CHRONIC WOUND ASSESSMENT

The regulatory mechanisms of cerium oxide nanoparticles in oxidative stress and emerging applications in refractory wound care

Cerium oxide nanoparticles (CeNPs) have emerged as a potent therapeutic agent in the realm of wound healing, attributing their efficacy predominantly to their exceptional antioxidant properties. Mimicking the activity of endogenous antioxidant enzymes, CeNPs alleviate oxidative stress and curtail the generation of inflammatory mediators, thus expediting the wound healing process. Their application spans various disease models, showcasing therapeutic potential in treating inflammatory responses and infections, particularly in oxidative stress-induced chronic wounds such as diabetic ulcers, radiation-induced skin injuries, and psoriasis. Despite the promising advancements in laboratory studies, the clinical translation of CeNPs is challenged by several factors, including biocompatibility, toxicity, effective drug delivery, and the development of multifunctional compounds. Addressing these challenges necessitates advancements in CeNP synthesis and functionalization, novel nano delivery systems, and comprehensive bio effectiveness and safety evaluations. This paper reviews the progress of CeNPs in wound healing, highlighting their mechanisms, applications, challenges, and future perspectives in clinical therapeutics.

Laser in the Treatment of Atonic Wounds

Atonic wounds represent a major health problem, being frequently encountered in medical practice with consequences that have a negative impact on the patient's daily life as well as their general condition. In this study, a brand laser with a 12-watt probe was used to stimulate patients' wounds. We involved in this study a group of 65 patients, which was compared with a group of 30 patients, the latter not receiving this laser therapy. The data were accumulated from the questionnaire of subjective assessment of the laser impact on patients' condition as well as from the local evolution. We noticed the improvement of the local symptomatology which was found to be more effective in the patients from the study group compared to the reference group. The beneficial and positive effects, mainly on the symptoms but also on the local evolution of atonic wounds, can be observed in our study. We consider that this therapy is of major importance considering the lower costs both from the shortening of hospitalization and the long-term use of various substances. The early reintegration of patients into daily life is an important benefit for them.

Efficacy of a Ceratothoa oestroides Olive Oil Extract in Patients With Chronic Ulcers: A Pilot Study

Chronic wounds unresponsive to existing treatments constitute a serious disease burden. Factors that contribute to the pathogenesis of chronic ulcers include oxidative stress, comorbid microbial infections, and the type of immune system response. Preclinically, and in a case study, a formulation containing a Ceratothoa oestroides olive oil extract promoted wound healing. Patients with chronic venous and pressure ulcers, clinically assessed as being unresponsive to healing agents, were treated for 3 months with an ointment containing the C oestroides extract combined with antibiotic and/or antiseptic agents chosen according to the type of bacterial infection. Treatment evaluation was performed using the Bates-Jensen criteria with +WoundDesk and MOWA cell phone applications. After 3 months of treatment, C oestroides resulted in an average decrease of 36% in the Bates-Jensen score of ulcers ( P < .000), with the decrease being significant from the first month ( P < .007). The combined use of topically applied antibiotics and antiseptics efficiently controlled microbial ulcer infection and facilitated wound healing. In relation to other factors such as initial wound size, chronicity appeared to be an important prognostic factor regarding the extent of wound healing. Future clinical investigations assessing the wound healing efficacy of the C oestroides olive oil extract are warranted.