated with delayed wound healing and slower HUVEC migration. The beneficial effect of PARP inhibition with PJ34 on ischemic and diabetic wound healing was observed in both animal and in vitro models. In the animal model, the percentage of wound healing was significantly enhanced from 43% ± 6% to 71% ± 9% (P < .05) by day 7 with the addition of PJ34. PARP inhibition promoted angiogenesis at the ischemic and diabetic wound beds as evidenced by significantly higher levels of endothelial cell markers (vascular endothelial growth factor receptor 2 [VEGFR2] and endothelial nitric oxide synthase) in mice treated with PJ34 compared with controls. Flow cytometry

  2. Neurotensin-loaded collagen dressings reduce inflammation and improve wound healing in diabetic mice.

    Science.gov (United States)

    Moura, Liane I F; Dias, Ana M A; Suesca, Edward; Casadiegos, Sergio; Leal, Ermelindo C; Fontanilla, Marta R; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia

    2014-01-01

    Impaired wound healing is an important clinical problem in diabetes mellitus and results in failure to completely heal diabetic foot ulcers (DFUs), which may lead to lower extremity amputations. In the present study, collagen based dressings were prepared to be applied as support for the delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. The performance of NT alone and NT-loaded collagen matrices to treat wounds in streptozotocin (STZ) diabetic induced mice was evaluated. Results showed that the prepared dressings were not-cytotoxic up to 72h after contact with macrophages (Raw 264.7) and human keratinocyte (HaCaT) cell lines. Moreover, those cells were shown to adhere to the collagen matrices without noticeable change in their morphology. NT-loaded collagen dressings induced faster healing (17% wound area reduction) in the early phases of wound healing in diabetic wounded mice. In addition, they also significantly reduced inflammatory cytokine expression namely, TNF-α (pphase). After complete healing, metalloproteinase 9 (MMP-9) is reduced in diabetic skin (phealing process. Nevertheless, a more prominent scar is observed in diabetic wounds treated with collagen when compared to the treatment with NT alone. © 2013.

  3. PKCδ inhibition normalizes the wound-healing capacity of diabetic human fibroblasts.

    Science.gov (United States)

    Khamaisi, Mogher; Katagiri, Sayaka; Keenan, Hillary; Park, Kyoungmin; Maeda, Yasutaka; Li, Qian; Qi, Weier; Thomou, Thomas; Eschuk, Danielle; Tellechea, Ana; Veves, Aris; Huang, Chenyu; Orgill, Dennis Paul; Wagers, Amy; King, George L

    2016-03-01

    Abnormal fibroblast function underlies poor wound healing in patients with diabetes; however, the mechanisms that impair wound healing are poorly defined. Here, we evaluated fibroblasts from individuals who had type 1 diabetes (T1D) for 50 years or more (Medalists, n = 26) and from age-matched controls (n = 7). Compared with those from controls, Medalist fibroblasts demonstrated a reduced migration response to insulin, lower VEGF expression, and less phosphorylated AKT (p-AKT), but not p-ERK, activation. Medalist fibroblasts were also functionally less effective at wound closure in nude mice. Activation of the δ isoform of protein kinase C (PKCδ) was increased in postmortem fibroblasts from Medalists, fibroblasts from living T1D subjects, biopsies of active wounds of living T1D subjects, and granulation tissues from mice with streptozotocin-induced diabetes. Diabetes-induced PKCD mRNA expression was related to a 2-fold increase in the mRNA half-life. Pharmacologic inhibition and siRNA-mediated knockdown of PKCδ or expression of a dominant-negative isoform restored insulin signaling of p-AKT and VEGF expression in vitro and improved wound healing in vivo. Additionally, increasing PKCδ expression in control fibroblasts produced the same abnormalities as those seen in Medalist fibroblasts. Our results indicate that persistent PKCδ elevation in fibroblasts from diabetic patients inhibits insulin signaling and function to impair wound healing and suggest PKCδ inhibition as a potential therapy to improve wound healing in diabetic patients.

  4. Negative pressure wound therapy in patients with diabetic foot.

    Science.gov (United States)

    Ulusal, Ali Engin; Sahin, M Sükrü; Ulusal, Betül; Cakmak, Gökhan; Tuncay, Cengiz

    2011-01-01

    In this study our aim was to compare the results of standard dressing treatment to negative pressure wound therapy (NPWT) performed with a vacuum-assisted closure (VAC) device in patients with diabetic foot ulcers. We assessed the results of 35 patients treated for diabetic foot ulcer between 2006 and 2008. Of these cases, 20 (4 women and 16 men; mean age: 66 years; range: 52-90 years) were treated with standard wet dressings and 16 feet in 15 patients (10 men, 5 women; mean age: 58.9 years; range: 42-83 years) with VAC therapy. The success of treatment was evaluated in terms of hospitalization length and rate of limb salvation. The average hospitalization period with VAC treatment was 32 days compared to 59 days with standard dressing treatment. All patients treated with standard dressings eventually had to undergo amputation. However, the amputation rate was 37% in the VAC treated group and 88% of patients had a functional extremity at the end of treatment. VAC therapy, together with debridement and appropriate antibiotic therapy, enables a higher rate of limb salvage, especially in Wagner Grade 3 and Grade 4 ulcers.

  5. Biochemical and Biophysical Cues in Matrix Design for Chronic and Diabetic Wound Treatment

    OpenAIRE

    Xiao, Yun; Ahadian, Samad; Radisic, Milica

    2017-01-01

    Progress in biomaterial science and engineering and increasing knowledge in cell biology have enabled us to develop functional biomaterials providing appropriate biochemical and biophysical cues for tissue regeneration applications. Tissue regeneration is particularly important to treat chronic wounds of people with diabetes. Understanding and controlling the cellular microenvironment of the wound tissue are important to improve the wound healing process. In this study, we review different bi...

  6. Study of the effect of PAPA NONOate on the rate of diabetic wound ...

    African Journals Online (AJOL)

    Yomi

    2012-04-03

    Apr 3, 2012 ... The dorsal surface of each rat was properly shaved and given full thickness ... represent a potential treatment for impaired wound healing in diabetes by increasing the rate of collagen synthesis at the wound site. Key words: .... which is reflected by direct measurements of plasma nitrate and nitrite levels.

  7. Topical Application of Sadat-Habdan Mesenchymal Stimulating Peptide (SHMSP Accelerates Wound Healing in Diabetic Rabbits

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    Abdulmohsen H. Al-Elq

    2012-01-01

    Full Text Available Objective. Diminished wound healing is a common problem in diabetic patients due to diminished angiogenesis. SHMSP was found to promote angiogenesis. The present study was carried out to examine the effect of this peptide in healing of wounds in diabetic rabbits. Materials and Methods. Twenty male New Zealand rabbits were used in this study. Diabetes mellitus was induced and the rabbits were randomly divided into two equal groups: control group and peptide group. A-full thickness punch biopsy was made to create a wound of about 10 mm on the right ears of all rabbits. Every day, the wound was cleaned with saline in control groups. In the peptide group, 15 mg of SHMSP was applied after cleaning. On day 15th, all animals were sacrificed, and the wounds were excised with a rim of 5 mm of normal surrounding tissue. Histo-pathological assessment of wound healing, inflammatory cell infiltration, blood vessel proliferation, and collagen deposition was performed. Results. There were no deaths among the groups. There was significant increase in wound healing, blood vessel proliferation and collagen deposition, and significant decrease in inflammatory cell infiltration in the peptide group compared to the control group. Conclusion. Topical application of SHMSP improves wound healing in diabetic rabbits.

  8. Neuroprotectin/protectin D1: endogenous biosynthesis and actions on diabetic macrophages in promoting wound healing and innervation impaired by diabetes.

    Science.gov (United States)

    Hong, Song; Tian, Haibin; Lu, Yan; Laborde, James Monroe; Muhale, Filipe A; Wang, Quansheng; Alapure, Bhagwat V; Serhan, Charles N; Bazan, Nicolas G

    2014-12-01

    Dysfunction of macrophages (MΦs) in diabetic wounds impairs the healing. MΦs produce anti-inflammatory and pro-resolving neuroprotectin/protectin D1 (NPD1/PD1, 10R,17S-dihydroxy-docosa-4Z,7Z,11E,13E,15Z,19Z-hexaenoic acid); however, little is known about endogenous NPD1 biosynthesis by MΦs and the actions of NPD1 on diabetic MΦ functions in diabetic wound healing. We used an excisional skin wound model of diabetic mice, MΦ depletion, MΦs isolated from diabetic mice, and mass spectrometry-based targeted lipidomics to study the time course progression of NPD1 levels in wounds, the roles of MΦs in NPD1 biosynthesis, and NPD1 action on diabetic MΦ inflammatory activities. We also investigated the healing, innervation, chronic inflammation, and oxidative stress in diabetic wounds treated with NPD1 or NPD1-modulated MΦs from diabetic mice. Injury induced endogenous NPD1 biosynthesis in wounds, but diabetes impeded NPD1 formation. NPD1 was mainly produced by MΦs. NPD1 enhanced wound healing and innervation in diabetic mice and promoted MΦs functions that accelerated these processes. The underlying mechanisms for these actions of NPD1 or NPD1-modulated MΦs involved 1) attenuating MΦ inflammatory activities and chronic inflammation and oxidative stress after acute inflammation in diabetic wound, and 2) increasing MΦ production of IL10 and hepatocyte growth factor. Taken together, NPD1 appears to be a MΦs-produced factor that accelerates diabetic wound healing and promotes MΦ pro-healing functions in diabetic wounds. Decreased NPD1 production in diabetic wound is associated with impaired healing. This study identifies a new molecular target that might be useful in development of more effective therapeutics based on NPD1 and syngeneic diabetic MΦs for treatment of diabetic wounds. Copyright © 2014 the American Physiological Society.

  9. Effect of powdered shells treatment of the snail Megalobulimus lopesi on wounds of diabetic rats.

    Science.gov (United States)

    Andrade, Paulo Henrique Muleta; Portugal, Luciane Canderolo; Rondon, Eric Schmidt; Kadri, Monica Cristina Toffoli; Matos, Maria de Fátima Cepa

    2018-02-01

    To analyzed the healing effect of the powdered shell of the Megalobulimus lopesi snail on wounds of diabetic rats, since in non-diabetic rats the powdered shell presented healing potential. Seventy-two Wistar rats (Rattus norvegicus albinus) were divided into three groups: Control group (GC.diab), no therapeutic intervention on the wound; Vehicle's Control group, topical via, in diabetic rats (GCvt.diab): Powder Shell Group (PC) applied topically (GPCvt.diab): Experimental group was administered topically shortly after wound dressing and once a day during the experimental period (3, 7, 14 and 21 days) the composition containing the powdered shell of the snail. The following variables related to the healing potential were analyzed: macroscopic one, where the capacity of reduction of the wound area was evaluated; histological analysis in HE, angiogenic activity, morphometric analysis (re-epithelization), leukocyte inflammatory infiltrate; leukocyte count and also differentiation in peripheral blood. The topical application in wounds of diabetic rats presented healing activity, accelerating wound closure, stimulating angiogenesis and being pro-inflammatory in the early and anti-inflammatory stages in the final times of the healing process. The topical administration of the powdered shell on wounds of diabetic patients becomes a therapeutic option of low cost, with ease in the administration and access as well.

  10. Influence of oxygen on wound healing dynamics in healing-impaired diabetic mice.

    Science.gov (United States)

    Sano, Hitomi; Ichioka, Shigeru

    2015-06-01

    A previous experiment using an in vivo mouse model has proved that hypoxia increased angiogenesis during wound healing. It was hypothesised that one of the mechanisms for wound healing impairment in diabetes includes insufficient angiogenic ability in response to hypoxia. The current study aims to investigate the influence of hypoxia on wound healing in diabetic mice. Oxygen-impermeable (hypoxic group) and -permeable membranes (normoxic group) were used to control topical oxygen tension. Membranes were applied to symmetrical excisional wounds on diabetic mice. Wound area, granulated tissue thickness, and vascular density were analyzed. As results, a decrease in wound size on day 7 was observed in the normoxic group (20.7 ± 3.64%) compared with the hypoxic group (34.1 ± 4.98%). The normoxic group also showed significantly thicker granulated tissue than the hypoxic group (225.7 ± 54.7 vs 128.7 ± 42.4 µm). There was no significant difference in mean vascular density between normoxic and hypoxic groups (0.046 ± 0.022 vs 0.038 ± 0.017 mm(2)/mm(2), p = 0.80). Contrary to healthy mice, diabetic mice have shown no enhancement of angiogenesis in hypoxic condition. The findings illustrate that neovascularisation in response to hypoxia is diminished in diabetic wounds.

  11. The effect of red, green and blue lasers on healing of oral wounds in diabetic rats.

    Science.gov (United States)

    Fekrazad, Reza; Mirmoezzi, Amir; Kalhori, Katayoun Am; Arany, Praveen

    2015-07-01

    Many studies have demonstrated that low-level laser therapy (LLLT) can improve wound healing in non-diabetic and diabetic animals. We compared the effects of red, green, and blue lasers in terms of accelerating oral wound healing in diabetic rats. Diabetes was successfully induced in 32 male Wistar rats using intraperitoneal injection of Streptozotocin (150 mg/kg). After intraperitoneal injection of the anesthetic agent, a full-thickness oral wound (10 mm × 2 mm) was created aseptically with a scalpel on hard palate of the diabetic rats. The study was performed using red (630 nm), green (532 nm), and blue (425 nm) lasers and a control group. We used an energy density of 2J/cm2 and a treatment schedule of 3 times/week for 10 days. The area of wounds was measured and recorded on a chart for all rats. On the 10th day, the samples were then sacrificed and a full-thickness sample of wound area was prepared for pathological study. We observed a significant difference (plaser and two other lasers - blue and green (plaser and green laser (p=0.777). The results of the present study provide evidence that wound healing is slower in control rats compared to the treatment groups. Moreover, the findings suggest that wound healing occurs faster with red laser compared to blue and green lasers. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Deregulated unfolded protein response in chronic wounds of diabetic ob/ob mice: a potential connection to inflammatory and angiogenic disorders in diabetes-impaired wound healing.

    Science.gov (United States)

    Schürmann, Christoph; Goren, Itamar; Linke, Andreas; Pfeilschifter, Josef; Frank, Stefan

    2014-03-28

    Type-2 diabetes mellitus (T2D) represents an important metabolic disorder, firmly connected to obesity and low level of chronic inflammation caused by deregulation of fat metabolism. The convergence of chronic inflammatory signals and nutrient overloading at the endoplasmic reticulum (ER) leads to activation of ER-specific stress responses, the unfolded protein response (UPR). As obesity and T2D are often associated with impaired wound healing, we investigated the role of UPR in the pathologic of diabetic-impaired cutaneuos wound healing. We determined the expression patterns of the three UPR branches during normal and diabetes-impaired skin repair. In healthy and diabetic mice, injury led to a strong induction of BiP (BiP/Grp78), C/EBP homologous protein (CHOP) and splicing of X-box-binding protein (XBP)1. Diabetic-impaired wounds showed gross and sustained induction of UPR associated with increased expression of the pro-inflammatory chemokine macrophage inflammatory protein (MIP)2 as compared to normal healing wounds. In vitro, treatment of RAW264.7 macrophages with tunicamycin, and subsequently stimulation with lipopolysaccharide (LPS) and interferon (IFN)-γ enhances MIP2 mRNA und protein expression compared to proinflammatory stimulation alone. However, LPS/IFNγ induced vascular endothelial growth factor (VEGF) production was blunted by tunicamycin induced-ER stress. Hence, UPR is activated following skin injury, and functionally connected to the production of proinflammatory mediators. In addition, prolongation of UPR in diabetic non-healing wounds aggravates ER stress and weakens the angiogenic phenotype of wound macrophages. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Reparation effects of vacuum wound therapy in patients with diabetic foot syndrome.

    OpenAIRE

    Besedin, A. M.

    2015-01-01

    Vacuum Therapy (Vacuum-assisted closure, VAC) - a method of complex therapy which is used to improve the healing of both acute chronic wounds in patients with diabetic foot syndrome. Due to widespread introduction of this technique, unique cell, extracellular and general effects of its use in the treatment of patients with purulent-necrotic complications of diabetic foot syndrome, a technique of vacuum wound therapy has been successfully used in many surgical departments of Ukraine. Despite t...

  14. Effect of Diabetes Condition on Topical Treatment of Binahong Leaf Fraction in Wound Healing Process

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    Kintoko Kintoko

    2017-08-01

    Full Text Available Diabetes mellitus (DM is a metabolic disease which is becoming the first number of health problem in Indonesia, based on the results of the Basic Health Research of Ministry of Health in 2013. One of the diabetes complications affected by high levels of blood glucose is diabetic ulcers wich 85% the number of cases was overed by amputation as the result of improper handling. Herbal treatments could be an alternative treatment of diabetic ulcers, one of them is binahong plant. The results of previous studies have shown the ability of ethanolic extract of binahong leaf in accelerating wound healing in diabetic rats. This study would be a continued study to test five kinds of binahong leaf fractions (FDB with gradual solvent polarity in accelerating wound healing in diabetic ulcer. Wound healing parameters observed were percentage of wound healing from the wound diameter contraction. The test begins with ethanolic extract of binahong leaf fractionation to produce fractions of hexane (FHDB, chloroform (FKDB, ethyl acetate (FEADB, and ethanol (FEDB. Water fraction (FADB was obtained from ethanolic leaf extract residues of binahong leaf extraction. Each fraction activity was tested topically twice daily on dorsal of test animals that created wounds using a punch biopsy 5 mm diameters. Grouping of test animals were divided into 13 groups with normal control group (non diabetes, negative control (diabetes + topical application of biocream®, positive control (diabetes + topical application of madecassol, and 10 diabetes groups with topical application of 5 kinds of binahong leaf fractions with each fractions consist of a concentrations of 5% and 10% with biocream® as a vehicle. Diabetic parameters measured include blood glucose levels (KGD and weight lost percentage (PB% in day 1 and 10 during a 10-day treatment. The results showed the influence of KGD in the condition of diabetes on wound healing rats diabetic ulcers which topically treated with

  15. Pathogenesis and treatment of impaired wound healing in diabetes mellitus: new insights.

    Science.gov (United States)

    Baltzis, Dimitrios; Eleftheriadou, Ioanna; Veves, Aristidis

    2014-08-01

    Diabetic foot ulcers (DFUs) are one of the most common and serious complications of diabetes mellitus, as wound healing is impaired in the diabetic foot. Wound healing is a dynamic and complex biological process that can be divided into four partly overlapping phases: hemostasis, inflammation, proliferative and remodeling. These phases involve a large number of cell types, extracellular components, growth factors and cytokines. Diabetes mellitus causes impaired wound healing by affecting one or more biological mechanisms of these processes. Most often, it is triggered by hyperglycemia, chronic inflammation, micro- and macro-circulatory dysfunction, hypoxia, autonomic and sensory neuropathy, and impaired neuropeptide signaling. Research focused on thoroughly understanding these mechanisms would allow for specifically targeted treatment of diabetic foot ulcers. The main principles for DFU treatment are wound debridement, pressure off-loading, revascularization and infection management. New treatment options such as bioengineered skin substitutes, extracellular matrix proteins, growth factors, and negative pressure wound therapy, have emerged as adjunctive therapies for ulcers. Future treatment strategies include stem cell-based therapies, delivery of gene encoding growth factors, application of angiotensin receptors analogs and neuropeptides like substance P, as well as inhibition of inflammatory cytokines. This review provides an outlook of the pathophysiology in diabetic wound healing and summarizes the established and adjunctive treatment strategies, as well as the future therapeutic options for the treatment of DFUs.

  16. Differentially expressed wound healing-related microRNAs in the human diabetic cornea.

    Science.gov (United States)

    Funari, Vincent A; Winkler, Michael; Brown, Jordan; Dimitrijevich, Slobodan D; Ljubimov, Alexander V; Saghizadeh, Mehrnoosh

    2013-01-01

    MicroRNAs are powerful gene expression regulators, but their corneal repertoire and potential changes in corneal diseases remain unknown. Our purpose was to identify miRNAs altered in the human diabetic cornea by microarray analysis, and to examine their effects on wound healing in cultured telomerase-immortalized human corneal epithelial cells (HCEC) in vitro. Total RNA was extracted from age-matched human autopsy normal (n=6) and diabetic (n=6) central corneas, Flash Tag end-labeled, and hybridized to Affymetrix® GeneChip® miRNA Arrays. Select miRNAs associated with diabetic cornea were validated by quantitative RT-PCR (Q-PCR) and by in situ hybridization (ISH) in independent samples. HCEC were transfected with human pre-miR™miRNA precursors (h-miR) or their inhibitors (antagomirs) using Lipofectamine 2000. Confluent transfected cultures were scratch-wounded with P200 pipette tip. Wound closure was monitored by digital photography. Expression of signaling proteins was detected by immunostaining and Western blot. Using microarrays, 29 miRNAs were identified as differentially expressed in diabetic samples. Two miRNA candidates showing the highest fold increased in expression in the diabetic cornea were confirmed by Q-PCR and further characterized. HCEC transfection with h-miR-146a or h-miR-424 significantly retarded wound closure, but their respective antagomirs significantly enhanced wound healing vs. controls. Cells treated with h-miR-146a or h-miR-424 had decreased p-p38 and p-EGFR staining, but these increased over control levels close to the wound edge upon antagomir treatment. In conclusion, several miRNAs with increased expression in human diabetic central corneas were found. Two such miRNAs inhibited cultured corneal epithelial cell wound healing. Dysregulation of miRNA expression in human diabetic cornea may be an important mediator of abnormal wound healing.

  17. Differentially expressed wound healing-related microRNAs in the human diabetic cornea.

    Directory of Open Access Journals (Sweden)

    Vincent A Funari

    Full Text Available MicroRNAs are powerful gene expression regulators, but their corneal repertoire and potential changes in corneal diseases remain unknown. Our purpose was to identify miRNAs altered in the human diabetic cornea by microarray analysis, and to examine their effects on wound healing in cultured telomerase-immortalized human corneal epithelial cells (HCEC in vitro. Total RNA was extracted from age-matched human autopsy normal (n=6 and diabetic (n=6 central corneas, Flash Tag end-labeled, and hybridized to Affymetrix® GeneChip® miRNA Arrays. Select miRNAs associated with diabetic cornea were validated by quantitative RT-PCR (Q-PCR and by in situ hybridization (ISH in independent samples. HCEC were transfected with human pre-miR™miRNA precursors (h-miR or their inhibitors (antagomirs using Lipofectamine 2000. Confluent transfected cultures were scratch-wounded with P200 pipette tip. Wound closure was monitored by digital photography. Expression of signaling proteins was detected by immunostaining and Western blot. Using microarrays, 29 miRNAs were identified as differentially expressed in diabetic samples. Two miRNA candidates showing the highest fold increased in expression in the diabetic cornea were confirmed by Q-PCR and further characterized. HCEC transfection with h-miR-146a or h-miR-424 significantly retarded wound closure, but their respective antagomirs significantly enhanced wound healing vs. controls. Cells treated with h-miR-146a or h-miR-424 had decreased p-p38 and p-EGFR staining, but these increased over control levels close to the wound edge upon antagomir treatment. In conclusion, several miRNAs with increased expression in human diabetic central corneas were found. Two such miRNAs inhibited cultured corneal epithelial cell wound healing. Dysregulation of miRNA expression in human diabetic cornea may be an important mediator of abnormal wound healing.

  18. The Effect of Hydroalcoholic Extract of Berberis vulgaris on Wound Healing of Diabetic Wistar Rats

    Directory of Open Access Journals (Sweden)

    Mansoureh Pashaee

    2016-09-01

    Full Text Available Diabetes mellitus is one of the most common diseases of the endocrine system. Barberry (Berberis vulgaris, as a common herb incorporated in treatment of various diseases, is used as anti-itch and anti-microbial medicine as well as lowering blood sugar and blood pressure. In this study, the effects of a hydroalcoholic extract of B. vulgaris on skin wound healing of diabetic rats were investigated. Forty eight male Wistar rats weighting 180 to 230 g were divided into four groups: control group (non-treated non-diabetic rats, sham group (oserin-treated diabetic rats, experimental 1 group (non-treated diabetic rats, experimental 2 group (B. vulgaris extract-treated diabetic rats and then, 3-cm-length cuts were created on the skin of the dorsal lumbar region and then the wounds were treated on a daily basis. Lesion length measurements were conducted during the experiments using a caliper. For the purpose of histological studies, wound samples were taken from each group and finally, statistical data analysis was conducted using the one-way ANOVA test in addition to the Duncan test performed using the SPSS software. The results indicated that the second experimental group had the best influence on wound healing compared to others. Accordingly, the B. vulgaris extract might be able to improve the wound healing process along with reducing the lesion length due to its anti-diabetic and antimicrobial effects in rats after 21 days.

  19. Local Administration of Interleukin-1 Receptor Antagonist Improves Diabetic Wound Healing.

    Science.gov (United States)

    Perrault, David P; Bramos, Athanasios; Xu, Xingtian; Shi, Songtao; Wong, Alex K

    2018-03-16

    Impaired healing of the skin is a notable cause of patient morbidity and mortality. In diabetic individuals, dysregulated inflammation contributes to delayed wound healing. Specific immunomodulatory agents may have a role in the treatment of diabetic wounds. One of these molecules is interleukin-1 receptor antagonist (Anakinra; Amgen Corp.). Although interleukin-1 receptor antagonist (Anakinra; Amgen Corp.) is approved by the Food and Drug Administration (FDA) for the treatment of rheumatoid arthritis and neonatal-onset multisystem inflammatory disease, little is known about the local use this drug in cutaneous wound healing. Therefore, the aim of this study is to determine the effect of locally administered interleukin-1 receptor antagonist on delayed wound healing, specifically, in a diabetic mouse model. Two 6-mm full-thickness wounds were created on the dorsa of diabetic (db/db) mice and stented. One-hour postwounding, wound margins were subcutaneously injected with either (1) low-dose interleukin-1 receptor antagonist in a gelatin-transglutaminase gel vehicle or (2) the gel vehicle only. Wounds were imaged on days 0, 7, 14, and 21 postwounding, and wound area was determined. Wound biopsies were collected on day 21 and immunohistochemically stained for neutrophil and macrophage infiltration. Wounds treated with interleukin-1 receptor antagonist had significantly smaller wound area than nontreated wounds on day 7 and day 14 postwounding. Treated wounds also showed significantly less neutrophil and macrophage infiltration. These findings support the hypothesis that interleukin-1 receptor antagonist may have an important role in cutaneous wound healing, possibly by promoting successful resolution of acute inflammation and hence accelerating wound closure. Thereby, administration of IL-1Ra may be useful in the treatment of nonhealing wounds.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives

  20. Biochemical and Biophysical Cues in Matrix Design for Chronic and Diabetic Wound Treatment.

    Science.gov (United States)

    Xiao, Yun; Ahadian, Samad; Radisic, Milica

    2017-02-01

    Progress in biomaterial science and engineering and increasing knowledge in cell biology have enabled us to develop functional biomaterials providing appropriate biochemical and biophysical cues for tissue regeneration applications. Tissue regeneration is particularly important to treat chronic wounds of people with diabetes. Understanding and controlling the cellular microenvironment of the wound tissue are important to improve the wound healing process. In this study, we review different biochemical (e.g., growth factors, peptides, DNA, and RNA) and biophysical (e.g., topographical guidance, pressure, electrical stimulation, and pulsed electromagnetic field) cues providing a functional and instructive acellular matrix to heal diabetic chronic wounds. The biochemical and biophysical signals generally regulate cell-matrix interactions and cell behavior and function inducing the tissue regeneration for chronic wounds. Some technologies and devices have already been developed and used in the clinic employing biochemical and biophysical cues for wound healing applications. These technologies can be integrated with smart biomaterials to deliver therapeutic agents to the wound tissue in a precise and controllable manner. This review provides useful guidance in understanding molecular mechanisms and signals in the healing of diabetic chronic wounds and in designing instructive biomaterials to treat them.

  1. Angelica Dahurica ethanolic extract improves impaired wound healing by activating angiogenesis in diabetes.

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    Xiao-Na Zhang

    Full Text Available Abnormal angiogenesis plays an important role in impaired wound healing and development of chronic wounds in diabetes mellitus. Angelica dahurica radix is a common traditional Chinese medicine with wide spectrum medicinal effects. In this study, we analyzed the potential roles of Angelica dahurica ethanolic extract (ADEE in correcting impaired angiogenesis and delayed wound healing in diabetes by using streptozotocin-induced diabetic rats. ADEE treatment accelerated diabetic wound healing through inducing angiogenesis and granulation tissue formation. The angiogenic property of ADEE was subsequently verified ex vivo using aortic ring assays. Furthermore, we investigated the in vitro angiogenic activity of ADEE and its underlying mechanisms using human umbilical vein endothelial cells. ADEE treatment induced HUVECs proliferation, migration, and tube formation, which are typical phenomena of angiogenesis, in dose-dependent manners. These effects were associated with activation of angiogenic signal modulators, including extracellular signal-regulated kinase 1/2 (ERK1/2, Akt, endothelial nitric oxide synthase (eNOS as well as increased NO production, and independent of affecting VEGF expression. ADEE-induced angiogenic events were inhibited by the MEK inhibitor PD98059, the PI3K inhibitor Wortmannin, and the eNOS inhibitor L-NAME. Our findings highlight an angiogenic role of ADEE and its ability to protect against impaired wound healing, which may be developed as a promising therapy for impaired angiogenesis and delayed wound healing in diabetes.

  2. Antioxidant Sol-Gel Improves Cutaneous Wound Healing in Streptozotocin-Induced Diabetic Rats

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    Lee, Yen-Hsien; Chang, Jung-Jhih; Chien, Chiang-Ting; Yang, Ming-Chien; Chien, Hsiung-Fei

    2012-01-01

    We examined the effects of vitamin C in Pluronic F127 on diabetic wound healing. Full-thickness excision skin wounds were made in normal and diabetic Wistar rats to evaluate the effect of saline, saline plus vitamin C (antioxidant sol), Pluronic F127, or Pluronic F127 plus vitamin C (antioxidant sol-gel). The rate of wound contraction, the levels of epidermal and dermal maturation, collagen synthesis, and apoptosis production in the wound tissue were determined. In vitro data showed that after 6 hours of air exposure, the order of the scavenging abilities for HOCl, H2O2, and O2  − was antioxidant sol-gel > antioxidant saline > Pluronic F127 = saline. After 7 and 14 days of wound injury, the antioxidant sol-gel improved wound healing significantly by accelerated epidermal and dermal maturation, an increase in collagen content, and a decrease in apoptosis formation. However, the wounds of all treatments healed mostly at 3 weeks. Vitamin C in Pluronic F127 hastened cutaneous wound healing by its antioxidant and antiapoptotic mechanisms through a good drug delivery system. This study showed that Pluronic F127 plus vitamin C could potentially be employed as a novel wound-healing enhancer. PMID:22919368

  3. Feasibility of speckle variance OCT for imaging cutaneous microvasculature regeneration during healing of wounds in diabetic mice

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    Sharma, P.; Kumawat, J.; Kumar, S.; Sahu, K.; Verma, Y.; Gupta, P. K.; Rao, K. D.

    2018-02-01

    We report on a study to assess the feasibility of a swept source-based speckle variance optical coherence tomography setup for monitoring cutaneous microvasculature. Punch wounds created in the ear pinnae of diabetic mice were monitored at different times post wounding to assess the structural and vascular changes. It was observed that the epithelium thickness increases post wounding and continues to be thick even after healing. Also, the wound size assessed by vascular images is larger than the physical wound size. The results show that the developed speckle variance optical coherence tomography system can be used to monitor vascular regeneration during wound healing in diabetic mice.

  4. Use of Vacuum Therapy in the Treatment of Wounds in Patients with Diabetic Foot Syndrome

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    P.O. Herasymchuk

    2016-03-01

    Full Text Available Introduction. Acute and chronic wound defects of the lower extremities occurs in 15–25 % of patients with diabetes mellitus, serving as the direct cause of frequent amputations of lower extremities in 12 % of patients. One of the current and promising directions of wound healing is vacuum therapy. Objective. To study the effect of vacuum therapy on the course of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenic form of the injury, and on the basis of the findings to improve the outcomes of surgical treatment of the above-mentioned pathology. Materials and methods. The study involved 239 patients with complicated forms of diabetic foot syndrome. Monitoring of the wound progress is complemented by clinical, cytological, microbiological and morphological criteria. In the treatment of patients, we have used vacuum therapy device by Agat-Dnepr company. Vacuum therapy of wounds was carried out in the modes of negative pressure within 80–125 mmHg. Results. On the 2nd — 3rd day of vacuum treatment, there was a significant decrease of local manifestations of acute inflammation. At the same time, we have noted a significantly reduction in the amount of wound defects. There were positive changes from the side of wound microbial contamination defects. Application of continuous vacuum therapy in the treatment of wound defects greatly improved the performance of local microcirculation. Conclusions. Use of vacuum therapy in the combination treatment of acute and chronic wounds in patients with diabetic foot syndrome has a local and systemic action that enables to stabilize the course of wound process, to stimulate regenerative processes, to eliminate manifestations of endogenous intoxication and violations of immunological reactivity.

  5. Outcomes of subatmospheric pressure dressing therapy on wounds of the diabetic foot.

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    Armstrong, David G; Lavery, Lawrence A; Abu-Rumman, Patricia; Espensen, Eric H; Vazquez, Jefferey R; Nixon, Brent P; Boulton, Andrew J M

    2002-04-01

    The purpose of this retrospective study was to evaluate outcomes of people with large diabetic foot wounds treated with subatmospheric pressure dressing therapy immediately following surgical wound debridement. Data were abstracted from the medical records of 31 consecutive patients with diabetes, 77.4% male (n = 24), aged 56.1 +/- 11.7 years, presenting for care at two large multidisciplinary wound care centers. All patients received surgical debridement for indolent diabetic foot wounds and were subsequently started on a regimen of subatmospheric pressure dressing therapy delivered using a vacuum-assisted closure device for a mean of 4.7 +/- 4.2 weeks (mode = 2 weeks) using a protocol that called for cessation of therapy when the wound bed approached 100% coverage with granulation tissue with no exposed tendon, joint capsule, or bone. Outcomes evaluated included time to complete wound closure, proportion of patients achieving wound healing at the level of initial debridement, and complications associated with use of the device. The mean duration of wounds before therapy was 25.4 +/- 23.8 weeks. In patients treated with subatmospheric pressure dressing therapy, 90.3% (n = 28) of wounds healed at the level of debridement without the need for further bony resection in a mean 8.1 +/- 5.5 weeks. The remaining 9.7% (n = 3) went on to higher level amputation (below knee amputation = 3.2%, [n = 1] and transmetatarsal amputation = 6.5% [n = 2]). Complications included periwound maceration (19.4% [n = 6]), periwound cellulitis (3.2% [n = 1]), and deep space infection (3.2% [n = 1]). The authors concluded that appropriate use of subatmospheric pressure dressing therapy to achieve a rapid granular bed in diabetic foot wounds may have promise in treatment of this population at high risk for amputation and that a large, randomized trial is now indicated.

  6. Negative pressure wound therapy after partial diabetic foot amputation: a multicentre, randomised controlled trial.

    Science.gov (United States)

    Armstrong, David G; Lavery, Lawrence A

    2005-11-12

    Diabetic foot wounds, particularly those secondary to amputation, are very complex and difficult to treat. We investigated whether negative pressure wound therapy (NPWT) improves the proportion and rate of wound healing after partial foot amputation in patients with diabetes. We enrolled 162 patients into a 16-week, 18-centre, randomised clinical trial in the USA. Inclusion criteria consisted of partial foot amputation wounds up to the transmetatarsal level and evidence of adequate perfusion. Patients who were randomly assigned to NPWT (n=77) received treatment with dressing changes every 48 h. Control patients (n=85) received standard moist wound care according to consensus guidelines. NPWT was delivered through the Vacuum Assisted Closure (VAC) Therapy System. Wounds were treated until healing or completion of the 112-day period of active treatment. Analysis was by intention to treat. This study has been registered with , number NCT00224796. More patients healed in the NPWT group than in the control group (43 [56%] vs 33 [39%], p=0.040). The rate of wound healing, based on the time to complete closure, was faster in the NPWT group than in controls (p=0.005). The rate of granulation tissue formation, based on the time to 76-100% formation in the wound bed, was faster in the NPWT group than in controls (p=0.002). The frequency and severity of adverse events (of which the most common was wound infection) were similar in both treatment groups. NPWT delivered by the VAC Therapy System seems to be a safe and effective treatment for complex diabetic foot wounds, and could lead to a higher proportion of healed wounds, faster healing rates, and potentially fewer re-amputations than standard care.

  7. Effects of ethanolic extract of Jasminum grandiflorum Linn. flowers on wound healing in diabetic Wistar albino rats

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    Hirapara, Hiren; Ghori, Vishal; Anovadiya, Ashish; Baxi, Seema; Tripathi, Chandrabhanu

    2017-01-01

    Objective: To evaluate wound healing activity of ethanolic extract of Jasminum grandiflorum Linn. (J. grandiflorum) flowers in diabetic rats. Materials and Methods: Streptozotocin-induced diabetic Wistar albino rats were divided into six groups (n=6).Three groups – diabetic control, positive control (that received Glibenclamide) and treatment (that received J. grandiflorum Linn. Flower extract) were operated for excision wounds (EW). These groups were evaluated for wound contraction and re-ep...

  8. Influence of irradiation on collagen content during wound healing in diabetic rats

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    Almeida, Solange Maria de; Ferreira, Rivea Ines; Boscolo, Frab Norberto [Universidade Estadual de Campinas, SP (Brazil). Faculdade de Odontologia. Dept. de Diagnostico Oral

    2002-12-01

    The aim of the present experimental research was to investigate the effects of electron irradiation on the collagen content and on the organization of the granulation tissue of skin, in diabetic rats. In this study, 48 Wistar rats were assigned to 4 groups: control, irradiated, diabetic and irradiated diabetic. First, diabetes mellitus was induced in the last two groups, by means of a single intravenous injection of streptozotocin. Fifteen days later, all animals underwent a surgery in order to create an excisional wound on their anterior dorsal skin. On the third post-operative day, only an approximately 1-cm-wide area around the wounds was exposed to 1 Gy of 6 MeV electron beam radiation, which was delivered in a single dose. Wound healing was examined by means of polarized light microscopy at 4-, 7-, 13- and 21-day time intervals after wounding. Based upon an essentially qualitative evaluation, it was possible to conclude that local electron irradiation and diabetes' associated dysfunctions caused a decrease in the collagen content of newly-formed tissue, which was more pronounced in irradiated diabetic animals. The macromolecular organization of granulation tissue was delayed in irradiated, diabetic and irradiated diabetic animals, in relation to what was observed in control animals. (author)

  9. Microbiota of Chronic Diabetic Wounds: Ecology, Impact, and Potential for Innovative Treatment Strategies

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    Sónia G. Pereira

    2017-09-01

    Full Text Available World Health Organization considered diabetes as one of the 20th century epidemics, estimating that over 10% of the world population is diabetic or at high risk. Self-assessment studies indicate that diabetic patients consider chronic wounds to affect their quality of life more dramatically than vision loss or renal failure. In addition to being the main reason for diabetic patients’ hospitalization, the economic burden of diabetic chronic wounds is close to 1% of United Kingdom and United States health systems budgets, which exceeds the funds allocated to the treatment of some types of cancer in both countries. Among the factors preceding the emergence of chronic diabetic wounds, also designated diabetic foot ulcers (DFUs, hygiene and pressure in specific areas are under patient control, while others are still far from being understood. A triple impairment in the innervation, immune responses, and vascularization associated to DFU has been extensively studied by the scientific community. However, the skin natural microbiota has only recently emerged as having a tremendous impact on DFU emergence and evolution to chronicity. Despite the great inter- and intra-variability of microbial colonizers, ongoing efforts are now focused on deciphering the impact of commensal and pathogenic microbiota on DFU etiology, as well as the mechanisms of interkingdom microbial–host communication. This review summarizes recent work in this context and offers new microbiological perspectives that may hold potential in the prevention and treatment of chronic diabetic wounds.

  10. Accelerated wound closure in a diabetic mouse model after exposure to phenanthrenequinone.

    Science.gov (United States)

    Polack, Glenda; McCray, Victor; Tyner, Tim; Kane, Saben; Vu, Kennedy; Yamaguchi, Kent; Merriman, Jarrad; Ishimoto, Michael; Hasson, Alam; Sian, Kenty; Yamaguchi, Kent T

    2013-06-01

    Reactive oxygen species (ROS) have been shown to be important in wound healing by promoting angiogenesis (also mentioned by Ushio-Fukai and Nakamura). Likewise ROS have been implicated by toxicological studies as a primary mechanism of air pollution-associated morbidity. We sought to determine how exposure to a reactive diesel exhaust chemical (phenanthrenequinone [PQ]), which promotes formation of ROS and is considered an air pollutant, would affect wound healing. Since wound healing is compromised in diabetic (db) individuals, we examined the effects of PQ on wound healing in a db mouse model. db mice consumed PQ-containing chow for a short period (2 weeks) before wounding and through generations. Wound closure rates and wound vascularization were evaluated 10 days after wounding. The effects of PQ on endothelial cell proliferation and ROS generation in vitro were also measured. db mice exposed to short-term PQ and PQ-exposed first-generation db mice demonstrated the highest closure rates, significantly better than control db mice (P < 0.05). Furthermore, a higher concentration of PQ in sera of db mice coincides with the higher rate of closure. PQ was also shown to produce ROS in cell culture and stimulate endothelial cell proliferation at nanomolar concentrations. Second- and third-generation db mice exposed to PQ did not show improved wound healing. This study suggests that the free radical-generating air pollutant PQ enhances wound closure in the db mouse model possibly by stimulating angiogenesis, as suggested by in vitro results. We speculate that PQ may increase oxidation levels systemically and therefore help modulate inflammation at the wound site. Alternatively, antioxidant mechanisms recruited for wound healing may interfere with PQ metabolism and elimination as it accumulates in sera. Generational resistance to improve wound healing in PQ-exposed db mice could also be due to disturbances in metabolism caused by continuous exposure. In either case

  11. Effects of ethanolic extract of Jasminum grandiflorum Linn. flowers on wound healing in diabetic Wistar albino rats

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    Hiren Hirapara

    2017-08-01

    Full Text Available Objective: To evaluate wound healing activity of ethanolic extract of Jasminum grandiflorum Linn. (J. grandiflorum flowers in diabetic rats. Materials and Methods: Streptozotocin-induced diabetic Wistar albino rats were divided into six groups (n=6.Three groups – diabetic control, positive control (that received Glibenclamide and treatment (that received J. grandiflorum Linn. Flower extract were operated for excision wounds (EW. These groups were evaluated for wound contraction and re-epithelization. The other three groups were operated for incision wounds (IW and dead space wounds (DW. Incision and dead space wounds were produced in the same rats. IWs were analyzed for wound breaking strength and the granulation tissues from DWs were analyzed for dry weight, hydroxyproline content, and histology. Results: IWs and DWs showed significant improvement in wound breaking strength (265.8±10.4 vs 332.5±8.2; p

  12. Investigation of an angiogenesis-promoting topical treatment for diabetic wounds using multimodal microscopy (Conference Presentation)

    Science.gov (United States)

    Li, Joanne; Bower, Andrew J.; Arp, Zane A.; Olson, Eric; Holland, Claire; Chaney, Eric J.; Marjanovic, Marina; Boppart, Stephen A.

    2016-02-01

    Impaired skin wound healing is a significant co-morbid condition of diabetes that is caused by poor microcirculation among other factors. Hypoxia-inducible factors (HIFs) are transcription factors that mediate the effects of decreased levels of oxygen in biological environments. Inducing mild hypoxia in the tissue could promote angiogenesis, a critical step in the wound healing process in diabetic wounds. To investigate the relationship between hypoxia and diabetic wound healing, a topical treatment consisting of a HIF-activating prolyl-hydroxylase inhibitor was administered to the wounded skin of diabetic (db/db) mice. Studies were conducted in accordance with the GSK Policy on the Care, Welfare and Treatment of Laboratory Animals and were reviewed at GSK or by the ethical review process at the institution where the work was performed. The wounded area was tracked in vivo for 28 days utilizing a custom-built multimodal microscopy system. An increase in vascular density around the wounds of treated animals was observed using phase-variance optical coherence tomography (PV-OCT), in comparison to normal controls. In addition, second harmonic generation (SHG) and fluorescence lifetime imaging microscopy (FLIM) were utilized to examine the collagen regeneration and cellular metabolic activity, respectively, in the wounded skin. The utilization of these light based methods can follow metabolic and morphologic changes in the wound healing process in ways not possible with current evaluation processes. Insights demonstrated in these studies could lead to new endpoints for evaluation of the efficacy of drugs and lead to more direct ways of detecting patient response to treatment.

  13. Recombinant human erythropoietin stimulates angiogenesis and wound healing in the genetically diabetic mouse.

    Science.gov (United States)

    Galeano, Mariarosaria; Altavilla, Domenica; Cucinotta, Domenico; Russo, Giuseppina T; Calò, Margherita; Bitto, Alessandra; Marini, Herbert; Marini, Rolando; Adamo, Elena B; Seminara, Paolo; Minutoli, Letteria; Torre, Valerio; Squadrito, Francesco

    2004-09-01

    The effects of recombinant human erythropoietin (rHuEPO) in diabetes-related healing defects were investigated by using an incisional skin-wound model produced on the back of female diabetic C57BL/KsJ-m(+/+)Lept(db) mice (db(+)/db(+)) and their normoglycemic littermates (db(+/+)m). Animals were treated with rHuEPO (400 units/kg in 100 microl s.c.) or its vehicle alone (100 microl). Mice were killed on different days (3, 6, and 12 days after skin injury) for measurement of vascular endothelial growth factor (VEGF) mRNA expression and protein synthesis, for monitoring angiogenesis by CD31 expression, and for evaluating histological changes. Furthermore, we evaluated wound-breaking strength at day 12. At day 6, rHuEPO injection in diabetic mice resulted in an increase in VEGF mRNA expression (vehicle = 0.33 +/- 0.1 relative amount of mRNA; rHuEPO = 0.9 +/- 0.09 relative amount of mRNA; P < 0.05) and protein wound content (vehicle = 23 +/- 5 pg/wound; rHuEPO = 92 +/- 12 pg/wound; P < 0.05) and caused a marked increase in CD31 gene expression (vehicle = 0.18 +/- 0.05 relative amount of mRNA; rHuEPO = 0.98 +/- 0.21 relative amount of mRNA; P < 0.05) and protein synthesis. Furthermore, rHuEPO injection improved the impaired wound healing and, at day 12, increased the wound-breaking strength in diabetic mice (vehicle = 12 +/- 2 g/mm; rHuEPO 21 +/- 5 g/mm; P < 0.05). Erythropoietin may have a potential application in diabetes-related wound disorders.

  14. Pro-Inflammatory Chemokine CCL2 (MCP-1) Promotes Healing in Diabetic Wounds by Restoring the Macrophage Response

    Science.gov (United States)

    Wood, Stephen; Jayaraman, Vijayakumar; Huelsmann, Erica J.; Bonish, Brian; Burgad, Derick; Sivaramakrishnan, Gayathri; Qin, Shanshan; DiPietro, Luisa A.; Zloza, Andrew; Zhang, Chunxiang; Shafikhani, Sasha H.

    2014-01-01

    Prior studies suggest that the impaired healing seen in diabetic wounds derives from a state of persistent hyper-inflammation characterized by harmful increases in inflammatory leukocytes including macrophages. However, such studies have focused on wounds at later time points (day 10 or older), and very little attention has been given to the dynamics of macrophage responses in diabetic wounds early after injury. Given the importance of macrophages for the process of healing, we studied the dynamics of macrophage response during early and late phases of healing in diabetic wounds. Here, we report that early after injury, the diabetic wound exhibits a significant delay in macrophage infiltration. The delay in the macrophage response in diabetic wounds results from reduced Chemokine (C-C motif) ligand 2 (CCL2) expression. Importantly, one-time treatment with chemoattractant CCL2 significantly stimulated healing in diabetic wounds by restoring the macrophage response. Our data demonstrate that, rather than a hyper-inflammatory state; the early diabetic wound exhibits a paradoxical and damaging decrease in essential macrophage response. Our studies suggest that the restoration of the proper kinetics of macrophage response may be able to jumpstart subsequent healing stages. CCL2 chemokine-based therapy may be an attractive strategy to promote healing in diabetic wounds. PMID:24618995

  15. The Influence of Flightless I on Toll-Like-Receptor-Mediated Inflammation in a Murine Model of Diabetic Wound Healing

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    Nadira Ruzehaji

    2013-01-01

    Full Text Available Impaired wound healing and ulceration represent a serious complication of both type 1 and type 2 diabetes. Cytoskeletal protein Flightless I (Flii is an important inhibitor of wound repair, and reduced Flii gene expression in fibroblasts increased migration, proliferation, and adhesion. As such it has the ability to influence all phases of wound healing including inflammation, remodelling and angiogenesis. Flii has the potential to modulate inflammation through its interaction with MyD88 which it an adaptor protein for TLR4. To assess the effect of Flii on the inflammatory response of diabetic wounds, we used a murine model of streptozocin-induced diabetes and Flii genetic mice. Increased levels of Flii were detected in Flii transgenic murine wounds resulting in impaired healing which was exacerbated when diabetes was induced. When Flii levels were reduced in diabetic wounds of Flii-deficient mice, healing was improved and decreased levels of TLR4 were observed. In contrast, increasing the level of Flii in diabetic mouse wounds led to increased TLR4 and NF-κB production. Treatment of murine diabetic wounds with neutralising antibodies to Flii led to an improvement in healing with decreased expression of TLR4. Decreasing the level of Flii in diabetic wounds may therefore reduce the inflammatory response and improve healing.

  16. Pro-inflammatory chemokine CCL2 (MCP-1 promotes healing in diabetic wounds by restoring the macrophage response.

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    Stephen Wood

    Full Text Available Prior studies suggest that the impaired healing seen in diabetic wounds derives from a state of persistent hyper-inflammation characterized by harmful increases in inflammatory leukocytes including macrophages. However, such studies have focused on wounds at later time points (day 10 or older, and very little attention has been given to the dynamics of macrophage responses in diabetic wounds early after injury. Given the importance of macrophages for the process of healing, we studied the dynamics of macrophage response during early and late phases of healing in diabetic wounds. Here, we report that early after injury, the diabetic wound exhibits a significant delay in macrophage infiltration. The delay in the macrophage response in diabetic wounds results from reduced Chemokine (C-C motif ligand 2 (CCL2 expression. Importantly, one-time treatment with chemoattractant CCL2 significantly stimulated healing in diabetic wounds by restoring the macrophage response. Our data demonstrate that, rather than a hyper-inflammatory state; the early diabetic wound exhibits a paradoxical and damaging decrease in essential macrophage response. Our studies suggest that the restoration of the proper kinetics of macrophage response may be able to jumpstart subsequent healing stages. CCL2 chemokine-based therapy may be an attractive strategy to promote healing in diabetic wounds.

  17. The Influence of Flightless I on Toll-Like-Receptor-Mediated Inflammation in a Murine Model of Diabetic Wound Healing

    Science.gov (United States)

    Ruzehaji, Nadira; Mills, Stuart J.; Melville, Elizabeth; Arkell, Ruth; Fitridge, Robert; Cowin, Allison J.

    2013-01-01

    Impaired wound healing and ulceration represent a serious complication of both type 1 and type 2 diabetes. Cytoskeletal protein Flightless I (Flii) is an important inhibitor of wound repair, and reduced Flii gene expression in fibroblasts increased migration, proliferation, and adhesion. As such it has the ability to influence all phases of wound healing including inflammation, remodelling and angiogenesis. Flii has the potential to modulate inflammation through its interaction with MyD88 which it an adaptor protein for TLR4. To assess the effect of Flii on the inflammatory response of diabetic wounds, we used a murine model of streptozocin-induced diabetes and Flii genetic mice. Increased levels of Flii were detected in Flii transgenic murine wounds resulting in impaired healing which was exacerbated when diabetes was induced. When Flii levels were reduced in diabetic wounds of Flii-deficient mice, healing was improved and decreased levels of TLR4 were observed. In contrast, increasing the level of Flii in diabetic mouse wounds led to increased TLR4 and NF-κB production. Treatment of murine diabetic wounds with neutralising antibodies to Flii led to an improvement in healing with decreased expression of TLR4. Decreasing the level of Flii in diabetic wounds may therefore reduce the inflammatory response and improve healing. PMID:23555084

  18. Wound management of chronic diabetic foot ulcers: from the basics to regenerative medicine.

    Science.gov (United States)

    Andrews, Karen L; Houdek, Matthew T; Kiemele, Lester J

    2015-02-01

    Hospital-based studies have shown that mortality rates in individuals with diabetic foot ulcers are about twice those observed in individuals with diabetes without foot ulcers. To assess the etiology and management of chronic diabetic foot ulcers. Literature review. Systematic review of the literature discussing management of diabetic foot ulcers. Since there were only a few randomized controlled trials on this topic, articles were selected to attempt to be comprehensive rather than a formal assessment of study quality. Chronic nonhealing foot ulcers occur in approximately 15% of patients with diabetes. Many factors contribute to impaired diabetic wound healing. Risk factors include peripheral neuropathy, peripheral arterial disease, limited joint mobility, foot deformities, abnormal foot pressures, minor trauma, a history of ulceration or amputation, and impaired visual acuity. With the current treatment for nonhealing diabetic foot ulcers, a significant number of patients require amputation. Diabetic foot ulcers are optimally managed by a multidisciplinary integrated team. Offloading and preventative management are important. Dressings play an adjunctive role. There is a critical need to develop novel treatments to improve healing of diabetic foot ulcers. The goal is to have wounds heal and remain healed. Diabetic neuropathy and peripheral arterial disease are major factors involved in a diabetic foot ulcer. Despite current treatment modalities for nonhealing diabetic foot ulcers, there are a significant number of patients who require amputations. No known therapy will be effective without concomitant management of ischemia, infection, and adequate offloading. © The International Society for Prosthetics and Orthotics 2014.

  19. "Healing Effect of Topical Nifedipine on Skin Wounds of Diabetic Rats "

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    Abbas Ebadi

    2003-07-01

    Full Text Available Non-healing foot ulcers in patients with diabetes are the leading causes of complications such as infection and amputation. Ulceration is the most common single precursor to amputation and has been identified as a causative factor in 85% of lower extremity amputations. It seems that poor outcomes are generally associated with infection, peripheral vascular disease and wounds of increasing depth. Nifedipine, a calcium channel blocker that is mainly used for the treatment of cardiovascular disorders has recently been used to treat wounds caused by peripheral vascular disorders. In present study topical Nifedipine 3% has been used to treat skin wounds in normal and diabetic rats. Effects of Nifedipine were evaluated in three different phases of wound healing process. In both experiments (normal and diabetic rats topical Nifedipine significantly improved inflammatory phase. However, maturation phase was only significantly improved in diabetic rats. Nifedipine did not affect proliferation phase in either group significantly. Overall results of this study showed topical Nifedipine improved skin wound healing process in normal and diabetic rats.

  20. Cytological characterization of wound healing in diabetic patients on the background of the VAC-therapy

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    Besedin A.M.

