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Lim Y, Avram M, Neel VA. Strategies to improve facial scars following Mohs micrographic surgery. J COSMET LASER THER 2025:1-10. [PMID: 40357566 DOI: 10.1080/14764172.2025.2496646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2025] [Accepted: 04/18/2025] [Indexed: 05/15/2025]
Abstract
Mohs micrographic surgery (MMS) is the gold standard treatment for skin cancers of the face, but scarring in these cosmetically sensitive areas remains a challenge, with no clear consensus on the most effective treatments. This study reviews the literature on therapies for specifically facial scars following Mohs surgery, emphasizing their mechanism of action and evidence of efficacy. Non-invasive options such as topical silicone and pressure therapy have shown benefits, while advanced techniques like dermabrasion, microneedling, or energy devices like the pulse-dye, CO2, Erbium, and Nd:YAG lasers, show promise in improving scar pliability and visibility. Intralesional injections of corticosteroids, botulinum toxin, and dermal fillers also have supportive data. Conversely, treatments like topical onion extract and vitamin E lack evidence of efficacy. Managing hypertrophic granulation tissue (HGT) also remains critical to reduce aberrant scarring from second-intention healing (SIH). To ensure optimal clinical outcomes, clinicians should remain updated on the wide range of scar therapies available, focusing on those with established biochemical mechanisms and evidence of efficacy.
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Affiliation(s)
- Young Lim
- Department of Dermatologic Surgery, Massachusetts General Hospital, Boston, MA, USA
| | - Mat Avram
- Dermatology Laser and Cosmetic Center, Massachusetts General Hospital, Boston, MA, USA
| | - Victor A Neel
- Department of Dermatologic Surgery, Massachusetts General Hospital, Boston, MA, USA
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2
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Angwin C, Doolan BJ, Hausser I, Labine B, Lavallee M, Mackay D, Pope FM, Seneviratne SL, Winship I, Burrows NP. Skin fragility and wound management in Ehlers-Danlos syndromes: a report by the International Consortium on Ehlers-Danlos Syndromes and Hypermobility Spectrum Disorders Skin Working Group. Clin Exp Dermatol 2024; 49:1496-1503. [PMID: 38767179 DOI: 10.1093/ced/llae201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/06/2024] [Accepted: 05/05/2024] [Indexed: 05/22/2024]
Abstract
The Ehlers-Danlos syndromes (EDSs) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin hyperextensibility and generalized tissue fragility. In all types of EDS, skin wound healing is impaired to a variable degree. Additional support through wound management plans may help to improve these outcomes; however, there is a paucity of evidence regarding clinical management of skin fragility and wounds in EDS. This paper aims to review current evidence and provide recommendations for management of skin wounds in EDS types. Preventative measures to avoid skin injury are strongly recommended, including avoidance of high-impact sports and use of appropriate protection such as shin guards. Bruising is common, and some types of EDS are associated with haematoma formation, with management including compression bandages and consideration of pharmacological therapy. Skin fragility and tears should be managed with a focus on protection of remaining tissue, avoidance of wound tension and low-adherence dressings to avoid further injury. This paper provides clear recommendations to address skin management for this group of patients. It highlights the lack of good-quality published data to support treatment decisions.
