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Carlock KD, Wilkerson JB, Yamaguchi JT, Fernando ND. A Comparison of Wound Complications Following Total Hip Arthroplasty Performed Through the Direct Anterior Versus Direct Lateral Approach. Arthroplast Today 2024; 27:101388. [PMID: 38774405 PMCID: PMC11106518 DOI: 10.1016/j.artd.2024.101388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/27/2024] [Accepted: 03/24/2024] [Indexed: 05/24/2024] Open
Abstract
Background Some studies have suggested the risk of wound complications may be higher using the direct anterior (DA) approach to total hip arthroplasty (THA). This study aimed to compare the risk of early postoperative wound complications between the DA and direct lateral (DL) approaches to THA and to determine patient risk factors that may contribute to this problem. Methods All patients who underwent primary THA with a single surgeon over a 5-year period were retrospectively reviewed. All patients were treated with either the DA or DL approach. Data collected included patient demographics, surgical approach, and wound status. There was a minimum follow-up of 6 weeks to allow for an adequate assessment of surgical wound healing. Univariate and multivariate analyses were used to compare the 2 approaches. Results Five hundred seventy-nine patients (77.6%) who underwent DA approach and 167 patients (22.4%) who underwent DL approach were included. Patients who underwent DL approach had a higher body mass index and a higher rate of diabetes than those treated with the DA approach. Forty patients (6.9%) in the DA cohort and 14 (8.4%) in the DL cohort experienced early wound complications, P = .523. After controlling for potential confounding variables, the surgical approach was not an independent risk factor for early postoperative wound complications. Conclusions While there have been concerns regarding use of the DA approach in patients with higher body mass index and certain medical comorbidities, the results of this study suggest the choice of surgical approach may have minimal effect on the rate of early postoperative wound complications.
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Affiliation(s)
- Kurtis D. Carlock
- Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Jacob B. Wilkerson
- Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Jonathan T. Yamaguchi
- Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA
| | - Navin D. Fernando
- Department of Orthopaedic Surgery and Sports Medicine, University of Washington, Seattle, WA, USA
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2
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Liu X, Wang B. Adipose stem cell-derived exosomes promote wound healing by regulating the let-7i-5p/GAS7 axis. J Cosmet Dermatol 2024; 23:2279-2287. [PMID: 38429909 DOI: 10.1111/jocd.16267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Injury to skin tissue is devastating for human health, making it imperative to devise strategies for hastening wound healing. Normal wound healing is a complex process comprising overlapping steps, including hemostasis, inflammatory response, proliferation, and matrix remodeling. This study investigated the effects of adipose stem cell-derived exosomes (ADSC-exos) on wound healing and the underlying mechanisms. METHODS In vitro hydrogen peroxide (H2O2)-treated human keratinocyte (HaCaT) cell lines and in vivo animal wound models were established for this purpose. The cell migration was assessed using transwell and wound healing assays, while exosome biomarker expressions were studied using western blot. Moreover, adipose stem cells were identified using flow cytometry, alizarin red S and oil red O staining, and transmission electron microscopy. RESULTS Results indicated that H2O2 treatment inhibited the cell viability and migration of HaCaT cells while being promoted by ADSC-exos. Mechanistic investigations revealed that microRNA-let-7i-5p (let-7i-5p) in ADSC-exos was carried into the HaCaT cells, inhibiting the expression of growth arrest-specific-7 (GAS7). Rescue experiments further verified these results, which indicated that GAS7 overexpression reversed the effect of let-7i-5p on the viability and migration of HaCaT cells, suggesting ADSC-exos promoted wound healing via the let-7i-5p/GAS7 axis. CONCLUSION Adipose stem cell-derived-exos enhanced the viability and migration of HaCaT via carrying let-7i-5p and targeting GAS7, ultimately promoting wound healing in rats.