    2016-05-01

    Full Text Available Recently the vacuum therapy of wounds (Vacuum-assisted closure, VAC is traditionally used method of treatment of wound complications in patients with diabetes in the majority of surgical departments of relevant profile in Ukraine. Due to publications of Ukrainian authors including the popularization of this treatment method, its therapeutic effects and significant advantages as compared with the traditionally used method of treating wounds by dressing in a moist environment (Moist Wound Healing has led to a number of unresolved issues relating to the application VAC-therapy. One of those is the way of assessment of wound process course on a background of the VAC-therapy. One of the most accessible and easy means of diagnostics of wound healing course is the cytological smear of wounds. Despite the long-term use of cytological method of diagnosis of wounds, peculiarities of phase course of wound process in diabetic patients on the background of VAC-therapy remain poorly studied. As a result of our research it was determined that a statistically significant difference between the basic cytological indices in the vacuum group and conventional treatment are revealed by 9-10 days of treatment. A more favorable course of wound healing on the background of vacuum therapy of wounds was reflected in the reduction of neutrophils number from 186,2±10,13 in the first cytogram to 87,3±6,12 in the fourth, presence of fibroblasts on an average of 0.8 in the field of vision on 9-10 days of treatment, absence of a smear microflora print on 7-8 days of treatment. At the end of the treatment in the conventional treatment group degenerative-regenerative index was 0,65±0,37, in the vacuum group – 1,31±0,63.

  1. Targeting O-glycosyltransferase (OGT) to promote healing of diabetic skin wounds.

    Science.gov (United States)

    Runager, Kasper; Bektas, Meryem; Berkowitz, Paula; Rubenstein, David S

    2014-02-28

    Non-healing wounds are a significant source of morbidity. This is particularly true for diabetic patients, who tend to develop chronic skin wounds. O-GlcNAc modification of serine and threonine residues is a common regulatory post-translational modification analogous to protein phosphorylation; increased intracellular protein O-GlcNAc modification has been observed in diabetic and hyperglycemic states. Two intracellular enzymes, UDP-N-acetylglucosamine-polypeptide β-N-acetylglucosaminyl transferase (OGT) and O-GlcNAc-selective N-acetyl-β-D-glucosaminidase (OGA), mediate addition and removal, respectively, of N-acetylglucosamine (GlcNAc) from intracellular protein substrates. Alterations in O-GlcNAc modification of intracellular proteins is linked to diabetes, and the increased levels of protein O-GlcNAc modification observed in diabetic tissues may in part explain some of the observed underlying pathophysiology that contributes to delayed wound healing. We have previously shown that increasing protein O-GlcNAc modification by overexpression of OGT in murine keratinocytes results in elevated protein O-GlcNAc modification and a hyperadhesive phenotype. This study was undertaken to explore the hypothesis that increased O-GlcNAc modification of cellular proteins in diabetic skin could contribute to the delayed wound healing observed in patients with diabetic skin ulcers. In the present study, we show that human keratinocytes cultured under hyperglycemic conditions display increased levels of O-GlcNAc modification as well as a delay in the rate of wound closure in vitro. We further show that specific knockdown of OGT by RNA interference (RNAi) reverses this effect, thereby opening up the opportunity for OGT-targeted therapies to promote wound healing in diabetic patients.

  2. Effects of ethanolic extract ofJasminum grandiflorumLinn. flowers on wound healing in diabeticWistaralbino rats.

    Science.gov (United States)

    Hirapara, Hiren; Ghori, Vishal; Anovadiya, Ashish; Baxi, Seema; Tripathi, Chandrabhanu

    2017-01-01

    To evaluate wound healing activity of ethanolic extract of Jasminum grandiflorum Linn. ( J. grandiflorum ) flowers in diabetic rats. Streptozotocin-induced diabetic Wistar albino rats were divided into six groups (n=6).Three groups - diabetic control, positive control (that received Glibenclamide) and treatment (that received J. grandiflorum Linn. Flower extract) were operated for excision wounds (EW). These groups were evaluated for wound contraction and re-epithelization. The other three groups were operated for incision wounds (IW) and dead space wounds (DW). Incision and dead space wounds were produced in the same rats. IWs were analyzed for wound breaking strength and the granulation tissues from DWs were analyzed for dry weight, hydroxyproline content, and histology. IWs and DWs showed significant improvement in wound breaking strength (265.8±10.4 vs 332.5±8.2; pday 14) in treatment group compared to diabetic control (day 20). No significant improvement was seen in re-epithelization in treatment group. Ethanolic extract of J. grandiflorum Linn. flowers increases granulation tissue formation as well as neo-angiogenesis. It also enhances wound contraction; however, re-epithelization was not significantly affected. J. grandiflorum Linn. flowers could be potentially effective in promotion of diabetic wounds healing by increasing granulation tissue formation and enhancing wound contraction; however, further studies are required for its clinical application.

  3. A concomitant review of the effects of diabetes mellitus and hypothyroidism in wound healing

    OpenAIRE

    Ekmektzoglou, Konstantinos A; Zografos, Georgios C

    2006-01-01

    This paper reviews the negative impact of diabetes mellitus or hypothyroidism on wound healing, both in experimental and clinical settings. Since both are metabolic disorders of great clinical importance, special attention is given, not only to their pathophysiology, but also to their biochemical and histological effects on tissue integrity and regeneration. Also, special focus is awarded on wound healing of the gastrointestinal tract, i.e. in intestinal anastomosis, and how these disorders c...

  4. Study of the effect of PAPA NONOate on the rate of diabetic wound ...

    African Journals Online (AJOL)

    Nine days before wounding, the rats were injected intraperitoneally (IP) with streptozotocin (STZ) (55 mg/kg body weight in citrate buffer 0.1 mol/L, pH 4.5) to induce diabetes. The dorsal surface of each rat was properly shaved and given full thickness dermal wound. The test group (n = 6) was treated with 100 μmole PAPA ...

  5. Activation of mitosis and angiogenesis in diabetes-impaired wound healing by processed human amniotic fluid.

    Science.gov (United States)

    Bazrafshan, Ameneh; Owji, Mohammad; Yazdani, Maryam; Varedi, Masoumeh

    2014-05-15

    Functional characterization of human amniotic fluid (AF) proteome, 845 proteins, has revealed that top three functions are cell proliferation, movement and differentiation, events fundamental to development, and tissue repair. Although these findings fortify the idea that AF components play roles in regeneration-like fetal wound healing, it is not known whether the components endure processing. Therefore, we processed AF and tested its effects on diabetes-impaired wound healing in an animal model. Through a germfree procedure, mature and premature AF samples were collected, respectively, from the mothers of full-term and preterm infants. Excisional wounds were generated on the dorsum of diabetic rats. Wounds were treated on day 3 and harvested on day 7 postwounding. Proliferating cell nuclear antigen and alpha-smooth muscles actin, markers for mitosis and angiogenesis, respectively, were assessed by in situ immunodetection method. Significant increases in the rate of wound closure and proliferating cell nuclear antigen-expressing cells were observed in AF-treated wounds when compared with that of sham and control wounds. Likewise, the number of large vessels was significantly increased in the wounds treated with the AF. However, population of myofibroblasts was not affected by the treatment. The mature and premature AF were almost equally effective. Our data, for the first time, show that processed AF accelerates diabetes-impaired wound healing by activating mitosis and angiogenesis, indicating that bioactive molecules in AF may endure processing. We believe that processed forms of this naturally designed "Cocktail" of bioactive molecules may have multiple clinical applications. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Systemic administration of high-molecular weight hyaluronan stimulates wound healing in genetically diabetic mice.

    Science.gov (United States)

    Galeano, Mariarosaria; Polito, Francesca; Bitto, Alessandra; Irrera, Natasha; Campo, Giuseppe M; Avenoso, Angela; Calò, Margherita; Lo Cascio, Patrizia; Minutoli, Letteria; Barone, Mauro; Squadrito, Francesco; Altavilla, Domenica

    2011-07-01

    Hyaluronic acid (HA), an essential component of the extracellular matrix, is an efficient space filler that maintains hydration, serves as a substrate for assembly of proteoglycans and is involved in wound healing. Although numerous pieces of evidence demonstrate beneficial effects in promoting wound healing in diabetes, a systemic approach has never been tested. We used an incisional wound healing model in genetically diabetic mice to test the effects of systemic injection of HA. Diabetic (n=56) and normoglycemic (n=56) mice were subjected to incision and randomized (8 groups of 7 animals each) to receive HA at different doses, 7.5, 15 and 30mg/kg/i.p., or vehicle (0.9% NaCl solution) for 12days. At the end of the experiment animals were sacrificed and skin wounds were excised for histological, biochemical and molecular analysis. Histology revealed that the most effective dose to improve wound repair and angiogenesis in diabetic mice was 30mg/kg. Furthermore HA injection (30mg/kg) improved the altered healing pattern in diabetic animals, increased skin remodeling proteins TGF-β and transglutaminase-II and restored the altered expression of cyclin B1/Cdc2 complex. Evaluation of skin from diabetic animals injected with HA revealed also an increase in HA content, suggesting that systemic injection may be able to restore the reduced intracellular HA pool of diabetic mice. Finally HA markedly improved skin mechanical properties. These promising results, if confirmed in a clinical setting, may improve the care and management of diabetic patients. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. The Application of Negative Pressure Wound Therapy with Installation in Diabetic Foot Associated with Phlegmon.

    Science.gov (United States)

    Wachal, Krzysztof; Szmyt, Krzysztof; Wachal, Magda; Stanisic, Michał

    2015-03-01

    The negative pressure wound therapy in the treatment of diabetic foot ulcers was used successfully for many years. In the case of complications associated with infection by this type of wound treatment to give very good results. From many years of sustained research on a device that could combine the advantages of the negative pressure wound therapy and drainage flow. Finally, in the last year, the first V.A.C. Ulta (KCI, USA) devices were included to the Polish hospital departments. In this paper we present a case of a patient of successfully using a negative pressure wound therapy with installation via a set of V.A.C. Ulta in the ischemic diabetic foot syndrome complicated by phlegmon and tissue necrosis. The patient was treated in stages. In first stage was performed angioplasty of critically stenosis of the superficial femoral artery segment. Secondly, the resection of the necrotic bone revised fingers and forefoot was conducted, and in the third step the negative pressure wound therapy with installation was used. Finally, the wound was closed by the intermediate thickness skin graft. The total duration of treatment was 21 days. The patient in good general condition with a completely healed wound was discharged. Currently, after the supply with orthopedic equipment, patient regained full mobility.

  8. Use of clinical laboratory parameters to evaluate wound healing potential in diabetes mellitus.

    Science.gov (United States)

    Abu-Rumman, Patricia L; Armstrong, David G; Nixon, Brent P

    2002-01-01

    Clinicians caring for chronic wounds can easily overlook nutritional status. Patients with diabetes are at high risk for primary and secondary malnutrition. Although profiles exist defining the extent of the deficiency, the process of wound healing and the interactions of the macronutrients and micronutrients necessary to accomplish it must first be understood. In elderly patients with diabetes, additional factors such as liver and renal function, the interdependence of the immune system, and protein synthesis, also must be considered. This article provides a practical format to assist clinicians in better evaluating this often difficult-to-assess area of care.

  9. Comparision of Vacuum-Asisted Closure and Moist Wound Dressing in the Treatment of Diabetic Foot Ulcers

    OpenAIRE

    Ravari, Hassan; Modaghegh, Mohammad-Hadi Saeed; Kazemzadeh, Gholam Hosein; Johari, Hamed Ghoddusi; Vatanchi, Attieh Mohammadzadeh; Sangaki, Abolghasem; Shahrodi, Mohammad Vahedian

    2013-01-01

    Background: Vacuum-assisted closure (VAC) is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Materials and Methods: Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days du...

  10. Activation of the EPOR-β common receptor complex by cibinetide ameliorates impaired wound healing in mice with genetic diabetes.

    Science.gov (United States)

    Bitto, Alessandra; Irrera, Natasha; Pizzino, Gabriele; Pallio, Giovanni; Mannino, Federica; Vaccaro, Mario; Arcoraci, Vincenzo; Aliquò, Federica; Minutoli, Letteria; Colonna, Michele R; Galeano, Maria Rosaria; Brines, Michael; De Ponte, Chiara; Collino, Massimo; Squadrito, Francesco; Altavilla, Domenica

    2018-02-01

    Diabetes is characterized by poor wound healing which currently lacks an efficacious treatment. The innate repair receptor (IRR) is a master regulator of tissue protection and repair which is expressed as a response injury or metabolic stress, including in diabetes. Activation of the IRR might provide benefit for diabetic wound healing. A specific IRR agonist cibinetide was administered in an incisional wound healing model performed mice with genetic diabetes (db + /db + ) and compared to the normal wild-type. Animals were treated daily with cibinetide (30μg/kg/s.c.) or vehicle and euthanized 3, 7, and 14days after the injury to quantitate vascular endothelial growth factor (VEGF), malondialdehyde (MAL), phospho-Akt (pAkt), phospho e-NOS (p-eNOS), and nitrite/nitrate content within the wound. Additional evaluations included quantification of skin histological change, angiogenesis, scar strength, and time to complete wound closure. Throughout the wound healing process diabetic animals treated with vehicle exhibited increased wound MAL with reduced VEGF, pAkt, peNOS and nitrite/nitrate, all associated with poor re-epitheliziation, angiogenesis, and wound breaking strength. Cibenitide administration significantly improved these abnormalities. The results suggest that cibinetide-mediated IRR activation may represent an interesting strategy to treat diabetes-associated wound healing. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Combined effect of substance P and curcumin on cutaneous wound healing in diabetic rats.

    Science.gov (United States)

    Kant, Vinay; Kumar, Dinesh; Prasad, Raju; Gopal, Anu; Pathak, Nitya N; Kumar, Pawan; Tandan, Surender K

    2017-05-15

    Our earlier studies demonstrated that topically applied substance P (SP) or curcumin on excision skin wound accelerated the wound healing in streptozotocin-induced diabetic rats. In the present study, we aimed to evaluate the wound healing potential of combination of SP and curcumin in diabetic rats. Open cutaneous excision wound was created on the back of each of the 60 diabetic rats. Wound-inflicted rats were equally divided into three groups namely, control, gel treated, and SP + curcumin treated. Normal saline, pluronic gel, and SP (0.5 × 10 -6 M) + curcumin (0.15%) were topically applied once daily for 19 d to these control, gel-treated, and SP + curcumin groups, respectively. SP + curcumin combination significantly accelerated wound closure and decreased messenger RNA expressions of tumor necrosis factor-alpha, interleukin-1beta, and matrix metalloproteinase-9, whereas the combination markedly increased the expressions of interleukin-10, vascular endothelial growth factor, transforming growth factor-beta1, hypoxia-inducible factor 1-alpha, stromal cell-derived factors-1alpha, heme oxygenase-1 and endothelial nitric oxide synthase, and activities of superoxide dismutase, catalase, and glutathione peroxidase in granulation-healing tissue, compared with control and gel-treated groups. In combination group, granulation tissue was better, as was evidenced by improved fibroblast proliferation, collagen deposition, microvessel density, growth-associated protein 43-positive nerve fibers, and thick regenerated epithelial layer. The combination of SP and curcumin accelerated wound healing in diabetic rats and both the drugs were compatible at the doses used in this study. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Diabetic foot ulcers – evidence-based wound management: A ...

    African Journals Online (AJOL)

    Diabetic foot ulcers have a significant impact on the individual patient's quality of life, potential morbidity and even mortality. Diabetic foot ulcers also consume a gradually increasing portion of our health care budget. Whenever possible the focus should be on prevention rather than cure. All diabetic patients must have both ...

  13. Electrospun chitosan nanofibre membranes for antimicrobial application: role of electrospinning processing parameters

    CSIR Research Space (South Africa)

    Jacobs, V

    2010-01-01

    Full Text Available for biomedical applications such as wound dressing. In this paper, the authors report investigation on the effects of governing parameters on the formation of chitosan nanofibre membranes. These membranes were subjected to various cell cultures for antibacterial...

  14. Interventions for wound healing among diabetic patients infected with Staphylococcus aureus: a systematic review

    OpenAIRE

    Lima, Anacássia Fonseca; Costa, Lívia Bandeira; Silva, Joás Lucas da; Maia, Maria Bernadete Sousa; Ximenes, Eulália Camelo Pessoa Azevedo

    2011-01-01

    CONTEXT AND OBJECTIVE: Staphylococcus aureus is the most frequent agent isolated in diabetic foot infections and may be associated with changes to wound healing times. The aim of this study was to perform a systematic review of the literature, including studies that assessed the efficacy of any clinical or surgical intervention, as well as oral or topical therapy for diabetic ulcers infected with S. aureus. DESIGN AND SETTING: Systematic review with a search conducted in databases. METHODS: W...

  15. The Visualization of Biofilms in Chronic Diabetic Foot Wounds Using Routine Diagnostic Microscopy Methods

    Directory of Open Access Journals (Sweden)

    Angela Oates

    2014-01-01

    Full Text Available Diabetic foot wounds are commonly colonised by taxonomically diverse microbial communities and may additionally be infected with specific pathogens. Since biofilms are demonstrably less susceptible to antimicrobial agents than are planktonic bacteria, and may be present in chronic wounds, there is increasing interest in their aetiological role. In the current investigation, the presence of structured microbial assemblages in chronic diabetic foot wounds is demonstrated using several visualization methods. Debridement samples, collected from the foot wounds of diabetic patients, were histologically sectioned and examined using bright-field, fluorescence, and environmental scanning electron microscopy and assessed by quantitative differential viable counting. All samples (n = 26 harboured bioburdens in excess of 5 log10 CFU/g. Microcolonies were identified in 4/4 samples by all three microscopy methods, although bright-field and fluorescence microscopy were more effective at highlighting putative biofilm morphology than ESEM. Results in this pilot study indicate that bacterial microcolonies and putative biofilm matrix can be visualized in chronic wounds using florescence microscopy and ESEM, but also using the simple Gram stain.

  16. Wound treatment on a diabetic rat model by a 808 nm diode laser

    International Nuclear Information System (INIS)

    Lau, Pik Suan; Bidin, Noriah; Krishnan, Ganesan; AnaybBaleg, Sana Mohammed; Baktiar, Harzi; Marsin, Faridah M; Sum, Mohamad Bin Md; Nassir, Zaleha; Chong, Pek Lian; Hamid, Asmah

    2015-01-01

    This paper presents a study on the effect of laser irradiation on wound healing. 808 nm diode laser was employed to facilitate the healing of impaired wounds in experimental diabetes using a rat model. Diabetes was induced in male rats by a streptozotocin injection with a dose of 60 mg kg −1 . The disease was verified via measurement of the blood glucose level, which was set having 20 mmol L −1 stability. The rats were randomly distributed into two groups; one served as a control group and the other group was treated with the laser. The power density of the laser used was 0.5 W cm −2 and the wounds were treated for 8 d with the contact time of one second daily. The energy density used was 0.5 J cm −2 . The healing progress was recorded via a digital camera. The recorded images were then transferred into Inspector Matrox and image J programs for the accurate measurement of the healing area. The tissue details of the wound were studied through histology. The wound contraction rate of laser therapy group was found to be two times faster than control group. This indicates that the 808 nm diode laser can accelerate the wound healing process. (paper)

  17. Atypical Diabetic Foot Ulcer Keratinocyte Protein Signaling Correlates with Impaired Wound Healing

    Directory of Open Access Journals (Sweden)

    Glenn D. Hoke

    2016-01-01

    Full Text Available Diabetes mellitus is associated with chronic diabetic foot ulcers (DFUs and wound infections often resulting in lower extremity amputations. The protein signaling architecture of the mechanisms responsible for impaired DFU healing has not been characterized. In this preliminary clinical study, the intracellular levels of proteins involved in signal transduction networks relevant to wound healing were non-biasedly measured using reverse-phase protein arrays (RPPA in keratinocytes isolated from DFU wound biopsies. RPPA allows for the simultaneous documentation and assessment of the signaling pathways active in each DFU. Thus, RPPA provides for the accurate mapping of wound healing pathways associated with apoptosis, proliferation, senescence, survival, and angiogenesis. From the study data, we have identified potential diagnostic, or predictive, biomarkers for DFU wound healing derived from the ratios of quantified signaling protein expressions within interconnected pathways. These biomarkers may allow physicians to personalize therapeutic strategies for DFU management on an individual basis based upon the signaling architecture present in each wound. Additionally, we have identified altered, interconnected signaling pathways within DFU keratinocytes that may help guide the development of therapeutics to modulate these dysregulated pathways, many of which parallel the therapeutic targets which are the hallmarks of molecular therapies for treating cancer.

  18. A Novel Autologous Cell Based Therapy to Promote Diabetic Wound Healing

    Science.gov (United States)

    Castilla, Diego M.; Liu, Zhao-Jun; Tian, Runxia; Li, Yan; Livingstone, Alan S.; Velazquez, Omaida C.

    2012-01-01

    Objectives We have previously shown that stromal-derived-factor-1 α(SDF-1α) is down-regulated within diabetic cutaneous wounds, and that direct application of recombinant SDF-1α increases wound closure rates, neovascularization and endothelial progenitor cell(s)(EPC) recruitment. However, increased wound levels of exogenous SDF-1α results in elevated systemic levels of this pro-angiogenic chemokine that raises concerns for tumorgenesis and inflammation. We now seek to test the efficacy of a novel, safer cell-based therapy (CBT) employing ex-vivo primed bone marrow stem cells (BMDSC) with SDF-1 α. We also elucidate the mechanism of action of this new approach for accelerating diabetic wound healing. Methods Unfractionated BMDSC from diabetic Leprdb/db mice were incubated for 20h with SDF-1α(100ng/mL) or BSA(control). Pre-treated-BMDSC (1×106) were injected subcutaneously into full-thickness skin wounds in Leprdb/db mice (n=8/group). Wound closure rates, capillary density and recruitment of EPC were assessed with serial photography, DiI-perfusion, confocal microscopy and immunohistochemistry. Expression of molecular targets, which may mediate pro-healing/pro-angiogenic effects of SDF-1α-primed-BMDSC was evaluated by PCRArray and immunoblotting assay. The biological function of a potential mediator was tested in a mouse wound healing model. Serum SDF-1α levels were measured with ELISA. Results SDF-1α-primed-BMDSC significantly promote wound healing (p<.0001), neovascularization (p=.0028) and EPC recruitment(p=.0059). Gene/ protein expression studies demonstrate up-regulation of EphRB4 and Plasminogen as downstream targets potentially mediating the pro-healing and pro-angiogenic responses. Ex-vivo BMDSC activation and subsequent inoculation of cells into wounds does not increase systemic SDF-1α levels. Conclusion We report a novel CBT that is highly effective in promoting healing and neovascularization in a murine model of Type 2 Diabetes. Furthermore, we

  19. Wound healing effect of Euphorbia hirta linn. (Euphorbiaceae) in alloxan induced diabetic rats.

    Science.gov (United States)

    Tuhin, Riazul Haque; Begum, Mst Marium; Rahman, Md Sohanur; Karim, Rubaba; Begum, Taslima; Ahmed, Siraj Uddin; Mostofa, Ronia; Hossain, Amir; Abdel-Daim, Mohamed; Begum, Rayhana

    2017-08-24

    Euphorbia hirta linn., is a species of Euphorbiaceae family. They are known as asthma plant, barokhervi. The plant E. hirta is famous for its medicinal importance among the tribal population. It is a common practice to use the whole to heal wounds. Several pharmacological properties including antiseptic, anti-inflammatory, antidibetic, antispasmodic, antibacterial, antiviral, antifungal, anticonvulsant, nootropic, antifertility and aphrodisiac properties have already been reported for this plant. The aim of present work was to evaluate the wound healing property in diabetic animals by oral and topical administration of ethanolic extract of E. hirta whole plant. The ethanolic extract of E. hirta was subjected to determine the total phenolic content and total flavonoid content using galic acid and quercetin, respectively as standard. A single injection of alloxan monohydrate (120 mg/kg, i.p.) prepared in normal saline was administered to produce diabetes in rats, after overnight fasting. For analyzing the rate of contraction of wound, excision wounds sized 4.90cm 2 and of 2 mm depth were used. Oral (100, 200 and 400 mg/kg/day; p.o.) and topical treatment with the extract (5% and 10% ointment 50 mg/kg/day) and standard (5% povidone iodine ointment 50 mg/kg/day) was started on the day of induction of wound and continued up to 16 days. The means of wound area measurement between groups at different time intervals were compared using ANOVA and Dunnet's test. The diabetic wound healing mechanism was studied by measuring the plasma level of glucose, malondialdehyde (MDA) and nitric oxide (NO) in both control and treated groups. For the confirmation of activity, histopathology of the wounds tissues from excision wound model was performed. Phytochemical investigations showed the presence of various phytoconstituents (carbohydrates, saponins, alkaloids, glycosides, steroids, flavonoids, tannins). In the ethanolic extract of E. hirta the total phenol content was 285

  20. Wound Healing Activity of Brown Algae plus Polyherbal Extract in Normal and Alloxan-induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Fedekar F. Madkour

    2013-07-01

    Full Text Available The aim of the present study was to assess the wound healing efficacy of the experimental medicinal extract mixture (EMEM composed of brown algae, Cystoseira trinodis, plus three medicinal plants (garlic, liquorice and ginger. The extract was applied on induced excised wounds in rats, either healthy or induced hyperglycemia by alloxan. Healing activity was evaluated for up to 21 days after wounding in terms of decrease in surface area of wound, percentage of wound closure and tissue regeneration using digital planimetry analysis and histopathological examination. The study revealed that topical application of the extract improved and enhanced the healing process in diabetic rat model when compared with diabetic non-treated rats. The extract promoted wound contraction, reduced the wound closure time and induced proliferation of fibroblast as well as angiogenesis and re-epithelialization.

  1. Recovery of Corneal Sensitivity and Increase in Nerve Density and Wound Healing in Diabetic Mice After PEDF Plus DHA Treatment.

    Science.gov (United States)

    He, Jiucheng; Pham, Thang Luong; Kakazu, Azucena; Bazan, Haydee E P

    2017-09-01

    Diabetic keratopathy decreases corneal sensation and tear secretion and delays wound healing after injury. In the current study, we tested the effect of treatment with pigment epithelium-derived factor (PEDF) in combination with docosahexaenoic acid (DHA) on corneal nerve regeneration in a mouse model of diabetes with or without corneal injury. The study was performed in streptozotocin-induced diabetic mice (C57BL/6). Ten weeks after streptozotocin injection, diabetic mice showed significant decreases of corneal sensitivity, tear production, and epithelial subbasal nerve density when compared with age-matched normal mice. After diabetic mice were wounded in the right eye and treated in both eyes with PEDF+DHA for 2 weeks, there was a significant increase in corneal epithelial nerve regeneration and substance P-positive nerve density in both wounded and unwounded eyes compared with vehicle-treated corneas. There also was elevated corneal sensitivity and tear production in the treated corneas compared with vehicle. In addition, PEDF+DHA accelerated corneal wound healing, selectively recruited type 2 macrophages, and prevented neutrophil infiltration in diabetic wounded corneas. These results suggest that topical treatment with PEDF+DHA promotes corneal nerve regeneration and wound healing in diabetic mice and could potentially be exploited as a therapeutic option for the treatment of diabetic keratopathy. © 2017 by the American Diabetes Association.

  2. Community analysis of chronic wound bacteria using 16S rRNA gene-based pyrosequencing: impact of diabetes and antibiotics on chronic wound microbiota.

    Directory of Open Access Journals (Sweden)

    Lance B Price

    Full Text Available BACKGROUND: Bacterial colonization is hypothesized to play a pathogenic role in the non-healing state of chronic wounds. We characterized wound bacteria from a cohort of chronic wound patients using a 16S rRNA gene-based pyrosequencing approach and assessed the impact of diabetes and antibiotics on chronic wound microbiota. METHODOLOGY/PRINCIPAL FINDINGS: We prospectively enrolled 24 patients at a referral wound center in Baltimore, MD; sampled patients' wounds by curette; cultured samples under aerobic and anaerobic conditions; and pyrosequenced the 16S rRNA V3 hypervariable region. The 16S rRNA gene-based analyses revealed an average of 10 different bacterial families in wounds--approximately 4 times more than estimated by culture-based analyses. Fastidious anaerobic bacteria belonging to the Clostridiales family XI were among the most prevalent bacteria identified exclusively by 16S rRNA gene-based analyses. Community-scale analyses showed that wound microbiota from antibiotic treated patients were significantly different from untreated patients (p = 0.007 and were characterized by increased Pseudomonadaceae abundance. These analyses also revealed that antibiotic use was associated with decreased Streptococcaceae among diabetics and that Streptococcaceae was more abundant among diabetics as compared to non-diabetics. CONCLUSIONS/SIGNIFICANCE: The 16S rRNA gene-based analyses revealed complex bacterial communities including anaerobic bacteria that may play causative roles in the non-healing state of some chronic wounds. Our data suggest that antimicrobial therapy alters community structure--reducing some bacteria while selecting for others.

  3. Human fibrocyte-derived exosomes accelerate wound healing in genetically diabetic mice

    Energy Technology Data Exchange (ETDEWEB)

    Geiger, Adolf, E-mail: ageiger@dreirosen-pharma.com; Walker, Audrey, E-mail: awalker@dreirosen-pharma.com; Nissen, Erwin, E-mail: enissen@dreirosen-pharma.com

    2015-11-13

    Diabetic ulcers represent a substantial societal and healthcare burden worldwide and scarcely respond to current treatment strategies. This study was addressed to evaluate the therapeutic potential of exosomes secreted by human circulating fibrocytes, a population of mesenchymal progenitors involved in normal wound healing via paracrine signaling. The exosomes released from cells sequentially stimulated with platelet-derived growth factor-BB and transforming growth factor-β1, in the presence of fibroblast growth factor 2, did not show potential immunogenicity. These exosomes exhibited in-vitro proangiogenic properties, activated diabetic dermal fibroblasts, induced the migration and proliferation of diabetic keratinocytes, and accelerated wound closure in diabetic mice in vivo. Important components of the exosomal cargo were heat shock protein-90α, total and activated signal transducer and activator of transcription 3, proangiogenic (miR-126, miR-130a, miR-132) and anti-inflammatory (miR124a, miR-125b) microRNAs, and a microRNA regulating collagen deposition (miR-21). This proof-of-concept study demonstrates the feasibility of the use of fibrocytes-derived exosomes for the treatment of diabetic ulcers. - Highlights: • Fibrocytes have shown potent wound healing properties in vitro and in vivo. • Their clinical use is precluded by low numbers and antigen-presenting function. • We isolated exosomes with no immunogenicity potential from human fibrocytes. • Their cargo included microRNAs and proteins that are known healing promoters. • They accelerated wound closure in diabetic mice in a dose-dependent manner.

  4. Reparation effects of vacuum wound therapy in patients with diabetic foot syndrome

    Directory of Open Access Journals (Sweden)

    Besedin A.M.

    2015-09-01

    Full Text Available Vacuum Therapy (Vacuum-assisted closure, VAC - a method of complex therapy which is used to improve the healing of both acute chronic wounds in patients with diabetic foot syndrome. Due to widespread introduction of this technique, unique cell, extracellular and general effects of its use in the treatment of patients with purulent-necrotic complications of diabetic foot syndrome, a technique of vacuum wound therapy has been successfully used in many surgical departments of Ukraine. Despite the diversity of the clinical effects of VAC-therapy and appearance of number of publications, in the domestic and foreign literature physiological basis of this method have not been studied completely. The effectiveness of vacuum therapy explain: the reduction of the size of the wound, the stabilization of the wound environment (due to the removal of inflammatory mediators and cytokines, microdeformation and remodeling of cell, rows reduction of edema, reduction of bacterial contamination, etc. At the same time, mechanisms of blood flow enhancement at different duration of VAC-therapy use, remain unclear its effect on the third phase of wound healing process as well.

  5. Composite poly(vinyl alcohol/poly(vinyl acetate electrospun nanofibrous mats as a novel wound dressing matrix for controlled release of drugs

    Directory of Open Access Journals (Sweden)

    Jannesari M

    2011-05-01

    Full Text Available Marziyeh Jannesari1, Jaleh Varshosaz2, Mohammad Morshed1, Maedeh Zamani11Department of Textile Engineering, Isfahan University of Technology, Isfahan, Iran; 2Department of Pharmaceutics, School of Pharmacy and Pharmaceutical Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, IranAbstract: The aim of this study was to develop novel biomedicated nanofiber electrospun mats for controlled drug release, especially drug release directly to an injury site to accelerate wound healing. Nanofibers of poly(vinyl alcohol (PVA, poly(vinyl acetate (PVAc, and a 50:50 composite blend, loaded with ciprofloxacin HCl (CipHCl, were successfully prepared by an electrospinning technique for the first time. The morphology and average diameter of the electrospun nanofibers were investigated by scanning electron microscopy. X-ray diffraction studies indicated an amorphous distribution of the drug inside the nanofiber blend. Introducing the drug into polymeric solutions significantly decreased solution viscosities as well as nanofiber diameter. In vitro drug release evaluations showed that both the kind of polymer and the amount of drug loaded greatly affected the degree of swelling, weight loss, and initial burst and rate of drug release. Blending PVA and PVAc exhibited a useful and convenient method for electrospinning in order to control the rate and period of drug release in wound healing applications. Also, the thickness of the blend nanofiber mats strongly influenced the initial release and rate of drug release.Keywords: biodegradable polymers, drug delivery, controlled release, electrospun nanofibers, wound dressing

  6. Predictive value of neutrophil-to-lymphocyte ratio in diabetic wound healing.

    Science.gov (United States)

    Vatankhah, Nasibeh; Jahangiri, Younes; Landry, Gregory J; McLafferty, Robert B; Alkayed, Nabil J; Moneta, Gregory L; Azarbal, Amir F

    2017-02-01

    The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds. The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer. The subjects' mean age was 59.4 ± 13.0 years, and 67 (66%) were male. Final outcome was complete healing in 24 ulcers (20%), minor amputation in 58 (48%) and major amputation in 16 (13%), and 22 chronic ulcers (18%) at the last follow-up (median follow-up time, 6.8 months). In multivariate analysis, higher NLR (odds ratio, 13.61; P = .01) was associated with higher odds of nonhealing. NLR can predict odds of complete healing in diabetic foot ulcers independent of wound infection and other factors. Copyright © 2016 Society for Vascular Surgery. All rights reserved.

  7. Pharmacological Evaluation of Chrozophora tinctoria as Wound Healing Potential in Diabetic Rat’s Model

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    Harikesh Maurya

    2016-01-01

    Full Text Available Objective. The study was designed to evaluate pharmacological potential of hydroalcoholic leaves extract of Chrozophora tinctoria intended for wound healing in diabetic rats’ model. Methods. The method used to evaluate the pharmacological potential of hydroalcoholic leave extract was physical incision rat model. In this model, cutting of the skin and/or other tissues with a sharp blade has been made and the rapid disruption of tissue integrity with minimal collateral damage was observed shortly. Animals used in the study were divided into four groups that consist of six animals in each group. Group I serves as normal control, Group II serves as disease control, Group III was used as standard treatment (Povidone iodine 50 mg/kg b.w., and Group IV was used for test drug (C. tinctoria 50 mg/kg b.w.. Result. The hydroalcoholic leave extract of Chrozophora tinctoria has been significantly observed to heal the wound (98% in diabetic rats within 21 days, while standard drug (Povidone iodine healed the wound about 95% in the same condition. The oral dose (50 mg/kg b.w. of Chrozophora tinctoria was also found to improve the elevated blood glucose level in comparison to disease control group, which increased after the oral administration of Streptozotocin. Conclusion. The Chrozophora tinctoria has significant wound healing potential in the animal having physically damaged tissue in diabetic condition.

  8. Intralesional epidermal growth factor for diabetic foot wounds: the first cases in Turkey

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    Bulent M. Ertugrul

    2015-08-01

    Full Text Available Background: Intralesional recombinant epidermal growth factor (EGF was produced in the Centre for Genetic Engineering and Biotechnology (CIGB, Cuba, in 1988 and licensed in 2006. Because it may accelerate wound healing, it is a potential new treatment option in patients with a diabetic foot wound (whether infected or not as an adjunct to standard treatment (i.e. debridement, antibiotics. We conducted the initial evaluation of EGF for diabetic foot wounds in Turkey. Methods: We enrolled 17 patients who were hospitalized in various medical centers for a foot ulcer and/or infection and for whom below the knee amputation was suggested to all except one. All patients received 75 μg intralesional EGF three times per week on alternate days. Results: The appearance of new granulation tissue on the wound site (≥75% was observed in 13 patients (76%, and complete wound closure was observed in 3 patients (18%, yielding a ‘complete recovery’ rate of 94%. The most common side effects were tremor (n=10, 59% and nausea (n=6, 35%. In only one case,a serious side effect requiring cessation of EGF treatment was noted. That patient experienced severe hypotension at the 16th application session, and treatment was discontinued. At baseline, a total of 21 causative bacteria were isolated from 15 patients, whereascultures were sterile in two patients. The most frequently isolated species was Pseudomonas aeruginosa. Conclusion: Thus, this preliminary study suggests that EGF seems to be a potential adjunctive treatment option in patients with limb-threatening diabetic foot wounds.

  9. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers.

    Science.gov (United States)

    Hicks, Caitlin W; Canner, Joseph K; Mathioudakis, Nestoras; Sherman, Ronald; Malas, Mahmoud B; Black, James H; Abularrage, Christopher J

    2018-04-02

    Previous studies have reported correlation between the Wound, Ischemia, and foot Infection (WIfI) classification system and wound healing time on unadjusted analyses. However, in the only multivariable analysis to date, WIfI stage was not predictive of wound healing. Our aim was to examine the association between WIfI classification and wound healing after risk adjustment in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. All patients presenting to our multidisciplinary DFU clinic from June 2012 to July 2017 were enrolled in a prospective database. A Cox proportional hazards model accounting for patients' sociodemographics, comorbidities, medication profiles, and wound characteristics was used to assess the association between WIfI classification and likelihood of wound healing at 1 year. There were 310 DFU patients enrolled (mean age, 59.0 ± 0.7 years; 60.3% male; 60.0% black) with 709 wounds, including 32.4% WIfI stage 1, 19.9% stage 2, 25.2% stage 3, and 22.4% stage 4. Mean wound healing time increased with increasing WIfI stage (stage 1, 96.9 ± 8.3 days; stage 4, 195.1 ± 10.6 days; P wound healing at 1 year was 94.1% ± 2.0% for stage 1 wounds vs 67.4% ± 4.4% for stage 4 (P wound healing (stage 4 vs stage 1: hazard ratio, [HR] 0.44; 95% confidence interval, 0.33-0.59). Peripheral artery disease (HR, 0.73), increasing wound area (HR, 0.99 per square centimeter), and longer time from wound onset to first assessment (HR, 0.97 per month) also decreased the likelihood of wound healing, whereas use of clopidogrel was protective (HR, 1.39; all, P ≤ .04). The top three predictors of poor wound healing were WIfI stage 4 (z score, -5.40), increasing wound area (z score, -3.14), and WIfI stage 3 (z score, -3.11), respectively. Among patients with DFU, the WIfI classification system predicts wound healing at 1 year in both crude and risk-adjusted analyses. This is the first study to validate the WIfI score as an

  10. Use of subatmospheric (VAC) therapy to improve bioengineered tissue grafting in diabetic foot wounds.

    Science.gov (United States)

    Espensen, Eric H; Nixon, Brent P; Lavery, Lawrence A; Armstrong, David G

    2002-01-01

    The use of bioengineered tissue and topical subatmospheric pressure therapy have both been widely accepted as adjunctive therapies for the treatment of noninfected, nonischemic diabetic foot wounds. This article describes a temporally overlapping method of care that includes a period of simultaneous application of bioengineered tissue (Apligraf, Novartis Pharmaceuticals Corp, East Hanover, New Jersey) and subatmospheric pressure therapy delivered through the VAC (Vacuum Assisted Closure) system (KCI, Inc, San Antonio, Texas). Future descriptive and analytic works may test the hypothesis that combined therapies used at different and often overlapping periods during the wound-healing cycle may be more effective than a single modality.

  11. Influence of low power density on wound healing in streptozotocin-induced diabetic rats

    Science.gov (United States)

    Lau, Pik Suan; Bidin, Noriah; Islam, Shumaila; Musa, Nurfatin; Zakaria, Nurlaily; Krishnan, Ganesan

    2017-05-01

    Photobiomodulation therapy (PBMT) is used for wound healing at two different power densities, i.e. 0.2 W cm-2 and 0.4 W cm-2, while maintaining the same fluence of 5 J cm-2. Forty-five streptozotocin (STZ)-induced diabetic rats were allocated into three groups: the untreated laser group (G0), 0.2 W cm-2 laser treated group (GL1), and 0.4 W cm-2 laser treated group (GL2). Six mm full thickness cutaneous wounds are created on the dorsal side of rats. A 808 nm diode laser irradiates the wound in GL1 and GL2 daily for 9 consecutive days. Groups GL1 and GL2 have the same total fluence but different power densities, 0.2 W cm-2 and 0.4 W cm-2, which results in stimulatory and inhibitory effects in wound healing, respectively. In group GL1, enhanced wound contraction and inflammation has been triggered at an earlier stage compared to the untreated laser group G0. Meanwhile, the laser treated group GL2 exhibits an escalated volume of inflammatory cells, and collagen synthesis is inhibited. Therefore, it can be concluded that PBMT has potential in promoting wound healing under the low power density (0.2 W cm-2) condition.

  12. [Effect of insulin on burn wound healing in aging diabetes mellitus rats].

    Science.gov (United States)

    Wu, Jian; Xue, Xiaodong; Liu, Junling; Si, Xiaoqiang; Yang, Guohu

    2009-12-01

    To investigate the effect of topical application of insulin on the burn wound healing in aging diabetes mellitus (DM) rats and to explore its mechanism. Seventy-five SPF Wistar rats (female and/or male), aged 12-24 months and weighing 300-350 g, were selected and randomly divided into group A (burn control group, n=25), group B (DM burn control group, n=25), and group C (DM insulin treatment group, n=25). The rats in group B and group C were fed with high-fat, high-protein, and high-sugar forage for 1 month and received intraperitoneal injection of streptozotocin (STZ) to establish experimental model of aging DM. The rats were fed with high-fat, high-protein, and high-sugar forage for another 8 weeks. Then, the deep second-degree burn model was established in the rats of group B and group C. The wounds in group A and B underwent local subcutaneous injection of 2 mL isotonic saline and group C received local subcutaneous injection of 0.1 U insulin. The rate of wound healing was calculated 7, 14, and 21 days after burn injury. At 1, 3, 7, 14, and 21 days after burn injury, HE staining observation, immunohistochemistry staining for CD34, detection of sugar and hydroxyproline (HOP) content in wound tissue, and microvessel density (MVD) calculation were performed. At 7, 14, and 21 days after burn injury, the wound healing rates of group A and group C was significantly higher than that of group B (P 0.05). Histology observation at 21 days after burn injury: in group A, certain degree of epithelization was evident in the wound epithelium; in group B, large quantity of necrotic tissue was evident; in group C, complete epithelization occurred in the wound epithelium with better epithelial cell differentiation and more neonatal collagen. For the sugar content in the wound tissue, group A was significantly lower than group B or group C at 1, 3, 7, 14, and 21 days (P wound tissue and the MVD count, group A or group C was significantly higher than group B (P 0.05). CD34

  13. Raman spectroscopy enables noninvasive biochemical identification of the collagen regeneration in cutaneous wound healing of diabetic mice treated with MSCs.

    Science.gov (United States)

    Yan, Wenxia; Liu, Hanping; Deng, Xiaoyuan; Jin, Ying; Sun, Huimin; Li, Caiyun; Wang, Ning; Chu, Jing

    2017-07-01

    Mesenchymal stem cells (MSCs) had been reported as a novel therapeutic strategy for non-healing diabetic cutaneous wound mainly by promoting the formation of extracellular matrix (ECM) and neovasculature. Collagen regeneration is one of the key processes of ECM remodeling in wound healing. Accordingly, rapid assessment of the collagen content in a noninvasive manner can promptly provide objective evaluation for MSC therapy of cutaneous wound healing and strength evidence to adjust therapeutic regimen. In the present study, noninvasive Raman microspectroscopy was used for tracing the regeneration status of collagen during diabetic wound healing with MSCs. Wound tissues of normal mice, diabetic mice, and MSC-treated diabetic mice were subjected to Masson trichrome staining assay and submitted to spectroscopic analysis by Raman microspectroscopy after wounding 7, 14, and 21 days. Masson trichrome staining demonstrated that there was more collagen deposition in diabetic + MSCs group relative to diabetic group. The relative intensity of Raman collagen peak positions at 937, 1004, 1321, 1452, and 1662 cm -1 increased in MSC-treated diabetic group compared to diabetic group, although normal mice group had the highest relative intensity of collagen peak bands. Correlation analysis suggested that the spectral bands had a high positive correlation with the collagen intensity detected by Masson trichrome staining in wound tissues of three groups. Our results demonstrate that Raman microspectroscopy has potential application in rapidly and quantitatively assessing diabetic wound healing with MSCs by monitoring collagen variation, which may provide a novel method for the study of skin regeneration.

  14. Use of collagenase ointment in conjunction with negative pressure wound therapy in the care of diabetic wounds: a case series of six patients

    Directory of Open Access Journals (Sweden)

    John D. Miller

    2015-01-01

    Full Text Available Background: Diabetic wounds with additional comorbidities are costly, time intensive, and difficult to heal. Often, multiple modalities may be necessary to achieve wound resolution, relying on the synergistic advantage of each therapy to affect wound healing. The selectivity of Clostridium collagenase is physiologically effective at degrading non-viable collagen fibers while preserving living collagen tissue. Additionally, negative pressure wound therapy (NPWT has long been used to aid wound healing while concurrently depreciating biological wound burden time. Methods: Six patients were selected from those appearing to our university based limb salvage service. Inclusion criteria included patients with a recurrent mixed fibrotic and granular wound base, in which NPWT was indicated, without exclusion criteria. Patients enrolled were administered clostridial collagenase ointment at each regularly scheduled NPWT dressing change. Patients were followed until healing, with visual representations of wound progression and time to full healing recorded. Results: Tandem application of these therapies appeared to expedite wound healing by clearing degenerative fibrous tissue and expediting wound granulation without additional complication. Unfortunately, not all patients were able to reach full healing; with two patients experiencing ulcer recurrence, likely a result of their significant comorbid nature. Conclusion: In our experience, we have noticed a specific subgroup of patients who benefit greatly when collagenase enzymatic debridement therapy is combined with NPWT. It is our belief that this combination therapy combines the molecular clearing of non-viable collagen with the wound granulation necessary to advance complex wounds to the next step in healing despite the current paucity in literature discussing this specific pairing.

  15. Application of platelet derived growth factor-BB and diabetic wound healing: the relationship with oxidative events.

    Science.gov (United States)

    Gökşen, Sibel; Balabanlı, Barbaros; Coşkun-Cevher, Şule

    2017-05-01

    The reasons that cause delay in wound healing in diabetes are a decrease in the level of growth factors secretion, an increase in the destruction of growth factors and in oxidative stress. Platelet derived growth factor (PDGF) is one of the important growth factors that play a role in all phases of wound healing. This study investigates time-dependent effects of topically PDGF-BB administration on oxidative events on the healing of dorsolateral-excisional wounds in diabetic rats. Forty-two female Wistar-albino rats with streptozotocin-induced diabetes were divided into four groups: control group, untreated group, chitosan-treated group, chitosan + PDGF-BB-treated group. Two identical full-thickness excisional skin wounds were made under anaesthesia in all rats except for the control group. In the PDGF-BB-treated and chitosan-treated groups, the wounds were treated topically PDGF-BB (7 ng/mL, single daily dose) and blank chitosan gel (equal amount) after wounding, respectively. After these administrations, on day 3 and day 7 of wound healing, rats were sacrificed. Thiobarbituric acid reactive substances, glutathione, nitric oxide, ascorbic acid levels, and superoxide dismutase activity in wound tissues were spectrophotometrically measured. PDGF-BB administration significantly increased TBARS levels and non-enzymatic antioxidant levels in early phase of diabetic wound healing. PDGF-BB dramatically reduced NO x levels on day 3 and sharply increased NO x levels on day 7 of wound healing. Consequently, PDGF-BB administration can be effective on oxidative balance in the early phase of diabetic wound healing.

  16. Collagen-based wound dressings for the treatment of diabetes-related foot ulcers: a systematic review

    Directory of Open Access Journals (Sweden)

    Holmes C

    2013-01-01

    Full Text Available Crystal Holmes,1 James S Wrobel,1 Mark P MacEachern,2 Blaise R Boles31Department of Internal Medicine, University of Michigan Medical School, 2A Alfred Taubman Health Sciences Library, University of Michigan, 3Department of Molecular, Cellular, and Developmental Biology, University of Michigan, Ann Arbor, MI, USABackground: Diabetic foot ulcers are a major source of morbidity, limb loss, and mortality. A prolonged inflammatory response, extracellular matrix degradation irregularities, and increased bacteria presence have all been hypothesized as major contributing factors in the delayed healing of diabetic wounds. Collagen components such as fibroblast and keratinocytes are fundamental to the process of wound healing and skin formation. Wound dressings that contain collagen products create a biological scaffold matrix that supports the regulation of extracellular components and promotes wound healing.Methods: A systematic review of studies reporting collagen wound dressings used in the treatment of Diabetic foot ulcers was conducted. Comprehensive searches were run in Ovid MEDLINE, PubMed, EMBASE, and ISI Web of Science to capture citations pertaining to the use of collagen wound dressings in the treatment of diabetic foot ulcers. The searches were limited to human studies reported in English.Results: Using our search strategy, 26 papers were discussed, and included 13 randomized designs, twelve prospective cohorts, and one retrospective cohort, representing 2386 patients with diabetic foot ulcers. Our design was not a formal meta-analysis. In those studies where complete epithelialization, 58% of collagen-treated wounds completely healed (weighted mean 67%. Only 23% of studies reported control group healing with 29% healing (weighted mean 11% described for controls.Conclusion: Collagen- based wound dressings can be an effective tool in the healing of diabetic foot wounds. The current studies show an overall increase in healing rates despite

  17. Electrospun nanofibres in agriculture and the food industry: a review.

    Science.gov (United States)

    Noruzi, Masumeh

    2016-11-01

    The interesting characteristics of electrospun nanofibres, such as high surface-to-volume ratio, nanoporosity, and high safety, make them suitable candidates for use in a variety of applications. In the recent decade, electrospun nanofibres have been applied to different potential fields such as filtration, wound dressing, drug delivery, etc. and a significant number of review papers have been published in these fields. However, the use of electrospun nanofibres in agriculture is comparatively novel and is still in its infancy. In this paper, the specific applications of electrospun nanofibres in agriculture and food science, including plant protection using pheromone-loaded nanofibres, plant protection using encapsulation of biocontrol agents, preparation of protective clothes for farm workers, encapsulation of agrochemical materials, deoxyribonucleic acid extraction in agricultural research studies, pre-concentration and measurement of pesticides in crops and environmental samples, preparation of nanobiosensors for pesticide detection, encapsulation of food materials, fabrication of food packaging materials, and filtration of beverage products are reviewed and discussed. This paper may help researchers develop the use of electrospun nanofibres in agriculture and food science to address some serious problems such as the intensive use of pesticides. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  18. Short term supplementation of dietary antioxidants selectively regulates the inflammatory responses during early cutaneous wound healing in diabetic mice

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    Park Na-Young

    2011-11-01

    Full Text Available Abstract Background Diabetic foot ulcers are serious complications for diabetic patients, yet the precise mechanism that underlines the treatment of these diabetic complications remains unclear. We hypothesized that dietary antioxidant supplementation with vitamin C, combined either with vitamin E or with vitamin E and NAC, improves delayed wound healing through modulation of blood glucose levels, oxidative stress, and inflammatory response. Methods Diabetes was induced by administration of alloxan monohydrate. Mice were divided into 4 groups; CON (non-diabetic control mice fed AIN 93 G purified rodent diet, DM (diabetic mice fed AIN 93 G purified rodent diet, VCE (diabetic mice fed 0.5% vitamin C and 0.5% vitamin E supplemented diet, and Comb (diabetic mice fed 0.5% vitamin C, 0.5% vitamin E, and 2.5% NAC supplemented diet. After 10 days of dietary antioxidant supplementation, cutaneous full-thickness excisional wounds were performed, and the rate of wound closure was examined. TBARS as lipid peroxidation products and vitamin E levels were measured in the liver. Expression levels of oxidative stress and inflammatory response related proteins were measured in the cutaneous wound site. Results Dietary antioxidant supplementation improved blood glucose levels and wound closure rate and increased liver vitamin E, but not liver TBARS levels in the diabetic mice as compared to those of the CON. In addition, dietary antioxidant supplementation modulated the expression levels of pIκBα, HO-1, CuZnSOD, iNOS and COX-2 proteins in the diabetic mice. Conclusions These findings demonstrated that delayed wound healing is associated with an inflammatory response induced by hyperglycaemia, and suggests that dietary antioxidant supplementation may have beneficial effects on wound healing through selective modulation of blood glucose levels, oxidative stress, and inflammatory response.

  19. Additive enhancement of wound healing in diabetic mice by low level light and topical CoQ10

    Science.gov (United States)

    Mao, Zhigang; Wu, Jeffrey H.; Dong, Tingting; Wu, Mei X.

    2016-02-01

    Diabetes, a highly prevalent disease that affects 9.3% of Americans, often leads to severe complications and slow wound healing. Preclinical studies have suggested that low level light therapy (LLLT) can accelerate wound healing in diabetic subjects, but significant improvements must be made to overcome the absence of persuasive evidence for its clinical use. We demonstrate here that LLLT can be combined with topical Coenzyme Q10 (CoQ10) to heal wounds in diabetic mice significantly faster than LLLT alone, CoQ10 alone, or controls. LLLT followed by topical CoQ10 enhanced wound healing by 68~103% in diabetic mice in the first week and more than 24% in the second week compared with untreated controls. All wounds were fully healed in two weeks following the dual treatment, in contrast to only 50% wounds or a fewer being fully healed for single or sham treatment. The accelerated healing was corroborated by at least 50% higher hydroxyproline levels, and tripling cell proliferation rates in LLLT and CoQ10 treated wounds over controls. The beneficial effects on wound healing were probably attributed to additive enhancement of ATP production by LLLT and CoQ10 treatment. The combination of LLLT and topical CoQ10 is safe and convenient, and merits further clinical study.

  20. Diabetes-impaired wound healing is improved by matrix therapy with heparan sulfate glycosaminoglycan mimetic OTR4120 in rats

    NARCIS (Netherlands)

    M. Tong (Miao); B. Tuk (Bastiaan); P. Shang (Peng); J.M. Hekking-Weijma (Ineke); E.M.G. Fijneman (Esther ); M. Guijt (Marnix); S.E.R. Hovius (Steven); J.W. van Neck (Han)

    2012-01-01

    textabstractWound healing in diabetes is frequently impaired, and its treatment remains a challenge. We tested a therapeutic strategy of potentiating intrinsic tissue regeneration by restoring the wound cellular environment using a heparan sulfate glycosaminoglycan mimetic, OTR4120. The effect of

  1. Effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing

    OpenAIRE

    Choi, Harry M. C.; Cheing, Alex K. K.; Ng, Gabriel Y. F.; Cheing, Gladys L. Y.

    2018-01-01

    The present study investigated the effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing. Two intensities of PEMF were adopted for comparison. We randomly assigned 111 10-week-old male streptozotocin-induced diabetic Sprague-Dawley rats to two PEMF groups and a sham control group. Six-millimetre biopsy punched full thickness wounds were made on the lateral side of their hindlimbs. The PEMF groups received activ...