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Affiliation(s)
- Chloe Angwin
- National Ehlers Danlos Syndrome Service, London North West University Healthcare NHS Trust, London, UK
| | - Brent J Doolan
- St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, UK
| | - Ingrid Hausser
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Barry Labine
- Department of Dermatology, Lakewood Health System, Sartell, MN, USA
| | - Mark Lavallee
- Department of Orthopedics and Sports Medicine, UPMC-Central PA, Harrisburg, PA, USA
| | - Donald Mackay
- Department of Surgery, Division of Plastic Surgery, Penn State College of Medicine, Hershey, PA, USA
| | - F Michael Pope
- National Ehlers Danlos Syndrome Service, London North West University Healthcare NHS Trust, London, UK
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust (West Middlesex University Hospital), London, UK
| | - Suranjith L Seneviratne
- Institute of Immunity and Transplantation, Royal Free Hospital and University College London, London, UK
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka
| | - Ingrid Winship
- Genomic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, and Department of Medicine, The University of Melbourne, Parkville, VIC, Australia
| | - Nigel P Burrows
- Department of Dermatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Hajj J, Sizemore B, Singh K. Impact of Epigenetics, Diet, and Nutrition-Related Pathologies on Wound Healing. Int J Mol Sci 2024; 25:10474. [PMID: 39408801 PMCID: PMC11476922 DOI: 10.3390/ijms251910474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/20/2024] [Accepted: 09/25/2024] [Indexed: 10/20/2024] Open
Abstract
Chronic wounds pose a significant challenge to healthcare. Stemming from impaired wound healing, the consequences can be severe, ranging from amputation to mortality. This comprehensive review explores the multifaceted impact of chronic wounds in medicine and the roles that diet and nutritional pathologies play in the wound-healing process. It has been well established that an adequate diet is crucial to proper wound healing. Nutrients such as vitamin D, zinc, and amino acids play significant roles in cellular regeneration, immune functioning, and collagen synthesis and processing. Additionally, this review discusses how patients with chronic conditions like diabetes, obesity, and nutritional deficiencies result in the formation of chronic wounds. By integrating current research findings, this review highlights the significant impact of the genetic make-up of an individual on the risk of developing chronic wounds and the necessity for adequate personalized dietary interventions. Addressing the nutritional needs of individuals, especially those with chronic conditions, is essential for improving wound outcomes and overall patient care. With new developments in the field of genomics, there are unprecedented opportunities to develop targeted interventions that can precisely address the unique metabolic needs of individuals suffering from chronic wounds, thereby enhancing treatment effectiveness and patient outcomes.
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Affiliation(s)
- John Hajj
- Indiana Center for Regenerative Medicine and Engineering, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (J.H.); (B.S.)
| | - Brandon Sizemore
- Indiana Center for Regenerative Medicine and Engineering, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (J.H.); (B.S.)
| | - Kanhaiya Singh
- Indiana Center for Regenerative Medicine and Engineering, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA; (J.H.); (B.S.)
- McGowan Institute for Regenerative Medicine, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15219, USA
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4
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Meetam T, Angspatt A, Aramwit P. Evidence of Potential Natural Products for the Management of Hypertrophic Scars. J Evid Based Integr Med 2024; 29:2515690X241271948. [PMID: 39196306 PMCID: PMC11359448 DOI: 10.1177/2515690x241271948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/29/2024] [Accepted: 06/26/2024] [Indexed: 08/29/2024] Open
Abstract
Hypertrophic scarring is an aberrant wound-healing response to reestablish dermal integrity after an injury and can cause significant abnormalities in physical, aesthetic, functional, and psychological symptoms, impacting the patient's quality of life. There is currently no gold standard for preventing and treating hypertrophic scars. Therefore, many researchers have attempted to search for antihypertrophic scar agents with greater efficacy and fewer side effects. Natural therapeutics are becoming attractive as potential alternative anti-scarring agents because of their high efficacy, safety, biocompatibility, low cost, and easy accessibility. This review demonstrates various kinds of natural product-based therapeutics, including onion, vitamin E, Gotu kola, green tea, resveratrol, emodin, curcumin, and others, in terms of their mechanisms of action, evidence of efficacy and safety, advantages, and disadvantages when used as anti-scarring agents. We reviewed the literature based on data from in vitro, in vivo, and clinical trials. A total of 23 clinical trials were identified in this review; most clinical trials were ranked as having uncertain results (level of evidence 2b; n = 16). Although these natural products showed beneficial effects in both in vitro and in vivo studies of potential anti-scarring agents, there was limited clinical evidence to support their efficacy due to the limited quality of the studies, with individual flaws including small sample sizes, poor randomization, and blinding, and short follow-up durations. More robust and well-designed clinical trials with large-scale and prolonged follow-up durations are required to clarify the benefits and risks of these agents.