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Affiliation(s)
- Xiaosong Liu
- Department of Surgery, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Biao Wang
- Department of Surgery, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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3
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Görlitz M, Justen L, Rochette PJ, Buonanno M, Welch D, Kleiman NJ, Eadie E, Kaidzu S, Bradshaw WJ, Javorsky E, Cridland N, Galor A, Guttmann M, Meinke MC, Schleusener J, Jensen P, Söderberg P, Yamano N, Nishigori C, O'Mahoney P, Manstein D, Croft R, Cole C, de Gruijl FR, Forbes PD, Trokel S, Marshall J, Brenner DJ, Sliney D, Esvelt K. Assessing the safety of new germicidal far-UVC technologies. Photochem Photobiol 2024; 100:501-520. [PMID: 37929787 DOI: 10.1111/php.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023]
Abstract
The COVID-19 pandemic underscored the crucial importance of enhanced indoor air quality control measures to mitigate the spread of respiratory pathogens. Far-UVC is a type of germicidal ultraviolet technology, with wavelengths between 200 and 235 nm, that has emerged as a highly promising approach for indoor air disinfection. Due to its enhanced safety compared to conventional 254 nm upper-room germicidal systems, far-UVC allows for whole-room direct exposure of occupied spaces, potentially offering greater efficacy, since the total room air is constantly treated. While current evidence supports using far-UVC systems within existing guidelines, understanding the upper safety limit is critical to maximizing its effectiveness, particularly for the acute phase of a pandemic or epidemic when greater protection may be needed. This review article summarizes the substantial present knowledge on far-UVC safety regarding skin and eye exposure and highlights research priorities to discern the maximum exposure levels that avoid adverse effects. We advocate for comprehensive safety studies that explore potential mechanisms of harm, generate action spectra for crucial biological effects and conduct high-dose, long-term exposure trials. Such rigorous scientific investigation will be key to determining safe and effective levels for far-UVC deployment in indoor environments, contributing significantly to future pandemic preparedness and response.
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Affiliation(s)
- Maximilian Görlitz
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Lennart Justen
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Patrick J Rochette
- Centre de recherche du CHU de Québec-Université Laval, Axe Médecine Régénératrice Quebec, Quebec City, Quebec, Canada
| | - Manuela Buonanno
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - David Welch
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Ewan Eadie
- Photobiology Unit, Ninewells Hospital, Dundee, UK
| | - Sachiko Kaidzu
- Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan
| | - William J Bradshaw
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
| | - Emilia Javorsky
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts, USA
- Future of Life Institute, Cambridge, Massachusetts, USA
| | - Nigel Cridland
- Radiation, Chemicals and Environment Directorate, UK Health Security Agency, Didcot, UK
| | - Anat Galor
- Miami Veterans Affairs Medical Center, University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, USA
| | | | - Martina C Meinke
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Johannes Schleusener
- Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Paul Jensen
- Final Approach Inc., Port Orange, Florida, USA
| | - Per Söderberg
- Ophthalmology, Department of Surgical Sciences, Uppsala Universitet, Uppsala, Sweden
| | - Nozomi Yamano
- Division of Dermatology, Department of Internal Related, Kobe University, Kobe, Japan
| | - Chikako Nishigori
- Division of Dermatology, Department of Internal Related, Kobe University, Kobe, Japan
- Japanese Red Cross Hyogo Blood Center, Kobe, Japan
| | - Paul O'Mahoney
- Optical Radiation Effects, UK Health Security Agency, Chilton, UK
| | - Dieter Manstein
- Department of Dermatology, Cutaneous Biology Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rodney Croft
- International Commission on Non-Ionizing Radiation Protection (ICNIRP), Chair, Wollongong, New South Wales, Australia
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Curtis Cole
- Sun & Skin Consulting LLC, New Holland, Pennsylvania, USA
| | - Frank R de Gruijl
- Department of Dermatology, Universiteit Leiden, Leiden, South Holland, The Netherlands
| | | | - Stephen Trokel
- Department of Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York City, New York, USA
| | - John Marshall
- Institute of Ophthalmology, University College London, London, UK
| | - David J Brenner
- Center for Radiological Research, Columbia University Medical Center, New York City, New York, USA
| | - David Sliney
- IES Photobiology Committee, Chair, Fallston, Maryland, USA
- Consulting Medical Physicist, Fallston, Maryland, USA