  2. Diabetic foot ulcers – evidence-based wound management

    African Journals Online (AJOL)

    and sensation is essential. This will influence the appropriate management of the patient with a diabetic foot ulcer prior to commencement of conservative ... ulcers. Cold fluids may contribute to pain and should be avoided. Dressings. Alginate and collagen-alginate products. Collagen-alginate dressings have not been.

  3. Tissue responses to postoperative laser therapy in diabetic rats submitted to excisional wounds.

    Directory of Open Access Journals (Sweden)

    Cristiano de Loura Santana

    Full Text Available In a previous study about low-level laser therapy biomodulation on a full-thickness burn model we showed that single and fractionated dose regimens increased wound healing and leukocyte influx similarly when compared with untreated control. In order to verify if this finding would be similar in an impaired wound model, we investigated the effect of single and multiple irradiations on wound closure rate, type of inflammatory infiltrate, myofibroblasts, collagen deposition, and optical retardation of collagen in diabetic rats. Female Wistar rats in the same estrous cycle had diabetes induced with streptozotocin and an 8-mm excisional wound performed with a punch. The experimental groups were: control group--untreated ulcer; single-dose group--ulcer submitted to single dose of diode laser therapy (λ = 660 ± 2 nm; P = 30 mW; energy density: 4 J/cm2 and fractionated-dose group--ulcer submitted to 1 J/cm2 laser therapy on Days 1, 3, 8, and 10. The ulcers were photographed on the experimental days and after euthanasia tissue samples were routinely processed for histological and immunohistochemistry analyses. Independently of the energy density, laser therapy accelerated wound closure by approximately 40% in the first three days in comparison to the control group. Laser therapy increased acute inflammatory infiltrate until Day 3. Both laser groups exhibited more myofibroblasts and better collagen organization than the control group. The findings demonstrate that low-level laser therapy in the immediate postoperative period can enhance the tissue repair process in a diabetes model. Similar effects were achieved with laser therapy applied a single time with an energy density of 4 J/cm2 and applied four times with an energy density of 1 J/cm2. The application of laser therapy in the inflammatory phase was the most important factor to the enhancement of the tissue repair process.

  4. Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers

    International Nuclear Information System (INIS)

    Sajid, M.T.; Mustafa, Q.U.A.

    2015-01-01

    Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Study Design: Randomized control trial. Place and Duration of Study: Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. Methodology: The study consisted of 278 patients, with 139 patients each in Group A and B, who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Results: Mean age of presentation in group Awas 55.88 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2and in group B 15.09 ± 2.81 cm2(p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p < 0.001). Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A(p < 0.001). Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers. (author)

  5. The role of bone marrow mesenchymal stromal cell derivatives in skin wound healing in diabetic mice.

    Science.gov (United States)

    de Mayo, Tomas; Conget, Paulette; Becerra-Bayona, Silvia; Sossa, Claudia L; Galvis, Virgilio; Arango-Rodríguez, Martha L

    2017-01-01

    Mesenchymal stromal cells (MSCs) have shown to be a promising tool in cell therapies to treat different conditions. Several pre-clinical and clinical studies have proved that the transplantation of MSCs improves wound healing. Here, we compare the beneficial effects of mouse bone marrow-derived allogeneic MSCs (allo-mBM-MSCs) and their acelullar derivatives (allo-acd-mMSCs) on skin wound healing in Non-Obese Diabetic (NOD) mice. One dose of allo-mBM-MSCs (1×106 cells) or one dose of allo-acd-mMSCs (1X) were intradermally injected around wounds in 8-10 week old female NOD mice. Wound healing was evaluated macroscopically (wound closure) every two days, and microscopically (reepithelialization, dermoepidermal junction, skin appendage regeneration, leukocyte infiltration, vascularization, granulation tissue formation, and density of collagen fibers in the dermis) after 16 days of MSC injection. In addition, we measured growth factors and specific proteins that were present in the allo-acd-mMSCs. Results showed significant differences in the wound healing kinetics of lesions that received allo-acd-mMSCs compared to lesions that received vehicle or allo-mBM-MSCs. In particular, mice treated with allo-acd-mMSCs reached significantly higher percentages of wound closure at day 4, 6 and 8, relative to the allo-mBM-MSCs and vehicle groups (p healing process. Specifically, they caused a less pronounced inflammatory severe response (p hand, ELISA analyses indicated that the allo-acd-mMSCs contained growth factors and proteins relevant to wound healing such as IGF-1, KGF, HGF, VEGF, ANG-2, MMP-1, CoL-1 and PGE2. Compared to allo-acd-mMSCs, the administration of allo-mBM-MSCs is insufficient for wound healing in diabetic mice and delays the therapeutic effect, which maybe explained by the fact that trophic factors secreted by MSCs are critical for skin regeneration, and not the cells per se, suggesting that MSCs may require some time to secrete these factors after their

  6. Healing potential of Iranian traditional medicinal plants on burn wounds in alloxan-induced diabetic rats

    Directory of Open Access Journals (Sweden)

    A Ghasemi Pirbalouti

    2011-10-01

    Full Text Available Malva sylvestris, Punica granatum, Amygdalus communis, Arnebia euchroma and Scrophularia deserti are important medicinal plants in Iranian traditional medicine (Unani whose have been used as remedy against edema, burn, and wound and for their carminative, antimicrobial and anti-inflammatory activities. The ethanol extracts of M. sylvestris and P. granatum flowers, A. communis leaves, A. euchroma roots and S. deserti stems were used to evaluate the burn healing activity in alloxan-induced diabetic rats. Burns were induced in Wistar rats divided into nine groups as following; Group-I: normal rats were treated with simple ointment base (control, Group-II: diabetic rats were treated with simple ointment base (control, Groups-III and -VII: diabetic rats were treated with simple ointment base containing of extracts (diabetic animals, Groups VIII: diabetic rats were treated with simple ointment base containing of mixed extracts, Group-IX: diabetic rats received the standard drug (Silver Sulfadiazine. The efficacy of treatments was evaluated based on wound area, epithelialization time and histopathological characteristics. Wound contraction showed that there is high significant difference between the different groups (p<0.001. At the 18th day, A. euchroma, S. deserti, A. communis and mixed extract ointment treated groups healed 80-90%. At the 9th and 18th days the experiment, the best results were obtained with A. communis and standard drug, when compared to the other groups as well as to the controls. It may be concluded that almond leaves (sweet and bitter formulated in the simple ointment base is effective in the treatment of burns and thus supports its traditional use.

  7. Tight glycaemic control is a key factor in wound healing enhancement strategies in an experimental diabetes mellitus model.

    LENUS (Irish Health Repository)

    O'Sullivan, J B

    2012-02-01

    BACKGROUND: Diabetes mellitus is a leading cause of impaired wound healing. The aim of this study was to establish a glucose-controlled diabetic wound healing model. METHOD: Sprague-Dawley rats were divided into three groups: Control group (C), Diabetic Non-glucose Controlled group (DNC) and Diabetic glucose Controlled group (DC). RESULTS: Glucose control was achieved using Insulman Rapid (average daily glucose level <10 mmol\\/L). 18 Sprague-Dawley rats underwent a dorsal skin wound incision and 10 days later were killed. Fresh and fixed wound tensile strength, hydroxyproline and transforming growth factor beta-1 levels were improved in the DC group when compared to the DNC group. The quantity of fibroblasts present was similar in each group. CONCLUSION: This study demonstrates the impact that diabetes has on acute wound healing and suggests that wound modulating agents must be tested in both the tightly glucose-controlled as well as the poorly glucose-controlled diabetic animal models prior to proceeding with translational clinical studies.

  8. Comparison of the Hydroxylase Inhibitor Dimethyloxalylglycine and the Iron Chelator Deferoxamine in Diabetic and Aged Wound Healing.

    Science.gov (United States)

    Duscher, Dominik; Januszyk, Michael; Maan, Zeshaan N; Whittam, Alexander J; Hu, Michael S; Walmsley, Graham G; Dong, Yixiao; Khong, Sacha M; Longaker, Michael T; Gurtner, Geoffrey C

    2017-03-01

    A hallmark of diabetes mellitus is the breakdown of almost every reparative process in the human body, leading to critical impairments of wound healing. Stabilization and activity of the transcription factor hypoxia-inducible factor (HIF)-1α is impaired in diabetes, leading to deficits in new blood vessel formation in response to injury. In this article, the authors compare the effectiveness of two promising small-molecule therapeutics, the hydroxylase inhibitor dimethyloxalylglycine and the iron chelator deferoxamine, for attenuating diabetes-associated deficits in cutaneous wound healing by enhancing HIF-1α activation. HIF-1α stabilization, phosphorylation, and transactivation were measured in murine fibroblasts cultured under normoxic or hypoxic and low-glucose or high-glucose conditions following treatment with deferoxamine or dimethyloxalylglycine. In addition, diabetic wound healing and neovascularization were evaluated in db/db mice treated with topical solutions of either deferoxamine or dimethyloxalylglycine, and the efficacy of these molecules was also compared in aged mice. The authors show that deferoxamine stabilizes HIF-1α expression and improves HIF-1α transactivity in hypoxic and hyperglycemic states in vitro, whereas the effects of dimethyloxalylglycine are significantly blunted under hyperglycemic hypoxic conditions. In vivo, both dimethyloxalylglycine and deferoxamine enhance wound healing and vascularity in aged mice, but only deferoxamine universally augmented wound healing and neovascularization in the setting of both advanced age and diabetes. This first direct comparison of deferoxamine and dimethyloxalylglycine in the treatment of impaired wound healing suggests significant therapeutic potential for topical deferoxamine treatment in ischemic and diabetic disease.

  9. Topical insulin accelerates cutaneous wound healing in insulin-resistant diabetic rats

    OpenAIRE

    Yu, Tianyi; Gao, Min; Yang, Peilang; Pei, Qing; Liu, Dan; Wang, Di; Zhang, Xiong; Liu, Yan

    2017-01-01

    Insulin signaling defects could lead to insulin resistance in insulin target organs: typically, in the muscler, liver, and adipose tissue. We have observed that insulin accelerated diabetic wound healing in our previous works; to further elucidate the mechanism, we investigated the expression and activation of insulin and insulin-like growth factor (IGF)-1 signaling, compared insulin sensitivity in skin tissue with that in liver tissue, and also observed the regulation of insulin on inflammat...

  10. Comparison of EGF with VEGF Non-Viral Gene Therapy for Cutaneous Wound Healing of Streptozotocin Diabetic Mice

    Directory of Open Access Journals (Sweden)

    Junghae Ko

    2011-06-01

    Full Text Available BackgroundTo accelerate the healing of diabetic wounds, various kinds of growth factors have been employed. It is the short half-life of administered growth factors in hostile wound beds that have limited wide-spread clinical usage. To overcome this limitation, growth factor gene therapy could be an attractive alternative rather than direct application of factors onto the wound beds. We administered two growth factor DNAs, epidermal growth factor (EGF and vascular endothelial growth factor (VEGF into a cutaneous wound on diabetic mice. We compared the different characteristics of the healing wounds.MethodsStreptozotocin was injected intraperitoneally to induce diabetes into C57BL/6J mice. The ultrasound micro-bubble destruction method with SonoVue as a bubbling agent was used for non-viral gene delivery of EGF828 and VEGF165 DNAs. Each gene was modified for increasing efficacy as FRM-EGF828 or minicircle VEGF165. The degree of neoangiogenesis was assessed using qualitative laser Doppler flowmetry. We compared wound size and histological findings of the skin wounds in each group.ResultsIn both groups, accelerated wound closure was observed in the mice receiving gene therapy compared with non treated diabetic control mice. Blood flow detected by laser doppler flowmetry was better in the VEGF group than in the EGF group. Wound healing rates and histological findings were more accelerated in the EGF gene therapy group than the VEGF group, but were not statistically significant.ConclusionBoth non-viral EGF and VEGF gene therapy administrations could improve the speed and quality of skin wound healing. However, the detailed histological characteristics of the healing wounds were different.

  11. The Mechanism of Hyperbaric Oxygen Therapy in the Treatment of Chronic Wounds and Diabetic Foot Ulcers.

    Science.gov (United States)

    Johnston, Benjamin R; Ha, Austin Y; Brea, Bielinsky; Liu, Paul Y

    2016-02-01

    Non-healing wounds are a growing public health concern, and more than $25 billion per year in the US are spent caring for patients with chronic wounds. Many of these patients are referred to specialized wound centers, where hyperbaric oxygen therapy (HBO2T) has become a mainstay in healing wounds, especially diabetic foot ulcers (DFU). However, it is costly, with a typical course of therapy running into the tens of thousands of dollars. Presently, as many as 30-40% of DFU patients with Wagner's Grade 3 and 4 ulcers treated with HBO2T fail to heal by 24 weeks. Unfortunately, the patient will have already received lengthy therapy (30-60 daily treatments over 6-10 week time period) before having the wound deemed non-responsive. Currently, practitioners employ a combination of clinical markers, diagnostic testing and a four-week preliminary healing response, but this approach is inaccurate and delays definitive identification of HBO2T responder and non-responder phenotypes.

  12. The effect of LED on blood microcirculation during chronic wound healing in diabetic and non-diabetic patients-a prospective, double-blind randomized study.

    Science.gov (United States)

    Frangez, Igor; Cankar, Ksenija; Ban Frangez, Helena; Smrke, Dragica Maja

    2017-05-01

    Chronic wounds, especially in diabetic patients, represent a challenging health issue. Since standard treatment protocols often do not provide satisfactory results, additional treatment methods-like phototherapy using low-level light therapy-are being investigated. The aim of our study was to evaluate the effect of phototherapy with light-emitting diodes on chronic wound treatment in diabetic and non-diabetic patients. Since a sufficient blood supply is mandatory for wound healing, the evaluation of microcirculation in the healthy skin at a wound's edge was the main outcome measure. Forty non-diabetic patients and 39 diabetics with lower limb chronic wounds who were referred to the University Medical Center Ljubljana between October 2012 and June 2014 were randomized to the treated and control groups. The treated group received phototherapy with LED 2.4 J/cm 2 (wavelengths 625, 660, 850 nm) three times a week for 8 weeks, and the control group received phototherapy with broadband 580-900 nm and power density 0.72 J/cm 2 . Microcirculation was measured using laser Doppler. A significant increase in blood flow was noted in the treated group of diabetic and non-diabetic patients (p = 0.040 and p = 0.033), while there was no difference in the control groups. Additional Falanga wound bed score evaluation showed a significant improvement in both treated groups as compared to the control group. According to our results, phototherapy with LED was shown to be an effective additional treatment method for chronic wounds in diabetic and non-diabetic patients.

  13. Statin Therapy Negatively Impacts Skeletal Muscle Regeneration and Cutaneous Wound Repair in Type 1 Diabetic Mice.

    Science.gov (United States)

    Rebalka, Irena A; Cao, Andrew W; Raleigh, Matthew J; Henriksbo, Brandyn D; Coleman, Samantha K; Schertzer, Jonathan D; Hawke, Thomas J

    2017-01-01

    Those with diabetes invariably develop complications including cardiovascular disease (CVD). To reduce their CVD risk, diabetics are generally prescribed cholesterol-lowering 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors (i.e., statins). Statins inhibit cholesterol biosynthesis, but also reduce the synthesis of a number of mevalonate pathway intermediates, leading to several cholesterol-independent effects. One of the pleiotropic effects of statins is the reduction of the anti-fibrinolytic hormone plasminogen activator inhibitor-1 (PAI-1). We have previously demonstrated that a PAI-1 specific inhibitor alleviated diabetes-induced delays in skin and muscle repair. Here we tested if statin administration, through its pleiotropic effects on PAI-1, could improve skin and muscle repair in a diabetic rodent model. Six weeks after diabetes onset, adult male streptozotocin-induced diabetic (STZ), and WT mice were assigned to receive control chow or a diet enriched with 600 mg/kg Fluvastatin. Tibialis anterior muscles were injured via Cardiotoxin injection to induce skeletal muscle injury. Punch biopsies were administered on the dorsal scapular region to induce injury of skin. Twenty-four days after the onset of statin therapy (10 days post-injury), tissues were harvested and analyzed. PAI-1 levels were attenuated in statin-treated diabetic tissue when compared to control-treated tissue, however no differences were observed in non-diabetic tissue as a result of treatment. Muscle and skin repair were significantly attenuated in Fluvastatin-treated STZ-diabetic mice as demonstrated by larger wound areas, less mature granulation tissue, and an increased presence of smaller regenerating muscle fibers. Despite attenuating PAI-1 levels in diabetic tissue, Fluvastatin treatment impaired cutaneous healing and skeletal muscle repair in STZ-diabetic mice.

  14. Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers.

    Science.gov (United States)

    Sajid, Muhammad Tanveer; Mustafa, Qurat ul Ain; Shaheen, Neelofar; Hussain, Syed Mukarram; Shukr, Irfan; Ahmed, Muhammad

    2015-11-01

    To evaluate the clinical efficacy of Negative Pressure Wound Therapy (NPWT) using Vacuum Assisted Closure (VAC) compared with Advanced Moist Wound Therapy (AMWT) to treat Diabetic Foot Ulcer (DFU). Randomized control trial. Surgical Department, Combined Military Hospital (CMH) / Military Hospital (MH), Rawalpindi, from November 2010 to June 2012. The study consisted of 278 patients, with 139 patients each in Group 'A' and 'B', who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio (UTHCSA) image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks. Mean age of presentation in group A was 55.88 ± 10.97 years while in group B, it was 56.83 ± 11.3 (p=0.48). Mean duration of diabetes at presentation was 15.65 ± 4.86 and 15.96 ± 5.79 years in group A and B, respectively (p=0.74). Majority of patients had Wagner's grade 2 ulcer (82% in group A and 87.8% in group B, p= 0.18). Initial wound size in group A was 15.07 ± 2.92 cm2 and in group B 15.09 ± 2.81 cm2 (p = 0.95). Wound size measured after 2 weeks, treatment was in group A13.70 ± 2.92 cm2 and in group B 11.53 ± 2.78 cm2 (p VAC was more efficacious than AMWT in the management of diabetic foot ulcers.

  15. Débridement and Autologous Lipotransfer for Chronic Ulceration of the Diabetic Foot and Lower Limb Improves Wound Healing.

    Science.gov (United States)

    Stasch, Tilman; Hoehne, Julius; Huynh, Tuan; De Baerdemaeker, Randy; Grandel, Siegfried; Herold, Christian

    2015-12-01

    The application of autologous lipotransfer (fat grafting, lipofilling) in reconstructive surgery is steadily becoming more popular as evidence of the regenerative and reparative effects of fat becomes better known. The authors investigated the use of autologous lipotransfer for treatment of chronic diabetic and other foot and lower limb ulcers. Twenty-six patients with nonhealing wounds were treated with surgical débridement and autologous lipotransfer (using the débridement and autologous lipotransfer method). The mean age of the wounds before intervention was 16.7 months. Wound size after débridement averaged 5.1 ± 2.6 cm2. On average, 7.1 ± 3.3 cc of lipoaspirate was transferred into the wound area. Twenty-two of 25 wounds (88 percent) healed completely within a mean of 68.0 ± 33.0 days. A reduction of wound size by 50 percent was achieved after an average of 4 weeks. In one patient with an ulcer within particularly scarred tissues on the lower limb, a repeated session of lipotransfer led to complete wound healing after another 4 weeks. The authors describe a simple and useful technique to improve wound healing in diabetic feet and chronic lower limb ulcers with a background of peripheral vascular disease, where other interventional options to achieve wound healing have failed.

  16. Comparisons of negative pressure wound therapy and ultrasonic debridement for diabetic foot ulcers: a network meta-analysis.

    Science.gov (United States)

    Wang, Ruran; Feng, Yanhua; Di, Bo

    2015-01-01

    a network meta-analysis was performed to compare the strength and weakness of negative pressure wound therapy (NPWT) with ultrasound debridement (UD) as for diabetic foot ulcers (DFU). PubMed, Ovid EMBASE, Web of Science, Cochrane library databases, and Chinese Biomedical Literature Database were searched till February 2015. Clinical compared studies of negative pressure wound therapy and ultrasound debridement were enrolled. The primary efficacy outcomes included healed ulcers, reduction of ulcer areas and time to closure. Secondary amputation including major and minor amputations was used to assess the safety profile. Out of 715 studies, 32 were selected which enrolled 2880 diabetic patients. The pooled analysis revealed that NPWT including vacuum assisted closure (VAC) and vacuum sealing drainage (VSD) were as efficacious as ultrasound debridement improving healed ulcers, odds ratio, 0.86; 95% CI 0.28 to 2.6 and 1.2; 95% CI 0.38 to 4, respectively. However, both were better to standard wound care in wound healing patients. Compared with the standard wound care treated diabetic foot ulcers, NPWT and UD resulted in a significantly superior efficacy in time to wound closure and decrement in area of wound. No significances were observed between NPWT and UD groups in both indicators. Fewer patients tended to receive amputation in NPWT and UD groups compared to standard wound care group. The results of the network meta-analysis indicated that negative pressure wound therapy was similar to ultrasound debridement for diabetic foot ulcers, but better than standard wound care both in efficacy and safety profile.

  17. Comparisons of negative pressure wound therapy and ultrasonic debridement for diabetic foot ulcers: a network meta-analysis

    Science.gov (United States)

    Wang, Ruran; Feng, Yanhua; Di, Bo

    2015-01-01

    Objective: a network meta-analysis was performed to compare the strength and weakness of negative pressure wound therapy (NPWT) with ultrasound debridement (UD) as for diabetic foot ulcers (DFU). Methods: PubMed, Ovid EMBASE, Web of Science, Cochrane library databases, and Chinese Biomedical Literature Database were searched till February 2015. Clinical compared studies of negative pressure wound therapy and ultrasound debridement were enrolled. The primary efficacy outcomes included healed ulcers, reduction of ulcer areas and time to closure. Secondary amputation including major and minor amputations was used to assess the safety profile. Results: Out of 715 studies, 32 were selected which enrolled 2880 diabetic patients. The pooled analysis revealed that NPWT including vacuum assisted closure (VAC) and vacuum sealing drainage (VSD) were as efficacious as ultrasound debridement improving healed ulcers, odds ratio, 0.86; 95% CI 0.28 to 2.6 and 1.2; 95% CI 0.38 to 4, respectively. However, both were better to standard wound care in wound healing patients. Compared with the standard wound care treated diabetic foot ulcers, NPWT and UD resulted in a significantly superior efficacy in time to wound closure and decrement in area of wound. No significances were observed between NPWT and UD groups in both indicators. Fewer patients tended to receive amputation in NPWT and UD groups compared to standard wound care group. Conclusions: The results of the network meta-analysis indicated that negative pressure wound therapy was similar to ultrasound debridement for diabetic foot ulcers, but better than standard wound care both in efficacy and safety profile. PMID:26550165

  18. Does Physiological Stress Slow Down Wound Healing in Patients With Diabetes?

    Science.gov (United States)

    Razjouyan, Javad; Grewal, Gurtej Singh; Talal, Talal K; Armstrong, David G; Mills, Joseph L; Najafi, Bijan

    2017-07-01

    Poor healing is an important contributing factor to amputation among patients with diabetic foot ulcers (DFUs). Physiological stress may slow wound healing and increase susceptibility to infection. The objective was to examine the association between heart rate variability (HRV) as an indicator of physiological stress response and healing speed (Heal Speed ) among outpatients with active DFUs. Ambulatory patients with diabetes with DFUs (n = 25, age: 59.3 ± 8.3 years) were recruited. HRV during pre-wound dressing was measured using a wearable sensor attached to participants' chest. HRVs were quantified in both time and frequency domains to assess physiological stress response and vagal tone (relaxation). Change in wound size between two consecutive visits was used to estimate Heal Speed . Participants were then categorized into slow healing and fast healing groups. Between the two groups, comparisons were performed for demographic, clinical, and HRV derived parameters. Associations between different descriptors of HRV and Heal Speed were also assessed. Heal Speed was significantly correlated with both vagal tone ( r = -.705, P = .001) and stress response ( r = .713, P = .001) extracted from frequency domain. No between-group differences were observed except those from HRV-derived parameters. Models based on HRVs were the highest predictors of slow/fast Heal Speed (AUC > 0.90), while models based on demographic and clinical information had poor classification performance (AUC = 0.44). This study confirms an association between stress/vagal tone and wound healing in patients with DFUs. In particular, it highlights the importance of vagal tone (relaxation) in expediting wound healing. It also demonstrates the feasibility of assessing physiological stress responses using wearable technology in outpatient clinic during routine clinic visits.

  19. Diabetic foot wound care practices among patients visiting a tertiary care hospital in north India

    Directory of Open Access Journals (Sweden)

    Samreen Khan

    2016-09-01

    Full Text Available Background: Diabetic foot syndrome is one of the most common and devastating preventable complications of diabetes resulting in major economic consequences for the patients, their families, and the society. Aims & Objectives: The present study was carried out to assess knowledge, attitude and practices of Diabetic Foot Wound Care among the patients suffering from Diabetic Foot and to correlate them with the socio-demographic parameters. Material & Methods: It was a Hospital based cross-sectional study involving clinically diagnosed adult (>18 years patients of Diabetic Foot visiting the Surgery and Medicine OPDs at Teerthankar Mahaveer Medical College & Research Centre, Moradabad, India. Results: Significant association KAP (Knowledge, Attitude and Practices score was seen with age of the patient, education, addiction, family history of Diabetes Mellitus, prior receipt of information regarding Diabetic foot-care practices, compliance towards the treatment and the type of foot wear used. Conclusions: The results highlight areas especially Health education, use of safe footwear and life style adjustments, where efforts to improve knowledge and practice may contribute to the prevention of development of Foot ulcers and amputation. 

  20. A reliable approach to diabetic neuroischemic foot wounds: below-the-knee angiosome-oriented angioplasty.

    Science.gov (United States)

    Alexandrescu, Vlad; Vincent, Gaetane; Azdad, Khalid; Hubermont, Gerard; Ledent, Gilles; Ngongang, Christian; Filimon, Ana-Maria

    2011-06-01

    To evaluate the clinical benefit in wound healing and limb preservation after primary below-the-knee angioplasty guided by an angiosome model of perfusion in diabetic patients with neuroischemic foot ulcers. From September 2001 to April 2010, 232 limb-threatening neuroischemic wounds in 208 diabetic patients (147 men; mean age 74.3 years, range 42-97) were treated by below-the-knee endoluminal and/or subintimal angioplasty. There were 19 (8%) TASC II type B, 80 (34%) type C, and 133 (57%) type D infrapopliteal lesions. Patients treated prior to 2005 when the angiosome-targeted revascularization protocol was introduced (89 limbs, group 1) were compared to 134 limbs treated subsequently according to the angiosome model (group 2). The angiosome-oriented group 2 included 25% procedures focusing on the anterior tibial and dorsalis pedis arteries, 68% on the posterior tibial and plantar vessels, and 7% on the peroneal arteries. The global technical success was 80% (187/232): 82% in group 1 and 79% in group 2. The cumulative patient survival rates were 90%, 78%, and 65% in group 1 and 93%, 82%, and 71% in group 2 at 12, 24, and 36 months, respectively (p = 0.545). At the same time points, the freedom from amputation rates were 84%, 79%, and 79% in group 1 versus 90%, 89%, and 89% in group 2 (p = 0.035). Clinical success rates were 76%, 68%, 68% in the group 1 and 85%, 79%, and 79% in group 2 (p = 0.025). Primary and secondary patency rates did not differ between groups (p = 0.813 and p = 0.511). Patients in group 2 treated with angiosome-targeted revascularization had significantly better wound healing (pangioplasty guided by an angiosome model may prove beneficial in terms of better wound healing of diabetic foot ulcers and subsequent limb salvage. Further technical improvements and large comparative studies are necessary to support these observations.

  1. The effect of oral supplementation with a combination of beta-hydroxy-beta-methylbutyrate, arginine and glutamine on wound healing: a retrospective analysis of diabetic haemodialysis patients

    OpenAIRE

    Sipahi, Savas; Gungor, Ozkan; Gunduz, Mehmet; Cilci, Mehmet; Demirci, Mustafa Cahit; Tamer, Ali

    2013-01-01

    Background Diabetes is an important reason for end-stage renal failure and diabetic foot wounds worsen the life qualities of these patients. Protein and amino acid support accelerates the wound healing. The purpose of this retrospective study is to examine the effect of beta-hydroxy-beta-methylbutyrate, arginine and glutamine (Abound?) supplementation on the wound healing. Methods A total of 11 diabetic dialysis patients were included in this retrospective study aiming to evaluate the effect ...

  2. Bioceramic Nanofibres by Electrospinning

    Directory of Open Access Journals (Sweden)

    Rajkamal Balu

    2014-08-01

    Full Text Available Nanoscale three-dimensional (3D scaffolds offer great promise for improved tissue integration and regeneration by their physical and chemical property enhancements. Electrospinning is a versatile bottom-up technique for producing porous 3D nanofibrous scaffolds that could closely mimic the structure of extracellular matrix. Much work has been committed to the development of this process through the years, and the resultant nanostructures have been subjugated to a wide range of applications in the field of bioengineering. In particular, the application of ceramic nanofibres in hard tissue engineering, such as dental and bone regeneration, is of increased research interest. This mini-review provides a brief overview of the bioceramic nanofibre scaffolds fabricated by electrospinning and highlights some of the significant process developments over recent years with their probable future trends and potential applications as biomedical implants.

  3. Experience with the vacuum assisted closure negative pressure technique in the treatment of non-healing diabetic and dysvascular wounds.

    Science.gov (United States)

    Clare, Michael P; Fitzgibbons, Timothy C; McMullen, Scott T; Stice, R Colleen; Hayes, Dennis F; Henkel, Loree

    2002-10-01

    The purpose of this study is to report our experience with the Vacuum Assisted Closure (VAC) negative pressure technique in patients with non-healing wounds of the foot, ankle, and lower limb. We retrospectively reviewed 17 patients with non-healing wounds of the lower extremity who underwent treatment using the Vacuum Assisted Closure (VAC) device. Thirteen of 17 (76%) had diabetes mellitus, nine of whom were insulin-dependent, and 10 of whom had associated peripheral neuropathy. Eight of 17 (47%) had severe peripheral vascular disease. All had failed previous management with serial wound debridements and dressing changes; 15 of 17 (88%) had previously completed at least one course of oral antibiotics. Thirteen of 17 (76%) had previously undergone operative irrigation and debridement of the wounds; six of 17 (35%) had previously undergone revascularization procedures of the involved extremity. Five of 17 (29%) had wounds necessitating an amputation procedure prior to the present treatment; seven of 17 (41%) had failed treatment with local growth factors prior to the present treatment. Average length of treatment with the VAC device was 8.2 weeks. Fourteen of 17 (82%) wounds successfully healed; four underwent split-thickness skin grafting for wound closure; four were briefly treated with local growth factors; six were treated with only dressing changes following VAC treatment. Three of 17 (18%) wounds failed VAC treatment; all three patients had diabetes and had wounds located in the midfoot or forefoot; two of three had severe peripheral vascular disease. Our results indicate that the Vacuum Assisted Closure negative pressure technique is emerging as an acceptable option for wound care of the lower extremity. Not all patients are candidates for such treatment; those patients with severe peripheral vascular disease or smaller forefoot wounds may be best treated by other modalities. Larger wounds seem to be better suited for skin grafting or two-stage primary

  4. Diabetic foot wounds in haemodialysis patients: 2-year outcome after percutaneous transluminal angioplasty and minor amputation.

    Science.gov (United States)

    Matsuzaki, Kyoichi; Miyamoto, Akira; Hakamata, Naohiro; Fukuda, Masahiro; Yamauchi, Yasutaka; Akita, Takako; Kuhara, Ryoji; Tezuka, Shingo

    2012-12-01

    Critical limb ischaemia (CLI) is known to be associated with high mortality. In some patients, surgery cannot be performed due to high risk of perioperative death and complications. In other cases, there is only pain at rest but no wound. Therefore, it is difficult to accurately predict the prognosis of individual patients. We examined the prognosis of CLI cases in which therapeutic footwear was made for ambulation after wounds healed. The subjects were 31 haemodialysis patients with diabetic foot wounds, which were treated with percutaneous transluminal angioplasty and minor amputation. The subjects were 22 men and 9 women. Female patients were significantly older than male patients (P = 0.046). Two-year postoperative outcomes were survival in 19 patients and death in 12 patients. Eight of twelve deceased patients had a history of coronary intervention. There were 8 deaths among 13 patients with such history, indicating a marginally significant increase in the mortality rate (P = 0.060). Re-amputation was performed in 6 of 19 patients who survived. Two years postoperatively, 41.9% of patients overall survived without re-amputation. It is important to increase the number of cases for further study to improve the well-being of CLI patients and to examine medical economics. © 2012 The Authors. International Wound Journal © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  5. Matrix- and plasma-derived peptides promote tissue-specific injury responses and wound healing in diabetic swine.

    Science.gov (United States)

    Sheets, Anthony R; Massey, Conner J; Cronk, Stephen M; Iafrati, Mark D; Herman, Ira M

    2016-07-02

    Non-healing wounds are a major global health concern and account for the majority of non-traumatic limb amputations worldwide. However, compared to standard care practices, few advanced therapeutics effectively resolve these injuries stemming from cardiovascular disease, aging, and diabetes-related vasculopathies. While matrix turnover is disrupted in these injuries, debriding enzymes may promote healing by releasing matrix fragments that induce cell migration, proliferation, and morphogenesis, and plasma products may also stimulate these processes. Thus, we created matrix- and plasma-derived peptides, Comb1 and UN3, which induce cellular injury responses in vitro, and accelerate healing in rodent models of non-healing wounds. However, the effects of these peptides in non-healing wounds in diabetes are not known. Here, we interrogated whether these peptides stimulate healing in a diabetic porcine model highly reminiscent of human healing impairments in type 1 and type 2-diabetes. After 3-6 weeks of streptozotocin-induced diabetes, full-thickness wounds were surgically created on the backs of adult female Yorkshire swine under general anesthesia. Comb1 and UN3 peptides or sterile saline (negative control) were administered to wounds daily for 3-7 days. Following sacrifice, wound tissues were harvested, and quantitative histological and immunohistochemical analyses were performed for wound closure, angiogenesis and granulation tissue deposition, along with quantitative molecular analyses of factors critical for angiogenesis, epithelialization, and dermal matrix remodeling. Comb1 and UN3 significantly increase re-epithelialization and angiogenesis in diabetic porcine wounds, compared to saline-treated controls. Additionally, fluorescein-conjugated Comb1 labels keratinocytes, fibroblasts, and vascular endothelial cells in porcine wounds, and Far western blotting reveals these cell populations express multiple fluorescein-Comb1-interacting proteins in vitro. Further

  6. Comparison of the effect of topical versus systemic L-arginine on wound healing in acute incisional diabetic rat model

    Directory of Open Access Journals (Sweden)

    Alireza Zandifar

    2015-01-01

    Full Text Available Background: Diabetes is associated with endothelial dysfunction and impaired wound healing. The amino acid L-arginine is the only substrate for nitric oxide (NO synthesis. The purpose of this study was to compare the topical versus systemic L-arginine treatment on total nitrite (NO x and vascular endothelial growth factor (VEGF concentrations in wound fluid and rate of wound healing in an acute incisional diabetic wound model. Materials and Methods: A total of 56 Sprague-Dawley rats were used of which 32 were rendered diabetic. Animals underwent a dorsal skin incision. Dm-sys-arg group (N = 8, diabetic and Norm-sys-arg group (N = 8, normoglycemic were gavaged with L-arginine. Dm-sys-control group (N = 8, diabetic and Norm-sys-control group (N = 8, normoglycemic were gavaged with water. Dm-top-arg group (N = 8, diabetic and norm-top-arg group (N = 8, normoglycemic received topical L-arginine gel. Dm-top-control group (N = 8, diabetic received gel vehicle. On the day 5 the amount of NO x in wound fluid was measured by Griess reaction. VEGF/total protein in wound fluids was also measured on day 5 using enzyme-linked immunosorbent assay. All wound tissue specimens were fixed and stained to be evaluated for rate of healing. Data were analyzed using SPSS software (version 18.0, Chicago, IL, USA through One-way analysis of variance test and Tukey′s post-hoc. Results: In dm-sys-arg group, the level of NO x on day 5 was significantly more than dm-top-arg group (P < 0.05. VEGF content in L-arginine treated groups were significantly more than controls (P < 0.05. Rate of diabetic wound healing in dm-sys-arg group was significantly more than dm-top-arg group. Conclusion: Systemic L-arginine is more efficient than topical L-arginine in wound healing. This process is mediated at least in part, by increasing VEGF and NO in the wound fluid.

  7. Diabetes induces stable intrinsic changes to myeloid cells that contribute to chronic inflammation during wound healing in mice

    Directory of Open Access Journals (Sweden)

    Pauline Bannon

    2013-11-01

    Acute inflammation in response to injury is a tightly regulated process by which subsets of leukocytes are recruited to the injured tissue and undergo behavioural changes that are essential for effective tissue repair and regeneration. The diabetic wound environment is characterised by excessive and prolonged inflammation that is linked to poor progression of healing and, in humans, the development of diabetic foot ulcers. However, the underlying mechanisms contributing to excessive inflammation remain poorly understood. Here we show in a murine model that the diabetic environment induces stable intrinsic changes in haematopoietic cells. These changes lead to a hyper-responsive phenotype to both pro-inflammatory and anti-inflammatory stimuli, producing extreme M1 and M2 polarised cells. During early wound healing, myeloid cells in diabetic mice show hyperpolarisation towards both M1 and M2 phenotypes, whereas, at late stages of healing, when non-diabetic macrophages have transitioned to an M2 phenotype, diabetic wound macrophages continue to display an M1 phenotype. Intriguingly, we show that this population predominantly consists of Gr-1+ CD11b+ CD14+ cells that have been previously reported as ‘inflammatory macrophages’ recruited to injured tissue in the early stages of wound healing. Finally, we show that this phenomenon is directly relevant to human diabetic ulcers, for which M2 polarisation predicts healing outcome. Thus, treatments focused at targeting this inflammatory cell subset could prove beneficial for pathological tissue repair.

  8. Amniotic mesenchymal stem cells enhance wound healing in diabetic NOD/SCID mice through high angiogenic and engraftment capabilities.

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    Kim, Sung-Whan; Zhang, Hong-Zhe; Guo, Longzhe; Kim, Jong-Min; Kim, Moo Hyun

    2012-01-01

    Although human amniotic mesenchymal stem cells (AMMs) have been recognised as a promising stem cell resource, their therapeutic potential for wound healing has not been widely investigated. In this study, we evaluated the therapeutic potential of AMMs using a diabetic mouse wound model. Quantitative real-time PCR and ELISA results revealed that the angiogenic factors, IGF-1, EGF and IL-8 were markedly upregulated in AMMs when compared with adipose-derived mesenchymal stem cells (ADMs) and dermal fibroblasts. In vitro scratch wound assays also showed that AMM-derived conditioned media (CM) significantly accelerated wound closure. Diabetic mice were generated using streptozotocin and wounds were created by skin excision, followed by AMM transplantation. AMM transplantation significantly promoted wound healing and increased re-epithelialization and cellularity. Notably, transplanted AMMs exhibited high engraftment rates and expressed keratinocyte-specific proteins and cytokeratin in the wound area, indicating a direct contribution to cutaneous closure. Taken together, these data suggest that AMMs possess considerable therapeutic potential for chronic wounds through the secretion of angiogenic factors and enhanced engraftment/differentiation capabilities.

  9. An integrated wound-care pathway, supported by telemedicine, and competent wound management-Essential in follow-up care of adults with diabetic foot ulcers.

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    Smith-Strøm, Hilde; Iversen, Marjolein M; Graue, Marit; Skeie, Svein; Kirkevold, Marit

    2016-10-01

    Diabetic foot ulcers are a feared complication of diabetes. Care delivered via telemedicine is suggested to be a more integrated care pathway to manage diabetic foot ulcers than traditionally delivered healthcare. Our aim was to explore patients' experiences with telemedicine follow-up care as compared to traditional care. Interpretive description was used as an analysis strategy. Data were collected using individual semi-structured interviews in the context of a larger ongoing clustered randomized controlled trial. Twenty-four patients (13 in the intervention group; 11 in the control group), aged 38-88 years were purposively recruited from the RCT in order to obtain a diverse sample in terms of group composition (intervention vs. control), age, gender, marital status, setting, and comorbidities present. The control group received traditional care. Three themes emerged from the interpretive analysis: competence of healthcare professionals, continuity of care, and easy access. This was independed of types of follow-up that had limited impact on the patients' follow-up experiences. Competence of healthcare professionals and continuity of care were crucial, because they can either enhance or jeopardize wound care. If these two latter factors were absent, patients would lose confidence in the wound care process. If this happened, patients pointed out that the expert knowledge of a specialist clinic was essential to receive good care. When telemedicine functioned optimally, telemedicine was an advantage in the treatment, because the images quickly captured changes in the wound healing that immediately could be corrected. Easy access is important for patients, but the importance of accessibility appears to be primary when the other two factors were present. The best wound care pathway for patients with diabetes foot ulcers is depended on a combination of competence and professional skills in wound management, and continuity of care. If telemedicine is functioning as

  10. Chitosan-based dressings loaded with neurotensin--an efficient strategy to improve early diabetic wound healing.

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    Moura, Liane I F; Dias, Ana M A; Leal, Ermelindo C; Carvalho, Lina; de Sousa, Hermínio C; Carvalho, Eugénia

    2014-02-01

    One important complication of diabetes mellitus is chronic, non-healing diabetic foot ulcers (DFUs). This study aims to develop and use dressings based on chitosan derivatives for the sustained delivery of neurotensin (NT), a neuropeptide that acts as an inflammatory modulator in wound healing. Three different derivatives, namely N-carboxymethyl chitosan, 5-methyl pyrrolidinone chitosan (MPC) and N-succinyl chitosan, are presented as potential biomaterials for wound healing applications. Our results show that MPC has the best fluid handling capacity and delivery profile, also being non-toxic to Raw 264.7 and HaCaT cells. NT-loaded and non-loaded MPC dressings were applied to control/diabetic wounds to evaluate their in vitro/in vivo performance. The results show that the former induced more rapid healing (50% wound area reduction) in the early phases of wound healing in diabetic mice. A NT-loaded MPC foam also reduced expression of the inflammatory cytokine TNF-α (P<0.001) and decreased the amount of inflammatory infiltrate on day 3. On day 10 MMP-9 was reduced in diabetic skin (P<0.001), significantly increasing fibroblast migration and collagen (COL1A1, COL1A2 and COL3A1) expression and deposition. These results suggest that MPC-based dressings may work as an effective support for sustained NT release to reduce DFUs. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  11. Topical oxygen therapy results in complete wound healing in diabetic foot ulcers.

    Science.gov (United States)

    Yu, Janelle; Lu, Suzanne; McLaren, Ann-Marie; Perry, Julie A; Cross, Karen M

    2016-11-01

    Diabetic foot ulcers (DFUs) are a significant problem in an aging population. Fifteen percent of diabetics develop a DFU over their lifetime, which can lead to potential amputation. The 5-year survival rate after amputation is 31%, which is greater than the lifetime risk of mortality from cancer. Topical oxygen is a promising technique for the adjunctive therapy of chronic wounds including DFUs, but few controlled studies exist to support its clinical adoption. The aim of this study was to compare a portable topical oxygen delivery system in patients with nonhealing DFUs to standard best practice. Twenty patients were randomized into a topical oxygen group (n = 10), and a nonplacebo control group with regular dressings and standard care (n = 10), and attended the diabetic foot clinic once weekly for 8 weeks. Ulcer surface area over time was analyzed using standardized digital imaging software. DFUs were present without healing for a mean duration of 76 weeks prior to the study. They found a significant difference in healing rate between patients receiving topical oxygen and those receiving standard care. Topical oxygen, therefore, represents a potentially exciting new technology to shorten healing time in patients with nonhealing DFUs. More prospective randomized and powered studies are needed to determine the benefits of topical oxygen, but our current results are very promising. © 2016 by the Wound Healing Society.

  12. Effects of pulsed electromagnetic field (PEMF on the tensile biomechanical properties of diabetic wounds at different phases of healing.

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    Harry M C Choi

    Full Text Available The present study investigated the effects of pulsed electromagnetic field (PEMF on the tensile biomechanical properties of diabetic wounds at different phases of healing. Two intensities of PEMF were adopted for comparison. We randomly assigned 111 10-week-old male streptozotocin-induced diabetic Sprague-Dawley rats to two PEMF groups and a sham control group. Six-millimetre biopsy punched full thickness wounds were made on the lateral side of their hindlimbs. The PEMF groups received active PEMF delivered at 25 Hz with intensity of either 2 mT or 10 mT daily, while the sham group was handled in a similar way except they were not exposed to PEMF. Wound tissues were harvested for tensile testing on post-wounding days 3, 5, 7, 10, 14 and 21. Maximum load, maximum stress, energy absorption capacity, Young's modulus and thickness of wound tissue were measured. On post-wounding day 5, the PEMF group that received 10-mT intensity had significantly increased energy absorption capacity and showed an apparent increase in the maximum load. However, the 10-mT PEMF group demonstrated a decrease in Young's modulus on day 14. The 10-mT PEMF groups showed a significant increase in the overall thickness of wound tissue whereas the 2-mT group showed a significant decrease in the overall maximum stress of the wounds tissue. The present findings demonstrated that the PEMF delivered at 10 mT can improve energy absorption capacity of diabetic wounds in the early healing phase. However, PEMF (both 2-mT and 10-mT seemed to impair the material properties (maximum stress and Young's modulus in the remodelling phase. PEMF may be a useful treatment for promoting the recovery of structural properties (maximum load and energy absorption capacity, but it might not be applied at the remodelling phase to avoid impairing the recovery of material properties.

  13. Effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing.

    Science.gov (United States)

    Choi, Harry M C; Cheing, Alex K K; Ng, Gabriel Y F; Cheing, Gladys L Y

    2018-01-01

    The present study investigated the effects of pulsed electromagnetic field (PEMF) on the tensile biomechanical properties of diabetic wounds at different phases of healing. Two intensities of PEMF were adopted for comparison. We randomly assigned 111 10-week-old male streptozotocin-induced diabetic Sprague-Dawley rats to two PEMF groups and a sham control group. Six-millimetre biopsy punched full thickness wounds were made on the lateral side of their hindlimbs. The PEMF groups received active PEMF delivered at 25 Hz with intensity of either 2 mT or 10 mT daily, while the sham group was handled in a similar way except they were not exposed to PEMF. Wound tissues were harvested for tensile testing on post-wounding days 3, 5, 7, 10, 14 and 21. Maximum load, maximum stress, energy absorption capacity, Young's modulus and thickness of wound tissue were measured. On post-wounding day 5, the PEMF group that received 10-mT intensity had significantly increased energy absorption capacity and showed an apparent increase in the maximum load. However, the 10-mT PEMF group demonstrated a decrease in Young's modulus on day 14. The 10-mT PEMF groups showed a significant increase in the overall thickness of wound tissue whereas the 2-mT group showed a significant decrease in the overall maximum stress of the wounds tissue. The present findings demonstrated that the PEMF delivered at 10 mT can improve energy absorption capacity of diabetic wounds in the early healing phase. However, PEMF (both 2-mT and 10-mT) seemed to impair the material properties (maximum stress and Young's modulus) in the remodelling phase. PEMF may be a useful treatment for promoting the recovery of structural properties (maximum load and energy absorption capacity), but it might not be applied at the remodelling phase to avoid impairing the recovery of material properties.

  14. Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy.

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    Dixit, Snehil; Maiya, Arun; Umakanth, Shashikiran; Borkar, Shirish

    2013-01-01

    In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT) on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH), and visual analogue scale (VAS) for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

  15. Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy

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    Snehil Dixit

    2013-01-01

    Full Text Available In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH, and visual analogue scale (VAS for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

  16. Comparing the Effect of Pentoxifylline Administration on Mast Cells Maturing Process in a Diabetic and Normoglycemic Rat Wound Healing

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    Saeid Babaei

    2014-12-01

    Full Text Available Background: Wound healing is a complicated process that is influenced by many factors. Studies at molecular level on human and animal models have revealed several molecular changes related to the effect of diabetes on wound healing process. Increasing number of researches implicates the influence of mast cells on skin wounds healing. The present experimental study was conducted to compare systemic pentoxifylline administration on maturing process of mast cells during skin wound healing in diabetic and normoglycemic rats. Materials and Methods: In this experimental study, 48 wistar rats were divided into 2 groups of normoglycemic and diabetic and each group was divided into experimental and control. Experimental group received intraperitoneal (25 mg/kg twice a day and control group received distilled water. The number of mast cells and their maturing process was evaluated by microscopically counting of the types of mast cells (types 1, 2, 3 by stereological methods on day 3 and 7 after surgery. Results: In all experimental groups receiving pentoxifylline there were significant difference in the number of total mast cells, comparing normoglycemic groups (p<0.05 and also we found that in wound healing process pentoxifylline caused increasing the number of type 2 mast cells in all experimental groups (p<0.05. Conclusion: In all pentoxifylline treated groups delay in converting type 2 into type 3 mast cell was seen. Pentoxifylline causes decreasing mast cell degranulation during wound healing process.

  17. Activation of α7nAChR Promotes Diabetic Wound Healing by Suppressing AGE-Induced TNF-α Production.

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    Dong, Miao-Wu; Li, Ming; Chen, Jie; Fu, Tong-Tong; Lin, Ke-Zhi; Ye, Guang-Hua; Han, Jun-Ge; Feng, Xiang-Ping; Li, Xing-Biao; Yu, Lin-Sheng; Fan, Yan-Yan

    2016-04-01

    Diabetes frequently presents accumulation of advanced glycation end products (AGEs), which might induce excessive TNF-α production from macrophages to cause impaired wound healing. Recent studies have shown that activation of α7 nicotinic acetylcholine receptor (α7nAChR) on macrophages efficiently suppressed TNF-α synthesis. The aim of this study was to investigate the accumulation of AGEs in the wounds and determine whether PNU282987, an α7nAChR agonist, can improve wound repair by inhibiting AGE-mediated TNF-α production in a streptozotocin (STZ)-induced diabetic mouse model. Animals were assigned into four groups: wounded control group, wounded diabetic group, wounded diabetic group treated intraperitoneally with PNU282987, or wounded diabetic group treated intraperitoneally with vehicle. Compared with the non-diabetic control mice, the diabetic mice exhibited delayed wound healing that was characterized by elevated accumulation of AGEs, increased TNF-α level and macrophage infiltration, and decreased fibroblast number and collagen deposition at the late stage of repair. Besides, macrophages of diabetic wounds showed expression of α7nAChR. During late repair, PNU282987 treatment of diabetic mice significantly reduced the level of TNF-α, accelerated wound healing, and elevated fibroblast number and collagen deposition. To investigate the cellular mechanism of these observations, RAW 264.7 cells, a macrophage cell line, were incubated with AGEs in the presence or absence of PNU282987. TNF-α production from AGE-stimulated macrophages was significantly decreased by PNU282987 in a dose-dependent manner. Furthermore, PNU282987 significantly inhibited AGE-induced nuclear factor-κB (NF-κB) activation and receptor for AGE (RAGE) expression. These results strongly suggest that activating α7nAChR can promote diabetic wound healing by suppressing AGE-induced TNF-α production, which may be closely associated with the blockage of NF-κB activation in macrophages.

  18. Non-healing foot ulcers in diabetic patients: general and local interfering conditions and management options with advanced wound dressings.

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    Uccioli, Luigi; Izzo, Valentina; Meloni, Marco; Vainieri, Erika; Ruotolo, Valeria; Giurato, Laura

    2015-04-01

    Medical knowledge about wound management has improved as recent studies have investigated the healing process and its biochemical background. Despite this, foot ulcers remain an important clinical problem, often resulting in costly, prolonged treatment. A non-healing ulcer is also a strong risk factor for major amputation. Many factors can interfere with wound healing, including the patient's general health status (i.e., nutritional condition indicated by albumin levels) or drugs such as steroids that can interfere with normal healing. Diabetic complications (i.e., renal insufficiency) may delay healing and account for higher amputation rates observed in diabetic patients under dialysis treatment. Wound environment (e.g., presence of neuropathy, ischaemia, and infection) may significantly influence healing by interfering with the physiological healing cascade and adding local release of factors that may worsen the wound. The timely and well-orchestrated release of factors regulating the healing process, observed in acute wounds, is impaired in non-healing wounds that are blocked in a chronic inflammatory phase without progressing to healing. This chronic phase is characterised by elevated protease activity (EPA) of metalloproteinases (MMPs) and serine proteases (e.g., human neutrophil elastase) that interfere with collagen synthesis, as well as growth factor release and action. EPA (mainly MMP 9, MMP-8 and elastase) and inflammatory factors present in the wound bed (such as IL-1, IL-6, and TNFa) account for the catabolic state of non-healing ulcers. The availability of wound dressings that modulate EPA has added new therapeutic options for treating non-healing ulcers. The literature confirms advantages obtained by reducing protease activity in the wound bed, with better outcomes achieved by using these dressings compared with traditional ones. New technologies also allow a physician to know the status of the wound bed environment, particularly EPA, in a clinical

  19. Cytocompatible Anti-microbial Dressings of Syzygium cumini Cellulose Nanocrystals Decorated with Silver Nanoparticles Accelerate Acute and Diabetic Wound Healing.

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    Singla, Rubbel; Soni, Sourabh; Patial, Vikram; Kulurkar, Pankaj Markand; Kumari, Avnesh; S, Mahesh; Padwad, Yogendra S; Yadav, Sudesh Kumar

    2017-09-05

    The ever increasing incidences of non-healing skin wounds have paved way for many efforts on the convoluted process of wound healing. Unfortunately, the lack of relevance and success of modern wound dressings in healing of acute and diabetic wounds still remains a matter of huge concern. Here, an in situ three step approach was embraced for the development of nanocomposite (NCs) dressings by impregnating silver nanoparticles (AgNPs) onto a matrix of cellulose nanocrystals (CNCs) isolated from Syzygium cumini leaves using an environmental friendly approach. Topical application of NCs (ointments and strips) on acute and diabetic wounds of mice documented enhanced tissue repair (~99% wound closure) via decrease in inflammation; increase in angiogenesis, collagen deposition, and rate of neo-epithelialization that ultimately led to formation of aesthetically sound skin in lesser time than controls. Due to the synergistic action of CNCs (having high water uptake capacity) and AgNPs (anti-microbial agents), NCs tend to increase the expression of essential growth factors (FGF, PDGF and VEGF) and collagen while decreasing the pro-inflammatory factors (IL-6 and TNF-α) at the same time, thus accelerating healing. The results suggested the potential of these developed anti-microbial, cytocompatible and nanoporous NCs having optimized AgNPs concentration as ideal dressings for effective wound management.

  20. Efficacy of Annona squamosa L in the synthesis of glycosaminoglycans and collagen during wound repair in streptozotocin induced diabetic rats.

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    Ponrasu, Thangavel; Suguna, Lonchin

    2014-01-01

    The aim of this work was to find out the effects of Annona squamosa on the formation of glycosaminoglycans and collagen during wound healing in normal and diabetic rats. Diabetes induced rats were segregated into 4 groups, each containing six animals. Groups I and III served as the normal and diabetic control while groups II and IV served as normal and diabetic treated. The animals were treated with 200 μL of Annona squamosa extract topically. The granulation tissues formed were removed on the 8th day and the amount of glycosaminoglycans (GAGs) and collagen formed was evaluated by sequential extraction and SDSPAGE, respectively. Histological evaluation was also carried out using Masson's trichrome stain. In vitro wound healing efficacy of A. squamosa in human dermal fibroblast culture (HDF) was also carried out. The fibroblasts treated with varying concentrations of A. squamosa were examined for proliferation and closure of the wound area and photographed. A. squamosa increased cellular proliferation in HDF culture. The granulation tissues of treated wounds showed increased levels of glycosaminoglycans (P < 0.05) and collagen which were also confirmed by histopathology. The results strongly substantiate the beneficial effects of A. squamosa on the formation of glycosaminoglycans and collagen during wound healing.