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Affiliation(s)
- Thunyaluk Meetam
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand
- Sirindhorn College of Public Health Trang, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute, Trang, Thailand
| | - Apichai Angspatt
- Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pornanong Aramwit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences and Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, Thailand
- The Academy of Science, The Royal Society of Thailand, Dusit, Bangkok,
Thailand
- Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand
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Torres A, Rego L, Martins MS, Ferreira MS, Cruz MT, Sousa E, Almeida IF. How to Promote Skin Repair? In-Depth Look at Pharmaceutical and Cosmetic Strategies. Pharmaceuticals (Basel) 2023; 16:ph16040573. [PMID: 37111330 PMCID: PMC10144563 DOI: 10.3390/ph16040573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Skin repair encompasses epidermal barrier repair and wound healing which involves multiple cellular and molecular stages. Therefore, many skin repair strategies have been proposed. In order to characterize the usage frequency of skin repair ingredients in cosmetics, medicines, and medical devices, commercialized in Portuguese pharmacies and parapharmacies, a comprehensive analysis of the products' composition was performed. A total of 120 cosmetic products, collected from national pharmacies online platforms, 21 topical medicines, and 46 medical devices, collected from INFARMED database, were included in the study, revealing the top 10 most used skin repair ingredients in these categories. A critical review regarding the effectiveness of the top ingredients was performed and an in-depth analysis focused on the top three skin repair ingredients pursued. Results demonstrated that top three most used cosmetic ingredients were metal salts and oxides (78.3%), vitamin E and its derivatives (54.2%), and Centella asiatica (L.) Urb. extract and actives (35.8%). Regarding medicines, metal salts and oxides were also the most used (47.4%) followed by vitamin B5 and derivatives (23.8%), and vitamin A and derivatives (26.3%). Silicones and derivatives were the most common skin repair ingredients in medical devices (33%), followed by petrolatum and derivatives (22%) and alginate (15%). This work provides an overview of the most used skin repair ingredients, highlighting their different mechanisms of action, aiming to provide an up-to-date tool to support health professionals' decisions.
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Affiliation(s)
- Ana Torres
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Liliana Rego
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Márcia S Martins
- Laboratory of Organic and Pharmaceutical Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- CIIMAR-Interdisciplinary Centre of Marine and Environmental Research, Avenida General Norton de Matos, S/N, 4450-208 Matosinhos, Portugal
| | - Marta S Ferreira
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Maria T Cruz
- Faculty of Pharmacy, University of Coimbra, 3004-531 Coimbra, Portugal
- Center for Neuroscience and Cell Biology, 3004-504 Coimbra, Portugal
| | - Emília Sousa
- Laboratory of Organic and Pharmaceutical Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- CIIMAR-Interdisciplinary Centre of Marine and Environmental Research, Avenida General Norton de Matos, S/N, 4450-208 Matosinhos, Portugal
| | - Isabel F Almeida
- UCIBIO-Applied Molecular Biosciences Unit, MedTech, Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
- Associate Laboratory i4HB, Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
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Alam MS, Ansari A, Ahsan I, Shafiq-Un-Nabi S, Md S, Shaik RA, Eid BG, Ahmad MZ, Ahmad J. Topical gel containing Polysiloxanes and hyaluronic acid for skin scar: Formulation design, characterization, and In vivo activity. J Cosmet Dermatol 2023; 22:1220-1232. [PMID: 36606411 DOI: 10.1111/jocd.15574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/21/2022] [Accepted: 12/06/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Scar formation is undesirable both cosmetically and functionally. It shows that silicone gel is effective in preventing and improving scars formed due to a wound formation after injury. OBJECTIVES This study investigates whether a silicone gel composition based on a novel concept of infusing a biologically active material such as hyaluronic acid and/or salts with various polysiloxane derivatives in a specific proportion to achieve desired viscosity range and their action has a synergistic beneficial effect on skin scar after injury. METHODS We have developed a topical gel utilizing a combination of emulsifiers, sodium hyaluronate, polysiloxane, and its derivatives. The method of preparation comprises mixing of aqueous phase dispersion and polysiloxanes blend under stirring at room temperature. RESULTS It results in the formation of a homogenous smooth gel formulation. The developed topical gel formulation was characterized for physicochemical properties, rheology, stability, and anti-scar activity in Wistar rats. It was found that the developed formulation system consists of desirable attributes for skin applications. In vivo investigation of developed polysiloxane gel formulation for anti-scar activity shown promising outcomes compared to marketed product (Kelo-cote scar gel). Furthermore, a histopathology study of healed skin tissues observed the formation of microscopic skin structures compared to the Kelo-cote scar gel. CONCLUSIONS It indicates that the combination of polysiloxanes and sodium hyaluronate resulting an improvement in anti-scar activity compared to the marketed product containing polysiloxanes alone.