| | - Kevin Esvelt
- Massachusetts Institute of Technology, Media Lab, Cambridge, Massachusetts, USA
- SecureBio, Inc., Cambridge, Massachusetts, USA
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Micheels P, Porcello A, Bezzola T, Perrenoud D, Christen MO, Applegate LA, Laurent A. Comprehensive Evaluation of Injectability Attributes in OxiFree™ Dermal Fillers: MaiLi ® Product Variants and Clinical Case Reports. Gels 2024; 10:276. [PMID: 38667695 PMCID: PMC11049332 DOI: 10.3390/gels10040276] [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: 03/18/2024] [Revised: 04/08/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Dermal filler injectability is a critical factor for commercial product adoption by medical aesthetic professionals and for successful clinical administration. We have previously reported (in vitro and ex vivo) cross-linked hyaluronic acid (HA)-based dermal filler benchmarking in terms of manual and automated injectability requirements. To further enhance the function-oriented product characterization workflows and the clinical relevance of dermal filler injectability assessments, the aim of this study was to perform in vivo evaluations. Therefore, several variants of the MaiLi® product range (OxiFree™ technology) were characterized in vitro and in vivo in terms of injectability attributes, with a focus on hydrogel system homogeneity and ease of injection. Firstly, standardized in vitro assays were performed in SimSkin® cutaneous equivalents, with variations of the clinical injector, injection site, and injection technique. Then, automated injections in SimSkin® cutaneous equivalents were comparatively performed in a texture analysis setup to obtain fine-granulometry injection force profile results. Finally, five female participants were recruited for the in vivo arm of the study (case reports), with variations of the clinical injector, injection site, and injection technique. Generally, the obtained quantitative force values and injection force profiles were critically appraised from a translational viewpoint, based on discussions around the OxiFree™ manufacturing technology and on in-use specialized clinician feedback. Overall, the present study outlined a notable level of homogeneity across the MaiLi® product range in terms of injectability attributes, as well as consistently high ease of administration by medical aesthetic clinicians.
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Affiliation(s)
| | - Alexandre Porcello
- Development Department, Abcello Sàrl, CH-1432 Belmont-sur-Yverdon, Switzerland;
| | | | | | | | - Lee Ann Applegate
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland;
- Center for Applied Biotechnology and Molecular Medicine, University of Zurich, CH-8057 Zurich, Switzerland
- Oxford OSCAR Suzhou Center, Oxford University, Suzhou 215123, China
| | - Alexis Laurent
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1066 Epalinges, Switzerland;
- Manufacturing Department, TEC-PHARMA SA, CH-1038 Bercher, Switzerland
- Manufacturing Department, LAM Biotechnologies SA, CH-1066 Epalinges, Switzerland
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5
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Oluwole DO, Diaz-Delgado J, Buchanan W, La Ragione RM, Chen T, Liu LX. Wound recovery efficacy of retinol based-micellar formulations in an organotypic skin wound model. Int J Pharm 2024; 653:123875. [PMID: 38316316 DOI: 10.1016/j.ijpharm.2024.123875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/18/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Impairment of the skin's structural integrity initially results in acute wounds which can become chronic if timely wound closure is not achieved. Chronic wounds (CWs) affect more than 1% of the global population with increasing cases of this condition due to the ageing population. Current wound management relies on debridement, hyperbaric oxygen, antibiotics, and wound dressings, which lack early intervention and specificity. Herein, antibiotics-free retinol-based micellar formulations (RMF) were made and their wound healing efficacy were investigated in vitro. Five different formulations with retinol contents of 0.3% and 1% against a placebo were topically applied to an organotypic full-thickness skin wound model (FT-SWM, MatTek®) with a 3 mm punch wound, and maintained in an incubator for 6 days. The histological analysis of the FT-SWM was conducted at depths of 60 µm and 80 µm. It was found that all the micellar retinol formulations accelerated wound bed contraction, with 0.3% RMF demonstrating the highest efficacy. At the depths of 60 µm and 80 µm, the 0.3% RMF exhibited inner wound diameter contraction of 58% and 77%, respectively, in comparison to the placebo showing 15% and 8%. The RMF significantly accelerated wound healing and can thus be a potential early intervention for speedy wound recovery. It should be pointed out that these results were obtained based on a small sample size and a large sample size will be explored to further validate the results.