  1. Antimicrobial Efficacy of Penicillium amestolkiae elv609 Extract Treated Cotton Fabric for Diabetic Wound Care.

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    Rozman, Nur Amiera Syuhada Binti; Hamin, Nurhanis Syafiqah Binti Mohd Nor; Ring, Leong Chean; Nee, Tan Wen; Mustapha, Mahfuzah Binti; Yenn, Tong Woei

    2017-09-01

    Diabetes mellitus is a chronic disorder which affects millions of population worldwide. Global estimates published in 2010 reported the world diabetic prevalence as 6.4%, affecting 285 million adults. Foot ulceration and wound infection are major forms of disabilities arising from diabetic diseases. This study was aimed to develop a natural antimicrobial finishing on medical grade textile that meets American Association of Textiles Chemists and Colorists (AATCC) standard. The textile samples were finished with the ethanolic extract of Penicillium amestolkiae elv609, an endophytic fungus isolated from Orthosiphon stamineus Benth (common name: cat's whiskers). Endophyte is defined as microorganism that reside in the living plant tissue, without causing apparent disease symptom to the host. The antimicrobial efficacy of the ethanolic extract of P. minioluteum was tested on clinical pathogens isolated from diabetic wound. The extract exhibited significant inhibitory activity against 4 bacteria and 1 yeast with the minimal inhibitory concentration ranged from 6.25 to 12.5 mg/mL. The results indicate different susceptibility levels of the test microorganism to the ethanolic extract. However, the killing activity of the extract was concentration-dependent. The finished medical textile showed excellent antimicrobial efficacy on AATCC test assays. All the microbial cultures treated with the textile sample displayed a growth reduction of 99.9% on Hoheinstein Challenge Test. The wash durability of the finished textile was found good even after 50 washes with commercial detergent. Besides, the gas chromatography mass spectrometry analysis showed that 6-octadecenoic acid and diethyl phthalate were the main bioactive constituents of the extract. In conclusion, the developed medical textile showed good antimicrobial efficacy on laboratory tests. This work can be extended to in vivo trials for developing healthcare textile products for antimicrobial applications.

  2. Study of Nigella sativa L. seed’s hydroethanolic extract on skin wound healing in male diabetic rats

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    E Noorbar

    2017-07-01

    Background and Aim: Skin wounds are a common complication of diabetes. The use of herbal medicines has had a beneficial effect on healing of the wound. The aim of this study was to evaluate the effect of hydrotanol black currant extract on skin ulcers in diabetic rats. Methods: The current experimental study was performed on 49 male Wistar rats (weighing 250-220 gr in 7 equal groups. Healthy, untreated, healthy subjects received 1% phenytoin, healthy treated with aspirin (sham, untreated diabetic, diabetic groups (receiving 1% phenytoin, 20% and 40% hydrotagonal extract of blackcurrant. Diabetes was induced by Streptozotocin (60 mg / kg. After anesthesia, injuries were made in the 1 × 2 cm area at the back of each animal, and each group received the treatment for their entire healing until complete healing. Histological studies were performed on tissue samples. The area of ​​the wound was measured every three days once, and the data were analyzed by one-way ANOVA and Tukey's post hoc test. Results: The mean wound healing time for non-treated diabetic groups and phenytoin-treated diabetics was 27 and 24 days, respectively. In healthy groups without treatment, the healthy phine thyinea hemorrhage was completed on days 23, 24 and 21, respectively. The shortest healing time was observed in diabetic groups treated with 20% (18 days and 40% (15 days black currant extracts. The two groups also had the lowest mean surface area of ​​the wound during the study period and the mean of the wound levels of the treated groups with the black yeast extract was significantly different from the control group (p<0.05. Conclusion: The extract of black currant has significant effects on the healing process of wounds in rats. Regarding the anti-inflammatory and anti-microbial properties of black cumin, it can be used to repair skin lesions. The antioxidant material in this plant accelerates the process of wound healing in comparison with conventional drugs.  

  3. Effectiveness of combined laser-puncture and conventional wound care to accelerate diabetic foot ulcer healing

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    Adiningsih Srilestari

    2017-05-01

    Full Text Available Background: Impaired wound healing is a common complication of diabetes. It has complex pathophysiologic mechanisms and often necessitates amputation. Our study aimed to evaluate the effectiveness of combined laser-puncture and conventional wound care in the treatment of diabetic foot ulcers.Methods: This was a double-blind controlled randomized clinical trial on 36 patients, conducted at the Metabolic Endocrine Outpatient Clinic, Cipto Mangunkusumo Hospital, Jakarta, between May and August 2015. Stimulation by laser-puncture (the treatment group or sham stimulation (the control group were performed on top of the standard wound care. Laser-puncture or sham were done on several acupuncture points i.e. LI4 Hegu, ST36 Zusanli, SP6 Sanyinjiao and KI3 Taixi bilaterally, combined with irradiation on the ulcers itself twice a week for four weeks. The mean reduction in ulcer sizes (week 2–1, week 3–1, week 4–1 were measured every week and compared between the two groups and analyzed by Mann-Whitney test.Results: The initial median ulcer size were 4.75 (0.10–9.94 cm2 and 2.33 (0.90–9.88 cm2 in laser-puncture and sham groups, respectively (p=0.027. The median reduction of ulcer size at week 2–1 was -1.079 (-3.25 to -0.09 vs -0.36 (-0.81 to -1.47 cm2, (p=0.000; at week 3–1 was -1.70 (-3.15 to -0.01 vs -0.36 (-0.80 to -0.28 cm2, (p=0.000; and at week 4–1 was -1.22 (-2.72 to 0.00 vs -0.38 (-0.74 to -0.57 cm2, (p=0.012.Conclusion: Combined laser-puncture and conventional wound care treatment are effective in accelerating the healing of diabetic foot ulcer.

  4. Emerging chitin and chitosan nanofibrous materials for biomedical applications

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    Ding, Fuyuan; Deng, Hongbing; Du, Yumin; Shi, Xiaowen; Wang, Qun

    2014-07-01

    Over the past several decades, we have witnessed significant progress in chitosan and chitin based nanostructured materials. The nanofibers from chitin and chitosan with appealing physical and biological features have attracted intense attention due to their excellent biological properties related to biodegradability, biocompatibility, antibacterial activity, low immunogenicity and wound healing capacity. Various methods, such as electrospinning, self-assembly, phase separation, mechanical treatment, printing, ultrasonication and chemical treatment were employed to prepare chitin and chitosan nanofibers. These nanofibrous materials have tremendous potential to be used as drug delivery systems, tissue engineering scaffolds, wound dressing materials, antimicrobial agents, and biosensors. This review article discusses the most recent progress in the preparation and application of chitin and chitosan based nanofibrous materials in biomedical fields.

  5. CONTAMINATED PROBLEMATIC SKIN WOUNDS IN DIABETIC PATIENTS TREATED WITH AUTOLOGOUS PLATELET-RICH PLASMA (PRP: A case series study

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    Tsvetan Sokolov

    2016-03-01

    Full Text Available OBJECTIVE: To study the effect of platelet-rich plasma (PRP on contaminated problematic skin ulcers in patients with diabetes. MATERIAL AND METHODS: A total of 6 patients had been treated within the period from 2012 to 2014; they had various types of problematic wounds and diabetes type 2. Patients’ distribution by sex was as follows: 1 man and 5 women; mean age- 68 years. Ulcer types: acute (2 patients, hard-to-heal (2 patients and chronic (2 patients ulcers. The mean size of the skin and soft tissue defect was 9,5 cm2. Pathogenic microflora was isolated in 4 patients - S. aureus in three and Е. Coli in one. Based on a scheme developed by us, all cases were treated by administering platelet-rich plasma, derived by PRGF Endoret system. Follow-up period was within 4 – 6 months (4,5 on average. We used platelet rich plasma derived by PRGF Endoret system, applied on the wound bed on a weekly basis. RESULTS: Application of PRP allowed successful closure of all wounds. There were no complications associated with treatment of PRP. Epithelialization of the wound took 15 weeks on average for all patients. One patient presented with hyperkeratosis. Initial score of followed wounds, based on the scales are as follows: Total wound score – 10 p. Total anatomic score – 8 p. Total score – 15 p. at the initial stage. At the end of the treatment period scores were as follows - 0 p., which means excellent results CONCLUSION: We believe that the application of PRP may become optimal therapy in the treatment of contaminated problematic wounds in diabetic patients. PRP not only stimulates wound healing, but also has antimicrobial properties, which may contribute to the prevention of infections.

  6. Efficient cutaneous wound healing using bixin-loaded PCL nanofibers in diabetic mice.

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    Pinzón-García, Ana Delia; Cassini-Vieira, Puebla; Ribeiro, Cyntia Cabral; de Matos Jensen, Carlos Eduardo; Barcelos, Luciola Silva; Cortes, Maria Esperanza; Sinisterra, Ruben Dario

    2017-10-01

    The present work demonstrated an efficient cutaneous wound healing using Bixin-loaded polycaprolactone (PCL) nanofibers as a controlled delivery system. The influence of Bixin (Bix) content on PCL nanofiber, Bix-PCL1(2.5% w/w bix) and Bix-PCL2 (12.5% w/w bix) formation was investigated using electrical conductivity, attenuated total reflectance infrared spectroscopy, X-ray diffraction, thermal analysis, and scanning electronic microscopy. The results showed that a greater bixin concentration resulted in higher polymeric solution electrical conductivity. Moreover, higher polymeric solution electrical conductivity provides lower nanofibers in terms of average diameter than pure PCL nanofibers. In vitro release was largely governed by a diffusion-controlled mechanism. The initial Bixin release domain showed a burst release over the first 10 hours where approximately 30% and 40% of Bixin was released from Bix-PCL1 and Bix-PCL2 nanofibers, respectively. The second kinetic domain was comprised of a continuous and slow Bixin release that led to almost 100% of the Bixin being released within 14 days. The results on excisional wound model in induced diabetic mice indicated that the low concentration of Bixin released from loaded Bix-PCL nanofibers maintain the biological activity of Bixin and is efficient in accelerating the wound healing as well as in reducing the scar tissue area compared with pure PCL nanofibers. Therefore, soft material Bixin-loaded PCL nanofibers are a promising candidate for use in wound dressing. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1938-1949, 2017. © 2016 Wiley Periodicals, Inc.

  7. Evaluation of wound healing properties of bioactive aqueous fraction from Moringa oleifera Lam on experimentally induced diabetic animal model

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    Muhammad AA

    2016-05-01

    Full Text Available Abubakar Amali Muhammad,1 Palanisamy Arulselvan,1 Cheah Pike See,2 Farida Abas,3 Sharida Fakurazi1,2 1Laboratory of Vaccine and Immunotherapeutics, Institute of Bioscience, 2Unit of Anatomy, Department of Human Anatomy, Faculty of Medicine and Health Sciences, 3Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Diabetic foot ulcer is a serious complication of diabetes, which affects a significant percentage (15% of diabetics and up to 15%–24% of those affected may require amputation. Therefore, the economic burden of diabetic foot ulcers is enormous and is associated with high cost of treatment and prolongs hospitalization. The present study was conducted to evaluate antibacterial and in vivo wound healing activities of an aqueous fraction of Moringa oleifera on a diabetic condition. Antibacterial activity testing was carried out using agar well and tube dilution techniques. The in vivo study was conducted using six groups of animals that comprise of one normal and diabetic control group each, three treatment groups of 0.5%, 1%, and 2% w/w aqueous fraction, and a positive control group (1% w/w silver sulfadiazine. Rats were induced with diabetes using a combination of streptozotocin 65 and 150 mg/kg nicotinamide daily for 2 days, and excision wounds were created and treated with various doses (0.5%, 1%, and 2% w/w aqueous fraction daily for 21 days. Biophysical, histological, and biochemical parameters were investigated. The results of the study revealed that aqueous fraction possessed antibacterial activity through inhibition of growth of Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli organisms. The topical application of aqueous fraction revealed enhancement of wound healing under sustained hyperglycemic condition for the duration of the experiment. This enhancement was achieved through decreased wound size, improved wound contraction, and tissue

  8. Proapoptotic effect of control-released basic fibroblast growth factor on skin wound healing in a diabetic mouse model.

    Science.gov (United States)

    Huang, Chenyu; Orbay, Hakan; Tobita, Morikuni; Miyamoto, Masaaki; Tabata, Yasuhiko; Hyakusoku, Hiko; Mizuno, Hiroshi

    2016-01-01

    The ability of basic fibroblast growth factor (bFGF) to improve wound healing is attenuated by its short half-life in free form. This study aimed to enhance skin wound healing in a diabetes mouse model while concomitantly decreasing scar formation using control-released bFGF together with acidic gelatin hydrogel microspheres (AGHMs). Bilateral full-thickness wounds (10 mm in diameter) were made on the backs of db/db mice. Forty-five mice were divided into three groups, and the base of the wound under the panniculus carnosus and the wound periphery were injected with phosphate-buffered saline (300 μL) containing (1) control-released bFGF (50 μg), (2) control-released bFGF (20 μg), or (3) AGHMs alone. The size of the wound area was recorded on each postoperative day (POD). Mice were sacrificed on postoperative day 4, 7, 10, 14, and 28, and skin wound specimens were obtained to assess the endothelium/angiogenesis index via cluster of differentiation 31 immunohistochemistry, the proliferation index via Ki-67 immunohistochemistry, and the myofibroblast and fibroblast apoptosis indices by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling and alpha-smooth muscle actin or vimentin staining, respectively. Epithelialization rates and indices of proliferation and myofibroblast/fibroblast apoptosis were higher in the bFGF groups than in the AGHM group, mainly within 2 weeks of injury. No dose-effect relationship was found for control-released bFGF, although the actions of 50 μg bFGF seemed to last longer than those of 20 μg bFGF. Therefore, control-released bFGF may accelerate diabetic skin wound healing and induce myofibroblast/fibroblast apoptosis, thereby reducing scar formation. © 2015 by the Wound Healing Society.

  9. Topical Insulin Accelerates Wound Healing in Diabetes by Enhancing the AKT and ERK Pathways: A Double-Blind Placebo-Controlled Clinical Trial

    Science.gov (United States)

    Lima, Maria H. M.; Caricilli, Andréa M.; de Abreu, Lélia L.; Araújo, Eliana P.; Pelegrinelli, Fabiana F.; Thirone, Ana C. P.; Tsukumo, Daniela M.; Pessoa, Ana Flávia M.; dos Santos, Marinilce F.; de Moraes, Maria A.; Carvalheira, José B. C.; Velloso, Lício A.; Saad, Mario J. A.

    2012-01-01

    Background Wound healing is impaired in diabetes mellitus, but the mechanisms involved in this process are virtually unknown. Proteins belonging to the insulin signaling pathway respond to insulin in the skin of rats. Objective The purpose of this study was to investigate the regulation of the insulin signaling pathway in wound healing and skin repair of normal and diabetic rats, and, in parallel, the effect of a topical insulin cream on wound healing and on the activation of this pathway. Research Design and Methods We investigated insulin signaling by immunoblotting during wound healing of control and diabetic animals with or without topical insulin. Diabetic patients with ulcers were randomized to receive topical insulin or placebo in a prospective, double-blind and placebo-controlled, randomized clinical trial (NCT 01295177) of wound healing. Results and Conclusions Expression of IR, IRS-1, IRS-2, SHC, ERK, and AKT are increased in the tissue of healing wounds compared to intact skin, suggesting that the insulin signaling pathway may have an important role in this process. These pathways were attenuated in the wounded skin of diabetic rats, in parallel with an increase in the time of complete wound healing. Upon topical application of insulin cream, the wound healing time of diabetic animals was normalized, followed by a reversal of defective insulin signal transduction. In addition, the treatment also increased expression of other proteins, such as eNOS (also in bone marrow), VEGF, and SDF-1α in wounded skin. In diabetic patients, topical insulin cream markedly improved wound healing, representing an attractive and cost-free method for treating this devastating complication of diabetes. Trial Registration ClinicalTrials.gov NCT01295177 PMID:22662132

  10. Limiting prolonged inflammation during proliferation and remodeling phases of wound healing in streptozotocin-induced diabetic rats supplemented with camel undenatured whey protein.

    Science.gov (United States)

    Ebaid, Hossam; Ahmed, Osama M; Mahmoud, Ayman M; Ahmed, Rasha R

    2013-07-25

    Impaired diabetic wound healing occurs as a consequence of excessive reactive oxygen species (ROS) and inflammatory cytokine production. We previously found that whey protein (WP) was able to normally regulate the ROS and inflammatory cytokines during the inflammatory phase (first day) in streptozotocin (STZ)-diabetic wound healing. This study was designed to assess the effect of WP on metabolic status, the inflammation and anti-inflammation response, oxidative stress and the antioxidant defense system during different phases of the wound healing process in diabetic rats. WP at a dosage of 100 mg/kg of body weight, dissolved in 1% CMC, was orally administered daily to wounded normal (non-diabetic) and STZ-induced diabetic rats for 8 days starting from the 1st day after wounding. The data revealed that WP enhanced wound closure and was associated with an increase in serum insulin levels in diabetic rats and an alleviation of hyperglycemic and hyperlipidemic states in diabetic animals. The increase in insulin levels as a result of WP administration is associated with a marked multiplication of β-cells in the core of islets of Langerhans. WP induced a reduction in serum TNF-α, IL-1β and IL-6 levels and an increase in IL-10 levels, especially on the 4th day after wounding and treatment. WP also suppressed hepatic lipid peroxidation and stimulated the antioxidant defense system by increasing the level of glutathione and the activity of glutathione-S-transferase, glutathione peroxidase and superoxide dismutase (SOD) in wounded diabetic rats. WP was observed to enhance wound closure by improving the diabetic condition, limiting prolonged inflammation, suppressing oxidative stress and elevating the antioxidant defense system in diabetic rats.

  11. Comparative Clinical Study of the Wound Healing Effects of a Novel Micropore Particle Technology: Effects on Wounds, Venous Leg Ulcers, and Diabetic Foot Ulcers

    Science.gov (United States)

    Bilyayeva, Olga O; Neshta, Viacheslav V; Golub, Alexander A; Sams-Dodd, Frank

    2017-08-01

    The purpose of this study was to determine the wound healing effects of Acapsil, a white, odorless powder based on micropore particle technology (MPPT) (Willingsford Ltd, Southampton, UK) by comparing it to Gentaxane (Gentaksan, Borshchagovsky CCP, Kyiv, Ukraine) (polydimethylsiloxane powder with gentamicin antibiotic) and Ioddicerin (Farmak, Kyiv, Ukraine) (iodine with dimethyl sulfoxide [DMSO]). The study included 266 patients with primarily trophic ulcers caused by pancreatic diabetes and venous insufficiency of the lower extremities, carbuncles, phlegmons, infected third- or fourth-degree heat burns, and infiltrations of postoperative wounds. The products were applied once daily to the wound until it was clean (ie, free from necrosis, pus, and fibrinogenous thickenings). The number of days (mean ± standard deviation) to a clean wound was 3.0 ± 0.9 for MPPT (n = 88) compared with 7.0 ± 1.2 and 8.0 ± 1.1 for Gentaxane (n = 90) and iodine/DMSO (n = 88), respectively. Thus, MPPT reduced the time to reach a clean wound by 57% and 62%, respectively. Products were used once daily until a clean wound was reached, which also reflects the number of applications. Days to onset of granulation for MPPT, Gentaxane, and iodine/DMSO were 4.5 ± 0.8, 9.2 ± 1.4, and 10.3 ± 1.5 days, respectively; and days to onset of epithelialization were 7.8 ± 1.1, 14.1 ± 1.9, and 16.4 ± 2.7 days, respectively. Subgroup analysis of patients with diabetic foot and venous leg ulcers found that each of these demonstrated the same pattern of healing as the overall study. The number of hospitalization days was 14.6 ± 5.6 for MPPT, 21.0 ± 10.7 for Gentaxane, and 24.0 ± 7.9 for iodine/DMSO. Compared with Gentaxane, patients receiving MPPT had a 31% reduction in hospitalization duration and a 39% reduction compared with iodine/DMSO. These findings demonstrate that MPPT represents a valuable new approach to wound care.

  12. Human Acellular Dermal Matrix Paired With Silver-zinc Coupled Electroceutical Dressing Results in Rapid Healing of Complicated Diabetic Wounds of Mixed Etiology: A Novel Case Series.

    Science.gov (United States)

    Cole, Windy

    2016-07-01

    Patients with diabetes are well known for having difficult-to-close wounds. When additional factors are added, such as gouty tophi or tumors, the difficulty is compounded and conventional care often fails to heal the wound. In this case series, an innovative wound modality that combined a human acellular dermal matrix with a silver-zinc coupled electroceutical wound dressing was used in 3 particularly difficult and complex cases. In all 3 cases, this alternative treatment provided full healing within 6 weeks in wounds that conventional care had been unable to close in up to 2 years.

  13. Nanofibrous Snake Venom Hemostat

    OpenAIRE

    Kumar, Vivek A.; Wickremasinghe, Navindee C.; Shi, Siyu; Hartgerink, Jeffrey D.

    2015-01-01

    Controlling perioperative bleeding is of critical importance to minimize hemorrhaging and fatality. Patients on anticoagulant therapy such as heparin have diminished clotting potential and are at risk for hemorrhaging. Here we describe a self-assembling nanofibrous peptide hydrogel (termed SLac) that on its own can act as a physical barrier to blood loss. SLac was loaded with snake-venom derived Batroxobin (50 μg/mL) yielding a drug-loaded hydrogel (SB50). SB50 was potentiated to enhance clot...

  14. An investigation of konjac glucomannan-keratin hydrogel scaffold loaded with Avena sativa extracts for diabetic wound healing.

    Science.gov (United States)

    Veerasubramanian, Praveen Krishna; Thangavel, Ponrasu; Kannan, Ramya; Chakraborty, Sudip; Ramachandran, Balaji; Suguna, Lonchin; Muthuvijayan, Vignesh

    2018-02-13

    We have developed a novel hydrogel composed of konjac glucomannan (KGM), human hair proteins (KER), and an ethanolic extract of Avena sativa (OAT) and evaluated its potential as a dressing material for diabetic wounds. KGM is an excellent biocompatible gelling agent that stimulates fibroblast proliferation and immunomodulation. Human hair proteins (KER) are biocompatible, biodegradable, and possess abundant cell adhesion sites. KER also promotes fibroblast attachment and proliferation, keratinocyte migration, and collagen expression, which can accelerate wound healing. OAT consists of oat β-glucans and several anti-inflammatory and antioxidant moieties that can reduce prolonged inflammation in chronic wounds. SEM images confirm the highly porous architecture of the scaffolds. When immersed in PBS, KGM + KER + OAT hydrogels absorb 7.5 times their dry weight. These hydrogels display a measured rate of degradation in lysozyme. KGM + KER + OAT hydrogels showed no significant cytotoxicity against NIH/3T3 fibroblasts. DAPI and SEM images obtained after 48 h of cell culture illustrate the attachment and infiltration of fibroblasts. In vivo studies performed using a diabetic rat excision wound model showed that KGM + KER + OAT hydrogels significantly accelerated wound healing compared to the control and the KGM + KER hydrogels. Copyright © 2018 Elsevier B.V. All rights reserved.

  15. Hyperbaric oxygen therapy for wound healing in diabetic rats: Varying efficacy after a clinically-based protocol.

    Directory of Open Access Journals (Sweden)

    Johan W van Neck

    Full Text Available Hyperbaric oxygen therapy (HBOT is a clinical treatment in which a patient breathes pure oxygen for a limited period of time at an increased pressure. Although this therapy has been used for decades to assist wound healing, its efficacy for many conditions is unproven and its mechanism of action is not yet fully clarified. This study investigated the effects of HBOT on wound healing using a diabetes-impaired pressure ulcer rat model. Seven weeks after streptozotocin-induced diabetes in rats (n = 55, a pressure ulcer was created on dorsal skin. Subsequently, animals received HBOT during 6 weeks following a standard clinical protocol (HBOT group with varying endpoints up to 42 days post-wounding versus controls without HBOT. Capillary venous oxygen saturation (SO2 showed a significant increase in the HBOT group on day 24; however, this increase was significant at this time point only. The quantity of hemoglobin in the micro-blood vessels (rHB showed a significant decrease in the HBOT group on days 21 and 42, and showed a trend to decrease on day 31. Blood flow in the microcirculation showed a significant increase on days 17, 21 and 31 but a significant decrease on days 24 and 28. Inflammation scoring showed significantly decreased CD68 counts in the HBOT group on day 42, but not in the early stages of wound healing. Animals in the HBOT group showed a trend for an increase in mean wound breaking strength on day 42.

  16. The effect of topical extract of Momordica charantia (bitter gourd) on wound healing in nondiabetic rats and in rats with diabetes induced by streptozotocin.

    Science.gov (United States)

    Teoh, S L; Latiff, A A; Das, S

    2009-10-01

    Momordica charantia (MC; bitter gourd) is a traditional herb commonly used for its antidiabetic, antioxidant, contraceptive and antibacterial properties. It is also used for the rapid healing of wounds. To observe the topical effect of MC extract on the wound-healing process in rats with diabetes induced by streptozotocin. In total, 72 Sprague-Dawley rats were used for the study. The animals were subdivided into two groups: a nondiabetic group (n = 36) and a group with diabetes induced by streptozotocin (n = 36). Both groups were subdivided further into a nontreated control group (n = 18), and a topically treated group with MC extract administered daily (n = 18). The wound was inflicted with a 6-mm punch-biopsy needle on the dorsal aspect of the thoracolumbar region. The animals were killed on the days 1, 5 and 10 after wound creation. The rate of wound closure and the total protein content was estimated. Histological study of the wound tissue at days 5 and 10 was also performed. The diabetic group exhibited delayed wound healing as compared to the normal group. Interestingly, the diabetic group treated with topical MC extract showed better results than the nontreated group. Results show that administration of MC extract improves and accelerates the process of wound healing in diabetic animals.

  17. Topical treatment with the opioid antagonist naltrexone accelerates the remodeling phase of full-thickness wound healing in type 1 diabetic rats.

    Science.gov (United States)

    Immonen, Jessica A; Zagon, Ian S; Lewis, Gregory S; McLaughlin, Patricia J

    2013-10-01

    Wound repair involves a series of overlapping phases that include inflammation, proliferation, and tissue remodeling, with the latter phase requiring months for proper healing. Delays in any of these processes can result in infection, chronic ulceration, and possible amputation. Diabetes is a major risk factor for improper wound repair, and impaired wound healing is a major complication for more than 26 million people in the US diagnosed with diabetes. Previous studies have demonstrated that the opioid antagonist naltrexone (NTX) dissolved in moisturizing cream reverses delays in wound closure in streptozotocin-induced type 1 diabetic (T1D) rats. NTX accelerated DNA synthesis and increased the number of epithelial and mast cells, as well as new blood vessel formation. In this study, remodeling was evaluated in T1D rats up to eight weeks after initial wounding. Twenty days following wounding, diabetic rats treated with vehicle had elevated numbers of MMP-2+ fibroblasts, suggesting delayed healing processes; birefringence of granulation tissue stained with Sirius red revealed diminished collagen formation and maturation. Wound tissue from NTX-treated T1D rats had comparable numbers of MMP-2+ fibroblasts to control specimens, as well as accelerated maturation of granulation tissue. The integrity of wounded skin was evaluated by tensile strength measurements. T1D resulted in delayed wound healing, and wounded skin that displayed reduced tensile strength relative to normal rats. Topical NTX applied to wounds in T1D rats resulted in enhanced collagen formation and maturation over a 60-day period of time. Moreover, the force required to tear skin of NTX-treated T1D rats was elevated relative to the force necessary to tear the skin of vehicle-treated T1D rats, and comparable to that for normal rats. These data reveal that complications in wound healing associated with T1D involve the novel OGF-OGFr pathway, and that topical NTX is an effective treatment to enhance wound

  18. Comparision of vacuum-asisted closure and moist wound dressing in the treatment of diabetic foot ulcers.

    Science.gov (United States)

    Ravari, Hassan; Modaghegh, Mohammad-Hadi Saeed; Kazemzadeh, Gholam Hosein; Johari, Hamed Ghoddusi; Vatanchi, Attieh Mohammadzadeh; Sangaki, Abolghasem; Shahrodi, Mohammad Vahedian

    2013-01-01

    Vacuum-assisted closure (VAC) is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days during the study period. Patient satisfaction and formation of granulation tissue were also assessed. Improvement of the wound in the form of reducing the diameter and depth and increasing proliferation of granulation tissue was significant in most of the patients of the VAC group after two weeks. Satisfaction of patients in the VAC group was evaluated as excellent as no amputation was done in this group. Wagner score was reduced in both the study groups, although this decrement was not significant in the moist dressing group. VAC appears to be as safe as and more efficacious than moist dressing for the treatment of diabetic foot ulcers.

  19. Comparision of vacuum-asisted closure and moist wound dressing in the treatment of diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Hassan Ravari

    2013-01-01

    Full Text Available Background: Vacuum-assisted closure (VAC is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Materials and Methods: Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days during the study period. Patient satisfaction and formation of granulation tissue were also assessed. Results: Improvement of the wound in the form of reducing the diameter and depth and increasing proliferation of granulation tissue was significant in most of the patients of the VAC group after two weeks. Satisfaction of patients in the VAC group was evaluated as excellent as no amputation was done in this group. Wagner score was reduced in both the study groups, although this decrement was not significant in the moist dressing group. Conclusion: VAC appears to be as safe as and more efficacious than moist dressing for the treatment of diabetic foot ulcers.

  20. Comparision of Vacuum-Asisted Closure and Moist Wound Dressing in the Treatment of Diabetic Foot Ulcers

    Science.gov (United States)

    Ravari, Hassan; Modaghegh, Mohammad-Hadi Saeed; Kazemzadeh, Gholam Hosein; Johari, Hamed Ghoddusi; Vatanchi, Attieh Mohammadzadeh; Sangaki, Abolghasem; Shahrodi, Mohammad Vahedian

    2013-01-01

    Background: Vacuum-assisted closure (VAC) is a new method in wound care which speeds wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates. This study aims to evaluate its efficacy in the treatment of diabetic foot ulcers. Materials and Methods: Thirteen patients with diabetic foot ulcers were enrolled in the moist dressing group, and 10 patients in the VAC group. The site, size and depth of the wound were inspected and recorded before and every three days during the study period. Patient satisfaction and formation of granulation tissue were also assessed. Results: Improvement of the wound in the form of reducing the diameter and depth and increasing proliferation of granulation tissue was significant in most of the patients of the VAC group after two weeks. Satisfaction of patients in the VAC group was evaluated as excellent as no amputation was done in this group. Wagner score was reduced in both the study groups, although this decrement was not significant in the moist dressing group. Conclusion: VAC appears to be as safe as and more efficacious than moist dressing for the treatment of diabetic foot ulcers. PMID:23723599

  1. Measurement of diabetic wounds with optical coherence tomography-based air-jet indentation system and a material testing system.

    Science.gov (United States)

    Choi, M-C; Cheung, K-K; Ng, G Y-F; Zheng, Y-P; Cheing, G L-Y

    2015-11-01

    Material testing system is a conventional but destructive method for measuring the biomechanical properties of wound tissues in basic research. The recently developed optical coherence tomography-based air-jet indentation system is a non-destructive method for measuring these properties of soft tissues in a non-contact manner. The aim of the study was to examine the correlation between the biomechanical properties of wound tissues measured by the two systems. Young male Sprague-Dawley rats with streptozotocin-induced diabetic were wounded by a 6 mm biopsy punch on their hind limbs. The biomechanical properties of wound tissues were assessed with the two systems on post-wounding days 3, 7, 10, 14, and 21. Wound sections were stained with picro-sirius red for analysis on the collagen fibres. Data obtained on the different days were charted to obtain the change in biomechanical properties across the time points, and then pooled to examine the correlation between measurements made by the two devices. Qualitative analysis to determine any correlation between indentation stiffness measured by the air-jet indentation system and the orientation of collagen fibres. The indentation stiffness is significantly negatively correlated to the maximum load, maximum tensile stress, and Young's modulus by the material testing system (all p<0.05). The orientation of collagen changes with the indentation stiffness over time. Our findings support the use of optical coherence tomography-based air-jet indentation system to evaluate the biomechanical properties of wounds in a non-contact manner. It is a potential clinical device to examine the biomechanical properties of chronic wounds in vivo in a repeatable manner.

  2. Development of reduced graphene oxide (rGO)-isabgol nanocomposite dressings for enhanced vascularization and accelerated wound healing in normal and diabetic rats.

    Science.gov (United States)

    Thangavel, Ponrasu; Kannan, Ramya; Ramachandran, Balaji; Moorthy, Ganeshkumar; Suguna, Lonchin; Muthuvijayan, Vignesh

    2018-05-01

    Treatment of chronic non-healing wounds in diabetes is still a major clinical challenge. Here, we have developed reduced graphene oxide (rGO) loaded isabgol nanocomposite scaffolds (Isab + rGO) to treat normal and diabetic wounds. rGO was synthesized by rapid reduction of graphene oxide (GO) under focused solar radiation. Then, rGO was uniformly dispersed into isabgol solution to prepare Isab + rGO nanocomposite scaffolds. These scaffolds were characterized using various physiochemical techniques. Isab + rGO nanocomposite scaffolds showed suitable cell viability, proliferation, and attachment. In vivo experiments were performed using Wistar rats to study the wound healing efficacy of these scaffolds in normal and diabetic rats. Results revealed that rGO stimulated collagen synthesis, collagen crosslinking, wound contraction, and reduced the wound re-epithelialization time significantly compared to control. Histology and immunohistochemistry analyses showed that Isab + rGO scaffold treatment enhanced angiogenesis, collagen synthesis, and deposition in treated wounds. Isab + rGO scaffold treatment also played a major role in shortening the inflammation phase and recruiting macrophages to enhance the early phase of wound healing. Overall, this investigation showed that Isab + rGO scaffold dressing could significantly accelerate the healing of normal and diabetic wounds. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. Angiopoietin-like 4 Stimulates STAT3-mediated iNOS Expression and Enhances Angiogenesis to Accelerate Wound Healing in Diabetic Mice

    NARCIS (Netherlands)

    Chong, H.C.; Goh, C.Q.; Gounko, N.V.; Luo, B.; Wang, X.; Kersten, A.H.

    2014-01-01

    Impaired wound healing is a major source of morbidity in diabetic patients. Poor outcome has, in part, been related to increased inflammation, poor angiogenesis, and deficiencies in extracellular matrix components. Despite the enormous impact of these chronic wounds, effective therapies are lacking.

  4. Fabrication and characterization of curcumin-loaded silk fibroin/P(LLA-CL) nanofibrous scaffold

    Science.gov (United States)

    Lian, Yuan; Zhan, Jian-Chao; Zhang, Kui-Hua; Mo, Xiu-Mei

    2014-12-01

    Curcumin exhibited excellent properties including antioxidant, antiinflammatory, antiviral, antibacterial, antifungal, anticancer, and anticoagulant activities. In this study, curcumin was incorporated into silk fibroin (SF)/poly(L-lactic acid- co-e-caprolactone) (P(LLA-CL)) nanofibrous scaffolds via electrospinning, and changes brought about by raising the curcumin content were observed: SEM images showed that the average nanofibrous diameter decreased at the beginning and then increased, and the nanofibers became uniform; FTIR showed that the conformation of SF transforming from random coil form to β-sheet structure had not been induced, while SF conformation converted to β-sheet after being treated with 75% ethanol vapor; XRD results confirmed that the crystal structure of (P(LLA-CL)) had been destroyed; The mechanical test illustrated that nanofibrous scaffolds still maintained good mechanical properties. Further, curcumin-loaded nanofibrous scaffolds were evaluated for drug release, antioxidant and antimicrobial activities in vitro. The results showed that curcumin presented a sustained release behavior from nanofibrous scaffolds and maintained its free radical scavenging ability, and such scaffolds could effectively inhibit S. aureus growth (> 95%). Thus, curcumin-loaded SF/P(LLA-CL) nanofibrous scaffolds might be potential candidates for wound dressing and tissue engineering scaffolds.

  5. A combination of 670 nm and 810 nm diode lasers for wound healing acceleration in diabetic rats.

    Science.gov (United States)

    Jahangiri Noudeh, Younes; Shabani, Mohammad; Vatankhah, Nasibeh; Hashemian, Seyyed Jafar; Akbari, Karim

    2010-10-01

    To study the effects of the combination of 670 nm and 810 nm diode lasers on diabetic wound healing parameters in rats. An alternative to traditional treatment modalities for diabetic ulcers is low-level laser therapy (LLLT). A number of published studies demonstrate the beneficial effects of LLLT, although several other studies also exist which indicate results to the contrary. Four groups were present in our study: Diabetic-laser (n = 5), Diabetic-control (n = 4), Nondiabetic-laser (n = 5) and Nondiabetic-control (n = 5) groups. Two intervention (laser) groups underwent low level laser therapy using 670 nm diode laser (500 mW, 10 J, 48 s) in the wound context, and 810 nm diode laser (250 mW, 12 J, 50 s) to the wound margins. The wound area was measured using computer software after digital microscopic photography on days 0, 3, 6, 9, 12, 15, 20, and 24. There were no statistically significant differences between the diabetic and non-diabetic groups in the wound area, percentage of open wound area, and wound healing rate throughout the repeated measurements of the study. After seven days of low level laser therapy in the non-diabetic group, urine excretion was significantly increased in comparison with the control group. Overall, our study showed results of measured wound healing parameters that were not significantly different in the LLLT group compared with the control group. The urine volume increase in non-diabetic rats after LLLT was an incidental observation that warrants future study.

  6. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

    OpenAIRE

    Çildağ, Mehmet Burak; Köseoğlu, Ömer Faruk Kutsi

    2017-01-01

    Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postproc...

  7. Preliminary development of a diabetic foot ulcer database from a wound electronic medical record: a tool to decrease limb amputations.

    Science.gov (United States)

    Golinko, Michael S; Margolis, David J; Tal, Adit; Hoffstad, Ole; Boulton, Andrew J M; Brem, Harold

    2009-01-01

    Our objective was to create a practical standardized database of clinically relevant variables in the care of patients with diabetes and foot ulcers. Numerical clinical variables such as age, baseline laboratory values, and wound area were extracted from the wound electronic medical record (WEMR). A coding system was developed to translate narrative data, culture, and pathology reports into discrete, quantifiable variables. Using data extracted from the WEMR, a diabetic foot ulcer-specific database incorporated the following tables: (1) demographics, medical history, and baseline laboratory values; (2) vascular testing data; (3) radiology data; (4) wound characteristics; and (5) wound debridement data including pathology, culture results, and amputation data. The database contains variables that can be easily exported for analysis. Amputation was studied in 146 patients who had at least two visits (e.g., two entries in the database). Analysis revealed that 19 (13%) patients underwent 32 amputations (nine major and 23 minor) in 23 limbs. There was a decreased risk of amputation, 0.87 (0.78, 1.00), using a proportional hazards model, associated with an increased number of visits and entries in the WEMR. Further analysis revealed no significant difference in age, gender, HbA1c%, cholesterol, white blood cell count, or prealbumin at baseline, whereas hemoglobin and albumin were significantly lower in the amputee group (psafety and quality of care, allowing clinicians to more easily identify a nonhealing wound and intervene. This report describes a method of capturing data relevant to clinical care of a patient with a diabetic foot ulcer, and may enable clinicians to adapt such a system to their own patient population.

  8. Platelet-rich plasma, bilayered acellular matrix grafting and negative pressure wound therapy in diabetic foot infection.

    Science.gov (United States)

    Deng, W; Boey, J; Chen, B; Byun, S; Lew, E; Liang, Z; Armstrong, D G

    2016-07-02

    Management and treatment of acute severe diabetic foot disease in patients with suboptimal glycaemic control is a critical issue in wound repair. This paper discusses the clinical efficacy of an aggressive surgical intervention combined with targeted use of regenerative medical therapies in limb preservation. Negative pressure wound therapy (NPWT), platelet-rich plasma (PRP), bilayered acellular matrix grafting and split-thickness skin grafting were combined to treat a patient with diabetes, foot necrotising fasciitis and gaseous gangrene. The wound was completely healed. The clinical outcome revealed that a multi-intervention strategy could be effective for large necrotising fasciitis wounds. Early clinical observation, suggests aggresive surgical intervention preserving intact tissue and targeted use of new regenerative technologies can lead to preservation of a limb. The authors have received no financial support for the material presented in this study outside of the scope of standard patient care reimbursement. This work was supported by the National Natural Science Foundation of China (NO. 81500596) awarded to Dr Wuquan Deng.

  9. Quality of life in patients with diabetic foot ulcers: validation of the Cardiff Wound Impact Schedule in a Canadian population.

    Science.gov (United States)

    Jaksa, Peter J; Mahoney, James L

    2010-12-01

    The purpose of this study was to evaluate and validate the Cardiff Wound Impact Schedule (CWIS), a disease-specific quality-of-life measure, in a diabetic foot ulcer (DFU) population. Patients with DFUs have restrictions as part of their treatment and rehabilitation, which can affect health-related quality of life (HRQoL). Because of the high number of comorbidities experienced in diabetes, a disease-specific quality-of-life measure is needed to best assess the affect of a foot ulcer on HRQoL. Patients with DFUs completed the CWIS and a World Health Organization generic quality-of-life questionnaire. Validity was assessed by comparing domains of the questionnaires. Patients were categorised using the University of Texas wound classification system. Mean CWIS scores were compared between categories to assess the questionnaire's ability to differentiate wound severity. Patients with open ulcers scored significantly lower on the CWIS than those with healed ulcers. Correlations between questionnaire domains were as follows: Social Life with Social Functioning (r = 0·641, P Health (r = 0·533, P Health-Related Quality of Life with Vitality (r = 0·425, P < 0·01). However, there was no significant difference in mean CWIS scores between categories of wound severity. We have demonstrated the ability of the CWIS in assessing HRQoL in a DFU population and its ability to differentiate between healed and non healed states. © 2010 The Authors. Journal Compilation © 2010 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  10. Electrospun polyacrylonitrile nanofibrous biomaterials.

    Science.gov (United States)

    Ren, Xuehong; Akdag, Akin; Zhu, Changyun; Kou, Lei; Worley, S D; Huang, T S

    2009-11-01

    An N-halamine precursor, 3-(5'-methyl-5'-hydantoinyl)acetanilide (I), was synthesized in our laboratory and loaded onto electrospun polyacrylonitrile fiber to prepare nanosized biocidal materials, which could be rendered antimicrobial by exposure to household bleach. Differential scanning calorimetry was used to study the thermal properties of the nanofibers with and without the N-halamine precursor and its chlorinated derivative loaded. Scanning electron microscopy demonstrated that the ultrafine fibers formed with diameters from 250 to 600 nm. Chlorinated nanofibrous mats composed of the fibers were challenged with Staphylococcus aureus (ATCC 6538) and Escherichia coli O157:H7 (ATCC 43895); they showed promising inactivation efficacies against the two bacterial species within 5 minutes of contact. Potential uses of the antimicrobial fibers include filters for industrial water and air disinfection and protective clothing. (c) 2008 Wiley Periodicals, Inc.

  11. CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England.

    Science.gov (United States)

    Nelson, Andrea; Wright-Hughes, Alexandra; Backhouse, Michael Ross; Lipsky, Benjamin A; Nixon, Jane; Bhogal, Moninder S; Reynolds, Catherine; Brown, Sarah

    2018-01-31

    To determine the extent of agreement and patterns of disagreement between wound swab and tissue samples in patients with an infected diabetic foot ulcer (DFU). Multicentre, prospective, cross-sectional study. Primary and secondary care foot ulcer/diabetic outpatient clinics and hospital wards across England. Inclusion criteria: consenting patients aged ≥18 years; diabetes mellitus; suspected infected DFU. clinically inappropriate to take either sample. Wound swab obtained using Levine's technique; tissue samples collected using a sterile dermal curette or scalpel. Coprimary: reported presence, and number, of pathogens per sample; prevalence of resistance to antimicrobials among likely pathogens. Secondary: recommended change in antibiotic therapy based on blinded clinical review; adverse events; sampling costs. 400 consenting patients (79% male) from 25 centres.Most prevalent reported pathogens were Staphylococcus aureus (43.8%), Streptococcus (16.7%) and other aerobic Gram-positive cocci (70.6%). At least one potential pathogen was reported from 70.1% of wound swab and 86.1% of tissue samples. Pathogen results differed between sampling methods in 58% of patients, with more pathogens and fewer contaminants reported from tissue specimens.The majority of pathogens were reported significantly more frequently in tissue than wound swab samples (P<0.01), with equal disagreement for S. aureus and Pseudomonas aeruginosa. Blinded clinicians more often recommended a change in antibiotic regimen based on tissue compared with wound swab results (increase of 8.9%, 95% CI 2.65% to 15.3%). Ulcer pain and bleeding occurred more often after tissue collection versus wound swabs (pain: 9.3%, 1.3%; bleeding: 6.8%, 1.5%, respectively). Reports of tissue samples more frequently identified pathogens, and less frequently identified non-pathogens compared with wound swab samples. Blinded clinicians more often recommended changes in antibiotic therapy based on tissue compared with wound

  12. Polyurethane foam containing rhEGF as a dressing material for healing diabetic wounds: Synthesis, characterization, in vitro and in vivo studies.

    Science.gov (United States)

    Pyun, Do Gi; Choi, Hyun Jun; Yoon, Hyoung Soon; Thambi, Thavasyappan; Lee, Doo Sung

    2015-11-01

    Diabetic wounds are a major health issue associated with diabetes mellitus. To surmount this issue, we developed polyurethane foams (PUFs) incorporating varying amounts of recombinant human epidermal growth factor (rhEGF) (rhEGF-PUFs) as a wound dressing for diabetic wounds. From electron microscopy images, it was found that the pore size of the rhEGF-PUFs surface (the wound contact layer) was less than 100μm, regardless of rhEGF content. The release of rhEGF from the PUFs was evaluated using an enzyme-linked immunosorbent assay. The result showed that the release of rhEGF was time and concentration dependent, i.e., the amount of released rhEGF significantly increased as the immersion time and the rhEGF content of the PUFs increased. In vitro cytotoxicity testing showed that rhEGF-PUFs increased the viability of HaCaT human keratinocytes and CCD986-sk human fibroblasts, which indicated that the incorporated rhEGF maintained its biological activity. In an in vitro scratch wound healing assay, the wound closure rate was faster in CCD986-sk human fibroblasts than in HaCaT human keratinocytes. Finally, the rhEGF-PUFs were evaluated as an in vivo treatment in a full-thickness wound model in diabetized Sprague-Dawley rats. The result indicated that compared with PUFs, rhEGF-PUFs accelerated wound healing by promoting wound contraction, re-epithelialization, collagen deposition and the formation of a skin appendage. These findings demonstrate that rhEGF-PUFs are a promising dressing for diabetic wounds. Copyright © 2015. Published by Elsevier B.V.

  13. Infection Agents Detected with Wound Culture in Patients with Diabetic Foot who will Undergo Hyperbaric Oxygen Treatment

    Directory of Open Access Journals (Sweden)

    Gurkan Mert

    2012-04-01

    Full Text Available AIM: We aimed to obtain the knowledge of appropriate antibiotic therapy and to make a contribution to improving treatment efficacy by conducting a microbiological study of diabetic foot ulcers. METHOD: 30 patients (18 male and 12 female with diabetic foot ulcer applying to our center for hyperbaric oxygen (HBO treatment in 2010 were enrolled in this study. The wounds were graded according to Meggitt-Wagner classification system. Wound cultures were obtained before starting antibiotic therapy and HBO treatment. Phoenix system (Becton Dickinson, USA and Kirby-Bauer disk diffusion antibiotic sensitivity testing were used in order to detect the antimicrobial susceptibility of the infection agents. The number of HBO sessions, glycemic control and treatment results were assessed. RESULTS: Mean age of the patients was 61.3 years (range: 35-83. 24 patients had a good glycemic control and 6 patients had not. The patients were given 5 to 55 HBO sessions (mean: 20. Of the 30 patients 19 (63.33% recovered from the infection but 11 (36.67% have not responded to the treatment. 14 different infectious agents were detected in diabetic foot ulcers we examined. Gram-positive agents were isolated in 12 (40% out of 30 wound cultures and gram-negative agents were isolated in 18 (60% wound culture. Pseudomonas aeruginosa was predominantly isolated and the other agents isolated were enterococcus faecalis, klebsiella pneumoniae, staphylococcus aureus and escherichia coli. CONCLUSION: The outcomes can not represent the general population rates due to the restriction factors. They give only an idea about the probability of infectious agent spectrum in diabetic foot ulcers and their antibiotic susceptibility. We want to attract attention to the fact that although pseudomonas aeruginosa infections are mostly encountered in hospital, they can also be acquired from the community and it will be useful to develop appropriate antibiotic policies and treatment protocols. [TAF

  14. Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis

    OpenAIRE

    Chae, Kum Ju; Shin, Jin Yong

    2016-01-01

    Purpose Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy. Methods We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the s...

  15. Wound healing outcomes in a diabetic foot ulcer outpatient clinic at an acute care hospital: a retrospective study.

    Science.gov (United States)

    Lu, S H; McLaren, A-M

    2017-10-01

    Patients with diabetic foot ulcers (DFU) have an increased risk of lower extremity amputation. A retrospective chart review of patients with DFUs attending the Foot Treatment and Assessment chiropodist-led outpatient clinic at an inner-city academic hospital was conducted to determine wound healing outcomes and characteristics contributing to outcomes. We reviewed the complete clinical history of 279 patients with 332 DFUs spanning over a five-year period. The mean age of patients was 61.5±12.5 years and most patients (83.5%) had one DFU. The majority of wounds (82.5%) were in the forefoot. Overall, 267/332 (80.5%) wounds healed. A greater proportion of wounds healed in the forefoot (82.5%) and midfoot (87.1%) than hindfoot (51.9%; pwound healing. Our findings are the first to demonstrate the benefits of chiropodists leading an acute care outpatient clinic in the management of DFUs in Canada and delivers wound healing outcomes equivalent to or exceeding those previously published.

  16. Comparison of two different vacuum-assisted closure (VAC) treatments of multiple chronic diabetic foot wounds in the same extremity.

    Science.gov (United States)

    Uğurlar, Meriç; Sönmez, Mesut Mehmet; Armağan, Raffi; Eren, Osman Tuğrul

    2017-09-01

    The aim of the present study is to compare the clinical efficacy and safety of two different vacuum-assisted closure (VAC) applications in one center between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds. The study was a randomized-controlled, prospective investigation between two groups of patients with Wagner Grade 3-4 multiple chronic diabetic foot wounds at single extremity. There were 10 patients in the first group receiving VAC treatment by means of Y-connector and 11 patients in the second group receiving bridge-VAC treatment. There were no significant difference in Revised Foot Function Index scores and total treatment costs between the both groups. The cost of the VAC dressing supplies in one session of the dressings was lower in the bridge-VAC group. In conclusion, although bridge-VAC treatment seems to be an alternative method to the VAC treatment by means of Y-connector, we found no superiority of one over the other VAC application for chronic diabetic foot wounds. Copyright © 2016 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  17. Effects of microcurrent application and 670 nm InGaP low-level laser irradiation on experimental wound healing in healthy and diabetic Wistar rats

    International Nuclear Information System (INIS)

    Neves, L M G; Matheus, R L; Santos, G M T; Esquisatto, M A M; Amaral, M E C; Mendonça, F A S

    2013-01-01

    This study evaluated the effects of microcurrent application and 670 nm InGaP laser irradiation on wound healing in healthy and alloxan diabetic rats. The animals were divided into eight groups: healthy control (HC); diabetic control (DC); healthy treated with microcurrent (HMC); diabetic treated with microcurrent (DMC); healthy irradiated with laser (HL); diabetic irradiated with laser (DL); healthy receiving laser and microcurrent application (HLMC) and diabetic receiving laser and microcurrent application (DLMC). Wound samples were collected on days 2, 6, 10 and 14 of treatment for structural analysis, morphometry, and Western blotting to quantify the expression of TGF-β1 and VEGF. Comparison of animals receiving laser and microcurrent therapy showed a reduction in the number of inflammatory cells in diabetic animals, as well as an increase of fibroblasts in healthy animals and of newly formed vessels in healthy and diabetic animals. Expression of TGF-β1 was increased on day 6 in all groups, especially diabetic animals. A reduction in the expression of this protein was observed on day 10 in all groups. VEGF expression was higher on day 6 in treated and control diabetic animals when compared to healthy animals. Analysis of VEGF expression in the laser- and microcurrent-treated groups on day 10 showed a decrease in diabetic animals and an increase in healthy animals. In conclusion, laser therapy and microcurrent stimulation exert beneficial effects on wound healing in both healthy and diabetic animals. (paper)

  18. The importance of growth factors for the treatment of chronic wounds in the case of diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Ehm, Alexandra

    2010-01-01

    Full Text Available Introduction: Ulcers as a result of diabetes mellitus are a serious problem with an enormous impact on the overall global disease burden due to the increasing prevalence of diabetes. Because of long hospital stays, rehabilitation, often required home care and the use of social services diabetic foot complications are costly. Therapy with growth factors could be an effective and innovative add-on to standard wound care. Research questions: What is the benefit of therapies with growth factors alone or in combination with other technologies in the treatment of diabetic foot ulcer assessed regarding medical, economical, social, ethical and juridical aspects? Methods: We systematically searched relevant databases limited to English and German language and publications since 1990. Cost values were adjusted to the price level of 2008 and converted into Euro. A review and an assessment of the quality of publications were conducted following approved methodical standards conforming to evidence-based medicine and health economics. Results: We identified 25 studies (14 randomized controlled trials (RCT, nine cost-effectiveness analyses, two meta-analyses. The RCT compared an add-on therapy to standard wound care with standard wound care/placebo alone or extracellular wound matrix: in six studies becaplermin, in two rhEGF, in one bFGF, and in five studies the metabolically active skin grafts Dermagraft and Apligraf. The study duration ranged from twelve to 20 weeks and the study population included between 17 to 382 patients, average 130 patients. The treatment with becaplermin, rhEGF and skin implants Dermagraft and Apligraf showed in eight out of 13 studies an advantage concerning complete wound closure and the time to complete wound healing. Evidence for a benefit of treatment with bFGF could not be found. In four out of 14 studies the proportion of adverse events was 30% per study group with no difference between the treatment groups. The methodological

  19. A Novel Chemically Modified Curcumin “Normalizes” Wound-Healing in Rats with Experimentally Induced Type I Diabetes: Initial Studies

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    Yazhou Zhang

    2016-01-01

    Full Text Available Introduction. Impaired wound-healing in diabetics can lead to life-threatening complications, such as limb amputation, associated in part with excessive matrix metalloproteinase- (MMP- mediated degradation of collagen and other matrix constituents. In the current study, a novel triketonic chemically modified curcumin, CMC2.24, was tested for efficacy in healing of standardized skin wounds in streptozotocin-induced diabetic rats. Initially, CMC2.24 was daily applied topically at 1% or 3% concentrations or administered systemically (oral intubation; 30 mg/kg; controls received vehicle treatment only. Over 7 days, the diabetics exhibited impaired wound closure, assessed by gross and histologic measurements, compared to the nondiabetic controls. All drug treatments significantly improved wound closure with efficacy ratings as follows: 1% 2.24 > systemic 2.24 > 3% 2.24 with no effect on the severe hyperglycemia. In subsequent experiments, 1% CMC2.24 “normalized” wound-healing in the diabetics, whereas 1% curcumin was no more effective than 0.25% CMC2.24, and the latter remained 34% worse than normal. MMP-8 was increased 10-fold in the diabetic wounds and topically applied 1% (but not 0.25% CMC2.24 significantly reduced this excessive collagenase-2; MMP-13/collagenase-3 did not show significant changes. Additional studies indicated efficacy of 1% CMC2.24 over more prolonged periods of time up to 30 days.