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Affiliation(s)
- Md Shoaib Alam
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | - Arif Ansari
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | - Iftikhar Ahsan
- Research and Development, Jamjoom Pharmaceuticals, Jeddah, Saudi Arabia
| | | | - Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rasheed A Shaik
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Basma G Eid
- Department of Pharmacology & Toxicology, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Zaki Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
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Nair AB, Gorain B, Pandey M, Jacob S, Shinu P, Aldhubiab B, Almuqbil RM, Elsewedy HS, Morsy MA. Tocotrienol in the Treatment of Topical Wounds: Recent Updates. Pharmaceutics 2022; 14:pharmaceutics14112479. [PMID: 36432670 PMCID: PMC9699634 DOI: 10.3390/pharmaceutics14112479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022] Open
Abstract
Healing wounds is an important attempt to keep the internal higher organs safe. Complications in topical wound healing may lead to the formation of scars, which can affect the patient's quality of life. Although several approaches are ongoing in parallel in the exploration of natural compounds via advanced delivery, in this article, an attempt has been made to highlight tocotrienol. Tocotrienol is a natural form of vitamin E and has shown its potential in certain pharmacological activities better than tocopherol. Its antioxidant, anti-inflammatory, cell signal-mediating effects, angiogenic properties, management of scar, and promotion of wound environment with essential factors have shown potential in the management of topical wound healing. Therefore, this review has aimed to focus on recent advances in topical wound healing through the application of tocotrienols. Challenges in delivering tocotrienols to the topical wound due to its large molecular weight and higher logP have also been explored using nanotechnological-based carriers, which has made tocotrienol a potential tool to facilitate the closure of wounds. Exploration of tocotrienol has also been made in human volunteers for biopsy wounds; however, the results are yet to be reported. Overall, based on the current findings in the literature, it could be inferred that tocotrienol would be a viable alternative to the existing wound dressing components for the management of topical wounds.
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Affiliation(s)
- Anroop B. Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Correspondence: (A.B.N.); (B.G.); Tel.: +966-536219868 (A.B.N.); +91-9088585676 (B.G.)
| | - Bapi Gorain
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi 835215, India
- Correspondence: (A.B.N.); (B.G.); Tel.: +966-536219868 (A.B.N.); +91-9088585676 (B.G.)
| | - Manisha Pandey
- Department of Pharmaceutical Sciences, Central University of Haryana, SSH 17, Jant, Mahendergarh 123031, India
| | - Shery Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman 4184, United Arab Emirates
| | - Pottathil Shinu
- Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Bandar Aldhubiab
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Rashed M. Almuqbil
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Heba S. Elsewedy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh 13713, Saudi Arabia
| | - Mohamed A. Morsy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Department of Pharmacology, Faculty of Medicine, Minia University, El-Minia 61511, Egypt
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Braťka P, Fenclová T, Hlinková J, Uherková L, Šebová E, Hefka Blahnová V, Hedvičáková V, Žižková R, Litvinec A, Trč T, Rosina J, Filová E. The Preparation and Biological Testing of Novel Wound Dressings with an Encapsulated Antibacterial and Antioxidant Substance. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:3824. [PMID: 36364600 PMCID: PMC9656126 DOI: 10.3390/nano12213824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Chronic wounds represent a significant socio-economic problem, and the improvement of their healing is therefore an essential issue. This paper describes the preparation and biological properties of a novel functionalized nanofiber wound dressing consisting of a polycaprolactone nanofiber carrier modified by a drug delivery system, based on the lipid particles formed by 1-tetradecanol and encapsulated gentamicin and tocopherol acetate. The cytotoxicity of extracts was tested using a metabolic activity assay, and the antibacterial properties of the extracts were tested in vitro on the bacterial strains Staphylococcus aureus and Pseudomonas aeruginosa. The effect of the wound dressing on chronic wound healing was subsequently tested using a mouse model. Fourteen days after surgery, the groups treated by the examined wound cover showed a lower granulation, reepithelization, and inflammation score compared to both the uninfected groups, a lower dermis organization compared to the control, a higher scar thickness compared to the other groups, and a higher thickness of hypodermis and bacteria score compared to both the uninfected groups. This work demonstrates the basic parameters of the safety (biocompatibility) and performance (effect on healing) of the dressing as a medical device and indicates the feasibility of the concept of its preparation in outpatient conditions using a suitable functionalization device.