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Affiliation(s)
- David O Oluwole
- School of Chemistry and Chemical Engineering, University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Josue Diaz-Delgado
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7AL, United Kingdom
| | | | - Roberto M La Ragione
- School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Tao Chen
- School of Chemistry and Chemical Engineering, University of Surrey, Guildford GU2 7XH, United Kingdom
| | - Lian X Liu
- School of Chemistry and Chemical Engineering, University of Surrey, Guildford GU2 7XH, United Kingdom.
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6
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Cho SW, Malick H, Kim SJ, Grattoni A. Advances in Skin-on-a-Chip Technologies for Dermatological Disease Modeling. J Invest Dermatol 2024:S0022-202X(24)00115-5. [PMID: 38493383 DOI: 10.1016/j.jid.2024.01.031] [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: 10/30/2023] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 03/18/2024]
Abstract
Skin-on-a-chip (SoC) technologies are emerging as a paradigm shift in dermatology research by replicating human physiology in a dynamic manner not achievable by current animal models. Although animal models have contributed to successful clinical trials, their ability to predict human outcomes remains questionable, owing to inherent differences in skin anatomy and immune response. Covering areas including infectious diseases, autoimmune skin conditions, wound healing, drug toxicity, aging, and antiaging, SoC aims to circumvent the inherent disparities created by traditional models. In this paper, we review current SoC technologies, highlighting their potential as an alternative to animal models for a deeper understanding of complex skin conditions.
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Affiliation(s)
- Seo Won Cho
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA; Texas A&M University School of Medicine, College Station, Texas, USA
| | - Hamza Malick
- Texas A&M University School of Medicine, College Station, Texas, USA
| | - Soo Jung Kim
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA
| | - Alessandro Grattoni
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, Texas, USA; Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA; Department of Radiation Oncology, Houston Methodist Hospital, Houston, Texas, USA.
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7
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Nurani W, Anwar Y, Batubara I, Arung ET, Fatriasari W. Kappaphycus alvarezii as a renewable source of kappa-carrageenan and other cosmetic ingredients. Int J Biol Macromol 2024; 260:129458. [PMID: 38232871 DOI: 10.1016/j.ijbiomac.2024.129458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024]
Abstract
Kappa-carrageenan is one of the most traded marine-derived hydrocolloids used in the food-and-beverage, pharmaceuticals, and personal care/cosmetics industries. K. alvarezii (previously known as Kappaphycus alvarezii) is arguably the most important natural producer based on annual production size and near-homogeneity of the product (i.e., primarily being the kappa-type). The anticipated expansion of the kappa-carrageenan market in the coming years could easily generate >100,000 MT of residual K. alvarezii biomass per year, which, if left untreated, can severely affect the environment and economy of the surrounding area. Among several possible valorization routes, turning the biomass residue into anti-photoaging cosmetic ingredients could potentially be the most sustainable one. Not only optimizing the profit (thus better ensuring economic sustainability) relative to the biofuels- and animal feed-routes, the action could also promote environmental sustainability. It could reduce the dependency of the current cosmetic industry on both petrochemicals and terrestrial plant-derived bioactive compounds. Note how, in contrast to terrestrial agriculture, industrial cultivation of seaweeds does not require arable land, freshwater, fertilizers, and pesticides. The valorization mode could also facilitate the sequestration of more greenhouse gas CO2 as daily-used chemicals, since the aerial productivity of seaweeds is much higher than that of terrestrial plants. This review first summarizes any scientific evidence that K. alvarezii extracts possess anti-photoaging properties. Next, realizing that conventional extraction methods may prevent the use of such extracts in cosmetic formulations, this review discusses the feasibility of obtaining various K. alvarezii compounds using green methods. Lastly, a perspective on several potential challenges to the proposed valorization scheme, as well as the potential solutions, is offered.