  20. A Novel Chemically Modified Curcumin “Normalizes” Wound-Healing in Rats with Experimentally Induced Type I Diabetes: Initial Studies

    Science.gov (United States)

    Zhang, Yazhou; McClain, Steve A.; Lee, Hsi-Ming; Elburki, Muna S.; Yu, Huiwen; Gu, Ying; Zhang, Yu; Wolff, Mark; Johnson, Francis; Golub, Lorne M.

    2016-01-01

    Introduction. Impaired wound-healing in diabetics can lead to life-threatening complications, such as limb amputation, associated in part with excessive matrix metalloproteinase- (MMP-) mediated degradation of collagen and other matrix constituents. In the current study, a novel triketonic chemically modified curcumin, CMC2.24, was tested for efficacy in healing of standardized skin wounds in streptozotocin-induced diabetic rats. Initially, CMC2.24 was daily applied topically at 1% or 3% concentrations or administered systemically (oral intubation; 30 mg/kg); controls received vehicle treatment only. Over 7 days, the diabetics exhibited impaired wound closure, assessed by gross and histologic measurements, compared to the nondiabetic controls. All drug treatments significantly improved wound closure with efficacy ratings as follows: 1% 2.24 > systemic 2.24 > 3% 2.24 with no effect on the severe hyperglycemia. In subsequent experiments, 1% CMC2.24 “normalized” wound-healing in the diabetics, whereas 1% curcumin was no more effective than 0.25% CMC2.24, and the latter remained 34% worse than normal. MMP-8 was increased 10-fold in the diabetic wounds and topically applied 1% (but not 0.25%) CMC2.24 significantly reduced this excessive collagenase-2; MMP-13/collagenase-3 did not show significant changes. Additional studies indicated efficacy of 1% CMC2.24 over more prolonged periods of time up to 30 days. PMID:27190999

  1. In vivo evaluation of adipose- and muscle-derived stem cells as a treatment for nonhealing diabetic wounds using multimodal microscopy

    Science.gov (United States)

    Li, Joanne; Pincu, Yair; Marjanovic, Marina; Bower, Andrew J.; Chaney, Eric J.; Jensen, Tor; Boppart, Marni D.; Boppart, Stephen A.

    2016-08-01

    Impaired skin wound healing is a significant comorbid condition of diabetes, which often results in nonhealing diabetic ulcers due to poor peripheral microcirculation, among other factors. The effectiveness of the regeneration of adipose-derived stem cells (ADSCs) and muscle-derived stem cells (MDSCs) was assessed using an integrated multimodal microscopy system equipped with two-photon fluorescence and second-harmonic generation imaging. These imaging modalities, integrated in a single platform for spatial and temporal coregistration, allowed us to monitor in vivo changes in the collagen network and cell dynamics in a skin wound. Fluorescently labeled ADSCs and MDSCs were applied topically to the wound bed of wild-type and diabetic (db/db) mice following punch biopsy. Longitudinal imaging demonstrated that ADSCs and MDSCs provided remarkable capacity for improved diabetic wound healing, and integrated microscopy revealed a more organized collagen remodeling in the wound bed of treated mice. The results from this study verify the regenerative capacity of stem cells toward healing and, with multimodal microscopy, provide insight regarding their impact on the skin microenvironment. The optical method outlined in this study, which has the potential for in vivo human use, may optimize the care and treatment of diabetic nonhealing wounds.

  2. Wound healing: total contact cast vs. custom-made temporary footwear for patients with diabetic foot ulceration.

    Science.gov (United States)

    Van De Weg, F B; Van Der Windt, D A W M; Vahl, A C

    2008-03-01

    The objective of this study was to compare the effectiveness of irremovable total-contact casts (TCC) and custom-made temporary footwear (CTF) to heal neuropathic foot ulcerations in individuals with diabetes. In this prospective clinical trial, 43 patients with plantar ulcer Grade 1 or 2 (Wagner scale) were randomized to one of two off-loading modalities: TCC or CTF. Outcomes assessed were wound surface area reduction (cm2) and time to wound healing (days) at 2, 4, 8 and 16 weeks. To evaluate safety, possible side effects were recorded at each follow-up visit. The results showed no significant difference in wound surface area reduction (adjusted for baseline wound surface) at 2, 4, 8 or 16 weeks (adjusted mean difference 0.10 cm2; 95% CI -0.92-0.72 at 16 weeks). At 16 weeks, 12 patients had a completely healed ulcer, 6 per group. The median time to healing was shorter for the patients using a cast (52 vs. 90 days, p = 0.26). Five patients with TCC and two with CTF developed device-related complications. It was concluded that: (i) the rate of wound healing is not significantly different for patients treated with CTF or TCC. The difference in wound surface area was small and not significant at any time during follow-up; and (ii) the difference in healing time (38 days) may have attained statistical significance if the numbers in these sub-groups (2 x 6) had been higher. Since there appears to be little difference in effectiveness between both off-loading modalities, further investigation into the benefits of CTF is warranted.

  3. Cell-based regenerative strategies for treatment of diabetic skin wounds, a comparative study between human umbilical cord blood-mononuclear cells and calves' blood haemodialysate.

    Directory of Open Access Journals (Sweden)

    Hala O El-Mesallamy

    Full Text Available BACKGROUND: Diabetes-related foot problems are bound to increase. However, medical therapies for wound care are limited; therefore, the need for development of new treatment modalities to improve wound healing in diabetic patients is essential and constitutes an emerging field of investigation. METHODS: Animals were randomly divided into 8 groups (I-VIII (32 rats/group, all were streptozotocin (STZ-induced diabetics except groups III and VIII were non-diabetic controls. The study comprised two experiments; the first included 3 groups. Group I injected with mononuclear cells (MNCs derived from human umbilical cord blood (HUCB, group II a diabetic control group (PBS i.v. The second experiment included 5 groups, groups IV, V, and VI received topical HUCB-haemodialysate (HD, calves' blood HD, and solcoseryl, respectively. Group VII was the diabetic control group (topical saline. Standard circular wounds were created on the back of rats. A sample of each type of HD was analyzed using the high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS system. Wound area measurement and photography were carried out every 4 days. Plasma glucose, catalase (CAT, malondialdehyde (MDA, nitric oxide (NO and platelets count were assessed. Wound samples were excised for hydroxyproline (HP and histopathological study. RESULTS: Treatment with HUCB MNCs or HUCB-HD resulted in wound contraction, increased CAT, NO, platelets count, body weights, and HP content, and decreased MDA and glucose. CONCLUSION: Systemic administration of HUCB MNCs and topical application of the newly prepared HUCB-HD or calves' blood HD significantly accelerated the rate of diabetic wound healing and would open the possibility of their future use in regenerative medicine.

  4. Cell-based regenerative strategies for treatment of diabetic skin wounds, a comparative study between human umbilical cord blood-mononuclear cells and calves' blood haemodialysate.

    Science.gov (United States)

    El-Mesallamy, Hala O; Diab, Mohamed R; Hamdy, Nadia M; Dardir, Sarah M

    2014-01-01

    Diabetes-related foot problems are bound to increase. However, medical therapies for wound care are limited; therefore, the need for development of new treatment modalities to improve wound healing in diabetic patients is essential and constitutes an emerging field of investigation. Animals were randomly divided into 8 groups (I-VIII) (32 rats/group), all were streptozotocin (STZ)-induced diabetics except groups III and VIII were non-diabetic controls. The study comprised two experiments; the first included 3 groups. Group I injected with mononuclear cells (MNCs) derived from human umbilical cord blood (HUCB), group II a diabetic control group (PBS i.v). The second experiment included 5 groups, groups IV, V, and VI received topical HUCB-haemodialysate (HD), calves' blood HD, and solcoseryl, respectively. Group VII was the diabetic control group (topical saline). Standard circular wounds were created on the back of rats. A sample of each type of HD was analyzed using the high performance liquid chromatography-electrospray ionization-mass spectrometry (HPLC-ESI-MS) system. Wound area measurement and photography were carried out every 4 days. Plasma glucose, catalase (CAT), malondialdehyde (MDA), nitric oxide (NO) and platelets count were assessed. Wound samples were excised for hydroxyproline (HP) and histopathological study. Treatment with HUCB MNCs or HUCB-HD resulted in wound contraction, increased CAT, NO, platelets count, body weights, and HP content, and decreased MDA and glucose. Systemic administration of HUCB MNCs and topical application of the newly prepared HUCB-HD or calves' blood HD significantly accelerated the rate of diabetic wound healing and would open the possibility of their future use in regenerative medicine.

  5. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing but not major amputation in patients with diabetic foot ulcers treated in a multidisciplinary setting.

    Science.gov (United States)

    Mathioudakis, Nestoras; Hicks, Caitlin W; Canner, Joseph K; Sherman, Ronald L; Hines, Kathryn F; Lum, Ying W; Perler, Bruce A; Abularrage, Christopher J

    2017-06-01

    The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 20% to 64%. Our aim was to determine the association between WIfI stage and wound healing and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. All patients presenting to our multidisciplinary DFU clinic from July 2012 to December 2015 were enrolled in a prospective database. Wound healing and major amputation were compared for patients stratified by WIfI classification. There were 217 DFU patients with 439 wounds (mean age, 58.3 ± 0.8 years; 58% male, 63% black) enrolled, including 28% WIfI stage 1, 11% stage 2, 33% stage 3, and 28% stage 4. Peripheral arterial disease and dialysis were more common in patients with advanced (stage 3 or 4) wounds (P ≤ .05). Demographics of the patients, socioeconomic status, and comorbidities were otherwise similar between groups. There was a significant increase in the number of active wounds per limb at presentation with increasing WIfI stage (stage 1, 1.1 ± 0.1; stage 4, 1.4 ± 0.1; P = .03). Mean wound area (stage 1, 2.6 ± 0.6 cm 2 ; stage 4, 15.3 ± 2.8 cm 2 ) and depth (stage 1, 0.2 ± 0.0 cm; stage 4, 0.8 ± 0.1 cm) also increased progressively with increasing wound stage (P wound healing (P wounds, the mean wound healing time was 190 ± 17 days, and risk of major amputation at 1 year was 5.7% ± 3.2%. Among patients with DFU, the WIfI classification system correlated well with wound healing but was not associated with risk of major amputation at 1 year. Although further prospective research is warranted, our results suggest that use of a multidisciplinary approach for DFUs may augment healing

  6. Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis.

    Science.gov (United States)

    Chae, Kum Ju; Shin, Jin Yong

    2016-01-01

    Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy. We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the study quality, along with the Cochrane Risk of Bias Tool. We evaluated publication bias using a funnel plot. The search strategy identified 518 publications. After screening these, we selected four articles for review. The meta-analysis revealed that overall limb salvage and wound healing rates were significantly higher (Odds ratio = 2.209, 3.290, p = 0.001, pangioplasty than in those who received nonangiosome-targeted angioplasty. The revision rate between the angiosome and nonangiosome groups was not significantly different (Odds ratio = 0.747, p = 0.314). Although a further randomized controlled trial is required for confirmation, angiosome-targeted angioplasty in diabetic foot was more effective than nonangiosome-targeted angioplasty with respect to wound healing and limb salvage.

  7. Is Angiosome-Targeted Angioplasty Effective for Limb Salvage and Wound Healing in Diabetic Foot? : A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Kum Ju Chae

    Full Text Available Given that the efficacy of employing angiosome-targeted angioplasty in the treatment of diabetic foot remains controversial, this study was conducted to examine its efficacy.We performed a systematic literature review and meta-analysis using core databases, extracting the treatment modality of angiosome-targeted angioplasty as the predictor variable, and limb salvage, wound healing, and revision rate as the outcome variables. We used the Newcastle-Ottawa Scale to assess the study quality, along with the Cochrane Risk of Bias Tool. We evaluated publication bias using a funnel plot.The search strategy identified 518 publications. After screening these, we selected four articles for review. The meta-analysis revealed that overall limb salvage and wound healing rates were significantly higher (Odds ratio = 2.209, 3.290, p = 0.001, p<0.001 in patients who received angiosome-targeted angioplasty than in those who received nonangiosome-targeted angioplasty. The revision rate between the angiosome and nonangiosome groups was not significantly different (Odds ratio = 0.747, p = 0.314.Although a further randomized controlled trial is required for confirmation, angiosome-targeted angioplasty in diabetic foot was more effective than nonangiosome-targeted angioplasty with respect to wound healing and limb salvage.

  8. Combination Ointment Containing Solid Tranilast Nanoparticles and Dissolved Sericin Is Efficacious for Treating Skin Wound-Healing Deficits and Redness in Diabetic Rats.

    Science.gov (United States)

    Nagai, Noriaki; Ogata, Fumihiko; Deguchi, Saori; Ueno, Akina; Kawasaki, Naohito; Ito, Yoshimasa

    2017-01-01

    We attempted to design a combination ointment containing solid tranilast nanoparticles and dissolved sericin as a wound-healing drug (TS-combination ointment), and evaluated its usefulness as therapy for wound-healing deficits in streptozotocin-induced diabetic rat (STZ rat) using kinetic analyses as an index. Solid tranilast nanoparticles were prepared by bead mill methods with low-substituted methylcellulose; the mean particle size of the tranilast nanoparticles was 70 nm. The ointment was designed to contain the tranilast nanoparticles plus sericin powder and/or Carbopol ® 934. Skin wound healing in STZ rats begins significantly later than in normal rats. Although the skin wound healing rate in STZ rats treated with an ointment containing tranilast nanoparticles was lower than in STZ rats treated with vehicle, the ointment was effective in reducing redness. An ointment containing sericin enhanced the skin-healing rate, but the preventive effect on redness was weak. On the other hand, the combination of tranilast and sericin increased both the skin healing rate and reduction in redness. In conclusion, we have adapted kinetic analyses to skin wound healing in rats, and found these analyses to be useful as an index of wound healing ability by a wound-healing drug. In addition, we show that treatment with the TS-combination ointment enhances the skin wound healing rate and reduces redness. These findings provide information significant to the search for new wound-healing therapies and for the design of wound-healing drugs.

  9. Kinetic analysis of the rate of corneal wound healing in Otsuka long-evans Tokushima Fatty rats, a model of type 2 diabetes mellitus.

    Science.gov (United States)

    Nagai, Noriaki; Murao, Takatoshi; Okamoto, Norio; Ito, Yoshimasa

    2010-01-01

    Diabetic keratopathy is a well-known ocular complication secondary to type 2 diabetes mellitus. In this study, we performed a kinetic analysis of corneal wound healing in Long-Evans rats (normal rat) and Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of type 2 diabetes mellitus. Corneal wound healing in 7-week-old normal rats was mostly complete 24 h after corneal epithelial abrasion, and the process of corneal wound healing took place according to an equation with a first-order rate constant. The rate of corneal wound healing in normal rats decreased with aging. The process of corneal wound healing in 38- and 60-week-old normal and OLETF rats occurred in two phases with rate constants for the first and second phases represented as alpha and beta, respectively. The alpha and beta values in 38- and 60-week-old OLETF rats were lower than those in normal rats of the corresponding age. Furthermore, a close relationship was observed between the corneal wound healing rate constant and plasma glucose levels in OLETF rats. The present studies suggest the sequence of events that occur following damage to the corneal surface in OLETF rats as a model animal for a human type 2 diabetes mellitus.

  10. Functional characterisation of bioactive peptide derived from terrestrial snail Cryptozona bistrialis and its wound-healing property in normal and diabetic-induced Wistar albino rats.

    Science.gov (United States)

    Ulagesan, Selvakumari; Sankaranarayanan, Kamatchi; Kuppusamy, Amutha

    2018-02-26

    A peptide might be an exciting biomaterial or template for the development of novel wound-healing agents. In this report, it was isolated from the terrestrial snail Cryptozona bistrialis by enzymatic digestion and was evaluated for its in vitro wound-healing activity in NIH/3T3 mouse fibroblasts cell line and in vivo wound-healing activity in normal and diabetic-induced Wistar albino rats. The C. bistrialis protein was digested by the papain enzyme, and 21.79 kDa peptide (Cb-peptide) was purified by reversed-phase high-performance liquid chromatography and identified by MALDI (matrix-assisted laser desorption/ionization)-TOF analysis. The isolated Cb-peptide was characterised by various analytical methods. The peptide demonstrated a capacity to prevent the development of pathogenic bacterial and fungal cultures and proved that it promotes significant wound-healing activity in the wound scratch assay method by rapid cell migration and closure of wound. Isolated Cb-peptide was lyophilised and formulated to ointment and analysed for in vivo wound-healing activity in normal and diabetic (alloxan monohydrate)-induced Wistar albino rats. Cb-peptide ointment-treated groups showed a greater degree of wound healing and early and complete period of epithelialisation in normal and diabetic-induced Wistar albino rats. Cb-peptide ointment-treated groups showed significant excision and incision wound-healing activity. A conclusion was reached that the peptide isolated from C. bistrialis showed greater wound-healing activity compared with vehicle control and standard control. © 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  11. Effect of fibrin-binding synthetic oligopeptide on the healing of full-thickness skin wounds in streptozotocin-induced diabetic rats.

    Science.gov (United States)

    Chung, Jae-Eun; Kim, Yun-Jeong; Park, Yoon-Jeong; Koo, Ki-Tae; Seol, Yang-Jo; Lee, Yong-Moo; Rhyu, In-Chul; Ku, Young

    2013-01-01

    The aim of this study was to investigate whether topical application of fibrin-binding oligopeptides derived from FN promotes wound healing in streptozotocin (STZ)-induced diabetic rats. Oligopeptides including fibrin-binding sequences (FF3: CFDKYTGNTYRV, FF5 : CTSRNRCNDQ) of FN repeats were synthesized. Each peptide was loaded in 15 x 15 mm fibrous alginate dressings, and the release kinetics of the peptides was evaluated using trinitrobenzene sulfonic acid for 336 hours. Two full-thickness cutaneous wounds were prepared on the dorsal skin of each 75 diabetes induced rats. Each wound was divided into FF3-loaded alginate dressing group, FF5-loaded alginate dressing group, alginate dressing group and negative control group. Animals were sacrificed at day 0,3,7 and 14. The wound closure rate, inflammation degree, expression of TGF-β1 and hydroxyproline contents were evaluated. Both FF3 and FF5 peptides were released rapidly within the first 24 hours. FF3-loaded dressing treated wounds closed significantly faster than other wounds at day 3. And at day 14, FF3- & FF5- loaded dressing treated wounds demonstrated less inflammatory cells infiltration than alginate dressing treated and negative group wounds. TGF-β1 positive cells were more abundant in FF3-, FF5-treated alginate dressing treated wound at day 3 and 14. At last, the hyrdroxyproline contents in the FF3, FF5 group were higher at day 7 and day 14. Topical application of fibrin-binding domain synthetic oligopeptides from FN resulted in acceleration of full-thickness cutaneous wound healing in diabetic rats.

  12. Photo-stimulatory effect of low energy helium-neon laser irradiation on excisional diabetic wound healing dynamics in wistar rats

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    Maiya Arun

    2009-01-01

    Full Text Available Background: Generally, the significances of laser photo stimulation are now accepted, but the laser light facilitates wound healing and tissue repair remains poorly understood. Aims: We have examined the hypothesis that the laser photo stimulation can enhance the collagen production in diabetic wounds using the excision wound model in the Wistar rat model. Methods: The circular wounds were created on the dorsum of the back of the animals. The animals were divided into two groups. The study group (N = 24 wound was treated with 632.8 nm He-Ne laser at a dose of 3-9J/cm 2 for 5 days a week until the wounds healed completely. The control group was sham irradiated. Result: A significant increase in the hydroxyproline content and reduction in the wound size were observed in the study group. The pro-healing actions seem to be due to increased collagen deposition as well as better alignment and maturation. Conclusion: The biochemical analysis and clinical observation suggested that 3-6 J/cm 2 laser photo stimulation facilitates the tissue repair process by accelerating collagen production in diabetic wound healing.

  13. The effect of the glycolipoprotein extract (G-90) from earthworm Eisenia foetida on the wound healing process in alloxan-induced diabetic rats.

    Science.gov (United States)

    Goodarzi, Golnaz; Qujeq, Durdi; Elmi, Maryam M; Feizi, Farideh; Fathai, Sadegh

    2016-06-01

    Diabetes is now regarded as a major public health problem. The number of patients is estimated to increase to over 439 million cases by 2030. One of the major health clinical problems in patients with diabetes patients is impaired wound healing. Diabetic foot ulcer is a major complication of diabetes mellitus in 12 to 25% of patients, which increases the risk of damage in the limbs or amputation. The earthworm Eisenia foetida glycolipoprotein (as known G-90) is a blend of macromolecules with some biological properties including mitogenicity, anticoagulation, fibrinolysis, bacteriostatic and antioxidatiaon. Given the biological properties of G-90, this study was conducted to investigate the effect of extract obtained from the homogenate of Eisenia foetida (G-90) on the wound healing process in alloxan-induced diabetic rats. The results of the present study revealed that treatment by using G-90 can speed up the wound healing process, which is exactly similar to the effect of D-panthenol treatment in rats. These findings also demonstrated that G-90 treatment decreases the risk of infection in the wound site compared with D-panthenol treatment. In addition, histological analysis indicated that a better extracellular matrix formation with increased fibroblast proliferation, neovascularization, collagen synthesis and early epithelial layer formation was observed in G-90 treated group. Therefore, the G-90 could be considered as a new wound healing agent introducing promising therapeutic approaches in both human and veterinary medicine. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Effective wound healing in streptozotocin-induced diabetic rats by adipose-derived stromal cell transplantation in plasma-gel containing fragmin/protamine microparticles.

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    Sumi, Yuki; Ishihara, Masayuki; Kishimoto, Satoko; Takikawa, Makoto; Hattori, Hidemi; Takikawa, Megumi; Azuma, Ryuichi; Nakamura, Shingo; Fujita, Masanori; Kiyosawa, Tomoharu

    2014-01-01

    We investigated the effectiveness of the application of inbred adipose-derived stromal cells (IR-ASCs) in high inbred rat plasma (IRP) (6%)-Dulbecco modified Eagle medium (DMEM) gel with fragmin/protamine microparticles (F/P MPs) (IR-ASCs + IRP-DMEM gel + F/P MPs) on wound healing in streptozotocin-induced diabetic rats. F/P MPs have previously been used as a cell carrier for IR-ASCs in inbred Fisher 344 rats and for preservation and controlled release of various cytokines in IRP-DMEM gel. We applied IR-ASCs + IRP-DMEM gel + F/P MPs to full-thickness skin excisions on the backs of the diabetic rats. The statistical significance of wound closure was evaluated on postwounding days 3, 7, 10, and 14, and the skin area surrounding the wound was removed for histological examination on days 7 and 14. The wound closure rate and histological examination of wounds treated with IR-ASCs + IRP-DMEM gel + F/P MPs demonstrated significantly advanced epithelialization, capillary formation, and granulation tissue formation. When DiI-labeled IR-ASCs + IRP-DMEM gel + F/P MPs were applied to full-thickness skin wounds on the backs of the diabetic rats, histological observation at 2 weeks showed appearances of both DiI-labeled granulation tissue and CD31-immunostained microvessels in the transplant areas. A portion of the transplanted IR-ASCs + IRP-DMEM gel + F/P MPs had been taken up into the granulation tissues to promote wound healing. Thus, IR-ASCs + IRP-DMEM gel + F/P MPs were effective for repairing healing-impaired wounds such as those arising in the diabetic rats.

  15. EFFICACY OF VACUUM ASSISTED CLOSURE DRESSINGS WHEN COMPARED TO MOIST WOUND DRESSINGS IN THE MANAGEMENT OF DIABETIC FOOT ULCERS : A PROSPECTIVE COMPARATIVE STUDY

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    Ballapalli Hari

    2015-10-01

    Full Text Available INTRODUCTION: F oot ulceration is mainly responsible for the morbidity of diabetes mellitus. They deprive the patient of quality working days and add to his financial burden. Several novel methods of wound healing came to vogue among which vacuum assisted dressing is becoming quite popular. Present study aim s to evaluate its efficacy when compared to regular moist wound dressings. OBJECTIVES: To study the effectiveness of vacuum assisted dressings in terms of Rate of wound healing. MATERIALS AND METHODS: we carried out a prospective study at Narayana medical college hospital on two groups (group A and group B of diabetic foot ulcer patients, whom we selected randomly after considering inclusion and exclusion criteria . Vacuum assisted dressings were done in group A patients and normal moist wound dressings in group B. At the start of the treatment and every week thereafter, size and depth of ulcers were recorded and results were compared at complete wound healing or at the end of 12 weeks of treatment whichever is earlier. S trict glycaemic control was maintaine d throughout the treatment period. RESULTS : significant healing was noticed in group A patients (vacuum assisted dressings group both in terms of ulcer size and depth. Wounds appeared more - healthy i.e. with less slough and more red granulation tissue in g roup A patients. CONCLUSION: vacuum assisted dressing is an efficacious method in the treatment of diabetic foot ulcers with significantly reduced hospital stay

  16. Polysaccharides-Rich Extract of Ganoderma lucidum (M.A. Curtis:Fr. P. Karst Accelerates Wound Healing in Streptozotocin-Induced Diabetic Rats

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    Poh-Guat Cheng

    2013-01-01

    Full Text Available Ganoderma lucidum (M.A. Curtis:Fr. P. Karst is a popular medicinal mushroom. Scientific reports had shown that the wound healing effects of G. lucidum were partly attributed to its rich polysaccharides. However, little attention has been paid to its potential effects on wounds associated with diabetes mellitus. In this study, we evaluated the wound healing activity of the hot aqueous extract of G. lucidum in streptozotocin-induced diabetic rats. The extract of G. lucidum was standardised based on chemical contents (w/w of total polysaccharides (25.1%, ganoderic acid A (0.45%, and adenosine (0.069%. Six groups of six rats were experimentally wounded in the posterior neck region. Intrasite gel was used as a positive control and aqueous cream as the placebo. Topical application with 10% (w/w of mushroom extract-incorporated aqueous cream was more effective than that with Intrasite gel in terms of wound closure. The antioxidant activity in serum of rats treated with aqueous extract of G. lucidum was significantly higher; whereas the oxidative protein products and lipid damage were lower when compared to those of the controls. These findings strongly support the beneficial effects of standardised aqueous extract of G. lucidum in accelerating wound healing in streptozotocin-induced diabetic rats.

  17. Hydroethanolic Extract of Strychnos pseudoquina Accelerates Skin Wound Healing by Modulating the Oxidative Status and Microstructural Reorganization of Scar Tissue in Experimental Type I Diabetes

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    Mariáurea M. Sarandy

    2017-01-01

    Full Text Available The effect of topical application of ointment based on Strychnos pseudoquina hydroethanolic extract in the cutaneous wounds healing in diabetic rats was evaluated. Samples of S. pseudoquina were submitted to phytochemical prospection and in vitro antioxidant assay. Thirty Wistar rats were divided into 5 groups: Sal-wounds treated with 0.9% saline solution; VH-wounds treated with 0.6 g of lanolin cream (vehicle; SS-wounds treated with silver sulfadiazine cream (10 mg/g; ES5- and ES10-wounds treated with an ointment of S. pseudoquina extract, 5% and 10%, respectively. Fragments of wounds were removed for histological and biochemical analysis every 7 days during 21 days. ES showed equivalent levels per gram of extract of total phenols and flavonoids equal to 122.04 mg for TAE and 0.60 mg for RE. The chlorogenic acid was one of the major constituents. S. pseudoquina extract presented high antioxidant potential in vitro. ES5 and ES10 showed higher wound healing rate and higher amount of cells, blood vessels, and type III and I collagen. The oxidative stress markers were lower in the ES5 and ES10 groups, while the antioxidants enzymes levels were higher. Ointment based on S. pseudoquina extract promotes a fast and efficient cutaneous repair in diabetic rats.

  18. The Effect of Foot Exercises on Wound Healing in Type 2 Diabetic Patients With a Foot Ulcer.

    Science.gov (United States)

    Eraydin, Şahizer; Avşar, Gülçin

    2017-12-19

    The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. Prospective, randomized controlled study. Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015. Subjects were recruited by the researchers in the clinics where they received treatment. Subjects were randomly allocated to either the control or intervention group. Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log. Patients in the intervention group received standard wound care and performed daily foot exercises for 12 weeks; the control group received standard wound care but no exercises. The ulcers of the patients in both the intervention and control groups were examined and measured at the 4th, 8th, and 12th weeks. The groups were compared in terms of the ulcer size and depth. To analyze and compare the data, frequency distribution, mean (standard deviation), variance analysis, and the independent samples t test and the χ test were used. The mean ulcer areas were 12.63 (14.43), 6.91 (5.44), 4.30 (3.70), and 3.29 (3.80) cm (P diabetic foot ulcer sizes in the study intervention group in the 4th and 12th weeks compared to beginning baseline (P ≤ .05). However, only the 12th week was different from the beginning in the control group (P = .000). The mean depths of the ulcers were 0.56 (0.85), 0.42 (0.68), 0.36 (0.50), and 0.28 (0.38) cm in the study intervention group (P ulcer areas decreased significantly in the study intervention group compared to the control group during the 3 follow-up measurements. An important finding in this study was the DFU area decreased more in those who exercised more. Findings suggests foot exercises should

  19. Effect of aqueous extract of Morus nigra on skin wound healing in type 1 diabetic rats

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    Mohammad Mahdi Mirjalili

    2017-07-01

    Conclusion: Topical application of the Morus nigra extract can accelrate wound contraction and improve the histological indices inclue formation of epithelial and granulated layers and increase collagen density in the repaired tissue.

  20. Aktivitas Salep Ekstrak Rimpang Kunyit dalam Proses Persembuhan Luka pada Mencit yang Diinduksi Diabetes (THE ACTIVITY OF TURMERIC EXTRACT OINTMENT IN THE WOUND HEALING PROCESS OF INDUCED DIABETIC MICE

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    Wiwin Winarsih

    2013-07-01

    Full Text Available The aim of this study was to evaluate the effectiveness of ethanol turmeric extract ointment in woundhealing process of streptozotocin-induced diabetic mice. Ethyl acetate and hexane fractions of ethanolturmeric extract were studied for their wound-healing properties in the formulation of ointment. Sixty micewere divided into 4 groups : group I was control (normal control, without treatment; group II was diabeticgroup (diabetic, without treatment; group III was diabetic and treated with ethyl acetate fraction ointment,group IV was diabetic and treated with hexane fraction ointment. The diabetic groups were i.p injectedwith 40mg/kg of streptozotocin and all groups were received incision 2 cm on their back skin. The ointmentsof ethyl acetate and hexane fraction were given topically twice a day. Three mice from each groups werenecropsied at 2nd, 4th, 7th, 14th and 21st days post incision (pi for gross pathological and histopathologicalevaluation of the injured skin. Gross examination revealed that the ethyl acetate and hexane fractionointment groups showed better result on wound-healing process compared to the diabetic group.Microscopically, the ethyl acetate and hexane fraction ointment groups showed faster neovascularizationand reepithelialization compared to the diabetic group. In comparison with the diabetic group, the ethylacetate and hexane fraction ointment groups showed fewer neutrophils infiltration which indicated antiinflammatory activities of ethyl acetate and hexane fractions. Based on the macroscopic and microscopicobservation, the ointments of ethyl acetate and hexane fraction have properties to promote wound healingin diabetic mice.

  1. Identification of E-Selectin as a Novel Target for the Regulation of Post-Natal Neovascularization: Implications for Diabetic Wound Healing

    Science.gov (United States)

    Liu, Zhao-Jun; Tian, Runxia; An, Weijun; Zhuge, Ying; Li, Yan; Shao, Hongwei; Habib, Bianca; Livingstone, Alan S.; Velazquez, Omaida C.

    2012-01-01

    Objectives We previously reported that stromal cell-derived factor-1α (SDF-1α, a homing signal for recruiting endothelial progenitor cells (EPC) to areas of neovascularization), is down-regulated in diabetic wounds 1. We now investigate signals whereby mature endothelial cells (EC) and circulating EPC achieve SDF-1α-mediated EPC homing. Methods SDF-1α in diabetic wounds were therapeutically increased by injection of SDF-1α–engineered bone marrow-derived fibroblasts versus control cells (N= 48 (20, NOD), (28, STZ-C57)). PCR-array gene expression differences were validated by Western blotting and immunohistochemistry. The role of adhesion molecule(s) in mediating SDF-1α-induced EPC homing and wound healing was furthered studied using antagonists in vitro and in vivo. Results Increasing wound SDF-1α via cell-base therapy promotes healing in diabetic mice (~20% increase in healing rates by day 3, p=0.006). SDF-1α increased EC-EPC adhesion and specifically upregulated E-selectin expression in human microvascular EC (2.3-fold increase, p<0.01). This effect was also significant in blood vessels of the experimental mice and resulted in increased wound neovascularization. The regulatory effects of SDF-1α on EC-EPC adhesion and EPC homing were specifically mediated by E-selectin, as the application of E-selectin antagonists significantly inhibited SDF-1α-induced EC-EPC adhesion, EPC homing, wound neovascularization, and wound healing. Conclusions SDF-1α–engineered cell-based therapy promotes diabetic wound healing in mice by specifically upregulating E-selectin expression in mature EC leading to increase EC-EPC adhesion, EPC homing and increased wound neovascularization. These findings provide novel insight into the signals underlying the biological effect of SDF-1α on EPC homing and point to E-selectin as a new potential target for therapeutic manipulation of EPC trafficking in diabetic wound healing. PMID:20881769

  2. The influence of local versus global heat on the healing of chronic wounds in patients with diabetes.

    Science.gov (United States)

    Petrofsky, Jerrold S; Lawson, Daryl; Suh, Hye Jin; Rossi, Christine; Zapata, Karina; Broadwell, Erin; Littleton, Lindsay

    2007-12-01

    In a previous study, it was shown that placing a subject with chronic diabetic ulcers in a warm room prior to the use of electrical stimulation dramatically increased the healing rate. However, global heating is impractical in many therapeutic environments, and therefore in the present investigation the effect of global heat versus using a local heat source to warm the wound was investigated. Twenty-nine male and female subjects participated in a series of experiments to determine the healing associated with electrical stimulation with the application of local heat through a heat lamp compared to global heating of the subject in a warm room. Treatment consisted of biphasic electrical stimulation at currents at 20 mA for 30 min three times per week for 4 weeks in either a 32 degrees C room or, with the application of local heat, to raise skin temperature to 37 degrees C. Skin blood flow was measured by a laser Doppler imager. Blood flow increased with either local or global heating. During electrical stimulation, blood flow almost doubled on the outside and on the edge of the wound with a smaller increase in the center of the wound. However, the largest increase in blood flow was in the subjects exposed to global heating. Further, healing rates, while insignificant for subjects who did not receive electrical stimulation, showed 74.5 +/- 23.4% healing with global heat and 55.3 +/- 31.1% healing with local heat in 1 month; controls actually had a worsening of their wounds. The best healing modality was global heat. However, there was still a significant advantage in healing with local heat.

  3. Risk factors for developing osteomyelitis in patients with diabetic foot wounds

    NARCIS (Netherlands)

    Lavery, Lawrence A.; Peters, Edgar J. G.; Armstrong, David G.; Wendel, Christopher S.; Murdoch, Douglas P.; Lipsky, Benjamin A.

    Aims: Osteomyelitis worsens the prognosis in the diabetic foot, but predisposing factors remain largely undefined, In a prospectively followed cohort we assessed risk factors for developing osteomyelitis. Methods: We enrolled consecutive persons with diabetes who presented to a managed-care diabetes

  4. Transcutaneous oxygen pressure measurement in diabetic foot ulcers: mean values and cut-point for wound healing.

    Science.gov (United States)

    Yang, Chuan; Weng, Huan; Chen, Lihong; Yang, Haiyun; Luo, Guangming; Mai, Lifang; Jin, Guoshu; Yan, Li

    2013-01-01

    The purpose of this study was to investigate mean values and cut-point of transcutaneous oxygen pressure (TcPO2) measurement in patients with diabetic foot ulcers. Prospective, descriptive study. Sixty-one patients with diabetes mellitus and foot ulcers comprised the sample. The research setting was Sun Yat-sen Memorial Hospital of SunYat-sen University, Guangzhou, China. Participants underwent transcutaneous oxygen (TcPO2) measurement at the dorsum of foot. Patients were classified into 3 groups according to clinical outcomes: (1) ulcers healed with intact skin group, (2) ulcer improved, and (3) ulcer failed to improve. TcPO2 was assessed and cut-points for predicting diabetic foot ulcer healing were calculated. Thirty-six patients healed with intact skin, 8 experienced improvement, and 17 showed no improvement. Mean TcPO2 levels were significantly higher (Pulcers with intact skin (32 ± 10 mmHg) when compared to the improvement group (30 ± 7 mmHg) and the nonhealing group (15 ± 12 mmHg). All patients with TcPO2≤ 10 mmHg failed to heal or experienced deterioration in their foot ulcers. In contrast, all patients with TcPO2≥ 40 mmHg achieved wound closure. Measurement of TcPO2 in the supine position revealed a cut-point value of 25 mmHg as the best threshold for predicting diabetic foot ulcer healing; the area under the curve using this cut-point was 0.838 (95% confidence interval = 0.700-0.976). The sensitivity, specificity, positive predictive value, and negative predictive value for TxPO2 were 88.6%, 82.4%, 90.7%, and 72.2%, respectively. TcPO2≥ 40 mmHg was associated with diabetic foot ulcer healing, but a TcPO2≤ 10 mmHg was associated with failure of wound healing. We found that a cut-point of 25 mmHg was most predictive of diabetic foot ulcer healing.

  5. Short Hairpin RNA Silencing of PHD-2 Improves Neovascularization and Functional Outcomes in Diabetic Wounds and Ischemic Limbs.

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    Kevin J Paik

    Full Text Available The transcription factor hypoxia-inducible factor 1-alpha (HIF-1α is responsible for the downstream expression of over 60 genes that regulate cell survival and metabolism in hypoxic conditions as well as those that enhance angiogenesis to alleviate hypoxia. However, under normoxic conditions, HIF-1α is hydroxylated by prolyl hydroxylase 2, and subsequently degraded, with a biological half-life of less than five minutes. Here we investigated the therapeutic potential of inhibiting HIF-1α degradation through short hairpin RNA silencing of PHD-2 in the setting of diabetic wounds and limb ischemia. Treatment of diabetic mouse fibroblasts with shPHD-2 in vitro resulted in decreased levels of PHD-2 transcript demonstrated by qRT-PCR, higher levels of HIF-1α as measured by western blot, and higher expression of the downstream angiogenic genes SDF-1 and VEGFα, as measured by qRT-PCR. In vivo, shPHD-2 accelerated healing of full thickness excisional wounds in diabetic mice compared to shScr control, (14.33 ± 0.45 days vs. 19 ± 0.33 days and was associated with an increased vascular density. Delivery of shPHD-2 also resulted in improved perfusion of ischemic hind limbs compared to shScr, prevention of distal digit tip necrosis, and increased survival of muscle tissue. Knockdown of PHD-2 through shRNA treatment has the potential to stimulate angiogenesis through overexpression of HIF-1α and upregulation of pro-angiogenic genes downstream of HIF-1α, and may represent a viable, non-viral approach to gene therapy for ischemia related applications.

  6. Pomegranate as a Possible Treatment in Reducing Risk of Developing Wound Healing, Obesity, Neurodegenerative Disorders, and Diabetes Mellitus.

    Science.gov (United States)

    AlMatar, Manaf; Islam, Md Rashedul; Albarri, Osman; Var, Isil; Koksal, Fatih

    2018-01-01

    Four distinguished although overlying stages make up the methodical procedure of wound healing, which are hemostasis, inflammation, proliferation and remodelling. Multiple sclerosis (MS) is described as an incessant inflammatory central nervous system disease, and is linked with neurodegeneration, demyelination, as well as susceptibility to oxidative pressure. Obesity signifies a swiftly developing danger to the wellbeing of populations in a rising number of nations. Usually called diabetes mellitus (DM) by medical practitioners, diabetes details a collection of metabolic diseases within which the individual has raised blood glucose, either due to an insufficiency of insulin generation, or the lack of suitable response by the body to insulin, or both. Conventionally, the pomegranate, as well as its flowers, leaves, fruit juice and tree bark, has been applied in the treatment of conditions including acidosis, haemorrhage, diarrhoea and microbial contagions. Extracts of pomegranate have been established to contain intense anti-inflammatory, antioxidant as well as antitumor features in vivo as well as ex vivo. Of late, beneficial consequences of decrease of fat have been illustrated employing the pomegranate as well as its extracts. Several of the favourable consequences are associated with the availability of anthocyanins, tannins, and considerably elevated amounts of antioxidants, as well as flavonoids and polyphenols. A summary of the endeavours applied to deal with the possible advantages of the pomegranate towards healing wounds, Alzheimer's disease (AD), diabetes mellitus (DM) and obesity, as well as an appraisal of the efficiency of intervention through the pomegranate and its extracts is provided in this article. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  7. Selenium-loaded cellulose film derived from Styela clava tunic accelerates the healing process of cutaneous wounds in streptozotocin-induced diabetic Sprague-Dawley rats.

    Science.gov (United States)

    Song, Sung Hwa; Kim, Ji Eun; Koh, Eun Kyoung; Sung, Ji Eun; Lee, Hyun Ah; Yun, Woo Bin; Hong, Jin Tae; Hwang, Dae Youn

    2018-02-07

    Aims of this study is to evaluate the therapeutic effects and toxicity of Se-loaded cellulose film originated from Styela clava tunic (SeSCTF) on cutaneous wounds during diabetic conditions. Alterations in skin regeneration, angiogenesis and toxicity were examined using streptozotocine (STZ)-induced diabetic Sprague Dawley ® (SD) rats with surgical skin wounds after application of SeSCTF for 12 days. SCTF showed high tensile strength (1.64 MPa), low elongation (28.59%), low water vapor transmission rate (WVTR) and outstanding porous structure. Although SeSCTF application did not induce any significant alterations in glucose concentration or toxicity, wound morphology was rapidly recovered in the SeSCTF treated group relative to the gauze (GZ) and SCTF treated group. Moreover, recovery of re-epithelization, wound contraction and number of blood vessel was observed in SeSCTF treated groups when compared with all other groups. Furthermore, the SeSCTF treated group showed complete recovery of key protein expressions of the downstream signaling pathway of vascular endothelial growth factor (VEGF), angiopoietin-2/1 (Ang-2/1), the signaling pathway of insulin receptors and anti-oxidative status. Overall, the results of this study suggest that SeSCTF accelerates the healing process of cutaneous wounds in STZ-induced diabetic SD rats through stimulation of angiogenesis and the glucose receptor signaling pathway.

  8. Buried chip skin grafting in neuropathic diabetic foot ulcers following vacuum-assisted wound bed preparation: enhancing a classic surgical tool with novel technologies.

    Science.gov (United States)

    Kopp, Jürgen; Kneser, Ulrich; Bach, Alexander D; Horch, Raymund E

    2004-09-01

    In patients with diabetes mellitus, complications such as polyneuropathy and peripheral angiopathy inevitably lead to diabetic foot complications including foot ulcers, gangrene, and osteoarthropathy. These conditions necessitate minor or major amputation as part of treatment. In patients with Charcot's arthropathy and predominant neuropathy, recurrent foot ulcers are common in areas of high pressure. Such high pressure is caused by the degrading of the architecture of the foot and inadequate footwear. These patients are a clinical challenge. A select group of such patients may benefit from free surgical tissue transfer, though free or local flap surgery is often difficult or even impossible owing to an impaired arterial circulation. In such wounds, surgical debridement followed by skin grafts often fail due to bacterial burden in the wounds. To circumvent these problems, the authors developed a therapeutic approach using buried chip skin grafting to close granulation wound beds in diabetic feet. Locally applied vacuum therapy (VAC) for wound bed preparation of chronic, nonresponsive foot ulcers and subsequent grafting using the burying technique with a minute fraction of skin was used. Firm closure was achieved. The closed wound was resistant to mechanical irritation.

  9. Enhanced Healing of Diabetic Wounds by Topical Administration of Adipose Tissue-Derived Stromal Cells Overexpressing Stromal-Derived Factor-1: Biodistribution and Engraftment Analysis by Bioluminescent Imaging

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    Giuliana Di Rocco

    2011-01-01

    Full Text Available Chronic ulcers represent a major health problem in diabetic patients resulting in pain and discomfort. Conventional therapy does not guarantee adequate wound repair. In diabetes, impaired healing is partly due to poor endothelial progenitor cells mobilisation and homing, with altered levels of the chemokine stromal-derived factor-1 (SDF-1 at the wound site. Adipose tissue-associated stromal cells (AT-SCs can provide an accessible source of progenitor cells secreting proangiogenic factors and differentiating into endothelial-like cells. We demonstrated that topical administration of AT-SCs genetically modified ex vivo to overexpress SDF-1, promotes wound healing into diabetic mice. In particular, by in vivo bioluminescent imaging analysis, we monitored biodistribution and survival after transplantation of luciferase-expressing cells. In conclusion, this study indicates the therapeutic potential of AT-SCs administration in wound healing, through cell differentiation, enhanced cellular recruitment at the wound site, and paracrine effects associated with local growth-factors production.

  10. Fabrication of ultra thin and aligned carbon nanofibres from ...

    Indian Academy of Sciences (India)

    Keywords. Nanofibres; carbon; nanotechnology; oxidation; aligned. Abstract. Ultra thin and aligned carbon nanofibres (CNFs) have been fabricated by heat treatment from aligned polyacrylonitrile (PAN) nanofibre precursors prepared by electrospinning. The alignment of the precursor nanofibres was achieved by using a ...

  11. [Effects of vacuum sealing drainage combined with irrigation of oxygen loaded fluid on chronic wounds in diabetic patients].

    Science.gov (United States)

    Zhang, Meiguang; Li, Zhiqing; Wang, Jiahan; Wu, Qi; Wen, Huangding

    2014-04-01

    To evaluate the therapeutic effects of VSD combined with irrigation of oxygen loaded fluid on chronic wounds in diabetic patients. Twenty-six diabetic patients hospitalized in Nanfang Hospital of Southern Medical University from September 2010 to June 2013, with chronic ulcers on lower extremities conforming to the inclusive criteria, were divided into group VSD (n = 8), VSD + irrigation control group (VSD + IC, n = 9), VSD + oxygen loaded fluid irrigation group (VSD OLI, n = 9) according to the random number table. After gross observation was conducted and wound secretion was sent for bacterial culturing right after admission, debridement was performed. During the debridement, granulation tissue of wound center was harvested for determination of the activity of lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) with ELISA. After debridement, the patients in group VSD were treated with VSD (negative pressure from -30 to -25 kPa, the same below); the patients in group VSD + IC were treated with VSD combining irrigation of normal saline; the patients in group VSD + OLI were treated with VSD combining normal saline loaded with oxygen (flow of 1 L/min ) irrigation. Drainage tube blockage was recorded and its incidence rate was recorded during the treatment. On post treatment day (PTD) 7, tissue exudates were collected and analyzed with blood gas analyzer for determining the partial pressure of oxygen of the exudate. After the VSD was terminated, bacterial culture was conducted as before, and the bacterial clearance rate was calculated. After the calculation of granulation tissue coverage rate, the granulation tissue in the center of the wound was harvested for histopathological observation with HE staining; morphological characteristics and density of mitochondria were observed with transmission electron microscopy; the activity of LDH and SDH was estimated as before; microvascular density (MVD) was counted after CD31 antibody immunohistochemical staining

  12. Cellulose acetate electrospun nanofibrous membrane: fabrication ...

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... Home; Journals; Bulletin of Materials Science; Volume 39; Issue 2. Cellulose acetate electrospun nanofibrous membrane: fabrication, characterization, drug loading and antibacterial properties. NAZNIN SULTANA ... The CA nanofibrous membrane was non-toxic to human skin fibroblast cells. Thus the CA ...

  13. Comparison of In-Vitro and Ex-Vivo Wound Healing Assays for the Investigation of Diabetic Wound Healing and Demonstration of a Beneficial Effect of a Triterpene Extract.

    Directory of Open Access Journals (Sweden)

    Christopher Ueck

    Full Text Available Diabetes mellitus is a frequent cause for chronic, difficult-to-treat wounds. New therapies for diabetic wounds are urgently needed and in-vitro or ex-vivo test systems are essential for the initial identification of new active molecules. The aim of this study is to compare in-vitro and ex-vivo test systems for their usability for early drug screening and to investigate the efficacy of a birch bark triterpene extract (TE that has been proven ex-vivo and clinically to accelerate non-diabetic wound healing (WH, in a diabetic context. We investigated in-vitro models for diabetic WH, i.e. scratch assays with human keratinocytes from diabetic donors or cultured under hyperglycaemic conditions and a newly developed porcine ex-vivo hyperglycaemic WH model for their potential to mimic delayed diabetic WH and for the influence of TE in these test systems. We show that keratinocytes from diabetic donors often fail to exhibit significantly delayed WH. For cells under hyperglycaemic conditions significant decrease is observed but is influenced by choice of medium and presence of supplements. Also, donor age plays a role. Interestingly, hyperglycaemic effects are mainly hyperosmolaric effects in scratch assays. Ex-vivo models under hyperglycaemic conditions show a clear and substantial decrease of WH, and here both glucose and hyperosmolarity effects are involved. Finally, we provide evidence that TE is also beneficial for ex-vivo hyperglycaemic WH, resulting in significantly increased length of regenerated epidermis to 188±16% and 183±11% (SEM; p<0.05 compared to controls when using two different TE formulations. In conclusion, our results suggest that microenvironmental influences are important in WH test systems and that therefore the more complex hyperglycaemic ex-vivo model is more suitable for early drug screening. Limitations of the in-vitro and ex-vivo models are discussed. Furthermore our data recommend TE as a promising candidate for in

  14. Impact of Hyperglycemia and Low Oxygen Tension on Adipose-Derived Stem Cells Compared with Dermal Fibroblasts and Keratinocytes: Importance for Wound Healing in Type 2 Diabetes.

    Directory of Open Access Journals (Sweden)

    Aurore Lafosse

    Full Text Available Adipose-derived stem cells (ASC are currently proposed for wound healing in those with type 2 diabetes mellitus (T2DM. Therefore, this study investigated the impact of diabetes on adipose tissue in relation to ASC isolation, proliferation, and growth factor release and the impact of hyperglycemia and low oxygen tension (found in diabetic wounds on dermal fibroblasts, keratinocytes, and ASC in vitro.Different sequences of hypoxia and hyperglycemia were applied in vitro to ASC from nondiabetic (n = 8 or T2DM patients (n = 4 to study cell survival, proliferation, and growth factor release. Comparisons of dermal fibroblasts (n = 8 and keratinocytes (primary lineage were made.No significant difference of isolation and proliferation capacities was found in ASC from nondiabetic and diabetic humans. Hypoxia and hyperglycemia did not impact cell viability and proliferation. Keratinocyte Growth Factor release was significantly lower in diabetic ASC than in nondiabetic ASC group in each condition, while Vascular Endothelial Growth Factor release was not affected by the diabetic origin. Nondiabetic ASC exposition to hypoxia (0.1% oxygen combined with hyperglycemia (25mM glucose, resulted in a significant increase in VEGF secretion (+64%, p<0.05 with no deleterious impact on KGF release in comparison to physiological conditions (5% oxygen and 5 mM glucose. Stromal cell-Derived Factor-1α (-93%, p<0.001 and KGF (-20%, p<0.05 secretion by DF decreased in these conditions.A better profile of growth factor secretion (regarding wound healing was found in vitro for ASC in hyperglycemia coupled with hypoxia in comparison to dermal fibroblasts and keratinocytes. Interestingly, ASC from T2DM donors demonstrated cellular growth rates and survival (in hypoxia and hyperglycemic conditions similar to those of healthy ASC (from normoglycemic donors; however, KGF secretion was significantly depleted in ASC obtained from T2DM patients. This study demonstrated the impact of

  15. Comprehensive review of the clinical application of autologous mesenchymal stem cells in the treatment of chronic wounds and diabetic bone healing.

    Science.gov (United States)

    Mulder, Gerit D; Lee, Daniel K; Jeppesen, Nathan S

    2012-12-01

    Chronic ulcerations are a physical and financial burden to the health and economic establishment in the United States and Worldwide. Improvements in biotechnology and knowledge in stem cell applications have progressed and basic science results are making their way slowly into the clinical arena. Chronic wounds and diabetic bone healing are the key components in the limb salvage of the common diabetic foot. We have examined the current available literature and present the latest on stem cells applications as a novel clinical technique in the treatment of chronic wound and diabetic bone healing and their impact in the treatment paradigm of patients. © 2012 The Authors. © 2012 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  16. Predictors of delayed wound healing after endovascular therapy of isolated infrapopliteal lesions underlying critical limb ischemia in patients with high prevalence of diabetes mellitus and hemodialysis.

    Science.gov (United States)

    Shiraki, T; Iida, O; Takahara, M; Soga, Y; Yamauchi, Y; Hirano, K; Kawasaki, D; Fujihara, M; Utsunomiya, M; Tazaki, J; Yamaoka, T; Shintani, Y; Suematsu, N; Suzuki, K; Miyashita, Y; Tsuchiya, T; Uematsu, M

    2015-05-01

    Acceptable limb salvage rates underlie the widespread use of endovascular therapy (EVT) for patients with critical limb ischemia (CLI) secondary to isolated infrapopliteal lesions; however, post-EVT delayed wound healing remains a challenge. Predictors of delayed wound healing and their use in risk stratification of EVT in patients with CLI due to isolated infrapopliteal lesions are explored. This was a retrospective multicenter study. 871 consecutive critically ischemic limbs were studied. There was tissue loss in 734 patients (age: 71 ± 10 years old; 71% male) who had undergone EVT between April 2004 and December 2012. The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between baseline characteristics and delayed wound healing was assessed by the Cox proportional hazard model. Diabetes mellitus and regular dialysis were present in 75% (553/734) and 64% (476/734) of patients, respectively; 67% of limbs (585/871) had Rutherford class 5 CLI; 8% (67/871) of wounds were located in the heel only; 25% (219/871) of limbs had Rutherford 6 (involving not only the heel); and 42% (354/871) of wounds were complicated by infection. The rate of freedom from major amputation at 1 year reached 88%, whereas the wound healing rate was 67%. Median time to wound healing was 146 days. By multivariate analysis, non-ambulatory status (hazard ratio [HR], 1.58; 95% confidence interval [CI] 1.31-1.91) serum albumin wound infection (HR 1.24; 95% CI 1.03-1.50), EVT not based on angiosome concept (HR 1.28; 95% CI 1.06-1.55), and below the ankle (BTA) 0 vessel runoff after EVT (HR 1.45; 95% CI 1.14-1.86) were independent predictors of delayed wound healing. Non-ambulatory status, low albumin level, Rutherford 6 (not only heel), wound infection, indirect intervention, and poor BTA runoff were independent predictors for delayed wound healing after EVT in patients with CLI secondary to infrapopliteal lesions, and their use in risk stratification allows

  17. Evaluating the Effect of Sarconesiopsis magellanica (Diptera: Calliphoridae Larvae-Derived Haemolymph and Fat Body Extracts on Chronic Wounds in Diabetic Rabbits

    Directory of Open Access Journals (Sweden)

    Jennifher Góngora

    2015-01-01

    Full Text Available We evaluated extracts taken from S. magellanica third instar larvae fat body and haemolymph using a diabetic rabbit model and compared this to the effect obtained with the same substances taken from Lucilia sericata larvae. Alloxan (a toxic glucose analogue was used to induce experimental diabetes in twelve rabbits. Dorsal wounds were made in each animal and they were infected with Staphylococcus aureus and Pseudomonas aeruginosa. They were then treated with haemolymph and lyophilized extracts taken from the selected blowflies’ larvae fat bodies. Each wound was then evaluated by using rating scales and histological analysis. More favourable scores were recorded on the PUSH and WBS scales for the wounds treated with fat body derived from the larvae of both species compared to that obtained with haemolymph; however, wounds treated with the substances taken from S. magellanica had better evolution. Histological analysis revealed that treatment led to tissue proliferation and more effective neovascularisation in less time with both species’ fat body extracts compared to treatment with just haemolymph. The results suggest the effectiveness of the substances evaluated and validate them in the animal model being used here as topical agents in treating chronic wounds.