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Affiliation(s)
- Petr Braťka
- Faculty of Biomedical Engineering, Czech Technical University, Náměstí Sítná 3105, 27201 Kladno, Czech Republic
- Grade Medical s.r.o., Náměstí Sítná 3105, 27201 Kladno, Czech Republic
| | - Taťána Fenclová
- Grade Medical s.r.o., Náměstí Sítná 3105, 27201 Kladno, Czech Republic
| | - Jana Hlinková
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Lenka Uherková
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Eva Šebová
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Veronika Hefka Blahnová
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Věra Hedvičáková
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Radmila Žižková
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Andrej Litvinec
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
| | - Tomáš Trč
- Grade Medical s.r.o., Náměstí Sítná 3105, 27201 Kladno, Czech Republic
| | - Jozef Rosina
- Faculty of Biomedical Engineering, Czech Technical University, Náměstí Sítná 3105, 27201 Kladno, Czech Republic
| | - Eva Filová
- Department of Tissue Engineering, Institute of Experimental Medicine of the Czech Academy of Sciences, Vídeňská 1083, 14220 Prague, Czech Republic
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Novel Curcumin-Encapsulated α-Tocopherol Nanoemulsion System and Its Potential Application for Wound Healing in Diabetic Animals. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7669255. [PMID: 36158895 PMCID: PMC9499807 DOI: 10.1155/2022/7669255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
Objective This project was aimed at formulating a novel nanoemulsion system and evaluating it for open incision wound healing in diabetic animals. Methods The nanoemulsions were characterized for droplet size and surface charge, drug content, antioxidant and antimicrobial profiling, and wound healing potential in diabetic animals. The skin samples excised were also analyzed for histology, mechanical strength, and vibrational and thermal analysis. Results The optimized nanoemulsion (CR-NE-II) exhibited droplet size of26.76 ± 0.9 nm with negative surface charge (−10.86 ± 1.06 mV), was homogenously dispersed with drug content of68.05 ± 1.2%, released almost82.95 ± 2.2%of the drug within first 2 h of experiment with synergistic antioxidant (95 ± 2.1%) and synergistic antimicrobial activity against selected bacterial strains in comparison to blank nanoemulsion, and promoted significantly fast percent reepithelization (96.47%). The histological, vibrational, thermal, and strength analysis of selected skin samples depicted a uniform and even distribution of collagen fibers which translated into significant increase in strength of skin samples in comparison to the control group. Conclusions The optimized nanoemulsion system significantly downregulated the oxidative stress, enhanced collagen deposition, and precluded bacterial contamination of wound, thus accelerating the skin tissue regeneration process.
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10
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Abbas DB, Lavin CV, Fahy EJ, Griffin M, Guardino NJ, Nazerali RS, Nguyen DH, Momeni A, Longaker MT, Wan DC. Fat Grafts Augmented With Vitamin E Improve Volume Retention and Radiation-Induced Fibrosis. Aesthet Surg J 2022; 42:946-955. [PMID: 35350074 PMCID: PMC9342682 DOI: 10.1093/asj/sjac066] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Treatments for radiation-induced fibrosis range from vitamin E and pentoxifylline systemically to deferoxamine and fat grafting locally. Regarding fat grafting, volume retention hinders its long-term functionality and is affected by two factors: inflammation and necrosis secondary to hypovascularity. OBJECTIVE We aimed to simultaneously improve fat graft retention and radiation-induced fibrosis by integrating vitamin E and pentoxifylline into fat grafts locally. METHODS Forty adult CD-1 nude male mice at 6 weeks of age underwent scalp irradiation and recovered for four weeks to allow for the development of fibrosis. Mice received 200μL of donor human fat graft to the scalp. Mice were separated into 4 conditions: no grafting, fat graft without treatment, graft treated with pentoxifylline, and graft treated with vitamin E. Fat graft volume retention was monitored in-vivo using microCT scans at weeks 0, 1, 2, 4, 6, and 8 after grafting. Histological and cytokine analysis of the scalp skin and fat grafts were also performed. RESULTS Vitamin E (VE) treated grafts had significant improvement in dermal thickness and collagen density of overlying skin compared to all other groups. VE decreased 8-isoprostane and increased CD31 + staining compared to the other grafted groups. Cytokine analysis revealed decreased inflammatory and increased angiogenic markers in both the fat graft and overlying skin of the vitamin E group. Fat graft volume retention was significantly improved in the vitamin E group starting at 1 week post grafting. CONCLUSION Radiation-induced fibrosis and fat graft volume retention are both simultaneously improved with local administration of vitamin E.