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Affiliation(s)
- Wasti Nurani
- Research Center for Biomass and Bioproducts, National Research and Innovation Agency (BRIN), Kawasan KST Soekarno, Jl. Raya Bogor KM 46, Cibinong 16911, Indonesia
| | - Yelfi Anwar
- Research Center for Biomass and Bioproducts, National Research and Innovation Agency (BRIN), Kawasan KST Soekarno, Jl. Raya Bogor KM 46, Cibinong 16911, Indonesia
| | - Irmanida Batubara
- Department of Chemistry, IPB University, Bogor, Indonesia; Tropical Biopharmaca Research Center (TropBRC), Institute of Research and Community Services, IPB University, Bogor, Indonesia
| | - Enos Tangke Arung
- Faculty of Forestry, Universitas Mulawarman, Samarinda, East Kalimantan, Indonesia; Research Collaboration Center for Biomass-Based Nano Cosmetic, in collaboration with National Research and Innovation Agency (BRIN), Samarinda, East Kalimantan, Indonesia
| | - Widya Fatriasari
- Research Center for Biomass and Bioproducts, National Research and Innovation Agency (BRIN), Kawasan KST Soekarno, Jl. Raya Bogor KM 46, Cibinong 16911, Indonesia; Research Collaboration Center for Biomass-Based Nano Cosmetic, in collaboration with National Research and Innovation Agency (BRIN), Samarinda, East Kalimantan, Indonesia; Research Collaboration Center for Marine Biomaterials, Jl. Ir. Sukarno, Jatinangor, Sumedang, Indonesia.
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8
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Guo W, Ding X, Zhang H, Liu Z, Han Y, Wei Q, Okoro OV, Shavandi A, Nie L. Recent Advances of Chitosan-Based Hydrogels for Skin-Wound Dressings. Gels 2024; 10:175. [PMID: 38534593 DOI: 10.3390/gels10030175] [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: 01/29/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
The management of wound healing represents a significant clinical challenge due to the complicated processes involved. Chitosan has remarkable properties that effectively prevent certain microorganisms from entering the body and positively influence both red blood cell aggregation and platelet adhesion and aggregation in the bloodstream, resulting in a favorable hemostatic outcome. In recent years, chitosan-based hydrogels have been widely used as wound dressings due to their biodegradability, biocompatibility, safety, non-toxicity, bioadhesiveness, and soft texture resembling the extracellular matrix. This article first summarizes an overview of the main chemical modifications of chitosan for wound dressings and then reviews the desired properties of chitosan-based hydrogel dressings. The applications of chitosan-based hydrogels in wound healing, including burn wounds, surgical wounds, infected wounds, and diabetic wounds are then discussed. Finally, future prospects for chitosan-based hydrogels as wound dressings are discussed. It is anticipated that this review will form a basis for the development of a range of chitosan-based hydrogel dressings for clinical treatment.
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Affiliation(s)
- Wei Guo
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Xiaoyue Ding
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Han Zhang
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Zhenzhong Liu
- Taizhou Key Laboratory of Medical Devices and Advanced Materials, Taizhou Institute of Zhejiang University, Taizhou 318000, China
| | - Yanting Han
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
| | - Qianqian Wei
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
- 3BIO-BioMatter, École Polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium
| | - Oseweuba Valentine Okoro
- 3BIO-BioMatter, École Polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium
| | - Amin Shavandi
- 3BIO-BioMatter, École Polytechnique de Bruxelles, Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium
| | - Lei Nie
- College of Life Sciences, Xinyang Normal University, Xinyang 464000, China
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9
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Tang C, Lin P, Zhao Y, Wang P, Wang P. A Retrospective Study: Clinical Characteristics and Lifestyle Analysis of Chinese Senile Gluteal Dermatosis Patients. Clin Interv Aging 2024; 19:333-338. [PMID: 38434574 PMCID: PMC10906672 DOI: 10.2147/cia.s448026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose To summarize the clinical, histopathological and therapeutic features of senile gluteal dermatosis. Patients and Methods Retrospective analysis of 230 cases who visited the outpatient clinic of Hangzhou No. 3 People's Hospital for skin lesions on the buttocks and hips from 2018.8-2023.8 were included in the study, basic clinical information was collected, and they were subjected to physical examination of the buttocks and hips, and 36 cases were senile gluteal dermatosis, of which 7 underwent histopathological biopsy. Results A total of 230 patients were included, of which 36 were diagnosed with geriatric buttock dermatosis, with a mean age of (84.2±12.6) years, mean body mass index of (21.7±3.8) kg/m2, and a male to female ratio of 2:1. There was a significant correlation between the occurrence of the disease and age, gender, body mass index, sedentary time, type of chair used, and hypertension (P<0.05). The severity of the lesions may be associated with longer sitting time and prolonged use of bamboo chairs (P<0.05). Histopathologic changes were not specific. The skin lesions could subside after general treatment such as improvement of lifestyle, use of pressure-reducing air mattresses, salicylic acid cream, and moisturizing creams. Conclusion Senile gluteal dermatosis is a common senile physical dermatosis, mainly manifested as brownish scaly plaques, erythema and crusted ulcers, which can often be cured under reasonable treatment.