  18. Pulsed electromagnetic field (PEMF) promotes collagen fibre deposition associated with increased myofibroblast population in the early healing phase of diabetic wound.

    Science.gov (United States)

    Choi, Ming-Chun; Cheung, Kwok-Kuen; Li, Xiaohui; Cheing, Gladys Lai-Ying

    2016-01-01

    The present study evaluated the effects of PEMF on collagen fibre deposition, collagen fibril alignment and collagen fibre orientation. The potential relationships between collagen fibre deposition and myofibroblast population in diabetic wound healing were also examined. Forty young male streptozotocin-induced diabetic Sprague-Dawley rats were randomly assigned to PEMF group or control group. 2 cm × 2 cm square wounds were made at their back. The PEMF group received daily exposure of PEMF to the wounds, while control group was handled in the same manner except that the PEMF device was not activated. Wound tissues harvested on post-wounding day 7, 10 and 14 were fixed, processed and sectioned. The abundance, fibril alignment and fibre orientation of type I collagen were quantified with picro-sirius polarization method and image analysis software (Nikon NIS Element AR). Myofibroblast population data were adopted from our previous study. Correlation between myofibroblast population and collagen fibre deposition was examined. There was significantly greater abundance of type I collagen fibre in the PEMF group than in the control on day 7 (P = .013), but not on day 10 or 14. No significant between-group differences were found in collagen fibril alignment and collagen fibre orientation at any measured time points. Positive correlation was found between collagen fibre deposition and myofibroblast population only on day 7 (r = .729, P = .007). In conclusion, PEMF can significantly increase collagen fibre in the early phase of diabetic wound healing, which is associated with the enhancement of myofibroblast population.

  19. Metformin Induces Cell Cycle Arrest, Reduced Proliferation, Wound Healing Impairment In Vivo and Is Associated to Clinical Outcomes in Diabetic Foot Ulcer Patients

    Science.gov (United States)

    Ochoa-Gonzalez, Fatima; Cervantes-Villagrana, Alberto R.; Fernandez-Ruiz, Julio C.; Nava-Ramirez, Hilda S.; Hernandez-Correa, Adriana C.; Enciso-Moreno, Jose A.; Castañeda-Delgado, Julio E.

    2016-01-01

    Background Several epidemiological studies in diabetic patients have demonstrated a protective effect of metformin to the development of several types of cancer. The underlying mechanisms of such phenomenon is related to the effect of metformin on cell proliferation among which, mTOR, AMPK and other targets have been identified. However, little is known about the role that metformin treatment have on other cell types such as keratinocytes and whether exposure to metformin of these cells might have serious repercussions in wound healing delay and in the development of complications in diabetic patients with foot ulcers or in their exacerbation. Material and Methods HaCaT Cells were exposed to various concentrations of metformin and cell viability was evaluated by a Resazurin assay; Proliferation was also evaluated with a colony formation assay and with CFSE dilution assay by flow cytometry. Cell cycle was also evaluated by flow cytometry by PI staining. An animal model of wound healing was used to evaluate the effect of metformin in wound closure. Also, an analysis of patients receiving metformin treatment was performed to determine the effect of metformin treatment on the outcome and wound area. Statistical analysis was performed on SPSS v. 18 and GraphPad software v.5. Results Metformin treatment significantly reduces cell proliferation; colony formation and alterations of the cell cycle are observed also in the metformin treated cells, particularly in the S phase. There is a significant increase in the area of the wound of the metformin treated animals at different time points (Pmetformin was observed for amputation, probably associated with the anti inflammatory effects reported of metformin. Conclusions Metformin treatment reduces cell proliferation and reduces wound healing in an animal model and affects clinical outcomes in diabetic foot ulcer patients. Chronic use of this drug should be further investigated to provide evidence of their security in

  20. The effect of combined photobiomodulation and metformin on open skin wound healing in a non-genetic model of type II diabetes.

    Science.gov (United States)

    Asghari, Mohammadali; Kanonisabet, Ali; Safakhah, Mandanad; Azimzadeh, Zahra; Mostafavinia, Ataroalsadat; Taheri, Soudabeh; Amini, Abdollah; Ghorishi, Seyed Kamran; JalaliFiroozkohi, Reza; Bayat, Sahar; Bayat, Mohammad

    2017-04-01

    This study intended to examine the combined influences of photobiomodulation (PBM) and metformin on the microbial flora and biomechanical parameters of wounds in a non-genetic model of type II diabetes mellitus (TII DM). We induced a non-genetic model of TII DM in 20 rats by feeding them a 10% fructose solution for 2weeks followed by an injection of streptozotocin (STZ, 40mg/kg). After 21days from the injection of STZ, we induced one full-thickness skin wound in each of the diabetic rats. We randomly divided the rats into four groups: i) placebo; ii) pulsed wave laser (890nm, 80Hz, 0.324J/cm 2 ); iii) metformin; and iv) laser+metformin. Rats received daily intraperitoneal injections of metformin (50mg/kg). On days 7and 15 we inspected the microbial flora of each wound. On day 15 we obtained a standard sample from each healing wound for biomechanical analyses. PBM significantly decreased colony-forming units (CFUs) 7days after wound infliction compared to the placebo group (LSD test, p=0.012). Metformin significantly enhanced the biomechanical property (stress high load) of the wounds compared to the placebo group (LSD test, p=0.028). We observed the same significant result for PBM compared to the placebo group (LSD test, p=0.047). PBM significantly accelerated the wound healing process and significantly reduced CFUs of bacteria in a non-genetic rat model of TII DM. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Characterization of patients with diabetic foot disease presenting to an Irish Podiatry Centre: profiling suitability for entry to a clinical trial of advanced wound therapeutics.

    Science.gov (United States)

    Mahon, A M; MacGilchrist, C; McIntosh, C; O'Brien, T

    2017-08-01

    Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment. A cross-sectional study of out-patients attending a Podiatry centre over 12 weeks was conducted. Information was collected through clinical assessment, including Neuropathy Disability Score and Ankle-Brachial Pressure Index. Ulcers were characterised as 'healing' or 'non-healing'; a 'healing' wound decreased by 30 % over the previous month, accomplished by retrospective analysis of files. Statistics, including binomial logistic regression and column analysis for eligibility assessment, were conducted. Seventy-four participants were identified with a mean age of 67 (± 8.79) years. Non-healing DFU status correlated significantly with larger wound area (P = 0.013), infection (P = 0.009), and greater degrees of ischaemia (P = 0.015). The eligibility criteria were modelled after those proposed by the EU consortium project REDDSTAR. In this Irish population, these criteria limit eligibility to 1.4 %. This research found an eligibility criterion of wound area 2-10 cm 2 for enrolment in a clinical trial of mesenchymal stromal cell therapy too restrictive. Extension of wound area to 1-10 cm 2 and the inclusion of neuro-ischaemic ulcers increased eligibility for enrolment from 1.4 to 20 %.

  2. A Real World, Observational Registry of Chronic Wounds and Ulcers

    Science.gov (United States)

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  3. Exosomes from adipose-derived stem cells overexpressing Nrf2 accelerate cutaneous wound healing by promoting vascularization in a diabetic foot ulcer rat model.

    Science.gov (United States)

    Li, Xue; Xie, Xiaoyun; Lian, Weishuai; Shi, Rongfeng; Han, Shilong; Zhang, Haijun; Lu, Ligong; Li, Maoquan

    2018-04-13

    Diabetic foot ulcers (DFU) increase the risks of infection and amputation in patients with diabetes mellitus (DM). The impaired function and senescence of endothelial progenitor cells (EPCs) and high glucose-induced ROS likely exacerbate DFUs. We assessed EPCs in 60 patients with DM in a hospital or primary care setting. We also evaluated the therapeutic effects of exosomes secreted from adipose-derived stem cells (ADSCs) on stress-mediated senescence of EPCs induced by high glucose. Additionally, the effects of exosomes and Nrf2 overexpression in ADSCs were investigated in vitro and in vivo in a diabetic rat model. We found that ADSCs that secreted exosomes promoted proliferation and angiopoiesis in EPCs in a high glucose environment and that overexpression of Nrf2 increased this protective effect. Wounds in the feet of diabetic rats had a significantly reduced ulcerated area when treated with exosomes from ADSCs overexpressing Nrf2. Increased granulation tissue formation, angiogenesis, and levels of growth factor expression as well as reduced levels of inflammation and oxidative stress-related proteins were detected in wound beds. Our data suggest that exosomes from ADSCs can potentially promote wound healing, particularly when overexpressing Nrf2 and therefore that the transplantation of exosomes may be suitable for clinical application in the treatment of DFUs.

  4. GMSC-Derived Exosomes Combined with a Chitosan/Silk Hydrogel Sponge Accelerates Wound Healing in a Diabetic Rat Skin Defect Model

    Directory of Open Access Journals (Sweden)

    Quan Shi

    2017-11-01

    Full Text Available Background: Delayed wound healing in diabetic patients is one of the most challenging complications in clinical medicine, as it poses a greater risk of gangrene, amputation and even death. Therefore, a novel method to promote diabetic wound healing is of considerable interest at present. Previous studies showed that injection of MSC-derived exosomes has beneficial effects on wound healing. In current studies, we aimed to isolate exosomes derived from gingival mesenchymal stem cells (GMSCs and then loading them to the chitosan/silk hydrogel sponge to evaluate the effects of this novel non-invasive method on skin defects in diabetic rats.Methods: GMSCs were isolated from human gingival connective tissue and characterized by surface antigen analysis and in vitro multipotent differentiation. The cell supernatant was collected to isolate the exosomes. The exosomes were characterized by transmission electron microscopy, Western blot and size distribution analysis. The chitosan/silk-based hydrogel sponge was prepared using the freeze-drying method and then structural and physical properties were characterized. Then, the exosomes were added to the hydrogel and tested in a diabetic rat skin defect model. The effects were evaluated by wound area measurement, histological, immunohistochemical and immunofluorescence analysis.Results: We have successfully isolated GMSCs and exosomes with a mean diameter of 127 nm. The chitosan/silk hydrogel had the appropriate properties of swelling and moisture retention capacity. The in vivo studies showed that the incorporating of GMSC-derived exosomes to hydrogel could effectively promote healing of diabetic skin defects. The histological analysis revealed more neo-epithelium and collagen in the hydrogel-exosome group. In addition, the hydrogel-exosome group had the highest microvessel density and nerve density.Conclusions: The combination of GMSC-derived exosomes and hydrogel could effectively promote skin wound healing

  5. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Mehmet Burak Çildağ

    2017-01-01

    Full Text Available Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI and those who have Charchot neuroarthropathy (CN accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05. Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005. Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

  6. The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty.

    Science.gov (United States)

    Çildağ, Mehmet Burak; Köseoğlu, Ömer Faruk Kutsi

    2017-01-01

    The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups ( p > 0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences ( p diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

  7. Enhancing effects of sericin on corneal wound healing in Otsuka Long-Evans Tokushima fatty rats as a model of human type 2 diabetes.

    Science.gov (United States)

    Nagai, Noriaki; Murao, Takatoshi; Ito, Yoshimasa; Okamoto, Norio; Sasaki, Masahiro

    2009-09-01

    The protein sericin is the main constituent of silk. We investigated the effects of sericin on corneal wound healing in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model for human type 2 diabetes. Corneal wounds were prepared by removal of the corneal epithelium, and documented using a TRC-50X equipped with a digital camera. Sericin solutions were instilled into the eyes of rats five times a day following corneal abrasion. Plasma glucose and triglycerides were determined using an Accutrend GCT. Cholesterol and insulin were measured using a Cholesterol E-Test Kit and ELISA Insulin Kit, respectively. The plasma levels of glucose, triglycerides, cholesterol and insulin in 38-week-old OLETF rats were significantly higher than in Long-Evans Tokushima Otsuka (LETO) rats used as normal controls, and the rate of corneal wound healing in OLETF rats was slower than in LETO rats. The corneal wounds of rats instilled with saline showed almost complete healing by 72 h after corneal epithelial abrasion. On the other hand, the corneal healing rate of OLETF rats instilled with 10% sericin solution was significantly higher than that of LETO rats instilled with saline, and the wounds showed almost complete healing at 48 h after abrasion. The corneal healing rate increased with increasing sericin concentration. The present study demonstrates that the corneal wound healing rate in OLETF rat is slower than in LETO rats, and the instillation of sericin solution has a potent effect in promoting wound healing and wound-size reduction in LETO and OLETF rats.

  8. Topical propolis improves wound healing in patients with diabetic foot ulcer: a randomized controlled trial.

    Science.gov (United States)

    Afkhamizadeh, Mozhgan; Aboutorabi, Robab; Ravari, Hassan; Fathi Najafi, Mohsen; Ataei Azimi, Sajad; Javadian Langaroodi, Adineh; Yaghoubi, Mohammad Ali; Sahebkar, Amirhossein

    2017-08-22

    In this randomized controlled trial, diabetic patients with foot ulcers (Wagner grades 1 and 2) were randomly assigned to conventional therapies for diabetic foot ulcer plus topical propolis ointment (5%; twice daily) or conventional therapies alone. The process of ulcer healing was observed during 4 weeks and compared between the two groups regarding the size, erythema, exudates, white blood cell (WBC) count and erythrocyte sedimentation rate (ESR). The process of ulcer size reduction during the four-week period of study was significantly different between the groups. However, this difference was not significant between the third and fourth weeks. There was no significant difference between two groups regarding erythema and exudate reduction as well as WBC count and ESR. Administration of topical propolis ointment in addition to the conventional treatments of diabetic foot ulcer could reduce the size of ulcers with Wagner grades 1 and 2.

  9. Optimization of electrospinning parameters for chitosan nanofibres

    CSIR Research Space (South Africa)

    Jacobs, V

    2011-06-01

    Full Text Available uniform chitosan nanofibres. The parameters studied were electric field strength, ratio of solvents - trifluoroacetic acid (TFA)/ dichloromethane (DCM), concentration of chitosan in the spinning solution, their individual and interaction effects...

  10. A Prospective, Randomized, Blinded, Controlled Trial Comparing Transdermal Continuous Oxygen Delivery to Moist Wound Therapy for the Treatment of Diabetic Foot Ulcers.

    Science.gov (United States)

    Driver, Vickie R; Reyzelman, Alexander; Kawalec, Jill; French, Michael

    2017-04-01

    Worldwide, diabetic foot ulcers (DFUs) continue to exact a major burden on patients and health care providers. Although hyperbaric oxygen therapy is well-known as an adjunct option, less is known about the efficacy of transdermal continuous oxygen therapy (TCOT). A prospective, randomized, blinded, multicenter, parallel study was conducted from October 2009 to November 2012 to evaluate healing time and the proportion of DFUs healed after 12 weeks of moist wound therapy (MWT) with or without TCOT. Study participants (persons with type 1 or type 2 diabetes and a nonhealing [>1-month but treatment consisted of continuous administration of 98+% oxygen to the wound site using a 15-day device with dressings changed every 3 to 7 days per care plan or more often when clinically required. Potential participants completed demographic and clinical screening and wound and laboratory evaluations at baseline, and wound evaluations, evaluation of adverse events, debridement, and treatment once weekly until the wound healed or up to 12 weeks. The primary endpoint was defined as complete wound closure by week 12. Wound measurements were made utilizing acetate tracings. Original tracings were collected at approximately 6-week intervals and analyzed upon study closure. Data were collected via paper Case Report Forms and entered into an electronic database after the patient's final visit. Statistical analysis was performed on datasets exported from the electronic database. Wound measurement data were analyzed using chi-squared. Time to complete closure was analyzed using Kaplan-Meier analysis in conjunction with the log-rank test. Of the 130 potential participants, 8 with protocol violations were excluded from analysis. In the intent-to-treat (ITT) population (N = 122, average age 59 years [range 28-85 years]), the majority were male (74%), Caucasian (81%), and had a plantar ulcer (76%). Mean baseline wound area was 2.3 ± 1.7 cm² (range 0.4-8.9 cm2) and 2.0 ± 1.7 cm² (range 0

  11. An economic evaluation of VAC therapy compared with wound dressings in the treatment of diabetic foot ulcers.

    Science.gov (United States)

    Flack, S; Apelqvist, J; Keith, M; Trueman, P; Williams, D

    2008-02-01

    To determine the cost-effectiveness ofVacuum Assisted Closure (VAC) therapy (KCI Medical), based on a comparison with both traditional and advanced wound dressings, for the treatment of diabetic foot ulcers in the US. A Markov model was designed to estimate the cost per amputation avoided and the cost per quality-adjusted life year (QALY) of VAC therapy, compared with both traditional and advanced dressings. Over a one-year period the Markov model simulated 1000 patients using transition probabilities obtained from the literature. The health states used in the model were: uninfected ulcer; infected ulcer; infected ulcer post-amputation; healed; healed post-amputation; amputation; and death. Patients initially treated with VAC switched to the advanced dressing after three months of treatment if their wound remained unhealed. Patients treated with traditional or advanced dressings were assumed to continue with their treatment for the full 12 months if they remained unhealed. The model results demonstrate improved healing rates (61% versus 59%), more QALYs (0.54 versus 0.53) and an overall lower cost of care ($52,830 versus $61,757 per person) for patients treated with VAC therapy compared with advanced dressings. Vacuum Assisted Closure was also shown to be a dominant intervention when compared with traditional dressings. The model results indicate thatVAC therapy is less costly and more effective than both traditional and advanced dressings. The results are robust to changes in key parameters, including the transition probabilities, the cost ofVAC therapy and the utility weights applied to health states.

  12. Granulation Response and Partial Wound Closure Predict Healing in Clinical Trials on Advanced Diabetes Foot Ulcers Treated With Recombinant Human Epidermal Growth Factor

    Science.gov (United States)

    Valenzuela-Silva, Carmen M.; Tuero-Iglesias, Ángela D.; García-Iglesias, Elizeth; González-Díaz, Odalys; del Río-Martín, Amaurys; Yera Alos, Isis Belkis; Fernández-Montequín, José I.; López-Saura, Pedro A.

    2013-01-01

    OBJECTIVE To determine if partial wound closure surrogate markers proposed for neuropathic, small diabetic foot ulcers (DFUs) can be extended to advanced lesions and if the development of granulation tissue can be used to predict complete healing. RESEARCH DESIGN AND METHODS Data from two multicenter, double-blind, randomized clinical trials (one of them placebo controlled) that used intralesional recombinant human epidermal growth factor (rhEGF) to promote granulation and healing were used. For confirmation in a larger sample from common clinical practice, the results of an active postmarketing surveillance of rhEGF treatment of DFUs in 60 healthcare units was included. The surrogates evaluated were percent area change, log healing rate, ratio of log areas, and percent of granulation tissue covering the wound area. The tests used were surrogate final end point correlation, receiver operating characteristic curves to discriminate healers from nonhealers, validation tests using logistic regression models, and the proportion-mediated estimation. RESULTS Two weeks >50% granulation, end of treatment >75% granulation, and 16.1% area change showed significant predictive value (>70% correct classification) for final wound closure. The granulation-based variables fulfilled the criterion that the effect of rhEGF treatment on wound closure was mediated by the surrogate. CONCLUSIONS This work provides the first evidence for the use of granulation tissue development as a predictor of wound healing in advanced DFUs. These results can be useful for clinical trial design, particularly during the exploratory phase of new products. PMID:22966096

  13. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers.

    Science.gov (United States)

    Zhang, Jing; Guan, Meiping; Xie, Cuihua; Luo, Xiangrong; Zhang, Qian; Xue, Yaoming

    2014-01-01

    Management of diabetic foot ulcers (DFUs) is a great challenge for clinicians. Although the oxygen-ozone treatment improves the diabetic outcome, there are few clinical trials to verify the efficacy and illuminate the underlying mechanisms of oxygen-ozone treatment on DFUs. In the present study, a total of 50 type 2 diabetic patients complicated with DFUs, Wagner stage 2~4, were randomized into control group treated by standard therapy only and ozone group treated by standard therapy plus oxygen-ozone treatment. The therapeutic effects were graded into 4 levels from grade 0 (no change) to grade 3 (wound healing). The wound sizes were measured at baseline and day 20, respectively. Tissue biopsies were performed at baseline and day 11. The expressions of vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet-derived growth factor (PDGF) proteins in the pathologic specimens were determined by immunohistochemical examinations. The effective rate of ozone group was significantly higher than that of control group (92% versus 64%, P ozone group than in control group (P treatment, the expressions of VEGF, TGF-β, and PDGF proteins at day 11 were significantly higher in ozone group than in control group. Ozone therapy promotes the wound healing of DFUs via potential induction of VEGF, TGF-β, and PDGF at early stage of the treatment. (Clinical trial registry number is ChiCTR-TRC-14004415).

  14. In situ depot comprising phase-change materials that can sustainably release a gasotransmitter H2S to treat diabetic wounds.

    Science.gov (United States)

    Lin, Wei-Chih; Huang, Chieh-Cheng; Lin, Shu-Jyuan; Li, Meng-Ju; Chang, Yen; Lin, Yu-Jung; Wan, Wei-Lin; Shih, Po-Chien; Sung, Hsing-Wen

    2017-11-01

    Patients with diabetes mellitus are prone to develop refractory wounds. They exhibit reduced synthesis and levels of circulating hydrogen sulfide (H 2 S), which is an ephemeral gaseous molecule. Physiologically, H 2 S is an endogenous gasotransmitter with multiple biological functions. An emulsion method is utilized to prepare a microparticle system that comprises phase-change materials with a nearly constant temperature of phase transitions to encapsulate sodium hydrosulfide (NaHS), a highly water-labile H 2 S donor. An emulsion technique that can minimize the loss of water-labile active compounds during emulsification must be developed. The as-prepared microparticles (NaHS@MPs) provide an in situ depot for the sustained release of exogenous H 2 S under physiological conditions. The sustained release of H 2 S promotes several cell behaviors, including epidermal/endothelial cell proliferation and migration, as well as angiogenesis, by extending the activation of cellular ERK1/2 and p38, accelerating the healing of full-thickness wounds in diabetic mice. These experimental results reveal the strong potential of NaHS@MPs for the sustained release of H 2 S for the treatment of diabetic wounds. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Wound healing and treating wounds: Chronic wound care and management.

    Science.gov (United States)

    Powers, Jennifer G; Higham, Catherine; Broussard, Karen; Phillips, Tania J

    2016-04-01

    In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  16. The molecular biology in wound healing & non-healing wound.

    Science.gov (United States)

    Qing, Chun

    2017-08-01

    The development of molecular biology and other new biotechnologies helps us to recognize the wound healing and non-healing wound of skin in the past 30 years. This review mainly focuses on the molecular biology of many cytokines (including growth factors) and other molecular factors such as extracellular matrix (ECM) on wound healing. The molecular biology in cell movement such as epidermal cells in wound healing was also discussed. Moreover many common chronic wounds such as pressure ulcers, leg ulcers, diabetic foot wounds, venous stasis ulcers, etc. usually deteriorate into non-healing wounds. Therefore the molecular biology such as advanced glycation end products (AGEs) and other molecular factors in diabetes non-healing wounds were also reviewed. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

  17. Localized and guided electroluminescence from roll printed organic nanofibres

    DEFF Research Database (Denmark)

    Tavares, Luciana; Kjelstrup-Hansen, Jakob; Rubahn, Horst-Günter

    2012-01-01

    is oriented along the long molecular axis. Furthermore, their morphology enables the nanofibres to operate as optical waveguides and part of the generated light is therefore guided along the nanofibre and radiated at the nanofibre end. In addition to the “standard” hexaphenylenenanofibres, we also demonstrate...

  18. Metal–polyaniline nanofibre composite for supercapacitor applications

    Indian Academy of Sciences (India)

    Administrator

    Abstract. The aim of the present work is to increase the electrical conductivity and specific capacitance of the polyaniline (PANi) nanofibres by introducing the metallic nanostructures. Herein, metal nanoparticle- incorporated PANi nanofibres were prepared from interfacially synthesized PANi nanofibres as seeds. In the.

  19. Levels of wound calprotectin and other inflammatory biomarkers aid in deciding which patients with a diabetic foot ulcer need antibiotic therapy (INDUCE study).

    Science.gov (United States)

    Ingram, J R; Cawley, S; Coulman, E; Gregory, C; Thomas-Jones, E; Pickles, T; Cannings-John, R; Francis, N A; Harding, K; Hood, K; Piguet, V

    2018-02-01

    Deciding if a diabetic foot ulcer is infected in a community setting is challenging without validated point-of-care tests. Four inflammatory biomarkers were investigated to develop a composite algorithm for mildly infected diabetic foot ulcers: venous white cell count, C-reactive protein (CRP) and procalcitonin, and a novel wound exudate calprotectin assay. Calprotectin is a marker of neutrophilic inflammation. In a prospective study, people with uninfected or mildly infected diabetic foot ulcers who had not received oral antibiotics in the preceding 2 weeks were recruited from community podiatry clinics for measurement of inflammatory biomarkers. Antibiotic prescribing decisions were based on clinicians' baseline assessments and participants were reviewed 1 week later; ulcer infection was defined by clinicians' overall impression from their two assessments. Some 363 potential participants were screened, of whom 67 were recruited, 29 with mildly infected diabetic foot ulcers and 38 with no infection. One participant withdrew early in each group. Ulcer area was 1.32 cm 2 [interquartile range (IQR) 0.32-3.61 cm 2 ] in infected ulcers and 0.22 cm 2 (IQR 0.09-1.46 cm 2 ) in uninfected ulcers. Baseline CRP for mild infection was 9.00 mg/ml and 6.00 mg/ml for uninfected ulcers; most procalcitonin levels were undetectable. Median calprotectin level in infected diabetic foot ulcers was 1437 ng/ml and 879 ng/ml in uninfected diabetic foot ulcers. Area under the receiver operating characteristic curve for a composite algorithm incorporating calprotectin, CRP, white cell count and ulcer area was 0.68 (95% confidence intervals 0.52-0.82), sensitivity 0.64, specificity 0.81. A composite algorithm including CRP, calprotectin, white cell count and ulcer area may help to distinguish uninfected from mildly infected diabetic foot ulcers. Venous procalcitonin is unhelpful for mild diabetic foot ulcer infection. © 2017 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd

  20. Impact of the controlled release of a connexin 43 peptide on corneal wound closure in an STZ model of type I diabetes.

    Directory of Open Access Journals (Sweden)

    Keith Moore

    Full Text Available The alpha-carboxy terminus 1 (αCT1 peptide is a synthetically produced mimetic modified from the DDLEI C-terminus sequence of connexin 43 (Cx43. Previous research using various wound healing models have found promising therapeutic effects when applying the drug, resulting in increased wound healing rates and reduced scarring. Previous data suggested a rapid metabolism rate in vitro, creating an interest in long term release. Using a streptozotocin (STZ type I diabetic rat model with a surgically induced corneal injury, we delivered αCT1 both directly, in a pluronic gel solution, and in a sustained system, using polymeric alginate-poly-l-ornithine (A-PLO microcapsules (MC. Fluorescent staining of wound area over a 5 day period indicated a significant increase in wound closure rates for both αCT1 and αCT1 MC treated groups, withαCT1 MC groups showing the most rapid wound closure overall. Analysis of inflammatory reaction to the treatment groups indicated significantly lower levels of both Interferon Inducible T-Cell Alpha Chemoattractant (ITAC and Tumor Necrosis Factor Alpha (TNFα markers using confocal quantification and ELISA assays. Additional analysis examining genes selected from the EMT pathway using RT-PCR and Western blotting suggested αCT1 modification of Transforming Growth Factor Beta 2 (TGFβ2, Keratin 8 (Krt8, Estrogen Receptor 1 (Esr1, and Glucose Transporter 4 (Glut4 over a 14 day period. Combined, this data indicated a possible suppression of the inflammatory response by αCT1, leading to increased wound healing rates.

  1. Nanofibre production in spiders without electric charge.

    Science.gov (United States)

    Joel, Anna-Christin; Baumgartner, Werner

    2017-06-15

    Technical nanofibre production is linked to high voltage, because nanofibres are typically produced by electrospinning. In contrast, spiders have evolved a way to produce nanofibres without high voltage. These spiders are called cribellate spiders and produce nanofibres within their capture thread production. It is suggested that their nanofibres become frictionally charged when brushed over a continuous area on the calamistrum, a comb-like structure at the metatarsus of the fourth leg. Although there are indications that electrostatic charges are involved in the formation of the thread structure, final proof is missing. We proposed three requirements to validate this hypothesis: (1) the removal of any charge during or after thread production has an influence on the structure of the thread; (2) the characteristic structure of the thread can be regenerated by charging; and (3) the thread is attracted to or repelled from differently charged objects. None of these three requirements were proven true. Furthermore, mathematical calculations reveal that even at low charges, the calculated structural assembly of the thread does not match the observed reality. Electrostatic forces are therefore not involved in the production of cribellate capture threads. © 2017. Published by The Company of Biologists Ltd.

  2. Wound healing and treating wounds: Differential diagnosis and evaluation of chronic wounds.

    Science.gov (United States)

    Morton, Laurel M; Phillips, Tania J

    2016-04-01

    Wounds are an excellent example of how the field of dermatology represents a cross-section of many medical disciplines. For instance, wounds may be caused by trauma, vascular insufficiency, and underlying medical conditions, such as diabetes, hypertension, and rheumatologic and inflammatory disease. This continuing medical education article provides an overview of wound healing and the pathophysiology of chronic wounds and reviews the broad differential diagnosis of chronic wounds. It also describes the initial steps necessary in evaluating a chronic wound and determining its underlying etiology. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Factors Affecting Wound Healing

    Science.gov (United States)

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  4. Wound healing effects of collagen-laminin dermal matrix impregnated with resveratrol loaded hyaluronic acid-DPPC microparticles in diabetic rats.

    Science.gov (United States)

    Gokce, Evren H; Tuncay Tanrıverdi, Sakine; Eroglu, Ipek; Tsapis, Nicolas; Gokce, Goksel; Tekmen, Isıl; Fattal, Elias; Ozer, Ozgen

    2017-10-01

    An alternative formulation for the treatment of diabetic foot wounds that heal slowly is a requirement in pharmaceutical field. The aim of this study was to develop a dermal matrix consisting of skin proteins and lipids with an antioxidant that will enhance healing and balance the oxidative stress in the diabetic wound area due to the high levels of glucose. Thus a novel three dimensional collagen-laminin porous dermal matrix was developed by lyophilization. Resveratrol-loaded hyaluronic acid and dipalmitoylphosphatidylcholine microparticles were combined with this dermal matrix. Characterization, in vitro release, microbiological and in vivo studies were performed. Spherical microparticles were obtained with a high RSV encapsulation efficacy. The microparticles were well dispersed in the dermal matrix from the surface to deeper layers. Collagenase degraded dermal matrix, however the addition of RSV loaded microparticles delayed the degradation time. The release of RSV was sustained and reached 70% after 6h. Histological changes and antioxidant parameters in different treatment groups were investigated in full-thickness excision diabetic rat model. Collagen fibers were intense and improved by the presence of formulation without any signs of inflammation. The highest healing score was obtained with the dermal matrix impregnated with RSV-microparticles with an increased antioxidant activity. Collagen-laminin dermal matrix with RSV microparticles was synergistically effective due to presence of skin components in the formulation and controlled release achieved. This combination is a safe and promising option for the treatment of diabetic wounds requiring long recovery. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: Report of twelve cases and discussion of mechanism of action

    Science.gov (United States)

    Lee, Bok Y.; AL-Waili, Noori; Stubbs, Dean; Wendell, Keith; Butler, Glenn; AL-Waili, Thia; AL-Waili, Ali

    2010-01-01

    Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT) device (EPRT Technologies-USA, Simi Valley, CA) in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes) of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30-100%). The patients

  6. Ultra-low microcurrent in the management of diabetes mellitus, hypertension and chronic wounds: report of twelve cases and discussion of mechanism of action.

    Science.gov (United States)

    Lee, Bok Y; Al-Waili, Noori; Stubbs, Dean; Wendell, Keith; Butler, Glenn; Al-Waili, Thia; Al-Waili, Ali

    2009-12-06

    Oxidative stress plays a major role in the pathogenesis of both types of diabetes mellitus and cardiovascular diseases including hypertension. The low levels of antioxidants accompanied by raised levels of markers of free radical damage play a major role in delaying wound healing. Ultra-low microcurrent presumably has an antioxidant effect, and it was shown to accelerate wound healing. The purpose of the study is to investigate the efficacy of ultra-low microcurrent delivered by the Electro Pressure Regeneration Therapy (EPRT) device (EPRT Technologies-USA, Simi Valley, CA) in the management of diabetes, hypertension and chronic wounds. The EPRT device is an electrical device that sends a pulsating stream of electrons in a relatively low concentration throughout the body. The device is noninvasive and delivers electrical currents that mimic the endogenous electric energy of the human body. It is a rechargeable battery-operated device that delivers a direct current (maximum of 3 milliAmperes) of one polarity for 11.5 minutes, which then switched to the opposite polarity for another 11.5 minutes. The resulting cycle time is approximately 23min or 0.000732 Hz and delivers a square wave bipolar current with a voltage ranging from 5V up to a maximum of 40 V. The device produces a current range of 3 mA down to 100 nA. Twelve patients with long standing diabetes, hypertension and unhealed wounds were treated with EPRT. The patients were treated approximately for 3.5 h/day/5 days a week. Assessment of ulcer was based on scale used by National Pressure Ulcer Advisory Panel Consensus Development Conference. Patients were followed-up with daily measurement of blood pressure and blood glucose level, and their requirement for medications was recorded. Treatment continued from 2-4 months according to their response. Results showed that diabetes mellitus and hypertension were well controlled after using this device, and their wounds were markedly healed (30-100%). The patients

  7. Comment on “Topically Applied Connective Tissue Growth Factor/CCN2 Improves Diabetic Preclinical Cutaneous Wound Healing: Potential Role for CTGF in Human Diabetic Foot Ulcer Healing”

    Directory of Open Access Journals (Sweden)

    Hongling Li

    2015-01-01

    Full Text Available A recent paper in this journal, presented a novel method by topical application of growth factors in stimulating diabetic cutaneous wound healing that caught our attention. We believe that the experimental method in the article is efficient and creative, but it also has some controversies and shortcomings to be discussed. We noted that the authors used “Tegaderm” as a semiocclusive dressing film and stated that it exerted a “splinting effect” on the wound margins and controlled contraction. Indeed, the “Tegaderm” itself can serve as a dressing film to isolate the wound bed with outside environments while the “splinting effect” is mainly achieved by adding silicone splints around the wound. Considering the unique properties of silicone splints and “Tegaderm,” our experimental group propose an alternative method named “combined-suturing” technique that is not only suturing the silicone splints but also securing the “Tegaderm” around the wound. The specific reasons and operative procedures are explained in detail in this letter.

  8. Persepsi Pasien Luka Diabetik Tentang Perawatan Luka Lembab ASRI Wound Care Clinic Medan

    OpenAIRE

    Sinaga, Ilda Putriani

    2014-01-01

    Diabetic wound is one of complicated chronic of diabetes mellitus which is most commonly found and feared because its application is often disappointing and ends in amputation. Amputation can be prevented by treating the wound which aims to maintain the moisture of the wound so it accelerates the healing of the wound. The purpose of this research is to identify perception of patients of diabetic wound about treatment for moist wound in ASRI Wound Center Medan. Design used in this research is ...

  9. Wound healing.

    Science.gov (United States)

    Wang, Peng-Hui; Huang, Ben-Shian; Horng, Huann-Cheng; Yeh, Chang-Ching; Chen, Yi-Jen

    2018-02-01

    Wound healing is an important physiological process to maintain the integrity of skin after trauma, either by accident or by intent procedure. The normal wound healing involves three successive but overlapping phases, including hemostasis/inflammatory phase, proliferative phase, and remodeling phase. Aberration of wound healing, such as excessive wound healing (hypertrophic scar and keloid) or chronic wound (ulcer) impairs the normal physical function. A large number of sophisticated experimental studies have provided insights into wound healing. This article highlights the information after 2010, and the main text includes (i) wound healing; (ii) wound healing in fetus and adult; (iii) prostaglandins and wound healing; (iv) the pathogenesis of excessive wound healing; (v) the epidemiology of excessive wound healing; (vi) in vitro and in vivo studies for excessive wound healing; (vii) stem cell therapy for excessive wound healing; and (viii) the prevention strategy for excessive wound healing. Copyright © 2017. Published by Elsevier Taiwan LLC.

  10. Wound healing

    Directory of Open Access Journals (Sweden)

    Peng-Hui Wang

    2018-02-01

    Full Text Available Wound healing is an important physiological process to maintain the integrity of skin after trauma, either by accident or by intent procedure. The normal wound healing involves three successive but overlapping phases, including hemostasis/inflammatory phase, proliferative phase, and remodeling phase. Aberration of wound healing, such as excessive wound healing (hypertrophic scar and keloid or chronic wound (ulcer impairs the normal physical function. A large number of sophisticated experimental studies have provided insights into wound healing. This article highlights the information after 2010, and the main text includes (i wound healing; (ii wound healing in fetus and adult; (iii prostaglandins and wound healing; (iv the pathogenesis of excessive wound healing; (v the epidemiology of excessive wound healing; (vi in vitro and in vivo studies for excessive wound healing; (vii stem cell therapy for excessive wound healing; and (viii the prevention strategy for excessive wound healing.

  11. Preparation and in vivo evaluation of cationic elastic liposomes comprising highly skin-permeable growth factors combined with hyaluronic acid for enhanced diabetic wound-healing therapy.

    Science.gov (United States)

    Choi, Jeong Uk; Lee, Seong Wook; Pangeni, Rudra; Byun, Youngro; Yoon, In-Soo; Park, Jin Woo

    2017-07-15

    To enhance the therapeutic effects of exogenous administration of growth factors (GFs) in the treatment of chronic wounds, we constructed GF combinations of highly skin-permeable epidermal growth factor (EGF), insulin-like growth factor-I (IGF-I), and platelet-derived growth factor-A (PDGF-A). We genetically conjugated a low-molecular-weight protamine (LMWP) to the N-termini of these GFs to form LMWP-EGF, LMWP-IGF-I, and LMWP-PDGF-A. Subsequently, these molecules were complexed with hyaluronic acid (HA). Combinations of native or LMWP-fused GFs significantly promoted fibroblast proliferation and the synthesis of procollagen, with a magnification of these results observed after the GFs were complexed with HA. The optimal proportions of LMWP-EGF, LMWP-IGF-I, LMWP-PDGF-A, and HA were 1, 1, 0.02, and 200, respectively. After confirming the presence of a synergistic effect, we incorporated the LMWP-fused GFs-HA complex into cationic elastic liposomes (ELs) of 107±0.757nm in diameter and a zeta potential of 56.5±1.13mV. The LMWP-fused GFs had significantly improved skin permeation compared with native GFs. The in vitro wound recovery rate of the LMWP-fused GFs-HA complex was 23% higher than that of cationic ELs composed of LMWP-fused GFs alone. Moreover, the cationic ELs containing the LMWP-fused GFs-HA complex significantly accelerated the wound closure rate in a diabetic mouse model and the wound size was maximally decreased by 65% and 58% compared to cationic ELs loaded with vehicle or native GFs-HA complex, respectively. Thus, topical treatment with cationic ELs loaded with the LMWP-fused GFs-HA complex synergistically enhanced the healing of chronic wounds, exerting both rapid and prolonged effects. We believe that our study makes a significant contribution to the literature, because it demonstrated the potential application of cationic elastic liposomes as topical delivery systems for growth factors (GFs) that have certain limitations in their therapeutic effects

  12. Upregulation of CREM/ICER suppresses wound endothelial CRE-HIF-1α-VEGF-dependent signaling and impairs angiogenesis in type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Milad S. Bitar

    2015-01-01

    Full Text Available Impaired angiogenesis and endothelial dysfunction in type 2 diabetes constitute dominant risk factors for non-healing wounds and most forms of cardiovascular disease. We propose that diabetes shifts the ‘angiogenic balance’ in favor of an excessive anti-angiogenic phenotype. Herein, we report that diabetes impairs in vivo sponge angiogenic capacity by decreasing VEGF expression and fibrovascular invasion, and reciprocally enhances the formation of angiostatic molecules, such as thrombospondins, NFκB and FasL. Defective in vivo angiogenesis prompted cellular studies in cultured endothelial cells derived from subcutaneous sponge implants (SIECs of control and Goto-Kakizaki rats. Ensuing data from diabetic SIECs demonstrated a marked upregulation in cAMP-PKA-CREB signaling, possibly stemming from increased expression of adenylyl cyclase isoforms 3 and 8, and decreased expression of PDE3. Mechanistically, we found that oxidative stress and PKA activation in diabetes enhanced CREM/ICER expression. This reduces IRS2 cellular content by inhibiting cAMP response element (CRE transcriptional activity. Consequently, a decrease in the activity of Akt-mTOR ensued with a concomitant reduction in the total and nuclear protein levels of HIF-1α. Limiting HIF-1α availability for the specific hypoxia response elements in diabetic SIECs elicited a marked reduction in VEGF expression, both at the mRNA and protein levels. These molecular abnormalities were illustrated functionally by a defect in various pro-angiogenic properties, including cell proliferation, migration and tube formation. A genetic-based strategy in diabetic SIECs using siRNAs against CREM/ICER significantly augmented the PKA-dependent VEGF expression. To this end, the current data identify the importance of CREM/ICER as a negative regulator of endothelial function and establish a link between CREM/ICER overexpression and impaired angiogenesis during the course of diabetes. Moreover, it could

  13. Cellulose acetate electrospun nanofibrous membrane: fabrication ...

    Indian Academy of Sciences (India)

    In recent times, research on developing biodegradable, bio- functional and biocompatible nanosized materials has gained much interest. Nanometre length is the ..... comparison to control (tissue culture plastic, without mem- brane). It was observed that the cell viability was more than 90% of control after the nanofibres were ...

  14. Nanofibrous Resonant Membrane for Acoustic Applications

    Directory of Open Access Journals (Sweden)

    K. Kalinová

    2011-01-01

    Full Text Available Because the absorption of lower-frequency sound is problematic with fibrous material made up of coarser fibers, highly efficient sound absorption materials must be developed. The focus of this paper is on the development of a new material with high acoustic absorption characteristics. For low-frequency absorption, structures based upon the resonance principle of nanofibrous layers are employed in which the resonance of some elements allows acoustic energy to be converted into thermal energy. A nanofibrous membrane was produced by an electrostatic spinning process from an aqueous solution of polyvinyl alcohol and the acoustic characteristics of the material measured. The resonant frequency prediction for the nanofibrous membrane is based on research into its production parameters. The distance between electrodes during the electrostatic spinning process determines the average diameter of the nanofibers, and the outlet velocity of the material determines its area density. The average diameter of nanofibers was measured using the Lucia software package directly from an electron microscope image. The resonant frequency of nanofibrous membranes was determined from the sound absorption coefficient and transmission loss measurement.

  15. Wound Healing in Older Adults.

    Science.gov (United States)

    Gould, Lisa J; Fulton, Ana Tuya

    2016-02-01

    Impaired wound healing in the elderly represents a major clinical problem that is growing as our population ages. Wound healing is affected by age and by co-morbid conditions, particularly diabetes and obesity. This is particularly important in Rhode Island as the state has a very high percentage of vulnerable older adults. A multi- disciplinary approach that incorporates the skills of a comprehensive wound center with specialized nursing, geriatric medicine and palliative care will facilitate rapid wound healing, reduce costs and improve outcomes for our older adults that suffer from 'problem wounds'.

  16. The Effect of Foot Exercises on Wound Healing in Type 2 Diabetic Patients With a Foot Ulcer: A Randomized Control Study.

    Science.gov (United States)

    Eraydin, Şahizer; Avşar, Gülçin

    The purpose of this study was to investigate the effect of foot exercises on wound healing in type 2 diabetic patients with a diabetic foot ulcer. Prospective, randomized controlled study. Sixty-five patients from an outpatient clinic with grade 1 or 2 ulcers (Wagner classification) who met study criteria agreed to participate; 60 patients completed the study and were included in the final analysis. Subjects were followed up between February 2014 and June 2015. Subjects were recruited by the researchers in the clinics where they received treatment. Subjects were randomly allocated to either the control or intervention group. Data were collected using investigator-developed forms: patient information form and the diabetic foot exercises log. Patients in the intervention group received standard wound care and performed daily foot exercises for 12 weeks; the control group received standard wound care but no exercises. The ulcers of the patients in both the intervention and control groups were examined and measured at the 4th, 8th, and 12th weeks. The groups were compared in terms of the ulcer size and depth. To analyze and compare the data, frequency distribution, mean (standard deviation), variance analysis, and the independent samples t test and the χ test were used. The mean ulcer areas were 12.63 (14.43), 6.91 (5.44), 4.30 (3.70), and 3.29 (3.80) cm (P diabetic foot ulcer sizes in the study intervention group in the 4th and 12th weeks compared to beginning baseline (P ≤ .05). However, only the 12th week was different from the beginning in the control group (P = .000). The mean depths of the ulcers were 0.56 (0.85), 0.42 (0.68), 0.36 (0.50), and 0.28 (0.38) cm in the study intervention group (P ulcer areas decreased significantly in the study intervention group compared to the control group during the 3 follow-up measurements. An important finding in this study was the DFU area decreased more in those who exercised more. Findings suggests foot exercises should

  17. 1,25-dihydroxyvitamin D3 induces LL-37 and HBD-2 production in keratinocytes from diabetic foot ulcers promoting wound healing: an in vitro model.

    Directory of Open Access Journals (Sweden)

    Irma Gonzalez-Curiel

    Full Text Available Diabetic foot ulcers (DFU are one of the most common diabetes-related cause of hospitalization and often lead to severe infections and poor healing. It has been recently reported that patients with DFU have lower levels of antimicrobial peptides (AMPs at the lesion area, which contributes with the impairment of wound healing. The aim of this study was to determine whether 1,25-dihydroxyvitamin D3 (1,25 (OH2 D3 and L-isoleucine induced HBD-2 and LL-37 in primary cultures from DFU. We developed primary cell cultures from skin biopsies from 15 patients with DFU and 15 from healthy donors. Cultures were treated with 1,25 (OH2D3 or L-isoleucine for 18 h. Keratinocytes phenotype was identified by western blot and flow cytometry. Real time qPCR for DEFB4, CAMP and VDR gene expression was performed as well as an ELISA to measure HBD-2 and LL-37 in supernatant. Antimicrobial activity, in vitro, wound healing and proliferation assays were performed with conditioned supernatant. The results show that primary culture from DFU treated with 1,25(OH2D3, increased DEFB4 and CAMP gene expression and increased the production of HBD-2 and LL-37 in the culture supernatant. These supernatants had antimicrobial activity over E. coli and induced remarkable keratinocyte migration. In conclusion the 1,25(OH2D3 restored the production of AMPs in primary cell from DFU which were capable to improve the in vitro wound healing assays, suggesting their potential therapeutic use on the treatment of DFU.

  18. Electrospun carbon nanotube composite nanofibres with uniaxially aligned arrays

    International Nuclear Information System (INIS)

    Zhang Qinghua; Chang Zhenjun; Zhu Meifang; Mo Xiumei; Chen Dajun

    2007-01-01

    Multiwalled carbon nanotubes (MWNTs) were functionalized by grafting Triton X-100 on their surface to improve their dispersion in a solution of polyacrylonitrile (PAN) matrix. Well-aligned composite nanofibres containing PAN and MWNTs were prepared by electrospinning in dimethyl formamide solution, and a collector consisting of two pieces of electrode was used to catch the nanofibres, as well as a slowly rotating drum with multi-electrodes. The nanofibres, with diameters of ∼100 nm, can be uniaxially aligned across the gap between the parallel electrodes. TEM images showed that the individual surface-functionalized MWNTs were embedded within the nanofibres

  19. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    Directory of Open Access Journals (Sweden)

    Langer Astrid

    2009-07-01

    Full Text Available Abstract Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Methods On the basis of an extensive explorative search, an appropriate algorithm for a systematic database search was developed. The following databases were searched: BIOSIS Previews, CRD databases, Cochrane Library, EconLit, Embase, Medline, and Web of Science. Only completed and published trial- or model-based studies which contained a full economic evaluation of growth factors and bioengineered skin substitutes for the treatment of chronic wounds were included. Two reviewers independently undertook the assessment of study quality. The relevant studies were assessed by a modified version of the Consensus on Health Economic Criteria (CHEC list and a published checklist for evaluating model-based economic evaluations. Results Eleven health economic evaluations were included. Three biotechnology products were identified for which topical growth factors or bioengineered skin substitutes for the treatment of chronic leg ulceration were economically assessed: (1 Apligraf®, a bilayered living human skin equivalent indicated for the treatment of diabetic foot and venous leg ulcers (five studies; (2 Dermagraft®, a human fibroblast-derived dermal substitute, which is indicated only for use in the treatment of full-thickness diabetic foot ulcers (one study; (3 REGRANEX® Gel, a human platelet-derived growth factor for the treatment of deep neuropathic diabetic foot ulcers (five studies. The studies considered in this review were of varying and partly low

  20. Surface modification of nanofibrous polycaprolactone/gelatin composite scaffold by collagen type I grafting for skin tissue engineering

    International Nuclear Information System (INIS)

    Gautam, Sneh; Chou, Chia-Fu; Dinda, Amit K.; Potdar, Pravin D.; Mishra, Narayan C.

    2014-01-01

    In the present study, a tri-polymer polycaprolactone (PCL)/gelatin/collagen type I composite nanofibrous scaffold has been fabricated by electrospinning for skin tissue engineering and wound healing applications. Firstly, PCL/gelatin nanofibrous scaffold was fabricated by electrospinning using a low cost solvent mixture [chloroform/methanol for PCL and acetic acid (80% v/v) for gelatin], and then the nanofibrous PCL/gelatin scaffold was modified by collagen type I (0.2–1.5 wt.%) grafting. Morphology of the collagen type I-modified PCL/gelatin composite scaffold that was analyzed by field emission scanning electron microscopy (FE-SEM), showed that the fiber diameter was increased and pore size was decreased by increasing the concentration of collagen type I. Fourier transform infrared (FT-IR) spectroscopy and thermogravimetric (TG) analysis indicated the surface modification of PCL/gelatin scaffold by collagen type I immobilization on the surface of the scaffold. MTT assay demonstrated the viability and high proliferation rate of L929 mouse fibroblast cells on the collagen type I-modified composite scaffold. FE-SEM analysis of cell-scaffold construct illustrated the cell adhesion of L929 mouse fibroblasts on the surface of scaffold. Characteristic cell morphology of L929 was also observed on the nanofiber mesh of the collagen type I-modified scaffold. Above results suggest that the collagen type I-modified PCL/gelatin scaffold was successful in maintaining characteristic shape of fibroblasts, besides good cell proliferation. Therefore, the fibroblast seeded PCL/gelatin/collagen type I composite nanofibrous scaffold might be a potential candidate for wound healing and skin tissue engineering applications. - Highlights: • PCL/gelatin/collagen type I scaffold was fabricated for skin tissue engineering. • PCL/gelatin/collagen type I scaffold showed higher fibroblast growth than PCL/gelatin one. • PCL/gelatin/collagen type I might be one of the ideal scaffold for

  1. Surface modification of nanofibrous polycaprolactone/gelatin composite scaffold by collagen type I grafting for skin tissue engineering.

    Science.gov (United States)

    Gautam, Sneh; Chou, Chia-Fu; Dinda, Amit K; Potdar, Pravin D; Mishra, Narayan C

    2014-01-01

    In the present study, a tri-polymer polycaprolactone (PCL)/gelatin/collagen type I composite nanofibrous scaffold has been fabricated by electrospinning for skin tissue engineering and wound healing applications. Firstly, PCL/gelatin nanofibrous scaffold was fabricated by electrospinning using a low cost solvent mixture [chloroform/methanol for PCL and acetic acid (80% v/v) for gelatin], and then the nanofibrous PCL/gelatin scaffold was modified by collagen type I (0.2-1.5wt.%) grafting. Morphology of the collagen type I-modified PCL/gelatin composite scaffold that was analyzed by field emission scanning electron microscopy (FE-SEM), showed that the fiber diameter was increased and pore size was decreased by increasing the concentration of collagen type I. Fourier transform infrared (FT-IR) spectroscopy and thermogravimetric (TG) analysis indicated the surface modification of PCL/gelatin scaffold by collagen type I immobilization on the surface of the scaffold. MTT assay demonstrated the viability and high proliferation rate of L929 mouse fibroblast cells on the collagen type I-modified composite scaffold. FE-SEM analysis of cell-scaffold construct illustrated the cell adhesion of L929 mouse fibroblasts on the surface of scaffold. Characteristic cell morphology of L929 was also observed on the nanofiber mesh of the collagen type I-modified scaffold. Above results suggest that the collagen type I-modified PCL/gelatin scaffold was successful in maintaining characteristic shape of fibroblasts, besides good cell proliferation. Therefore, the fibroblast seeded PCL/gelatin/collagen type I composite nanofibrous scaffold might be a potential candidate for wound healing and skin tissue engineering applications. © 2013.

  2. Hyperbaric oxygen therapy for wound healing in diabetic rats: Varying efficacy after a clinically-based protocol

    NARCIS (Netherlands)

    J.W. van Neck (Han); B. Tuk (Bastiaan); E.M.G. Fijneman (Esther ); Redeker, J.J. (Jonathan J.); Talahatu, E.M. (Edwin M.); M. Tong (Miao)

    2017-01-01

    textabstractHyperbaric oxygen therapy (HBOT) is a clinical treatment in which a patient breathes pure oxygen for a limited period of time at an increased pressure. Although this therapy has been used for decades to assist wound healing, its efficacy for many conditions is unproven and its mechanism

  3. A carbon nanofibre scanning probe assembled using an electrothermal microgripper

    DEFF Research Database (Denmark)

    Carlson, Kenneth; Dyvelkov, Karin Nordström; Eicchorn, V.

    2007-01-01

    nanofibre from a fixed position on a substrate to the tip of an atomic force microscope cantilever, inside a scanning electron microscope. Scanning of high aspect ratio trenches using the nanofibre supertip shows a significantly better performance than that with standard pyramidal silicon tips. Based...