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Affiliation(s)
- Darren B Abbas
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Christopher V Lavin
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Evan J Fahy
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michelle Griffin
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Nicholas J Guardino
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Rahim S Nazerali
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Dung H Nguyen
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Arash Momeni
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael T Longaker
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Derrick C Wan
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Doostmohammadi M, Forootanfar H, Shakibaie M, Torkzadeh-Mahani M, Rahimi HR, Jafari E, Ameri A, Amirheidari B. Bioactive anti-oxidative polycaprolactone/gelatin electrospun nanofibers containing selenium nanoparticles/vitamin E for wound dressing applications. J Biomater Appl 2021; 36:193-209. [PMID: 33722085 DOI: 10.1177/08853282211001359] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In this study, polycaprolactone/gelatin (PCL/GEL) electrospun nanofibers containing biogenic selenium nanoparticles (Se NPs) and Se NPs/vitamin E (VE) with average diameters of 397.8 nm and 279.5 nm, respectively (as determined by SEM inspection) were prepared and their effect on wound healing was evaluated using in-vivo studies. The energy dispersive X-ray (EDX) mapping, TEM micrograph, and FTIR spectra of the prepared nanofibers strongly demonstrated well entrapment of Se NPs and VE into scaffolds. An amount of 57% Se NPs and 43% VE were gradually released from PCL/GEL/Se NPs/VE scaffold after 4 days immersion in PBS solution (pH 7.4). The both PCL/GEL/Se NPs and PCL/GEL/Se NPs/VE scaffolds supported 3T3 cell proliferation and attachment as confirmed by MTT assay and SEM imaging. Complete re-epithelialization, low level of edema and inflammatory cells in coordination with high level of oriented collagens demonstrated the wound healing activity of PCL/GEL/Se NPs/VE. Besides, significant antioxidant efficacy of PCL/GEL/Se NPs and PCL/GEL/Se NPs/VE scaffolds was demonstrated according to GSH and MDA assays. To sum up, the prepared PCL/GEL/Se NPs/VE scaffold in the present study represented suitable healing effect on animal model which candidate it for further studies.
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Affiliation(s)
- Mohsen Doostmohammadi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Forootanfar
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Mojtaba Shakibaie
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran.,Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Torkzadeh-Mahani
- Department of Biotechnology, Institute of Science, High Technology and Environmental Sciences, Graduate University of Advanced Technology, Kerman, Iran
| | - Hamid-Reza Rahimi
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Elham Jafari
- Pathology and Stem Cells Research Center, Department of Pathology, Kerman University of Medical Science, Kerman, Iran
| | - Alieh Ameri
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Bagher Amirheidari
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
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12
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Abstract
BACKGROUND There is an increasing number of over-the-counter topical products that are said to prevent pathologic scar formation and improve scar cosmesis. However, robust clinical data are lacking to substantiate these claims and to guide selection of topical products. OBJECTIVE To determine the effectiveness of topical scar management products, including silicone gel, Allium cepa onion extract, vitamin E, trolamine, and microporous tape. METHODS AND MATERIALS A PubMed search (2005-2019) was performed to identify studies of topical scar management products. Randomized controlled trials (RCTs), quasi-RCTs, meta-analyses, and controlled clinical trials were included for analysis. RESULTS A total of 34 trials were included in this study. Of the 16 trials investigating silicone gel sheets, numerous high-quality RCTs found that silicone gel sheets and silicone gels significantly improved scar outcomes. Only a limited number of studies supported the effectiveness of onion extract, vitamin E, trolamine, and microporous tape products. CONCLUSION Silicone gel products are an effective noninvasive treatment to prevent formation of pathologic scars and improve mature scars. Further high-quality studies are needed to elucidate the long-term effectiveness of these therapies.