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Affiliation(s)
- Chenyu Tang
- Department of Dermatology, Hangzhou Third People’s Hospital, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Ping Lin
- Department of Gerontology, Hangzhou Third People’s Hospital, Hangzhou, People’s Republic of China
| | - Yige Zhao
- Department of Dermatology, Hangzhou Third People’s Hospital, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Panpan Wang
- Department of Dermatology, Hangzhou Third People’s Hospital, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of China
| | - Ping Wang
- Department of Dermatology, Hangzhou Third People’s Hospital, Hangzhou, People’s Republic of China
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10
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Parmeshwar N, Dugan CL, Barnes LL, Cheng JK, Patterson AK, Miller A, Mukhtar R, Piper M. Nipple-Sparing Mastectomies in Patients over the Age of 60 Years: Factors Associated with Surgical Outcomes. Ann Surg Oncol 2023; 30:8428-8435. [PMID: 37700172 DOI: 10.1245/s10434-023-14278-6] [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: 06/09/2023] [Accepted: 08/24/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Nipple-sparing mastectomy (NSM) outcomes in the elderly have not been well characterized. The goal of this study was to evaluate NSM outcomes in patients over age 60. PATIENTS AND METHODS A single-institution retrospective cohort study was performed for NSM patients over the age of 60 from January 2004 to January 2022. Demographic, intraoperative, and postoperative variables were collected. RESULTS We identified 136 women who underwent a total of 200 NSMs at a mean age 65.2 years and with mean body mass index of 25. Most (56%) had invasive breast cancer, requiring neoadjuvant chemotherapy in 15%, and 17.5% had radiation prior to NSM. A total of 91% had immediate tissue expander placement. The infection rate was 19%, with 11.5% requiring expander explantation in the follow-up period. In binomial logistic regression analysis, prior radiation increased the odds of any complication by 2.9 (OR 2.93, CI 1.30-6.58, p = 0.009) and increased the odds of infection by 5.7 (OR 5.70, CI 1.95-16.66, p = 0.001), but no associations were seen for other covariates including age, comorbidities, prior chemotherapy, or presence of invasive disease. Diabetes increased the odds of wound breakdown specifically by 9.0 (OR 8.97, CI 2.01-39.92, p = 0.004). Local recurrence was 3% in mean 3.4-year follow-up. CONCLUSIONS Our data support NSM in patients over the age of 60 years with acceptable outcomes within the standard of care. Locoregional recurrence was within the cited range of 0-5%, and only diabetes and prior radiation were associated with reconstructive complications. NSM should thus be offered when appropriate regardless of increased age to achieve oncologic and reconstructive goals.
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Affiliation(s)
- Nisha Parmeshwar
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
| | - Catherine L Dugan
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Laura L Barnes
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Justin K Cheng
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Anne K Patterson
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Amanda Miller
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Rita Mukhtar
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Merisa Piper
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
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11
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Yuceler Kacmaz H, Kahraman H, Cinar SL, Ozkan F. Skin properties associated with skin tears in older adults: A case-control study. J Tissue Viability 2023; 32:585-589. [PMID: 37839901 DOI: 10.1016/j.jtv.2023.09.004] [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: 07/15/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The world population is growing rapidly and skin problems such as skin tears (STs) are more common in aging skin due to changes in the epidermis and dermis. Identification of ageing related skin properties, which are risk factors for STs, is essential for the development of ST prevention protocols. OBJECTIVE The aim of this study was to reveal the skin properties related to epidermal function and dermal associated with STs. MATERIAL AND METHODS A prospective case-control study was conducted with a sample of 36 older adults, 18 participants with ST and 18 participants without ST, in two elderly care centers. Tewameter TM 210 was used to measure transepidermal water loss, the Sebumeter SM810 was used to measure sebum, and Cutometer Dual MPA 580 was used to measure skin viscoelasticity (R0-R9). The differences of skin properties between groups were analyzed using the independent t-test and Mann-Whitney U test. RESULTS The case group had a mean age of 77,17 ± 9,7 and the control group had a mean age of 75,33 ± 6,8. It was determined that there were more ecchymosis (p < 0.000), hematoma (p = 0.008), and ST history (p = 0.001) in the case group. Older adults in the case group were more frail than the control group (p = 0.044). Regarding the score of the skin properties, the case group showed that the TEWL levels of the older adults in the case group were lower (p = 0.031) compared to the control groups. There was a significant difference between the groups and R0, R2, R5, and R7. While R0 was higher in the case group, R2, R5, and R7 were lower than the control group. CONCLUSION Older adults with ST showed differences in skin properties compared to those without ST, especially transepidermal water loss, and viscoelasticity (R0, R2, R5, R7). The results of this study suggest that some changes in skin properties may be a risk factor for STs.