  4. Precision deposition of a nanofibre by near-field electrospinning

    International Nuclear Information System (INIS)

    Zheng Gaofeng; Li Wenwang; Wang Xiang; Wu Dezhi; Sun Daoheng; Lin Liwei

    2010-01-01

    The deposition behaviour of an individual nanofibre on planar and patterned silicon substrates is studied using near-field electrospinning (NFES). A high-speed camera was utilized to investigate the formation and motion process of a liquid jet. Thanks to the shorter distance from the spinneret to the collector, bending instability and splitting of the charged jet in electrospinning were overcome. In NFES, a straight-line jet between the spinneret and the collector can be utilized to direct-write an orderly nanofibre. Perturbation stemming from residual charges on the collector caused the oscillation of the charged jet, and the deposition of the non-woven nanofibre on the planar substrate. With increasing collector speed, the impact of residual charges was weakened by the strong drag force from the collector and a straight-line nanofibre could be obtained. In addition, the nanofibre can be direct-written in a special pattern by controlling the motion track of the collector. Therefore, it can be concluded that a micro-strip pattern was a good guidance for nanofibre deposition, and the nanofibre deposition track followed well along the top surface of the micro-strip pattern. The position-controlled deposition of a single nanofibre provides a new aspect for applications of electrospinning.

  5. Sol gel growth of titania from electrospun polyacrylonitrile nanofibres

    Science.gov (United States)

    Hong, Youliang; Li, Domgmei; Zheng, Jian; Zou, Guangtian

    2006-04-01

    In this paper we report on the development of TiO2 surface-residing electrospun nanofibres with controllable density of TiO2 on the support fibre surface by means of an electrospinning technique and a sol-gel process. The TiO2 precursor/PAN composite nanofibres were synthesized by electrospinning a polyacrylonitrile (PAN) solution containing TiO2 precursors. Subsequently, an immersion of the electrospun composite nanofibres in deionized water led to the hydrolysis of the TiO2 precursors. SEM, TEM and XRD pattern analyses demonstrated that TiO2 was formed and resided on the nanofibre surface. On further calcining the hydrolysed nanofibres in air at 300 °C, TiO2 could be conveniently converted into anatase without essentially changing the morphology of the hydrolysed nanofibres. Furthermore, surface photovoltage spectroscopy (SPS) confirmed that the TiO2 surface-residing nanofibre nonwovens had a strong SPS response. It can be attributed that the surface residence of TiO2 permits the transfer of the photogenerated electron originating from TiO2 to ITO electrodes. Potential applications of the TiO2 surface-residing nanofibres include filters, catalysis films and environmental pollution remediation films.

  6. SU-8 photoresist-derived electrospun carbon nanofibres as high ...

    Indian Academy of Sciences (India)

    2017-06-09

    Jun 9, 2017 ... electrospinning appears to be a promising and scalable method for preparing continuous nanofibres. Electrospinning received much attention in recent years due to spinnability of a wide range of polymer materials, tunable fibre diameter and ability to make core–shell and composite nanofibres with.

  7. Patients' intention to speak up for health care providers' hand hygiene in inpatient diabetic foot wound treatment: a cross-sectional survey in diabetes outpatient centres in Lower Saxony, Germany.

    Science.gov (United States)

    von Lengerke, Thomas; Kröning, Barbara; Lange, Karin

    2017-12-01

    Hand hygiene in wound care by health care providers (HCPs) is a key principle in treating hospitalized patients with diabetic foot infections. This study aimed to estimate the extent to which patients with type-2-diabetes (T2D) intend to speak up for HCPs' hand hygiene during inpatient foot treatment, test whether this motivation increases given the hospital would invite patients to speak up, and identify associations with socio-demographics, knowledge of hand hygiene requirements, and diabetes-related factors. A questionnaire-survey was conducted in eight diabetes outpatient centres in Lower Saxony/Germany. Intentions to speak up (without and with institutional encouragement) and knowledge about hand hygiene during foot-care were assessed. Analyses of variance were conducted, partly as repeated measures-models with intention-items as within-subject factor. N = 473 patients participated (response = 77.4%). N = 177 (41%) strongly intended to speak up. Institutional encouragement was associated with an increased rate of strong (54% vs. 41%; p speak for HCPs' hand hygiene in inpatient foot treatment, and are receptive to institutional encouragement. However, this presupposes at least medium education and knowledge about hand hygiene, emphasizing that patient empowerment begins with knowledge.

  8. Hyperglycemia Induces Skin Barrier Dysfunctions with Impairment of Epidermal Integrity in Non-Wounded Skin of Type 1 Diabetic Mice.

    Directory of Open Access Journals (Sweden)

    Junko Okano

    Full Text Available Diabetes causes skin complications, including xerosis and foot ulcers. Ulcers complicated by infections exacerbate skin conditions, and in severe cases, limb/toe amputations are required to prevent the development of sepsis. Here, we hypothesize that hyperglycemia induces skin barrier dysfunction with alterations of epidermal integrity. The effects of hyperglycemia on the epidermis were examined in streptozotocin-induced diabetic mice with/without insulin therapy. The results showed that dye leakages were prominent, and transepidermal water loss after tape stripping was exacerbated in diabetic mice. These data indicate that hyperglycemia impaired skin barrier functions. Additionally, the distribution of the protein associated with the tight junction structure, tight junction protein-1 (ZO-1, was characterized by diffuse and significantly wider expression in the diabetic mice compared to that in the control mice. In turn, epidermal cell number was significantly reduced and basal cells were irregularly aligned with ultrastructural alterations in diabetic mice. In contrast, the number of corneocytes, namely, denucleated and terminally differentiated keratinocytes significantly increased, while their sensitivity to mechanical stress was enhanced in the diabetic mice. We found that cell proliferation was significantly decreased, while apoptotic cells were comparable in the skin of diabetic mice, compared to those in the control mice. In the epidermis, Keratin 5 and keratin 14 expressions were reduced, while keratin 10 and loricrin were ectopically induced in diabetic mice. These data suggest that hyperglycemia altered keratinocyte proliferation/differentiation. Finally, these phenotypes observed in diabetic mice were mitigated by insulin treatment. Reduction in basal cell number and perturbation of the proliferation/differentiation process could be the underlying mechanisms for impaired skin barrier functions in diabetic mice.

  9. Reliability Assessment of an Innovative Wound Score.

    Science.gov (United States)

    Strauss, Michael B; Moon, Hojin; Busch, Jeremy A; Jones, Christopher K; Nhan, Lisa; Miller, Stuart; Le, Phi-Nga Jeannie

    2016-06-01

    The authors describe an innovative wound score and demonstrate its versatility for scoring a variety of wound types in addition to diabetic foot ulcers (DFUs). To further test its merits, they determined its interobserver reliability in a prospective series of patients. The Wound Score system the authors created integrates the most important features of 4 predominantly used wound scoring systems. It utilizes a logical 0 to 10 format based on 5 assessments each graded from 2 (best) to 0 (worst). The versatility and reliability of the Wound Score were studied in a prospective series of 94 patients with lower extremity wounds. The Wound Score was quick to determine, applicable to a variety of wound types and locations, and highly objective for grading the severity of each of the 5 assessments. The Wound Score categorized wound types as "healthy," "problem," or "futile" for evaluation and management. Diabetes was present in 75.9%, with 70% of the DFUs scoring in the "problem" wound range. Interobserver reli- ability was high (r = 0.81). The objectivity, versatility, and reliability of the Wound Score system facilitates making decisions about the management of wounds, whether DFUs or not, and provides quantification for compara- tive effectiveness research for wound management.

  10. Wound healing in animal models: review article

    Directory of Open Access Journals (Sweden)

    Fariba Jaffary

    2017-10-01

    Full Text Available Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as  surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.

  11. Zinc in Wound Healing Modulation

    Directory of Open Access Journals (Sweden)

    Pei-Hui Lin

    2017-12-01

    Full Text Available Wound care is a major healthcare expenditure. Treatment of burns, surgical and trauma wounds, diabetic lower limb ulcers and skin wounds is a major medical challenge with current therapies largely focused on supportive care measures. Successful wound repair requires a series of tightly coordinated steps including coagulation, inflammation, angiogenesis, new tissue formation and extracellular matrix remodelling. Zinc is an essential trace element (micronutrient which plays important roles in human physiology. Zinc is a cofactor for many metalloenzymes required for cell membrane repair, cell proliferation, growth and immune system function. The pathological effects of zinc deficiency include the occurrence of skin lesions, growth retardation, impaired immune function and compromised would healing. Here, we discuss investigations on the cellular and molecular mechanisms of zinc in modulating the wound healing process. Knowledge gained from this body of research will help to translate these findings into future clinical management of wound healing.

  12. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system correlates with cost of care for diabetic foot ulcers treated in a multidisciplinary setting.

    Science.gov (United States)

    Hicks, Caitlin W; Canner, Joseph K; Karagozlu, Hikmet; Mathioudakis, Nestoras; Sherman, Ronald L; Black, James H; Abularrage, Christopher J

    2017-12-13

    We have previously demonstrated that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing time in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. Our aim was to assess whether the charges and costs associated with DFU care increase with higher WIfI stages. All patients presenting to our multidisciplinary diabetic limb preservation service from June 2012 to June 2016 were enrolled in a prospective database. Inpatient and outpatient charges, costs, and total revenue from initial visit until complete wound healing were compared for wounds stratified by WIfI classification. A total of 319 wound episodes in 248 patients were captured, including 31% WIfI stage 1, 16% stage 2, 30% stage 3, and 24% stage 4 wounds. Limb salvage at 1 year was 95% ± 2%, and wound healing was achieved in 85% ± 2%. The mean number of overall inpatient admissions (stage 1, 2.07 ± 0.48 vs stage 4, 3.40 ± 0.27; P WIfI stage. There were no significant differences in mean number of inpatient podiatric interventions or outpatient procedures between groups (P ≥ .10). The total cost of care per wound episode increased progressively from stage 1 ($3995 ± $1047) to stage 4 ($50,546 ± $4887) wounds (P WIfI stage (stage 1, $4182 ± $1185 vs stage 4, $55,790 ± $5540; P WIfI stage is associated with a prolonged wound healing time, a higher number of surgical procedures, and an increased cost of care. While limb salvage outcomes are excellent, the overall cost of DFU care from presentation to healing is substantial, especially for patients with advanced (WIfI stage 3/4) disease treated in a multidisciplinary setting. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  13. Negative pressure wound therapy via vacuum-assisted closure following partial foot amputation: what is the role of wound chronicity?

    Science.gov (United States)

    Armstrong, David G; Lavery, Lawrence A; Boulton, Andrew J M

    2007-03-01

    Randomised clinical trials (RCTs) to evaluate diabetic foot wound therapies have systematically eliminated large acute wounds from evaluation, focusing only on smaller chronic wounds. The purpose of this study was to evaluate the proportion and rate of wound healing in acute and chronic wounds after partial foot amputation in individuals with diabetes treated with negative pressure wound therapy (NPWT) delivered by the vacuum-assisted closure (VAC) device or with standard wound therapy (SWT). This study constitutes a secondary analysis of patients enrolled in a 16-week RCT of NPWT: 162 open foot amputation wounds (mean wound size = 20.7 cm(2)) were included. Acute wounds were defined as the wounds less than 30 days after amputation, whereas chronic wounds as the wounds greater than 30 days. Inclusion criteria consisted of individuals older than 18 years, presence of a diabetic foot amputation wound up to the transmetatarsal level and adequate perfusion. Wound size and healing were confirmed by independent, blinded wound evaluators. Analyses were done on an intent-to-treat basis. There was a significantly higher proportion of acute wounds (SWT = 59; NPWT = 63) than chronic wounds (SWT = 26; NPWT = 14), evaluated in this clinical trial (P = 0.001). There was no significant difference in the proportion of acute and chronic wounds achieving complete wound closure in either treatment group. Despite this finding, the Kaplan-Meier curves demonstrated statistically significantly faster healing in the NPWT group in both acute (P = 0.030) and chronic wounds (P = 0.033). Among the patients treated with NPWT via the VAC, there was not a significant difference in healing as a function of chronicity. In both the acute and the chronic wound groups, results for patients treated with NPWT were superior to those for the patients treated with SWT. These results appear to indicate that wound duration should not deter the clinician from using this modality to treat complex wounds.

  14. Synthesis of polymer-based triglycine sulfate nanofibres by electrospinning

    Energy Technology Data Exchange (ETDEWEB)

    Isakov, Dmitry; Gomes, Etelvina de Matos; Dekola, Tatjana; Macedo, Francisco [Physics Department, University of Minho, Campus de Gualtar, 4710-057 Braga (Portugal); Martins, Albino M; Guimaraes, Ana; Almeida, Bernardo; Neves, Nuno M; Reis, Rui L [3B' s Research Group-Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, AvePark, Zona Industrial da Gandra, S.Claudio do Barco, 4806-909 Caldas das Taipas, Guimar aes (Portugal); Bdikin, Igor, E-mail: dmitry@fisica.uminho.p [Department of Mechanical Engineering and TEMA, University of Aveiro, 3810-193 Aveiro (Portugal)

    2009-10-21

    In this work we present the synthesis and characterization of polyethylene oxide (PEO) based triglycine sulfate (NH{sub 2}(CH{sub 2}OOH){sub 3}H{sub 2}S0{sub 4}, TGS) nanofibres obtained by electrospinning. The fibres, with typical diameters of about 190-750 nm and above several hundred micrometres in length, present the nanocrystals of TGS embedded in a polymer matrix. The obtained nanofibres were characterized by FT-IR spectroscopy and the domain structure was examined by piezoforce microscopy. Dielectric permittivity measurements on the TGS-PEO nanofibres exhibit the characteristic ferroelectric-paraelectric phase transition at around 50 {sup 0}C.

  15. FT-Raman spectroscopic study of skin wound healing in diabetic rats treated with Cenostigma macrophyllum Tul

    Energy Technology Data Exchange (ETDEWEB)

    Coelho, Nayana Pinheiro Machado de Freitas; Martins, Marcelino, E-mail: nayanamachado@oi.com.br [Faculdade Diferencial Integral (FACID), Teresina, PI (Brazil); Costa, Charlytton Luis Sena da; Maia Filho, Antonio Luis [Universidade Estadual do Piaui (UESPI), Teresina, PI (Brazil); Raniero, Leandro; Martin, Airton Abrahao; Arisawa, Emilia Angela Loschiavo [Universidade do Vale do Paraiba (UNIVAP), Sao Jose dos Campos, SP (Brazil). Instituto de Pesquisa e Desenvolvimento

    2014-07-01

    Introduction: patients with diabetes mellitus exhibit a delay in the lesion repair process. The active components of Cenostigma macrophyllum may represent a viable alternative to facilitate the recovery of these lesions. The aim of this study was to evaluate the effects of emulsion oil-water Cenostigma macrophyllum in the repair process of lesions in rats with induced diabetes. Methods: 63 male rats (Wistar, 200-250 g body weight, 30-40 days old) were distributed into the following groups: control (C), diabetic (D) and diabetic treated with Cenostigma macrophyllum (P), subdivided based on the experimental times, days 7, 14 and 28, with 21 animals per main group. Diabetes mellitus (DM) was induced by administration of streptozotocin (50 mg/kg via penile vein and 12-h fasting) and confirmed at day 21 (glycemic index > 240 mg/dL). In the animals of group P, 0.5 ml of the oil-water emulsion obtained from the plant seed was used. The samples were removed and hemisectioned, and one portion was used for the quantitative histological analysis of collagen using Masson's trichrome staining, while another portion was analyzed by FT-Raman spectroscopy. Results: A higher percentage area of the volume of collagen fibers was observed for the experimental time Day 14 in group P compared with group D (p < 0.001). Regarding the ratio of areas of the amides I (1700-1600 cm{sup -1}) and III (1245-1345 cm{sup -1}), the groups D and P show the opposite behavior. Conclusion: Cenostigma macrophyllum accelerated the repair process in skin of diabetic ratsfor14 days. (author)

  16. Needleless Melt-Electrospinning of Polypropylene Nanofibres

    Directory of Open Access Journals (Sweden)

    Jian Fang

    2012-01-01

    Full Text Available Polypropylene (PP nanofibres have been electrospun from molten PP using a needleless melt-electrospinning setup containing a rotary metal disc spinneret. The influence of the disc spinneret (e.g., disc material and diameter, operating parameters (e.g., applied voltage, spinning distance, and a cationic surfactant on the fibre formation and average fibre diameter were examined. It was shown that the metal material used for making the disc spinneret had a significant effect on the fibre formation. Although the applied voltage had little effect on the fibre diameter, the spinning distance affected the fibre diameter considerably, with shorter spinning distance resulting in finer fibres. When a small amount of cationic surfactant (dodecyl trimethyl ammonium bromide was added to the PP melt for melt-electrospinning, the fibre diameter was reduced considerably. The finest fibres produced from this system were 400±290 nm. This novel melt-electrospinning setup may provide a continuous and efficient method to produce PP nanofibres.

  17. Wound healing: total contact cast vs. custom-made temporary footwear for patients with diabetic foot ulceration

    NARCIS (Netherlands)

    van der Weg, F.B.; van der Windt, D.A.W.M.; Vahl, A.C.

    2008-01-01

    The objective of this study was to compare the effectiveness of irremovable total-contact casts (TCC) and custom-made temporary footwear (CTF) to heal neuropathic foot ulcerations in individuals with diabetes. In this prospective clinical trial, 43 patients with plantar ulcer Grade 1 or 2 (Wagner

  18. A novel transdermal drug delivery system based on self-adhesive Janus nanofibrous film with high breathability and monodirectional water-penetration.

    Science.gov (United States)

    Shi, Yongli; Li, Yue; Wu, Jianming; Wang, Weiguo; Dong, Anjie; Zhang, Jianhua

    2014-01-01

    Transdermal drug delivery systems (TDDS) had achieved significant success in medical practice, but still suffered from adhesion failure and skin reaction due to the occlusive properties of hydrophobic pressure sensitive adhesives (PSAs). In order to solve these problems, a novel TDDS patch based on self-adhesive Janus nanofibrous film was prepared by a multilayered electrospinning. This multifunctional patch was a bilayer structure. The subjacent layer was a hydrophobic and adhesive fibrous layer electrospun from polyacrylate PSA (HPSA), and the upper backing layer was a hydrophilic cross-linked poly (vinyl alcohol) (c-PVA) nanofibrous film. The structures of the HPSA/c-PVA composite fibrous films were characterized and their application properties, including adherence performance, water vapor permeability, water-penetration, release characteristics, and skin irritation were evaluated. The results indicated that the HPSA/c-PVA composite fibrous films could provide suitable adhesive properties for TDDS application, excellent capacity for drug loading and release, aesthetical appearance and high safety for use on the skin. Especially, due to the nanofibrous network structures and the hydrophobic-hydrophilic wettability gradient from hydrophobic HPSA layer to the hydrophilic c-PVA layer, the Janus films possessed high breathability and monodirectional water-penetration. Water could penetrate from the hydrophobic to the hydrophilic side, but could not permeate through in the opposite direction. This may provide a feasible solution to the problems caused by the water, sweat, or wound exudate on the skin, when the hydrophobic PSAs were used as matrix for TDDS and wound dressing patches.

  19. [Effect of insulin by local injection on the level of systemic blood glucose and granulation tissue formation of wound in patients with diabetic foot ulcer].

    Science.gov (United States)

    Zhang, Zhao-xin; Liu, Xiao-long; Lü, Lei; Zhang, Liang; Ji, Dong-liang; Liu, Li-hua

    2011-12-01

    To investigate the effects of local injection of insulin on the level of systemic blood glucose and granulation tissue formation of wound in patients with diabetic foot ulcer. Thirty-two patients with diabetic foot ulcer hospitalized in our wards from June 2009 to June 2010 were divided into insulin (I, n = 16) and control (C, n = 16) groups according to the random number table. For patients in I group, after debridement, one half of calculated dose of insulin diluted with equal amount of normal saline was injected diffusely into the base of the ulcer, and another half dose of insulin was subcutaneously injected into abdominal wall for 7 days, two times a day. For patients in C group, after debridement, primary insulin was subcutaneously injected into abdominal wall, 1 mL saline was subcutaneously injected into basal layer of ulcer for 7 days, two times a day. Before injection and 0.5, 1.0, 2.0, and 4.0 hours after injection (PIH), level of fasting blood glucose was determined. Before injection and on post injection day (PID) 3, 5, and 7, the growth of granulation tissue was assessed, and wound specimens were harvested for observation of CD34 expression and calculation of microvessel density (MVD). Data were processed with t test. The levels of fasting blood glucose in both groups during observational time points ranged from 6.6 mmol/L to 12.8 mmol/L with a mean of (10.0 ± 2.2) mmol/L, and there was no statistical difference (with t values from 0.000 to 2.209, P values all above 0.05). Growth of granulation tissue in I group was more exuberant from PID 5, especially on PID 7 [(59.06 ± 1.58)%], which was significantly richer than that in C group [(23.61 ± 1.57)%, t = 17.420, P = 0.000]. New vessels were observed in I group from PID 3 as indicated by CD34 expression. There was no obvious difference in the number of MVD between I group and C group on PID 3 (t = 0.247, P > 0.05). The number of MVD per 200 times visual field in I group was respectively 8.34 ± 0

  20. A review on electrospinning design and nanofibre assemblies

    International Nuclear Information System (INIS)

    Teo, W E; Ramakrishna, S

    2006-01-01

    Although there are many methods of fabricating nanofibres, electrospinning is perhaps the most versatile process. Materials such as polymer, composites, ceramic and metal nanofibres have been fabricated using electrospinning directly or through post-spinning processes. However, what makes electrospinning different from other nanofibre fabrication processes is its ability to form various fibre assemblies. This will certainly enhance the performance of products made from nanofibres and allow application specific modifications. It is therefore vital for us to understand the various parameters and processes that allow us to fabricate the desired fibre assemblies. Fibre assemblies that can be fabricated include nonwoven fibre mesh, aligned fibre mesh, patterned fibre mesh, random three-dimensional structures and sub-micron spring and convoluted fibres. Nevertheless, more studies are required to understand and precisely control the actual mechanics in the formation of various electrospun fibrous assemblies. (topical review)

  1. Preparation of Aligned Polymer Micro/Nanofibres by Electrospinning

    International Nuclear Information System (INIS)

    Jin-Shan, Tan; Yun-Ze, Long; Meng-Meng, Li

    2008-01-01

    Polymer micro/nanofibres are prepared by typical and modified methods of electrospinning. The morphologies and microstructures of the electrospun micro/nanofibres are characterized by a scanning electron microscope (SEM). The micro/nanofibres prepared by the typical electrospinning are usually collected in the form of non-woven mats lacking of structural orientation. However, by modifying collector(s) of the electrospinning setup, the resulting polymer fibres show aligned structures to some extent. We analyse all the forces that the fibres experienced during electrospinning and find that the electrostatic force originating from the splitting electric field plays a key role in the alignment of the micro/nanofibres. (cross-disciplinary physics and related areas of science and technology)

  2. Synthesis of nano-carbon (nanotubes, nanofibres, graphene ...

    Indian Academy of Sciences (India)

    Administrator

    Synthesis of nano-carbon (nanotubes, nanofibres, graphene) materials. KALPANA AWASTHI, RAJESH KUMAR, HIMANSHU RAGHUBANSHI,. SEEMA AWASTHI, RATNESH PANDEY, DEVINDER SINGH, T P YADAV and. O N SRIVASTAVA*. Centre of Nanoscience and Nanotechnology, Department of Physics, Banaras ...

  3. Cytoprotection, proliferation and epidermal differentiation of adipose tissue-derived stem cells on emu oil based electrospun nanofibrous mat.

    Science.gov (United States)

    Pilehvar-Soltanahmadi, Younes; Nouri, Mohammad; Martino, Mikaël M; Fattahi, Amir; Alizadeh, Effat; Darabi, Masoud; Rahmati-Yamchi, Mohammad; Zarghami, Nosratollah

    2017-08-15

    Electrospun nanofibrous scaffolds containing natural substances with wound healing properties such as Emu oil (EO) may have a great potential for increasing the efficiency of stem cell-based skin bioengineering. For this purpose, EO blended PCL/PEG electrospun nanofibrous mats were successfully fabricated and characterized using FE-SEM, FTIR and Universal Testing Machine. The efficiency of the scaffolds in supporting the adherence, cytoprotection, proliferation and differentiation of adipose tissue-derived stem cells (ADSCs) to keratinocyte was evaluated. GC/MS and HPLC were used to determine the composition of pure EO, which revealed to be mainly fatty acids and carotenoids. FE-SEM and cell proliferation assays showed that adhesion and proliferation of ADSCs on EO-PCL/PEG nanofibers was significantly higher than on PCL/PEG nanofibers. Additionally, EO-PCL/PEG nanofibers with free radical scavenging properties conferred a cytoprotective effect against cell-damaging free radicals, while the ability to support cell adhesion and growth was maintained or even improved. Immunostaining of ADSCs on EO-PCL/PEG nanofibers confirmed the change in morphology of ADSCs from spindle to polygonal shape suggesting their differentiation toward an epidermal linage. Moreover, the expression levels of the keratin 10, filaggrin, and involucrin that are involved in epidermal differentiation were upregulated in a stage-specific manner. This preliminary study shows that EO-PCL/PEG nanofibers could be a good candidate for the fabrication of wound dressings and skin bioengineered substitutes with ADSCs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Hydroxyapatite-intertwined hybrid nanofibres for the mineralization of osteoblasts.

    Science.gov (United States)

    Sujana, Andra; Venugopal, Jayarama Reddy; Velmurugan, Bhaarathy; Góra, Aleksander; Salla, Manohar; Ramakrishna, Seeram

    2017-06-01

    Advances in tissue engineering have enabled the development of bioactive composite materials to generate biomimetic nanofibrous scaffolds for bone replacement therapies. Polymeric biocomposite nanofibrous scaffolds architecturally mimic the native extracellular matrix (ECM), delivering tremendous regenerative potential for bone tissue engineering. In the present study, biocompatible poly(l-lactic acid)-co-poly(ε-caprolactone)-silk fibroin-hydroxyapatite-hyaluronic acid (PLACL-SF-HaP-HA) nanofibrous scaffolds were fabricated by electrospinning to mimic the native ECM. The developed nanofibrous scaffolds were characterized in terms of fibre morphology, functional group, hydrophilicity and mechanical strength, using SEM, FTIR, contact angle and tabletop tensile-tester, respectively. The nanofibrous scaffolds showed a higher level of pore size and increased porosity of up to 95% for the exchange of nutrients and metabolic wastes. The fibre diameters obtained were in the range of around 255 ± 13.4-789 ± 22.41 nm. Osteoblasts cultured on PLACL-SF-HaP-HA showed a significantly (p functionalized PLACL-SF-HaP-HA nanofibrous scaffolds proved them to be a potential biocomposite for bone tissue engineering. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Conducting MWNT/poly(vinyl acetate) composite nanofibres by electrospinning

    International Nuclear Information System (INIS)

    Wang Guan; Tan Zhongkui; Liu Xueqing; Chawda, Samrat; Koo, Ja-Seung; Samuilov, Vladimir; Dudley, Michael

    2006-01-01

    Electrospinning is a relatively simple and versatile method to produce polymer nanofibres and their composites. In this work, functionalized multiwalled carbon nanotubes (f-MWNTs) were used for the fabrication of conducting nanocomposite fibres, in comparison with the composite nanofibres made of unfunctionalized MWNTs (u-MWNTs). Our results showed that the addition of f-MWNTs could improve the dispersion of carbon nanotubes in the polymer solution and therefore result in composite nanofibres with uniform diameters by electrospinning. Alignment of the composite nanofibres was achieved by using a rotating drum as the collector. F-MWNTs were found to align parallel to the axis direction of the nanofibres. DC electrical properties of a single composite fibre were investigated at room temperature as well as cryogenic states (100-300 K). An electrical percolation phenomenon was observed for nanofibres with different mass fractions of MWNTs. It was shown that the conductivity of the material could be significantly improved above the percolation threshold. The conductivity could be of several orders of magnitude higher than the pure PVAc

  6. In vivo diabetic wound healing effect and HPLC–DAD–ESI–MS/MS profiling of the methanol extracts of eight Aloe species

    Directory of Open Access Journals (Sweden)

    Abeer M. El Sayed

    Full Text Available Abstract Genus Aloe, Xanthorrhoeaceae, is well distributed all over Egypt, and many species have been used as medicinal plants; mainly reported to prevent cardiovascular diseases, cancer and diabetes. This study attempts to analyze the secondary metabolites in the methanol extract of the leaves of eight Aloe species; A. vera (L. Burm. f., A. arborescens Mill., A. eru A. Berger, A. grandidentata Salm-Dyck, A. perfoliata L., A. brevifolia Mill., A. saponaria Haw. and A. ferox Mill. growing in Egypt. For this aim HPLC–DAD–MS/MS in negative ion mode was used. Although belonging to the same genus, the composition of each species presented different particularities. Seventy one compounds were identified in the investigated Aloe species, of which cis-p-coumaric acid derivaties, 3,4-O-(E caffeoylferuloylquinic acid and caffeoyl quinic acid hexoside were the most common phenolic acids identified. Aloeresin E and isoaloeresin D, 2'-O-feruloylaloesin were the common anthraquinones identified. Lucenin II, vicenin II, and orientin were the common identified flavonoids in the investigated Aloe species. 6'-Malonylnataloin, aloe-emodin-8-O-glucoside, flavone-6,8-di-C-glucosides could be considered as chemotaxonomic markers for the investigated Aloe species. The eight Aloe species had significant anti-inflammatory activity, in addition to the significant acceleration of diabetic wound healing in rats following topical application of the methanol extracts of their leaves. This is the first simultaneous characterization and qualitative determination of multiple phenolic compounds in Aloe species from locally grown cultivars in Egypt using HPLC–DAD–MS/MS, which can be applied to standardize the quality of different Aloe species and the future design of nutraceuticals and cosmetic preparations.

  7. Composite poly-L-lactic acid/poly-({alpha},{beta})-DL-aspartic acid/collagen nanofibrous scaffolds for dermal tissue regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Ravichandran, Rajeswari [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Department of Mechanical Engineering, National University of Singapore, 117576 (Singapore); Venugopal, Jayarama Reddy, E-mail: nnijrv@nus.edu.sg [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Sundarrajan, Subramanian [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Department of Mechanical Engineering, National University of Singapore, 117576 (Singapore); Mukherjee, Shayanti [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Sridhar, Radhakrishnan [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Department of Mechanical Engineering, National University of Singapore, 117576 (Singapore); Ramakrishna, Seeram, E-mail: seeram@nus.edu.sg [Healthcare and Energy Materials Laboratory, Nanoscience and Nanotechnology Initiative, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Department of Mechanical Engineering, National University of Singapore, 117576 (Singapore)

    2012-08-01

    Tissue engineering scaffolds for skin tissue regeneration is an ever expounding area of research, as the products that meet the necessary requirements are far and elite. The nanofibrous poly-L-lactic acid/poly-({alpha},{beta})-DL-aspartic acid/Collagen (PLLA/PAA/Col I and III) scaffolds were fabricated by electrospinning and characterized by SEM, contact angle and FTIR analysis for skin tissue regeneration. The cell-scaffold interactions were analyzed by cell proliferation and their morphology observed in SEM. The results showed that the cell proliferation was significantly increased (p {<=} 0.05) in PLLA/PAA/Col I and III scaffolds compared to PLLA and PLLA/PAA nanofibrous scaffolds. The abundance and accessibility of adipose derived stem cells (ADSCs) may prove to be novel cell therapeutics for dermal tissue regeneration. The differentiation of ADSCs was confirmed using collagen expression and their morphology by CMFDA dye extrusion technique. The current study focuses on the application of PLLA/PAA/Col I and III nanofibrous scaffolds for skin tissue engineering and their potential use as substrate for the culture and differentiation of ADSCs. The objective for inclusion of a novel cell binding moiety like PAA was to replace damaged extracellular matrix and to guide new cells directly into the wound bed with enhanced proliferation and overall organization. This combinatorial epitome of PLLA/PAA/Col I and III nanofibrous scaffold with stem cell therapy to induce the necessary paracrine signalling effect would favour faster regeneration of the damaged skin tissues. - Highlights: Black-Right-Pointing-Pointer Differentiation of adipose derived stem cells in the presence of bFGF for wound healing Black-Right-Pointing-Pointer Introduction of PAA as ECM mimetic cell binding moiety Black-Right-Pointing-Pointer Combination of PLLA/PAA/Col I and III nanofibers and stem cell therapy for skin regeneration.

  8. [Chronic wounds as a public health problem].

    Science.gov (United States)

    Situm, Mirna; Kolić, Maja; Redzepi, Gzim; Antolić, Slavko

    2014-10-01

    Chronic wounds represent a significant burden to patients, health care professionals and the entire health care system. Regarding the healing process, wounds can be classified as acute or chronic wounds. A wound is considered chronic if healing does not occur within the expected period according to the wound etiology and localization. Chronic wounds can be classified as typical and atypical. The majority of wounds (95 percent) are typical ones, which include ischemic, neurotrophic and hypostatic ulcers and two separate entities: diabetic foot and decubital ulcers. Eighty percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the rest are mostly neuropathic ulcers. Chronic wounds significantly decrease the quality of life of patients by requiring continuous topical treatment, causing immobility and pain in a high percentage of patients. Chronic wounds affect elderly population. Chronic leg ulcers affect 0.6-3 percent of those aged over 60, increasing to over 5 percent of those aged over 80. Emergence of chronic wounds is a substantial socioeconomic problem as 1-2 percent of western population will suffer from it. This estimate is expected to rise due to the increasing proportion of elderly population along with the diabetic and obesity epidemic. It has been proved that chronic wounds account for the large proportion of costs in the health care system, even in rich societies. Socioeconomically, the management of chronic wounds reaches a total of 2-4 percent of the health budget in western countries. Treatment costs for some other diseases are not irrelevant, nor are the method and materials used for treating these wounds. Considering etiologic factors, a chronic wound demands a multidisciplinary approach with great efforts of health care professionals to treat it more efficiently, more simply and more painlessly for the patient, as well as more inexpensively for

  9. Perineal Wound Complications after Abdominoperineal Resection

    OpenAIRE

    Wiatrek, Rebecca L.; Thomas, J. Scott; Papaconstantinou, Harry T.

    2008-01-01

    Perineal wound complications following abdominoperineal resection (APR) is a common occurrence. Risk factors such as operative technique, preoperative radiation therapy, and indication for surgery (i.e., rectal cancer, anal cancer, or inflammatory bowel disease [IBD]) are strong predictors of these complications. Patient risk factors include diabetes, obesity, and smoking. Intraoperative perineal wound management has evolved from open wound packing to primary closure with closed suctioned tra...

  10. Synthesis, characterization, and antimicrobial properties of novel double layer nanocomposite electrospun fibers for wound dressing applications

    Directory of Open Access Journals (Sweden)

    Hassiba AJ

    2017-03-01

    Full Text Available Alaa J Hassiba,1 Mohamed E El Zowalaty,2 Thomas J Webster,3–5 Aboubakr M Abdullah,6 Gheyath K Nasrallah,7 Khalil Abdelrazek Khalil,8 Adriaan S Luyt,6 Ahmed A Elzatahry1 1Materials Science and Technology Program, College of Arts and Sciences, Qatar University, Doha, Qatar; 2School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; 3Department of Chemical Engineering, 4Department of Bioengineering, Northeastern University, Boston, MA, USA; 5Center of Excellence for Advanced Materials Research, King Abdulaziz University, Jeddah, Saudi Arabia; 6Center for Advanced Materials, 7Department of Biomedical Science, College of Health Sciences, Biomedical Research Center, Qatar University, Doha, Qatar; 8Department of Mechanical Engineering, College of Engineering, University of Sharjah, Sharjah, United Arab Emirates Abstract: Herein, novel hybrid nanomaterials were developed for wound dressing applications with antimicrobial properties. Electrospinning was used to fabricate a double layer nanocomposite nanofibrous mat consisting of an upper layer of poly(vinyl alcohol and chitosan loaded with silver nanoparticles (AgNPs and a lower layer of polyethylene oxide (PEO or polyvinylpyrrolidone (PVP nanofibers loaded with chlorhexidine (as an antiseptic. The top layer containing AgNPs, whose purpose was to protect the wound site against environmental germ invasion, was prepared by reducing silver nitrate to its nanoparticulate form through interaction with chitosan. The lower layer, which would be in direct contact with the injured site, contained the antibiotic drug needed to avoid wound infections which would otherwise interfere with the healing process. Initially, the upper layer was electrospun, followed sequentially by electrospinning the second layer, creating a bilayer nanofibrous mat. The morphology of the nanofibrous mats was studied by scanning electron microscopy and transmission electron microscopy, showing successful nanofiber

  11. Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study.

    Science.gov (United States)

    Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

    2015-10-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  12. Directly electrospun ultrafine nanofibres with Cu grid spinneret

    International Nuclear Information System (INIS)

    Li Wenwang; Zheng Gaofeng; Wang Xiang; Wang Lingyun; Wang Han; Sun Daoheng; Zhang Yulong; Li Lei

    2011-01-01

    A hydrophobic Cu grid was used as an electrospinning spinneret to fabricate ultrafine organic nanofibres. The Cu grid used in this study was that which holds samples in TEM. Due to the hydrophobic surface and larger contact angle of the electrospinning solution on the Cu grid surface, the solution flow was divided into several finer ones by the holes in the Cu grid instead of accumulating. Each finer flow was stretched into individual jets and established a multi-jet mode by the electrical field force. The finer jets played an important role in decreasing the diameter of the nanofibre. The charge repulsion force among charged jets enhanced the whipping instability motion of the liquid jets, which improved the uniformity of the nanofibre and decreased the diameter of the nanofibre. An ultrafine uniform nanofibre of diameter less than 80 nm could be fabricated directly with the novel Cu grid spinneret without any additive. This study provided a unique way to promote the application of one-dimensional organic nanostructures in micro/nanosystems.

  13. Puncture Wounds

    Science.gov (United States)

    ... piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away. Foreign Bodies in Puncture Wounds A variety of foreign bodies can become embedded in a ...

  14. Electrospinning of silver nanoparticles loaded highly porous cellulose acetate nanofibrous membrane for treatment of dye wastewater

    Science.gov (United States)

    Wang, Ke; Ma, Qian; Wang, Shu-Dong; Liu, Hua; Zhang, Sheng-Zhong; Bao, Wei; Zhang, Ke-Qin; Ling, Liang-Zhong

    2016-01-01

    In this paper, silver nanoparticles (NPs) were reduced form silver nitrate. Morphology and distribution of the synthesized silver NPs were characterized. In order to obtain cellulose acetate (CA), nanofibrous membrane with high effective adsorption performance to carry silver NPs for treatment of dye wastewater, different solvent systems were used to fabricate CA nanofibrous membranes with different morphologies and porous structures via electrospinning. Morphologies and structures of the obtained CA nanofibrous membranes were compared by scanning electron microscopy (SEM), which showed that CA nanofibrous membrane obtained from acetone/dichloromethane (1/2, v/v) was with the highly porous structure. SEM, energy-dispersive spectrometry and Fourier transform infrared spectrometry showed that the silver NPs were effectively incorporated in the CA nanofibrous membrane and the addition of silver NPs did not damage the porous structure of the CA nanofibrous membrane. Adsorption of dye solution (rhodamine B aqueous solution) revealed that the highly porous CA nanofibrous membrane exhibited effective adsorption performance and the addition of silver NPs did not affect the adsorption of the dye. Antibacterial property of the CA nanofibrous membrane showed that the silver-loaded highly porous CA nanofibrous membrane had remarkable antibacterial property when compared to the CA nanofibrous membrane without silver NPs. The silver-loaded highly porous CA nanofibrous membrane could be considered as an ideal candidate for treatment of the dye wastewater.

  15. Novel PVA/MOF Nanofibres: Fabrication, Evaluation and Adsorption of Lead Ions from Aqueous Solution.

    Science.gov (United States)

    Shooto, Ntaote David; Dikio, Charity Wokwu; Wankasi, Donbebe; Sikhwivhilu, Lucky Mashudu; Mtunzi, Fanyana Moses; Dikio, Ezekiel Dixon

    2016-12-01

    Plain polyvinyl alcohol (PVA) nanofibres and novel polyvinyl alcohol benzene tetracarboxylate nanofibres incorporated with strontium, lanthanum and antimony ((PVA/Sr-TBC), (PVA/La-TBC) and (PVA/Sb-TBC)), respectively, where TBC is benzene 1,2,4,5-tetracarboxylate adsorbents, were fabricated by electrospinning. The as-prepared electrospun nanofibres were characterized by scanning electron microscope (SEM), Fourier transform infrared (FTIR) and thermogravimetric analysis (TGA). Only plain PVA nanofibres followed the Freundlich isotherm with a correlation coefficient of 0.9814, while novel nanofibres (PVA/Sb-TBC, PVA/Sr-TBC and PVA/La-TBC) followed the Langmuir isotherm with correlation coefficients of 0.9999, 0.9994 and 0.9947, respectively. The sorption process of all nanofibres followed a pseudo second-order kinetic model. Adsorption capacity of novel nanofibres was twofold and more compared to that of plain PVA nanofibres. The thermodynamic studies: apparent enthalpy (ΔH°) and entropy (ΔS°), showed that the adsorption of Pb(II) onto nanofibres was spontaneous and exothermic. The novel nanofibres exhibited higher potential removal of Pb(II) ions than plain PVA nanofibres. Ubiquitous cations adsorption test was also investigated and studied.

  16. Functionalized polymer nanofibre membranes for protection from chemical warfare stimulants

    International Nuclear Information System (INIS)

    Ramaseshan, Ramakrishnan; Sundarrajan, Subramanian; Liu, Yingjun; Barhate, R S; Lala, Neeta L; Ramakrishna, S

    2006-01-01

    A catalyst for the detoxification of nerve agents is synthesized from β-cyclodextrin (β-CD) and o-iodosobenzoic acid (IBA). Functionalized polymer nanofibre membranes from PVC polymer are fabricated with β-CD, IBA, a blend of β-CD+IBA, and the synthesized catalyst. These functionalized nanofibres are then tested for the decontamination of paraoxon, a nerve agent stimulant, and it is observed that the stimulant gets hydrolysed. The kinetics of hydrolysis is investigated using UV spectroscopy. The rates of hydrolysis for different organophosphate hydrolyzing agents are compared. The reactivity and amount of adsorption of these catalysts are of higher capacity than the conventionally used activated charcoal. A new design for protective wear is proposed based on the functionalized nanofibre membrane

  17. Dielectric barrier discharge plasma treatment of cellulose nanofibre surfaces

    DEFF Research Database (Denmark)

    Kusano, Yukihiro; Madsen, Bo; Berglund, Linn

    2017-01-01

    Dielectric barrier discharge plasma treatment was applied to modify cellulose nanofibre (CNF) surfaces with and without ultrasonic irradiation. The plasma treatment improved the wetting by deionised water and glycerol, and increased the contents of oxygen, carbonyl group, and carboxyl group...... and amorphous phases. Ultrasonic irradiation also improved the uniformity of the treatment. Altogether, it is demonstrated that atmospheric pressure plasma treatment is a promising technique to modify the CNF surface before composite processing....... on the nanofibre surface. Ultrasonic irradiation further enhanced the wetting and oxidation of the nanofibre coating. Scanning electron microscopic observations showed skeleton-like features on the plasma-treated surface, indicating preferential etching of weaker domains, such as low-molecular weight domains...

  18. Different Structures of PVA Nanofibrous Membrane for Sound Absorption Application

    Directory of Open Access Journals (Sweden)

    Jana Mohrova

    2012-01-01

    Full Text Available The thin nanofibrous layer has different properties in the field of sound absorption in comparison with porous fibrous material which works on a principle of friction of air particles in contact with walls of pores. In case of the thin nanofibrous layer, which represents a sound absorber here, the energy of sonic waves is absorbed by the principle of membrane resonance. The structure of the membrane can play an important role in the process of converting the sonic energy to a different energy type. The vibration system acts differently depending on the presence of smooth fibers in the structure, amount of partly merged fibers, or structure of polymer foil as extreme. Polyvinyl alcohol (PVA was used as a polymer because of its good water solubility. It is possible to influence the structure of nanofibrous layer during the production process thanks to this property of polyvinyl alcohol.

  19. Effect of Equal Daily Doses Achieved by Different Power Densities of Low-Level Laser Therapy at 635 nm on Open Skin Wound Healing in Normal and Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Róbert Kilík

    2014-01-01

    Full Text Available Background and Objective. Despite the fact that the molecular mechanism of low-level laser therapy (LLLT is not yet known, the exploitation of phototherapy in clinical medicine and surgery is of great interest. The present study investigates the effects of LLLT on open skin wound healing in normal and diabetic rats. Materials and Methods. Four round full-thickness skin wounds on dorsum were performed in male adult nondiabetic (n=24 and diabetic (n=24 Sprague–Dawley rats. AlGaInP (635 nm, wavelength; 5 J/cm2, daily dose was used to deliver power densities of 1, 5, and 15 mW/cm2 three times daily until euthanasia. Results. PMNL infiltration was lower in the irradiated groups (15 mW/cm2. The synthesis and organisation of collagen fibres were consecutively enhanced in the 5 mW/cm2 and 15 mW/cm2 groups compared to the others in nondiabetic rats. In the diabetic group the only significant difference was recorded in the ratio PMNL/Ma at 15 mW/cm2. A significant difference in the number of newly formed capillaries in the irradiated group (5, 15 mW/cm2 was recorded on day six after injury compared to the control group. Conclusion. LLLT confers a protective effect against excessive inflammatory tissue response; it stimulates neovascularization and the early formation of collagen fibres.

  20. Antioxidative study of Cerium Oxide nanoparticle functionalised PCL-Gelatin electrospun fibers for wound healing application

    Directory of Open Access Journals (Sweden)

    Hilal Ahmad Rather

    2018-06-01

    Full Text Available Skin wound healing involves a coordinated cellular response to achieve complete reepithelialisation. Elevated levels of reactive oxygen species (ROS in the wound environment often pose a hindrance in wound healing resulting in impaired wound healing process. Cerium oxide nanoparticles (CeNPs have the ability to protect the cells from oxidative damage by actively scavenging the ROS. Furthermore, matrices like nanofibers have also been explored for enhancing wound healing. In the current study CeNP functionalised polycaprolactone (PCL-gelatin nanofiber (PGNPNF mesh was fabricated by electrospinning and evaluated for its antioxidative potential. Wide angle XRD analysis of randomly oriented nanofibers revealed ∼2.6 times reduced crystallinity than pristine PCL which aided in rapid degradation of nanofibers and release of CeNP. However, bioactive composite made between nanoparticles and PCL-gelatin maintained the fibrous morphology of PGNPNF upto 14 days. The PGNPNF mesh exhibited a superoxide dismutase (SOD mimetic activity due to the incorporated CeNPs. The PGNPNF mesh enhanced proliferation of 3T3-L1 cells by ∼48% as confirmed by alamar blue assay and SEM micrographs of cells grown on the nanofibrous mesh. Furthermore, the PGNPNF mesh scavenged ROS, which was measured by relative DCF intensity and fluorescence microscopy; and subsequently increased the viability and proliferation of cells by three folds as it alleviated the oxidative stress. Overall, the results of this study suggest the potential of CeNP functionalised PCL-gelatin nanofibrous mesh for wound healing applications.

  1. Simultaneous irrigation and negative pressure wound therapy enhances wound healing and reduces wound bioburden in a porcine model.

    Science.gov (United States)

    Davis, Kathryn; Bills, Jessica; Barker, Jenny; Kim, Paul; Lavery, Lawrence

    2013-01-01

    Infected foot wounds are one of the most common reasons for hospitalization and amputation among persons with diabetes. The objective of the study was to investigate a new wound therapy system that employs negative pressure wound therapy (NPWT) with simultaneous irrigation therapy. For this study, we used a porcine model with full-thickness excisional wounds, inoculated with Pseudomonas aeruginosa. Wounds were treated for 21 days of therapy with either NPWT, NPWT with simultaneous irrigation therapy using normal saline or polyhexanide biguanide (PHMB) at low or high flow rates, or control. Data show that NPWT with either irrigation condition improved wound healing rates over control-treated wounds, yet did not differ from NPWT alone. NPWT improved bioburden over control-treated wounds. NPWT with simultaneous irrigation further reduced bioburden over control and NPWT-treated wounds; however, flow rate did not affect these outcomes. Together, these data show that NPWT with simultaneous irrigation therapy with either normal saline or PHMB has a positive effect on bioburden in a porcine model, which may translate clinically to improved wound healing outcomes. © 2013 by the Wound Healing Society.

  2. Psoriasis and wound healing outcomes: A retrospective cohort study examining wound complications and antibiotic use.

    Science.gov (United States)

    Young, Paulina M; Parsi, Kory K; Schupp, Clayton W; Armstrong, April W

    2017-11-15

    Little is known about wound healing in psoriasis. We performed a cohort study examining differences in wound healing complications between patients with and without psoriasis. Psoriasis patients with traumatic wounds were matched 1:3 to non-psoriasis patients with traumatic wounds based on age, gender, and body mass index (BMI). We examined theincidence of wound complications including infection, necrosis, and hematoma as well as incident antibiotic use within three months following diagnosis of a traumatic wound. The study included 164 patients with traumatic wounds, comprised of 41 patients with psoriasis matched to 123 patients without psoriasis. No statistically significant differences were detected in the incidence of overall wound complications between wound patients with psoriasis and wound patients without psoriasis (14.6% versus. 13.0%, HR 1.18, CI 0.39-3.56). After adjustment for diabetes, peripheral vascular disease, and smoking, no statistically significant differences were detected in the incidence of overall wound complications between patients with and without psoriasis (HR 1.11, CI 0.34-3.58). Specifically, the adjusted rates of antibiotic use were not significantly different between those with and without psoriasis (HR 0.65, CI 0.29-1.46). The incidence of wound complications following traumatic wounds of the skin was found to be similar between patients with and without psoriasis.

  3. Haematological changes and wound healing effects of sildenafil ...

    African Journals Online (AJOL)

    ADEYEYE

    2016-12-07

    Dec 7, 2016 ... Haematological changes and wound healing effects of sildenafil citrate in diabetic albino rats ... Group G were normal rats without wound treated with sildenafil citrate as in Group A. Blood samples were taken before (day 0) and after the ..... Detection of erythrocyte influenced by aging and type 2 diabetes.

  4. Nerve growth factor and wound healing.

    Science.gov (United States)

    Kawamoto, Keiko; Matsuda, Hiroshi

    2004-01-01

    The wound healing process following tissue injury consists of a highly regulated sequence of events. Besides many biological activities on both neuronal and nonneuronal cells, nerve growth factor (NGF) has been proposed as an important component of wound healing and tissue repair process in vivo and in vitro. For example, NGF accelerates the rate of wound healing both in normal mice and healing-impaired diabetic mice, and has a potent pharmacological effect in the treatment for ulcer of the skin and cornea in humans. This review summarizes the evidence for the role of NGF in wound healing and tissue repair, and introduces its clinical utility as a therapeutic agent for various diseases.

  5. Complex wounds Feridas complexas

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    2006-01-01

    Full Text Available Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treatment is unavoidable, because the extent of skin and subcutaneous tissue loss requires reconstruction with grafts and flaps. New technologies, such as the negative pressure device, should be introduced. A brief review is provided of the major groups of complex wounds-diabetic wounds, pressure sores, chronic venous ulcers, post-infection soft-tissue gangrenes, and ulcers resulting from vasculitis.Ferida complexa é uma nova definição para identificar aquelas feridas crônicas e algumas agudas já bem conhecidas e que desafiam equipes médicas e de enfermagem. São difíceis de serem resolvidas usando tratamentos convencionais e simples curativos. Têm atualmente grande impacto sócio-econômico. Esta revisão procura atrair atenção da comunidade de profissionais de saúde para estas feridas, sugerindo que devam ser tratadas por equipe multidisciplinar em centro hospitalar especializado. Na maioria dos casos o tratamento cirúrgico deve ser indicado, uma vez que a perda de pele e tecido subcutâneo é extensa, necessitando de reconstrução com enxertos e retalhos. Nova tecnologia, como uso da terapia por pressão negativa foi introduzido. Breves comentários sobre os principais grupos de feridas complexas: pé diabético, úlceras por pressão, úlceras venosas, síndrome de Fournier e vasculites.

  6. Innate defense regulator peptide 1018 in wound healing and wound infection.

    Directory of Open Access Journals (Sweden)

    Lars Steinstraesser

    Full Text Available Innate defense regulators (IDRs are synthetic immunomodulatory versions of natural host defense peptides (HDP. IDRs mediate protection against bacterial challenge in the absence of direct antimicrobial activity, representing a novel approach to anti-infective and anti-inflammatory therapy. Previously, we reported that IDR-1018 selectively induced chemokine responses and suppressed pro-inflammatory responses. As there has been an increasing appreciation for the ability of HDPs to modulate complex immune processes, including wound healing, we characterized the wound healing activities of IDR-1018 in vitro. Further, we investigated the efficacy of IDR-1018 in diabetic and non-diabetic wound healing models. In all experiments, IDR-1018 was compared to the human HDP LL-37 and HDP-derived wound healing peptide HB-107. IDR-1018 was significantly less cytotoxic in vitro as compared to either LL-37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However, no significant differences in bacterial colonization were observed. Our investigation demonstrates that in addition to previously reported immunomodulatory activities IDR-1018 promotes wound healing independent of direct antibacterial activity. Interestingly, these effects were not observed in diabetic wounds. It is anticipated that the wound healing activities of IDR-1018 can be attributed to modulation of host immune pathways that are suppressed in diabetic wounds and provide further evidence of the multiple immunomodulatory activities of IDR-1018.

  7. Scientific production on the applicability of phenytoin in wound healing

    OpenAIRE

    Firmino, Flávia; Almeida, Alessandra Maria Pereira de; Silva, Rita de Jesus Grijó e; Alves, Graziela da Silva; Grandeiro, Daniel da Silva; Penna, Lúcia Helena Garcia

    2014-01-01

    Phenytoin is an anticonvulsant that has been used in wound healing. The objectives of this study were to describe how the scientific production presents the use ofphenytoinas a healing agent and to discuss its applicability in wounds. A literature review and hierarchy analysis of evidence-based practices was performed. Eighteen articles were analyzed that tested the intervention in wounds such as leprosy ulcers, leg ulcers, diabetic foot ulcers, pressure ulcers, trophic ulcers, war wounds, bu...

  8. The Electrical Response to Injury: Molecular Mechanisms and Wound Healing

    Science.gov (United States)

    Reid, Brian; Zhao, Min

    2014-01-01

    Significance: Natural, endogenous electric fields (EFs) and currents arise spontaneously after wounding of many tissues, especially epithelia, and are necessary for normal healing. This wound electrical activity is a long-lasting and regulated response. Enhancing or inhibiting this electrical activity increases or decreases wound healing, respectively. Cells that are responsible for wound closure such as corneal epithelial cells or skin keratinocytes migrate directionally in EFs of physiological magnitude. However, the mechanisms of how the wound electrical response is initiated and regulated remain unclear. Recent Advances: Wound EFs and currents appear to arise by ion channel up-regulation and redistribution, which are perhaps triggered by an intracellular calcium wave or cell depolarization. We discuss the possibility of stimulation of wound healing via pharmacological enhancement of the wound electric signal by stimulation of ion pumping. Critical Issues: Chronic wounds are a major problem in the elderly and diabetic patient. Any strategy to stimulate wound healing in these patients is desirable. Applying electrical stimulation directly is problematic, but pharmacological enhancement of the wound signal may be a promising strategy. Future Directions: Understanding the molecular regulation of wound electric signals may reveal some fundamental mechanisms in wound healing. Manipulating fluxes of ions and electric currents at wounds might offer new approaches to achieve better wound healing and to heal chronic wounds. PMID:24761358

  9. Composite poly-L-lactic acid/poly-(α,β)-DL-aspartic acid/collagen nanofibrous scaffolds for dermal tissue regeneration.