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13
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Keserü M, Dulz S, Wolf A, Green S, Press U, Schaudig U. [Postoperative care and options for scar treatment in eyelid surgery]. Ophthalmologe 2019; 115:283-292. [PMID: 29188383 DOI: 10.1007/s00347-017-0617-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oculoplastic surgery places special demands on postoperative care because of the functional importance of the eyelids for the ocular surface. We present an overview of postoperative care after surgical eyelid interventions. All options, limits and the scientific evidence are discussed with a special focus on the treatment of postoperative edema, analgesia, infection prophylaxis and scar treatment.
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Affiliation(s)
- M Keserü
- Augenklinik, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - S Dulz
- Klinik und Poliklinik für Augenheilkunde, Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - A Wolf
- Augenklinik, Krankenhaus der Barmherzigen Brüder, Trier, Deutschland
| | - S Green
- Klinik und Poliklinik für Augenheilkunde, Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - U Press
- Augenklinik, Krankenhaus der Barmherzigen Brüder, Trier, Deutschland
| | - U Schaudig
- Augenklinik, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
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14
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Bieszczad B, Gilheany DG. Highly stereoselective construction of the C2 stereocentre of α-tocopherol (vitamin E) by asymmetric addition of Grignard reagents to ketones. Org Biomol Chem 2017; 15:6483-6492. [PMID: 28741644 DOI: 10.1039/c7ob00751e] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Tertiary alcohol precursors of both C2 diastereoisomers of α-tocopherol were prepared in three ways by our recently reported asymmetric Grignard synthesis. The versatility of Grignard chemistry inherent in its three-way disconnection was exploited to allow the synthesis of three product grades: 77 : 23 dr (5 steps), 81 : 19 dr (5 steps) and 96 : 4 dr (7 steps, one gram scale) from readily available and abundant starting materials. The products were converted to their respective α-tocopherols in 3 steps, which allowed a definitive re-assignment of their absolute configurations.
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Affiliation(s)
- Bartosz Bieszczad
- Centre for Synthesis and Chemical Biology, School of Chemistry, University College Dublin, Belfield, Dublin 4, Ireland.
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15
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Vitamins, Amino Acids and Drugs and Formulations Used in Nutrition. SIDE EFFECTS OF DRUGS ANNUAL 2017. [DOI: 10.1016/bs.seda.2017.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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16
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Zhao J, Liu YC, Shi YH, Xie YQ, Cui HP, Li Y, Li XJ, Ren LQ. Role of rat autologous skin fibroblasts and mechanism underlying the repair of depressed scars. Exp Ther Med 2016; 12:945-950. [PMID: 27446300 PMCID: PMC4950163 DOI: 10.3892/etm.2016.3442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 05/04/2016] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to provide reliable experimental evidence for the application of autologous skin fibroblasts (asFbs) in the repair of depressed scars. In the experiments, depressed trauma was induced in male Wistar rats, and fibroblasts were separated from the removed skin tissues to culture in medium. In vitro cultured asFbs were injected into the depressed scar sites of rats, and the repair function of asFbs in the depressed scars was then examined at the cellular and whole-animal levels. The expression levels of type I and type III collagen in the dermal layer of the skin injected with asFb cells were significantly higher, as compared with those of the control, and type I collagen expression was significantly higher compared with Type III. Re-injection of asFbs into the dermal layer of depressed scars can markedly improve their repair. These results may prove useful for skin repair in clinical settings.
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Affiliation(s)
- Juan Zhao
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Yan-Chun Liu
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Yan-Hua Shi
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Ya-Qin Xie
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Hai-Peng Cui
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Ying Li
- Department of Pathophysiology, Chengde Medical College, Chengde, Hebei 067000, P.R. China
| | - Xiang-Jun Li
- Department of Experimental Pharmacology and Toxicology, Medical School of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Li-Qun Ren
- Department of Experimental Pharmacology and Toxicology, Medical School of Jilin University, Changchun, Jilin 130021, P.R. China
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