    Science.gov (United States)

    Ravichandran, Rajeswari; Venugopal, Jayarama Reddy; Sundarrajan, Subramanian; Mukherjee, Shayanti; Sridhar, Radhakrishnan; Ramakrishna, Seeram

    2012-08-01

    Tissue engineering scaffolds for skin tissue regeneration is an ever expounding area of research, as the products that meet the necessary requirements are far and elite. The nanofibrous poly-L-lactic acid/poly-(α,β)-DL-aspartic acid/Collagen (PLLA/PAA/Col I&III) scaffolds were fabricated by electrospinning and characterized by SEM, contact angle and FTIR analysis for skin tissue regeneration. The cell-scaffold interactions were analyzed by cell proliferation and their morphology observed in SEM. The results showed that the cell proliferation was significantly increased (p≤0.05) in PLLA/PAA/Col I&III scaffolds compared to PLLA and PLLA/PAA nanofibrous scaffolds. The abundance and accessibility of adipose derived stem cells (ADSCs) may prove to be novel cell therapeutics for dermal tissue regeneration. The differentiation of ADSCs was confirmed using collagen expression and their morphology by CMFDA dye extrusion technique. The current study focuses on the application of PLLA/PAA/Col I&III nanofibrous scaffolds for skin tissue engineering and their potential use as substrate for the culture and differentiation of ADSCs. The objective for inclusion of a novel cell binding moiety like PAA was to replace damaged extracellular matrix and to guide new cells directly into the wound bed with enhanced proliferation and overall organization. This combinatorial epitome of PLLA/PAA/Col I&III nanofibrous scaffold with stem cell therapy to induce the necessary paracrine signalling effect would favour faster regeneration of the damaged skin tissues. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Testing photobiomodulatory effects of laser irradiation on wound healing: development of an improved model for dressing wounds in mice.

    Science.gov (United States)

    Chung, Tzu-Yun; Peplow, Philip V; Baxter, G David

    2010-10-01

    To develop a suitable method for dressing skin wounds in BKS.Cg-m(+)/(+)Lepr(db) mice for subsequent use in laser irradiation of wounds. The healing of nonirradiated wounds (controls) was examined histologically to provide essential reference data. Dressing excisional skin wounds in mice has many advantages. However, previous studies using dressings such as Tegaderm W or OpSite, with or without adhesives, have shown that this is not easily achieved. In a pilot study, a full-thickness wound was made on the left flank in six diabetic and six nondiabetic mice, and five different methods were tried for dressing the wounds with Tegaderm HP to develop an optimized procedure. The optimized procedure was used in subsequent studies, with a total of 23 diabetic and 13 nondiabetic mice being controls for laser-irradiated mice. Measurements of healing outcomes from histologic sections of controls were statistically analyzed. The optimized procedure used Tegaderm HP with Cavilon and Fixomull Stretch strips for the first dressing, and with Mastisol for subsequent dressings. Wound closure by contraction was retarded in a large proportion of diabetic mice (approximately 80%) and a small proportion of nondiabetic mice. These wounds, described as "splinted," healed mainly by epithelial regeneration and granulation tissue formation. A simple, easy-to-perform procedure was developed for dressing wounds in diabetic and nondiabetic mice. It was found to cause splinting with wound healing mimicking that in human patients. This model is suitable for examining the effects of different therapies on wound healing, including lasers.

  11. Management of gunshot wounds

    Energy Technology Data Exchange (ETDEWEB)

    Ordog, G.; Drew, R.

    1987-01-01

    Management of Gunshot Wounds provides a review of wound ballistics and a systemic review of gunshot wound management of all major body areas and systems. This volume includes information on pre-hospital care, nursing care, and care of infants, children, and the elderly patient with gunshot wounds. This volume also features information on: lead toxicity; complications of gunshot wounds; socioeconomic aspects of gunshot wounds; the forensic and pathological aspects of gunshot wounds; future directions in the care of gunshot wounds.

  12. Bicomponent AgCl/PVP nanofibre fabricated by electrospinning with ...

    Indian Academy of Sciences (India)

    Administrator

    AgCl nanoparticles in the PVP solution, and then the solutions were electrospun to obtain AgCl/PVP composite nanofibres. The final products were thoroughly characterized by X-ray powder diffraction (XRD), transmission electron microscopy (TEM), and field-emission scanning electron microscopy (FESEM), which showed ...

  13. Initial testing of electrospun nanofibre filters in water filtration ...

    African Journals Online (AJOL)

    2009-11-17

    Nov 17, 2009 ... techniques for the production of flat-sheet membranes and the application of these membranes in water filtration. ... be used for water filtration applications, but that further improvements are necessary before these membranes can be practically .... nanofibres so that the pore size increases and bacteria leak.

  14. Effect of carbon nanofibre addition on the mechanical properties of ...

    Indian Academy of Sciences (India)

    Abstract. Carbon-epoxy (C-epoxy) laminated composites having different fibre volume fractions (40, 50, 60 and. 70) were fabricated with and without the addition of aminofunctionalized carbon nanofibres (A-CNF). Flexural strength, interlaminar shear strength (ILSS) and tensile strength of the composite laminates were ...

  15. Synthesis of nano-carbon (nanotubes, nanofibres, graphene ...

    Indian Academy of Sciences (India)

    Administrator

    Carbon nanotube; graphitic nanofibres; graphene; CNTs–polymer composite; polyacrylamide. 1. Introduction. In the emerging field of nanomaterials, carbon nanostruc- tures have potential ... trial application, an important issue in the production is the cost, quality, and .... have bamboo-shaped structures. The TEM image ( ...

  16. Electrospun chitosan/baker's yeast nanofibre adsorbent: preparation ...

    Indian Academy of Sciences (India)

    The prepared adsorbent was characterized by Brunauer–Emmett–Teller (BET), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analyses. The influences of experimental parameters on the chitosan/baker's yeast nanofibre such as contact time, pH, temperature and initial concentration were studied ...

  17. Construction of CaF2-appended PVA nanofibre scaffold

    Indian Academy of Sciences (India)

    2018-02-02

    Feb 2, 2018 ... Construction of CaF2-appended PVA nanofibre scaffold. JIA XU1,2,3,∗. , JIANFENG MA1,3,4, YAN HE5, CHUNHONG LIU2 and QINGSONG YE3,5. 1College of Medicine and Dentistry, James Cook University, Cairns 4878, Australia. 2Key Laboratory of Applied Chemistry and Nanotechnology at ...

  18. Fabrication of ultra thin and aligned carbon nanofibres from ...

    Indian Academy of Sciences (India)

    Administrator

    fibres below 1 μm readily (Reneker and Chun 1996;. Reneker et al 2000; Deitzel et al 2001; Huang et al 2003). In recent years, electrospinning has received great interest due to its simplicity and versatility for fabricating ultrathin and continuous nanofibres. In electrospinning a polymer solution or melt is kept in a reservoir ...

  19. Mechanical performance of laminated composites incorporated with nanofibrous membranes

    International Nuclear Information System (INIS)

    Liu, L.; Huang, Z.-M.; He, C.L.; Han, X.J.

    2006-01-01

    The effect of non-woven nanofibrous membranes as interlaminar interfaces on the mechanical performance of laminated composites was investigated experimentally. The nanofibrous membranes are porous, thin and lightweight, and exhibit toughness and strength to some extent. They give little increase in weight and thickness when incorporated into a laminate. More important, they can be used as a functional agent carrier for the laminate. The nanofiber membranes used in this paper were prepared by electrospinning of Nylon-6 (PA6), Epoxy 609 (EPO 1691-410) and thermoplastic polyurethane (TPU), with a thickness ranging from 20 to 150 μm. The non-woven fabrics were attached to one side of a glass/epoxy fabric lamina prior to lamination and each fabric was arranged in between two adjacent plies of the laminate. The nanofibrous membranes were characterized through scanning electron microscopy (SEM) and tensile testing, whereas the mechanical properties of the laminate were understood in terms of three-point bending and short-beam shear tests. Results have shown that the nanofibrous membranes in the ply interfaces with a proper thickness did not affect the mechanical performance of the composite laminates significantly

  20. Initial testing of electrospun nanofibre filters in water filtration ...

    African Journals Online (AJOL)

    The aim of this study was to evaluate the use of nanofibre microfiltration membranes, spun by an innovative electrospinning technique, in water filtration applications. As such, this study bridges the gap between developments in electrospinning techniques for the production of flat-sheet membranes and the application of ...

  1. SU-8 photoresist-derived electrospun carbon nanofibres as high ...

    Indian Academy of Sciences (India)

    2017-06-09

    Jun 9, 2017 ... Carbon nanofibres (CNF), due to their advantages like large surface area and thus enhanced interface of electrolyte and active material surface, short Li ion transport distances and high resilience to volume expansion during cycling even at high current densities, have drawn a great attention for being used ...

  2. Partially nanofibrous architecture of 3D tissue engineering scaffolds.

    Science.gov (United States)

    Wei, Guobao; Ma, Peter X

    2009-11-01

    An ideal tissue-engineering scaffold should provide suitable pores and appropriate pore surface to induce desired cellular activities and to guide 3D tissue regeneration. In the present work, we have developed macroporous polymer scaffolds with varying pore wall architectures from smooth (solid), microporous, partially nanofibrous, to entirely nanofibrous ones. All scaffolds are designed to have well-controlled interconnected macropores, resulting from leaching sugar sphere template. We examine the effects of material composition, solvent, and phase separation temperature on the pore surface architecture of 3D scaffolds. In particular, phase separation of PLLA/PDLLA or PLLA/PLGA blends leads to partially nanofibrous scaffolds, in which PLLA forms nanofibers and PDLLA or PLGA forms the smooth (solid) surfaces on macropore walls, respectively. Specific surface areas are measured for scaffolds with similar macroporosity but different macropore wall architectures. It is found that the pore wall architecture predominates the total surface area of the scaffolds. The surface area of a partially nanofibrous scaffold increases linearly with the PLLA content in the polymer blend. The amounts of adsorbed proteins from serum increase with the surface area of the scaffolds. These macroporous scaffolds with adjustable pore wall surface architectures may provide a platform for investigating the cellular responses to pore surface architecture, and provide us with a powerful tool to develop superior scaffolds for various tissue-engineering applications.

  3. Electrospun chitosan/baker's yeast nanofibre adsorbent: preparation ...

    Indian Academy of Sciences (India)

    Abstract. In this study, chitosan/baker's yeast nanofibre was synthesized by electrospinning method and sub- sequently ... The maximum adsorption capacities of U(VI) and Th(IV) were estimated by Langmuir model to be 219 and. 131.9 mg g−1 at ..... Kinetic data of process are needed to design adsorption units. Metal ions ...

  4. Aligned and random nanofibrous nanocomposite scaffolds for bone tissue engineering

    Directory of Open Access Journals (Sweden)

    Amir Doustgani

    2013-01-01

    Full Text Available Abstract  Aligned and random nanocomposite nanofibrous scaffolds were electrospun from polycaprolactone (PCL, poly (vinyl alcohol (PVA and hydroxyapatite nanoparticles (nHA. The morphology and mechanical characteristics of the nanofibers were evaluated using scanning electron microscopy and tensile testing, respectively. Scanning electron microscopy revealed fibers with an average diameter of 123 ± 32 nm and 339 ± 107 nm for aligned and random nanofibers, respectively. The mechanical data indicated the higher tensile strength and elastic modulus of aligned nanofibers. The in vitro biocompatibility of aligned and random nanofibrous scaffolds was also assessed by growing mesenchymal stem cells (MSCs, and investigating the proliferation and alkaline phosphatase activity (ALP on different nanofibrous scaffolds. Our  findings  showed  that  the  alignment  orientation  of  nanofibers  enhanced  the osteogenic differentiation of stem cells. The in vitro results showed that the aligned biocomposite nanofibrous scaffolds of PCL/nHA/PVA could be a potential substrate for tissue engineering applications, especially in the field of artificial bone implant.

  5. Fabrication of three-dimensional nanofibrous macrostructures by electrospinning

    Directory of Open Access Journals (Sweden)

    Ping Zhu

    2016-05-01

    Full Text Available Electrospinning has been widely used in fabricating nanofibers and nanofibrous membranes. Recently, the fabrication of three-dimensional (3D nanofibrous macrostructures has become a hot subject in the development of electrospinning technology. In this paper, the 3D nanofibrous macrostructure was constructed by using electrospinning apparatus with both dynamic and static 3D collecting templates. The effect of the governing parameters on the formation process of 3D macrostructure is studied, such as the applied voltage, the flow rate, the needle-tip-to-collector distance, and the rotating speed. It was found that laying the collecting device either in parallel or perpendicularly with some gap in between, would lead to orderly deposition of nanofibers. In this study, a “dumbbell” dynamic collector was used to fabricate special 3D macrostructures consisting of multilayers of fibrous membranes. By adjusting the rotating speed of the collector, the formation process of multilayer 3D macrostructure can be controlled. An umbrella-shaped static structure collector was used to fabricate 3D framework structures. It is feasible to fabricate various 3D nanofibrous structures via electrospinning with 3D collecting templates, which has great potential in tissue engineering.

  6. SU-8 photoresist-derived electrospun carbon nanofibres as high ...

    Indian Academy of Sciences (India)

    ... Refresher Courses · Symposia · Live Streaming. Home; Journals; Bulletin of Materials Science; Volume 40; Issue 3. SU-8 photoresist-derived electrospun carbon nanofibres as high-capacity anode material for lithium ion battery. M KAKUNURI S KAUSHIK A SAINI C S SHARMA. Volume 40 Issue 3 June 2017 pp 435-439 ...

  7. Fabrication of nanofibrous scaffolds for tissue engineering applications

    NARCIS (Netherlands)

    Chen, H.; Truckenmüller, R.K.; van Blitterswijk, Clemens; Moroni, Lorenzo; Gaharwar, A.K.; Sant, S.; Hancock, M.J.; Hacking, A.A.

    2013-01-01

    Nanofibrous scaffolds which mimic the structural features of a natural extracellular matrix (ECM) can be appealing scaffold candidates for tissue engineering as they provide similar physical cues to the native environment of the targeted tissue to regenerate. This chapter discusses different

  8. Comparative Assessment of Tedizolid Pharmacokinetics and Tissue Penetration between Diabetic Patients with Wound Infections and Healthy Volunteers via In Vivo Microdialysis.

    Science.gov (United States)

    Stainton, Sean M; Monogue, Marguerite L; Baummer-Carr, Arlinda; Shepard, Ashley K; Nugent, James F; Kuti, Joseph L; Nicolau, David P

    2018-01-01

    Herein, we present pharmacokinetic and tissue penetration data for oral tedizolid in hospitalized patients with diabetic foot infections (DFI) compared with healthy volunteers. Participants received oral tedizolid phosphate 200 mg every 24 h for 3 doses to achieve steady state. A microdialysis catheter was inserted into the subcutaneous tissue near the margin of the wound for patients or into thigh tissue of volunteers. Following the third dose, 12 blood and 14 dialysate fluid samples were collected over 24 h to characterize tedizolid concentrations in plasma and interstitial extracellular fluid of soft tissue. Mean ± standard deviation (SD) tedizolid pharmacokinetic parameters in plasma for patients compared with volunteers, respectively, were as follows: maximum concentration ( C max ), 1.5 ± 0.5 versus 2.7 ± 1.1 mg/liter ( P = 0.005); time to C max ( T max ) (median [range]), 5.9 (1.2 to 8.0) versus 2.5 (2.0 to 3.0 h) ( P = 0.003); half-life (t 1/2 ), 9.1 ± 3.6 versus 8.9 ± 2.2 h ( P = 0.932); and plasma area under the concentration-time curve for the dosing interval (AUC p ), 18.5 ± 9.7 versus 28.7 ± 9.6 mg · h/liter ( P = 0.004). The tissue area under the concentration-time curve (AUC t ) for the dosing interval was 3.4 ± 1.5 versus 5.2 ± 1.6 mg · h/liter ( P = 0.075). Tissue penetration median (range) was 1.1 (0.3 to 1.6) versus 0.8 (0.7 to 1.0) ( P = 0.351). Despite lower plasma C max and delayed T max values for patients with DFI relative to healthy volunteers, the penetration into and exposure to tissue were similar. Based on available pharmacodynamic thresholds for tedizolid, the plasma and tissue exposures using the oral 200 mg once-daily regimen are suitable for further study in treatment of DFI. Copyright © 2017 American Society for Microbiology.

  9. Wound emergencies: the importance of assessment, documentation, and early treatment using a wound electronic medical record.

    Science.gov (United States)

    Golinko, Michael S; Clark, Sunday; Rennert, Robert; Flattau, Anna; Boulton, Andrew J M; Brem, Harold

    2009-05-01

    Chronic wounds such as diabetic foot ulcers, venous ulcers, and pressure ulcers are a major source of morbidity and mortality. To describe wound characteristics associated with a wound emergency, the Wound Electronic Medical Records (WEMR) of 200 consecutive admissions (139 patients, average number of admissions 1.4) to a dedicated inpatient wound healing unit over a period of 5 months were retrospectively reviewed. Patient mean age was 62 +/- 16 years, 59% were men, 27% had a foot ulcer and diabetes mellitus, and 29% had venous ulcers. Presenting signs and symptoms included wound pain, cellulitis, nonpurulent drainage, and undermining, but few presented with classic local clinical signs of infection. Treatment consisted of sharp debridement with deep tissue culture and pathology from the wound base and/or systemic antibiotics. Twenty-percent (20%) of patients had pathology-confirmed and 38% had pathology- or radiology-confirmed osteomyelitis on admission, supporting that new or increasing wound pain, cellulitis, and/or nonpurulent drainage or presence of significant undermining may be indicative of an invasive infection and that patients presenting with these signs and symptoms require an immediate treatment plan and consideration of hospital admission. Use of an objective documentation system such as the WEMR may help alert clinicians to subtle wound changes that require aggressive treatment; thereby, avoiding emergency room visits and hospital admissions. Future research is needed utilizing the WEMR across multiple medical centers to further define criteria for a chronic wound emergency.

  10. Comparative Analysis of Angiogenic Gene Expression in Normal and Impaired Wound Healing in Diabetic Mice: Effects of Extracorporeal Shock Wave Therapy

    Science.gov (United States)

    2010-01-01

    accelerating wound healing in difficult-to-heal/chronic pressure, dia- betic and venous ulcers [25, 28, 30]. In a clinical feasibility study we...of the TGF alpha gene have abnormal skin architecture, wavy hair, and curly whiskers and often develop corneal inflammation. Cell 73(2):249-261 41...pressure ulcers contain ~Springer Angiogenesis (2010) 13:293-304 elevated matrix metalloproteinase levels and activity compared to surgical wound

  11. The Effect of Poly (Glycerol Sebacate Incorporation within Hybrid Chitin–Lignin Sol–Gel Nanofibrous Scaffolds

    Directory of Open Access Journals (Sweden)

    Tuerdimaimaiti Abudula

    2018-03-01

    Full Text Available Chitin and lignin primarily accumulate as bio-waste resulting from byproducts of crustacean crusts and plant biomass. Recently, their use has been proposed for diverse and unique bioengineering applications, amongst others. However, their weak mechanical properties need to be improved in order to facilitate their industrial utilization. In this paper, we fabricated hybrid fibers composed of a chitin–lignin (CL-based sol–gel mixture and elastomeric poly (glycerol sebacate (PGS using a standard electrospinning approach. Obtained results showed that PGS could be coherently blended with the sol–gel mixture to form a nanofibrous scaffold exhibiting remarkable mechanical performance and improved antibacterial and antifungal activity. The developed hybrid fibers showed promising potential in advanced biomedical applications such as wound care products. Ultimately, recycling these sustainable biopolymers and other bio-wastes alike could propel a “greener” economy.

  12. The Effect of Poly (Glycerol Sebacate) Incorporation within Hybrid Chitin-Lignin Sol-Gel Nanofibrous Scaffolds.

    Science.gov (United States)

    Abudula, Tuerdimaimaiti; Gzara, Lassaad; Simonetti, Giovanna; Alshahrie, Ahmed; Salah, Numan; Morganti, Pierfrancesco; Chianese, Angelo; Fallahi, Afsoon; Tamayol, Ali; Bencherif, Sidi A; Memic, Adnan

    2018-03-19

    Chitin and lignin primarily accumulate as bio-waste resulting from byproducts of crustacean crusts and plant biomass. Recently, their use has been proposed for diverse and unique bioengineering applications, amongst others. However, their weak mechanical properties need to be improved in order to facilitate their industrial utilization. In this paper, we fabricated hybrid fibers composed of a chitin-lignin (CL)-based sol-gel mixture and elastomeric poly (glycerol sebacate) (PGS) using a standard electrospinning approach. Obtained results showed that PGS could be coherently blended with the sol-gel mixture to form a nanofibrous scaffold exhibiting remarkable mechanical performance and improved antibacterial and antifungal activity. The developed hybrid fibers showed promising potential in advanced biomedical applications such as wound care products. Ultimately, recycling these sustainable biopolymers and other bio-wastes alike could propel a "greener" economy.

  13. The beneficial effects of probiotic administration on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Mohseni, Sima; Bayani, Masomeh; Bahmani, Fereshteh; Tajabadi-Ebrahimi, Maryam; Bayani, Mohammad Ali; Jafari, Parvaneh; Asemi, Zatollah

    2018-03-01

    This study was conducted to evaluate the effects of probiotic supplementation on wound healing and metabolic status in subjects with diabetic foot ulcer (DFU). This randomized, double-blind, placebo-controlled trial was conducted among 60 subjects (aged 40-85 years old) with grade 3 diabetic foot ulcer. Individuals were randomly divided into 2 groups (30 subjects each group) to receive either probiotic or placebo daily for 12 weeks. After the 12-week intervention, compared with the placebo, probiotic supplementation led to significant reductions in ulcer length (-1.3 ± 0.9 vs. -0.8 ± 0.7 cm, P = .01), width (-1.1 ± 0.7 vs. -0.7 ± 0.7 cm, P = .02), and depth (-0.5 ± 0.3 vs. -0.3 ± 0.3 cm, P = .02). Furthermore, significant reductions in fasting plasma glucose (-29.6 ± 30.3 vs. -5.8 ± 39.8 mg/dL, P = .01), serum insulin concentrations (-4.3 ± 7.9 vs. +0.4 ± 8.5 μIU/mL, P = .03), and haemoglobin A1c (-0.6 ± 0.5 vs. -0.2 ± 0.4%, P = .003) and a significant rise in the quantitative insulin sensitivity check index (+0.01 ± 0.01 vs. -0.01 ± 0.02, P = .003) were seen following supplementation of probiotic compared with the placebo. Additionally, compared with the placebo, probiotic supplementation resulted in significant decreases in serum total cholesterol (-4.8 ± 16.1 vs. +7.0 ± 27.1 mg/dL, P = .04), high-sensitivity C-reactive protein (-9.0 ± 14.7 vs. -1.7 ± 8.6 mg/L, P = .02), plasma malondialdehyde (-0.8 ± 0.8 vs. -0.2 ± 0.8 μmol/L, P = .001), and significant increases in plasma nitric oxide (+6.2 ± 8.2 vs. +0.8 ± 8.0 μmol/L, P = .01) and total antioxidant capacity concentrations (+179.3 ± 97.2 vs. -85.1 ± 203.4 mmol/L, P foot ulcer had beneficial effects on ulcer size, glycaemic control, total cholesterol, high-sensitivity C-reactive protein, plasma nitric oxide, total antioxidant capacity, and malondialdehyde levels. Copyright © 2017 John Wiley & Sons, Ltd.

  14. The comparative efficacy of angiosome-directed and indirect revascularisation strategies to aid healing of chronic foot wounds in patients with co-morbid diabetes mellitus and critical limb ischaemia: a literature review.

    Science.gov (United States)

    Khor, Benedictine Y C; Price, Pamela

    2017-01-01

    Ischaemic ulcerations have been reported to persist and/or deteriorate despite technically successful revascularisations; a higher incidence of which affects patients with diabetes and critical limb ischaemia. In the context of wound healing, it is unclear if applications of the angiosome concept in 'direct revascularisation' (DR) would be able to aid the healing of chronic foot ulcerations better than the current 'best vessel' or 'indirect revascularisation' (IR) strategy in patients with co-morbid diabetes and critical limb ischaemia. A literature search was conducted in eight electronic databases, namely AMED, CINAHL, The Cochrane Library, ProQuest Health & Medicine Complete, ProQuest Nursing & Allied Health Source, PubMed, ScienceDirect and TRIP database. Articles were initially screened against a pre-established inclusion and exclusion criteria to determine eligibility and subsequently appraised using the Newcastle-Ottawa Scale. Five retrospective studies of varying methodological quality were eligible for inclusion in this review. Critical analysis of an aggregated population ( n  = 280) from methodologically stronger studies indicates better wound healing outcomes in subjects who had undergone DR as compared to IR ( p  critical limb ischaemia is warranted.

  15. Hyperbaric oxygen and wound healing

    Directory of Open Access Journals (Sweden)

    Sourabh Bhutani

    2012-01-01

    Full Text Available Hyperbaric oxygen therapy (HBOT is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier′s gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon.

  16. Development of Electrospun Chitosan-Polyethylene Oxide/Fibrinogen Biocomposite for Potential Wound Healing Applications.

    Science.gov (United States)

    Yuan, Tony T; DiGeorge Foushee, Ann Marie; Johnson, Monica C; Jockheck-Clark, Angela R; Stahl, Jonathan M

    2018-04-02

    Normal wound healing is a highly complex process that requires the interplay of various growth factors and cell types. Despite advancements in biomaterials, only a few bioactive wound dressings reach the clinical setting. The purpose of this research was to explore the feasibility of electrospinning a novel nanofibrous chitosan (CS)-fibrinogen (Fb) scaffold capable of sustained release of platelet-derived growth factor (PDGF) for the promotion of fibroblast migration and wound healing. CS-Fb scaffolds were successfully electrospun using a dual-spinneret electrospinner and directly evaluated for their physical, chemical, and biological characteristics. CS-polyethylene/Fb scaffolds exhibited thinner fiber diameters than nanofibers electrospun from the individual components while demonstrating adequate mechanical properties and homogeneous polymer distribution. In addition, the scaffold demonstrated acceptable water transfer rates for wound healing applications. PDGF was successfully incorporated in the scaffold and maintained functional activity throughout the electrospinning process. Furthermore, released PDGF was effective at promoting fibroblast migration equivalent to a single 50 ng/mL dose of PDGF. The current study demonstrates that PDGF-loaded CS-Fb nanofibrous scaffolds possess characteristics that would be highly beneficial as novel bioactive dressings for enhancement of wound healing.

  17. Pengalaman Pasien Luka Kaki Diabetik dalam Menjalani Perawatan Luka dengan Metode Moisture Balance di Asri Wound Care Center Medan

    OpenAIRE

    Yosefine, Anita Carolina

    2016-01-01

    Moisture balance is a new method in wound treatment which prioritizes moisture-based treatment. It is important to be applied in diabetic foot treatment in order to accelerate the process of wound healing. The research used phenomenological design which was aimed to explore the experience of diabetic foot wound patients in wound treatment with moisture balance method. The samples were ten respondents, taken by using purposive sampling technique. The research was conducted in Asri Wound Care C...

  18. Surface Modification of Electrospun PVDF/PAN Nanofibrous Layers by Low Vacuum Plasma Treatment

    Directory of Open Access Journals (Sweden)

    Fatma Yalcinkaya

    2016-01-01

    Full Text Available Nanofibres are very promising for water remediation due to their high porosity and small pore size. Mechanical properties of nanofibres restrict the application of pressure needed water treatments. Various PAN, PVDF, and PVDF/PAN nanofibre layers were produced, and mechanical properties were improved via a lamination process. Low vacuum plasma treatment was applied for the surface modification of nanofibres. Atmospheric air was used to improve hydrophilicity while sulphur hexafluoride gas was used to improve hydrophobicity of membranes. Hydrophilic membranes showed higher affinity to attach plasma particles compared to hydrophobic membranes.

  19. Biologically improved nanofibrous scaffolds for cardiac tissue engineering

    Energy Technology Data Exchange (ETDEWEB)

    Bhaarathy, V. [Centre for Nanofibers and Nanotechnology, NUSNNI, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Department of Nanoscience and Technology, School of Physical Sciences, Bharathiar University, Coimbatore 641046 (India); Lee Kong Chian School of Medicine, Nanyang Technological University, 138673 (Singapore); Venugopal, J., E-mail: nnijrv@nus.edu.sg [Centre for Nanofibers and Nanotechnology, NUSNNI, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Gandhimathi, C. [Centre for Nanofibers and Nanotechnology, NUSNNI, Faculty of Engineering, National University of Singapore, 117576 (Singapore); Ponpandian, N.; Mangalaraj, D. [Department of Nanoscience and Technology, School of Physical Sciences, Bharathiar University, Coimbatore 641046 (India); Ramakrishna, S. [Centre for Nanofibers and Nanotechnology, NUSNNI, Faculty of Engineering, National University of Singapore, 117576 (Singapore)

    2014-11-01

    Nanofibrous structure developed by electrospinning technology provides attractive extracellular matrix conditions for the anchorage, migration and differentiation of stem cells, including those responsible for regenerative medicine. Recently, biocomposite nanofibers consisting of two or more polymeric blends are electrospun more tidily in order to obtain scaffolds with desired functional and mechanical properties depending on their applications. The study focuses on one such an attempt of using copolymer Poly(L-lactic acid)-co-poly (ε-caprolactone) (PLACL), silk fibroin (SF) and Aloe Vera (AV) for fabricating biocomposite nanofibrous scaffolds for cardiac tissue engineering. SEM micrographs of fabricated electrospun PLACL, PLACL/SF and PLACL/SF/AV nanofibrous scaffolds are porous, beadless, uniform nanofibers with interconnected pores and obtained fibre diameter in the range of 459 ± 22 nm, 202 ± 12 nm and 188 ± 16 nm respectively. PLACL, PLACL/SF and PLACL/SF/AV electrospun mats obtained at room temperature with an elastic modulus of 14.1 ± 0.7, 9.96 ± 2.5 and 7.0 ± 0.9 MPa respectively. PLACL/SF/AV nanofibers have more desirable properties to act as flexible cell supporting scaffolds compared to PLACL for the repair of myocardial infarction (MI). The PLACL/SF and PLACL/SF/AV nanofibers had a contact angle of 51 ± 12° compared to that of 133 ± 15° of PLACL alone. Cardiac cell proliferation was increased by 21% in PLACL/SF/AV nanofibers compared to PLACL by day 6 and further increased to 42% by day 9. Confocal analysis for cardiac expression proteins myosin and connexin 43 was observed better by day 9 compared to all other nanofibrous scaffolds. The results proved that the fabricated PLACL/SF/AV nanofibrous scaffolds have good potentiality for the regeneration of infarcted myocardium in cardiac tissue engineering. - Highlights: • Fabricated nanofibrous scaffolds are porous, beadless and uniform structures. • PLACL/SF/AV nanofibers improve the

  20. Biologically improved nanofibrous scaffolds for cardiac tissue engineering

    International Nuclear Information System (INIS)

    Bhaarathy, V.; Venugopal, J.; Gandhimathi, C.; Ponpandian, N.; Mangalaraj, D.; Ramakrishna, S.

    2014-01-01

    Nanofibrous structure developed by electrospinning technology provides attractive extracellular matrix conditions for the anchorage, migration and differentiation of stem cells, including those responsible for regenerative medicine. Recently, biocomposite nanofibers consisting of two or more polymeric blends are electrospun more tidily in order to obtain scaffolds with desired functional and mechanical properties depending on their applications. The study focuses on one such an attempt of using copolymer Poly(L-lactic acid)-co-poly (ε-caprolactone) (PLACL), silk fibroin (SF) and Aloe Vera (AV) for fabricating biocomposite nanofibrous scaffolds for cardiac tissue engineering. SEM micrographs of fabricated electrospun PLACL, PLACL/SF and PLACL/SF/AV nanofibrous scaffolds are porous, beadless, uniform nanofibers with interconnected pores and obtained fibre diameter in the range of 459 ± 22 nm, 202 ± 12 nm and 188 ± 16 nm respectively. PLACL, PLACL/SF and PLACL/SF/AV electrospun mats obtained at room temperature with an elastic modulus of 14.1 ± 0.7, 9.96 ± 2.5 and 7.0 ± 0.9 MPa respectively. PLACL/SF/AV nanofibers have more desirable properties to act as flexible cell supporting scaffolds compared to PLACL for the repair of myocardial infarction (MI). The PLACL/SF and PLACL/SF/AV nanofibers had a contact angle of 51 ± 12° compared to that of 133 ± 15° of PLACL alone. Cardiac cell proliferation was increased by 21% in PLACL/SF/AV nanofibers compared to PLACL by day 6 and further increased to 42% by day 9. Confocal analysis for cardiac expression proteins myosin and connexin 43 was observed better by day 9 compared to all other nanofibrous scaffolds. The results proved that the fabricated PLACL/SF/AV nanofibrous scaffolds have good potentiality for the regeneration of infarcted myocardium in cardiac tissue engineering. - Highlights: • Fabricated nanofibrous scaffolds are porous, beadless and uniform structures. • PLACL/SF/AV nanofibers improve the

  1. Perineal wound complications after abdominoperineal resection.

    Science.gov (United States)

    Wiatrek, Rebecca L; Thomas, J Scott; Papaconstantinou, Harry T

    2008-02-01

    Perineal wound complications following abdominoperineal resection (APR) is a common occurrence. Risk factors such as operative technique, preoperative radiation therapy, and indication for surgery (i.e., rectal cancer, anal cancer, or inflammatory bowel disease [IBD]) are strong predictors of these complications. Patient risk factors include diabetes, obesity, and smoking. Intraoperative perineal wound management has evolved from open wound packing to primary closure with closed suctioned transabdominal pelvic drains. Wide excision is used to gain local control in cancer patients, and coupled with the increased use of pelvic radiation therapy, we have experienced increased challenges with primary closure of the perineal wound. Tissue transfer techniques such as omental pedicle flaps, and vertical rectus abdominis and gracilis muscle or myocutaneous flaps are being used to reconstruct large perineal defects and decrease the incidence of perineal wound complications. Wound failure is frequently managed by wet to dry dressing changes, but can result in prolonged hospital stay, hospital readmission, home nursing wound care needs, and the expenditure of significant medical costs. Adjuvant therapies to conservative wound care have been suggested, but evidence is still lacking. The use of the vacuum-assisted closure device has shown promise in chronic soft tissue wounds; however, experience is lacking, and is likely due to the difficulty in application techniques.

  2. PDGF-metronidazole-encapsulated nanofibrous functional layers on collagen membrane promote alveolar ridge regeneration

    Directory of Open Access Journals (Sweden)

    Ho MH

    2017-08-01

    Full Text Available Ming-Hua Ho,1 Hao-Chieh Chang,2,3 Yu-Chia Chang,3 Jeiannete Claudia,1 Tzu-Chiao Lin,2 Po-Chun Chang2,3 1Department of Chemical Engineering, College of Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan; 2Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; 3Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan Abstract: This study aimed to develop a functionally graded membrane (FGM to prevent infection and promote tissue regeneration. Poly(L-lactide-co-D,L-lactide encapsulating platelet-derived growth factor (PDLLA-PDGF or metronidazole (PDLLA-MTZ was electrospun to form a nanofibrous layer on the inner or outer surface of a clinically available collagen membrane, respectively. The membrane was characterized for the morphology, molecule release profile, in vitro and in vivo biocompatibility, and preclinical efficiency for alveolar ridge regeneration. The PDLLA-MTZ and PDLLA-PDGF nanofibers were 800–900 nm in diameter, and the thicknesses of the functional layers were 20–30 µm, with sustained molecule release over 28 days. All of the membranes tested were compatible with cell survival in vitro and showed good tissue integration with minimal fibrous capsule formation or inflammation. Cell proliferation was especially prominent on the PDLLA-PDGF layer in vivo. On the alveolar ridge, all FGMs reduced wound dehiscence compared with the control collagen membrane, and the FGM with PDLLA-PDGF promoted osteogenesis significantly. In conclusion, the FGMs with PDLLA-PDGF and PDLLA-MTZ showed high biocompatibility and facilitated wound healing compared with conventional membrane, and the FGM with PDLLA-PDGF enhanced alveolar ridge regeneration in vivo. The design represents a beneficial modification, which may be easily adapted for future clinical use. Keywords: tissue engineering, platelet-derived growth factor, metronidazole, alveolar process

  3. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-11-01

    Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.

  4. Carbon Nanofibrous Materials from Electrospinning: Preparation and Energy Applications

    Science.gov (United States)

    Aboagye, Alex

    Carbon nanofibers with diameters that fall into submicron and nanometer range have attracted growing attention in recent years due to their superior chemical, electrical, and mechanical properties in combination with their unique one-dimensional nanostructures. Unlike catalytic synthesis, electrospinning polyacrylonitrile (PAN) followed by stabilization and carbonization has become a straightforward and convenient route to make continuous carbon nanofibers. The overall objective of this research was the design and production fiber based carbon nanomaterials, investigation of their structures and use in functional applications. Specifically, these carbon nanofibrous materials were employed as electrode material for energy storage and conversion devices such as dye sensitized solar cells and supercapacitors Morphology and structure of the carbon nanofibrous materials were investigated and their performance in corresponding applications were evaluated.

  5. A carbon nanofibre scanning probe assembled using an electrothermal microgripper

    International Nuclear Information System (INIS)

    Carlson, K; Andersen, K N; Eichorn, V; Petersen, D H; Moelhave, K; Bu, I Y Y; Teo, K B K; Milne, W I; Fatikow, S; Boeggild, P

    2007-01-01

    Functional devices can be directly assembled using microgrippers with an in situ electron microscope. Two simple and compact silicon microgripper designs are investigated here. These are operated by electrothermal actuation, and are used to transfer a catalytically grown multi-walled carbon nanofibre from a fixed position on a substrate to the tip of an atomic force microscope cantilever, inside a scanning electron microscope. Scanning of high aspect ratio trenches using the nanofibre supertip shows a significantly better performance than that with standard pyramidal silicon tips. Based on manipulation experiments as well as a simple analysis, we show that shear pulling (lateral movement of the gripper) is far more effective than tensile pulling (vertical movement of gripper) for the mechanical removal of carbon nanotubes from a substrate

  6. Fabrication of electrospun nanofibrous membranes for membrane distillation application

    KAUST Repository

    Francis, Lijo

    2013-02-01

    Nanofibrous membranes of Matrimid have been successfully fabricated using an electrospinning technique under optimized conditions. Nanofibrous membranes are found to be highly hydrophobic with a high water contact angle of 130°. Field emission scanning electron microscopy and pore size distribution analysis revealed the big pore size structure of electrospun membranes to be greater than 2 μm and the pore size distribution is found to be narrow. Flat sheet Matrimid membranes were fabricated via casting followed by phase inversion. The morphology, pore size distribution, and water contact angle were measured and compared with the electrospun membranes. Both membranes fabricated by electrospinning and phase inversion techniques were tested in a direct contact membrane distillation process. Electrospun membranes showed high water vapor flux of 56 kg/m2-h, which is very high compared to the casted membrane as well as most of the fabricated and commercially available highly hydrophobic membranes. ©2013 Desalination Publications.

  7. SCF increases in utero-labeled stem cells migration and improves wound healing.

    Science.gov (United States)

    Zgheib, Carlos; Xu, Junwang; Mallette, Andrew C; Caskey, Robert C; Zhang, Liping; Hu, Junyi; Liechty, Kenneth W

    2015-01-01

    Diabetic skin wounds lack the ability to heal properly and constitute a major and significant complication of diabetes. Nontraumatic lower extremity amputations are the number one complication of diabetic skin wounds. The complexity of their pathophysiology requires an intervention at many levels to enhance healing and wound closure. Stem cells are a promising treatment for diabetic skin wounds as they have the ability to correct abnormal healing. Stem cell factor (SCF), a chemokine expressed in the skin, can induce stem cells migration, however the role of SCF in diabetic skin wound healing is still unknown. We hypothesize that SCF would correct the impairment and promote the healing of diabetic skin wounds. Our results show that SCF improved wound closure in diabetic mice and increased HIF-1α and vascular endothelial growth factor (VEGF) expression levels in these wounds. SCF treatment also enhanced the migration of red fluorescent protein (RFP)-labeled skin stem cells via in utero intra-amniotic injection of lenti-RFP at E8. Interestingly these RFP+ cells are present in the epidermis, stain negative for K15, and appear to be distinct from the already known hair follicle stem cells. These results demonstrate that SCF improves diabetic wound healing in part by increasing the recruitment of a unique stem cell population present in the skin. © 2015 by the Wound Healing Society.

  8. Animal models of chronic wound care

    DEFF Research Database (Denmark)

    Trøstrup, Hannah; Thomsen, Kim; Calum, Henrik

    2016-01-01

    Chronic wounds are a substantial clinical problem affecting millions of people worldwide. Pathophysiologically, chronic wounds are stuck in the inflammatory state of healing. The role of bacterial biofilms in suppression and perturbation of host response could be an explanation for this observation....... An inhibiting effect of bacterial biofilms on wound healing is gaining significant clinical attention over the last few years. There is still a paucity of suitable animal models to recapitulate human chronic wounds. The etiology of the wound (venous insufficiency, ischemia, diabetes, pressure) has to be taken...... into consideration as underlying pathophysiological mechanisms and comorbidities display tremendous variation in humans. Confounders such as infection, smoking, chronological age, sex, medication, metabolic disturbances, and renal impairment add to the difficulty in gaining systematic and comparable studies...

  9. Diamond growth on copper rods from polymer composite nanofibres

    Czech Academy of Sciences Publication Activity Database

    Varga, Marián; Potocký, Štěpán; Tesárek, P.; Babchenko, Oleg; Davydova, Marina; Kromka, Alexander

    2014-01-01

    Roč. 312, SEP (2014), s. 220-225 ISSN 0169-4332 R&D Projects: GA ČR(CZ) GBP108/12/G108 Institutional support: RVO:68378271 Keywords : linear antenna MWCVD * diamond * copper * polymer nanofibres Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.711, year: 2014 http://www.sciencedirect.com/science/article/pii/S0169433214011003

  10. Cell Based Meniscal Repair Using an Aligned Bioactive Nanofibrous Sheath

    Science.gov (United States)

    2017-07-01

    supplement with each medium change. This has tremendous potential for targeted therapy of focal meniscal lesions . Building on these in vitro results, we...of biomaterials capable of promoting endogenous MSC recruitment to the meniscal lesion . Additionally, the GelMA hydrogel itself possesses good...AWARD NUMBER: W81XWH-15-1-0104 TITLE: Cell-Based Meniscal Repair Using an Aligned Bioactive Nanofibrous Sheath PRINCIPAL INVESTIGATOR

  11. Hemocompatible surface of electrospun nanofibrous scaffolds by ATRP modification

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Wenjie [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Feng, Yakai, E-mail: yakaifeng@hotmail.com [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Key Laboratory of Systems Bioengineering of Ministry of Education, Tianjin University, Tianjin 300072 (China); Tianjin University-Helmholtz-Zentrum Geesthacht, Joint Laboratory for Biomaterials and Regenerative Medicine, Weijin Road 92, 300072 Tianjin (China); Wang, Heyun [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); School of Chemistry and Chemical Engineering, Shihezi University, Shihezi 832002 (China); Yang, Dazhi [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); An, Bo [Department of Orthopedics, Affiliated Hospital of Logistics University of Chinese People' s Armed Police Force, Tianjin 300162 (China); Zhang, Wencheng [Department of Physiology and Pathophysiology, Logistics University of Chinese People' s Armed Police Force, Tianjin 300162 (China); Khan, Musammir [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Guo, Jintang [School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072 (China); Tianjin University-Helmholtz-Zentrum Geesthacht, Joint Laboratory for Biomaterials and Regenerative Medicine, Weijin Road 92, 300072 Tianjin (China)

    2013-10-15

    The electrospun scaffolds are potential application in vascular tissue engineering since they can mimic the nano-sized dimension of natural extracellular matrix (ECM). We prepared a fibrous scaffold from polycarbonateurethane (PCU) by electrospinning technology. In order to improve the hydrophilicity and hemocompatibility of the fibrous scaffold, poly(ethylene glycol) methacrylate (PEGMA) was grafted onto the fiber surface by surface-initiated atom transfer radical polymerization (SI-ATRP) method. Although SI-ATRP has been developed and used for surface modification for many years, there are only few studies about the modification of electrospun fiber by this method. The modified fibrous scaffolds were characterized by SEM, Fourier transform infrared (FTIR), and X-ray photoelectron spectroscopy (XPS). The scaffold morphology showed no significant difference when PEGMA was grafted onto the scaffold surface. Based on the water contact angle measurement, the surface hydrophilicity of the scaffold surface was improved significantly after grafting hydrophilic PEGMA (P = 0.0012). The modified surface showed effective resistance for platelet adhesion compared with the unmodified surface. Activated partial thromboplastin time (APTT) of the PCU-g-PEGMA scaffold was much longer than that of the unmodified PCU scaffold. The cyto-compatibility of electrospun nanofibrous scaffolds was tested by human umbilical vein endothelial cells (HUVECs). The images of 7-day cultured cells on the scaffold surface were observed by SEM. The modified scaffolds showed high tendency to induce cell adhesion. Moreover, the cells reached out pseudopodia along the fibrous direction and formed a continuous monolayer. Hemolysis test showed that the grafted chains of PEGMA reduced blood coagulation. These results indicated that the modified electrospun nanofibrous scaffolds were potential application as artificial blood vessels. Highlights: • Electrospun nanofibrous scaffolds were successfully

  12. Electrospun fibers for wound healing and treatment of hyperglycemia

    African Journals Online (AJOL)

    This review aimed to summarize the state-of-art in the application of electrospun fibers on diabetes, hyperglycemic and diabetic ulcers treatment. Regarding the diabetes control and treatment, electrospinning technique contributes to application of wound healing (in vitro and in vivo experiments). The glycemic control is ...

  13. Functionalization of Carbon Nanofibres Obtained by Floating Catalyst Method

    Directory of Open Access Journals (Sweden)

    Adolfo Fernández

    2015-01-01

    Full Text Available The excellent physicochemical and electrical properties of carbon nanofibres (CNF combined with the possibility of being produced at industrial scale at reasonable costs have promoted the interest in their use in very diverse areas. However, there are still some drawbacks that must be solved in order to optimize their set of properties such as the presence of impurities or the imperfections in the crystalline structure. In this work, different modification treatments of CNFs produced by the floating catalyst method have been studied. Three types of modification processes have been explored that can be grouped as mechanical, thermal, and chemical functionalization processes. Mechanical processing has allowed solving the agglomeration problem related to CNFs produced by floating catalyst method and the resulting modified product ensures the secure handling of carbon nanofibres. Thermal and chemical treatments lead to purer and more crystalline products by removing catalyst impurities and amorphous carbon. Functionalization processes explored in this work open the possibility of customized posttreatment of carbon nanofibres according to the desired requirements.

  14. Nanofibrous nonmulberry silk/PVA scaffold for osteoinduction and osseointegration.

    Science.gov (United States)

    Bhattacharjee, Promita; Kundu, Banani; Naskar, Deboki; Maiti, Tapas K; Bhattacharya, Debasis; Kundu, Subhas C

    2015-05-01

    Poly-vinyl alcohol and nonmulberry tasar silk fibroin of Antheraea mylitta are blended to fabricate nanofibrous scaffolds for bone regeneration. Nanofibrous matrices are prepared by electrospinning the equal volume ratio blends of silk fibroin (2 and 4 wt%) with poly-vinyl alcohol solution (10 wt%) and designated as 2SF/PVA and 4SF/PVA, respectively with average nanofiber diameters of 177 ± 13 nm (2SF/PVA) and 193 ± 17 nm (4SF/PVA). Fourier transform infrared spectroscopy confirms retention of the secondary structure of fibroin in blends indicating the structural stability of neo-matrix. Both thermal stability and contact angle of the blends decrease with increasing fibroin percentage. Conversely, fibroin imparts mechanical stability to the blends; greater tensile strength is observed with increasing fibroin concentration. Blended scaffolds are biodegradable and support well the neo-bone matrix synthesis by human osteoblast like cells. The findings indicate the potentiality of nanofibrous scaffolds of nonmulberry fibroin as bone scaffolding material. © 2014 Wiley Periodicals, Inc.

  15. Parameter dependence of conic angle of nanofibres during electrospinning

    International Nuclear Information System (INIS)

    Zhou Zhengping; Wu Xiangfa; Jiang Long; Gao Xueqin; Zhao Yong; Fong Hao

    2011-01-01

    This paper reports the dependence of conic angle of nanofibres on the processing and material parameters during electrospinning. Solutions of polyacrylonitrile (PAN) in dimethylformamide (DMF) with varied PAN concentrations were studied as the model systems, and they were electrospun into nanofibres at different high direct current (dc) voltages, flow rates and needle diameters. The dynamic and transient shear viscosities of the PAN/DMF solutions were characterized by a parallel-plate rheometer at varied shear rates. Rheological measurements showed that the PAN/DMF solutions behaved as Newtonian fluids at relatively low to medium shear rates, while the solutions with high PAN concentrations of 18 and 20 wt% exhibited a significant shear-thinning behaviour at high shear rates, especially in the case of transient shear mode. Experimental results indicated that at the electrostatic field of ∼80 kV m -1 and needle inner diameter of 0.48 mm (22 gauge), the conic angle of the nanofibre envelope decreased from ∼160° to ∼75° with an increase in PAN concentration from 12 to 20 wt%; at the PAN concentration of 16 wt%, the conic angle increased nonlinearly from ∼40° to ∼160° with an increase in electric field from 50 to 140 kV m -1 . In addition, experimental results showed that the needle inner diameter also noticeably influenced the conic angle. This study provided the experimental evidence useful for understanding the scaling properties of electrohydrodynamic jet motion for controllable electrospinning and process modelling.

  16. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

    For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestat......For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women...... with gestational diabetes mellitus is highly relevant....

  17. Comparing the Meggitt-Wagner and the University of Texas wound classification systems for diabetic foot ulcers: inter-observer analyses

    NARCIS (Netherlands)

    Santema, Trientje B.; Lenselink, Ellie A.; Balm, Ron; Ubbink, Dirk T.

    2016-01-01

    Accurate classification of diabetic foot ulcers is essential for inter-clinician communication, assessment of healing tendency and determination of treatment options. The aim of this study was to assess the inter-observer agreement (IOA) of the most commonly used classification systems for diabetic

  18. Diabetes

    Science.gov (United States)

    ... including: Blurry vision Excess thirst Fatigue Frequent urination Hunger Weight loss Because type 2 diabetes develops slowly, ... must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get ...

  19. Diabetes

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for diabetes. The data is provided by three managed care organizations in Allegheny County (Gateway Health Plan,...

  20. Nanofibrous nonwovens based on dendritic-linear-dendritic poly(ethylene glycol) hybrids

    DEFF Research Database (Denmark)

    Kikionis, Stefanos; Ioannou, Efstathia; Andren, Oliver C.J.

    2017-01-01

    unsuccessful. Nevertheless, when these DLD hybrids were blended with an array of different biodegradable polymers as entanglement enhancers, nanofibrous nonwovens were successfully prepared by electrospinning. The pseudogeneration degree of the DLDs, the nature of the co-electrospun polymer and the solvent...... nanofibers. Such dendritic nanofibrous scaffolds can be promising materials for biomedical applications due to their biocompatibility, biodegradability, multifunctionality, and advanced structural architecture....

  1. A Novel Nanohybrid Nanofibrous Adsorbent for Water Purification from Dye Pollutants

    DEFF Research Database (Denmark)

    Homaeigohar, Shahin; Zillohu, Ahnaf; Abdelaziz, Ramzy

    2016-01-01

    In this study, we devised a novel nanofibrous adsorbent made of polyethersulfone (PES) for removal of methylene blue (MB) dye pollutant from water. The polymer shows a low isoelectric point thus at elevated pHs and, being nanofibrous, can offer a huge highly hydroxylated surface area for adsorption...

  2. Effects of MWNT nanofillers on structures and properties of PVA electrospun nanofibres

    International Nuclear Information System (INIS)

    Naebe, Minoo; Lin Tong; Tian, Wendy; Dai Liming; Wang Xungai

    2007-01-01

    In this study, we have electrospun poly(vinyl alcohol)(PVA) nanofibres and PVA composite nanofibres containing multi-wall carbon nanotubes (MWNTs) (4.5 wt%), and examined the effect of the carbon nanotubes and the PVA morphology change induced by post-spinning treatments on the tensile properties, surface hydrophilicity and thermal stability of the nanofibres. Through differential scanning calorimetry (DSC) and wide-angle x-ray diffraction (WAXD) characterizations, we have observed that the presence of the carbon nanotubes nucleated crystallization of PVA in the MWNTs/PVA composite nanofibres, and hence considerably improved the fibre tensile strength. Also, the presence of carbon nanotubes in PVA reduced the fibre diameter and the surface hydrophilicity of the nanofibre mat. The MWNTs/PVA composite nanofibres and the neat PVA nanofibres responded differently to post-spinning treatments, such as soaking in methanol and crosslinking with glutaric dialdehyde, with the purpose of increasing PVA crystallinity and establishing a crosslinked PVA network, respectively. The presence of carbon nanotubes reduced the PVA crystallization rate during the methanol treatment, but prevented the decrease of crystallinity induced by the crosslinking reaction. In comparison with the crosslinking reaction, the methanol treatment resulted in better improvement in the fibre tensile strength and less reduction in the tensile strain. In addition, the presence of carbon nanotubes reduced the onset decomposition temperature of the composite nanofibres, but stabilized the thermal degradation for the post-spinning treated nanofibres. The MWNTs/PVA composite nanofibres treated by both methanol and crosslinking reaction gave the largest improvement in the fibre tensile strength, water contact angle and thermal stability

  3. [The principles of chronic wound assessment and measurement].

    Science.gov (United States)

    Lo, Shu-Fen; Hu, Wen-Yu

    2007-04-01

    The management of chronic diseases in the elderly population is a major challenge for professional nurses. Chronic wounds, such as pressure ulcers, diabetic foot ulcers, venous ulcers, and arterial ulcers are common problems among patients with chronic diseases. This article aims to improve the knowledge base of nurses who assess and identify the etiology of chronic wounds, in the hope that an improved pool of knowledge can be drawn upon and applied in clinical practice. The article discusses patient assessment, chronic wound assessment, assessment of healing, and wound classification systems that can provide a structured approach to the management of chronic wounds. It provides a rational and systematic approach to both assessment and management that is particularly useful in the management of non-healing wounds. It can be used as a source of reference for nurses in the organization of wound management plans and the provision of better care for patients.

  4. [Significance and assessments of impaired microcirculation in chronic wounds].

    Science.gov (United States)

    Mani, Rajgopal

    2012-02-01

    Chronic wounds pose a clinical challenge. Such wounds may present all over the body although the majority appear on the lower extremities. In the main, wounds are caused by hypertension (venous or arterial), diabetes, although infection, trauma, and animal bites can result in non-healing wounds. It is vital to have a reliable diagnosis in order to plan treatment. Despite advances in diagnostics and the development of standard care packages, chronic wounds present a growing burden to all societies. One of the problems faced is the poor understanding of the pathophysiology of wounds; it is commonly accepted that microcirculation is impaired in lower extremity chronic wounds. This paper is focused on the significance and assessment of impaired microcirculation.

  5. Stem Cells and Engineered Scaffolds for Regenerative Wound Healing

    Directory of Open Access Journals (Sweden)

    Biraja C. Dash

    2018-03-01

    Full Text Available The