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Affiliation(s)
- Hatice Yuceler Kacmaz
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Hilal Kahraman
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Salih Levent Cinar
- Erciyes University, Faculty of Medicine, Department of Dermatology, Kayseri, Turkey.
| | - Filiz Ozkan
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
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12
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Fu H, She D, Zhang H, Guo J, Zhang G, Ma Y, Han L. Epidemiological characteristics of pressure injury and the predictive validity of Braden scale among the older hospitalized patients: A cross-sectional study. J Clin Nurs 2023; 32:7802-7811. [PMID: 37644731 DOI: 10.1111/jocn.16858] [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: 05/17/2023] [Revised: 06/28/2023] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
AIMS AND OBJECTIVES To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale. DESIGN Cross-sectional study. METHODS Conducted in a 2600-bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut-off value were assessed using receiver operating curve (ROC). RESULTS The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut-off value of 19 yielded the best predictive performance with a Yoden index of 0.710. CONCLUSION PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut-off value of 19 showing improved predictive accuracy. PATIENT OR PUBLIC CONTRIBUTION Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work.
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Affiliation(s)
- Hongqiong Fu
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Dongli She
- Gansu Provincial Hospital, Lanzhou, China
| | | | - Jiali Guo
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Guoli Zhang
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Yuxia Ma
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Lin Han
- School of Nursing, Lanzhou University & Gansu Provincial Hospital, Lanzhou, China
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13
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Frota OP, Pinho JN, Ferreira-Júnior MA, Sarti ECFB, Paula FM, Ferreira DN. Incidence and risk factors for medical adhesive-related skin injury in catheters of critically ill patients: A prospective cohort study. Aust Crit Care 2023; 36:997-1003. [PMID: 37002019 DOI: 10.1016/j.aucc.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The skin in contact with the adhesives used to secure catheters is vulnerable to medical adhesive-related skin injury (MARSI). The incidence of these injuries and the risks associated with their development have not been accurately estimated previously in critically ill patients. AIM The aim of this study was to investigate the incidence and risk factors for MARSI in catheters of critically ill patients. METHODS A prospective cohort study was conducted in adult intensive care units of two Brazilian university hospitals. A total of 150 patients (439 catheters) were included. The skin exposed to the catheter fixation adhesives (central venous, nasogastric, nasoenteral, and indwelling urinary) was examined daily by four trained researchers. The patients' sociodemographic and clinical data were collected from their electronic medical records. The association between independent variables and MARSI was investigated by bivariate statistics, followed by a multiple logistic regression. RESULTS The MARSI incidence was 42% (86.5 MARSIs per 1000 patient-days). Advanced age, prolonged hospital stay, dry skin, repetitive adhesive removal, low Braden Scale score, and hypoalbuminemia were associated with MARSI (p < .05). According to the multivariate logistic regression, dry skin increased the chance of MARSI by 5.2 times (odds ratio: 5.2; 95% confidence interval: 2.4-11.1), while the Braden Scale score was a protective factor, showing 30% less chance of MARSI for each added score (odds ratio: 0.7; 95% confidence interval: 0.6-0.9). A higher incidence of MARSI was observed in nasoenteral catheters and in those fixed with adhesive using natural rubber. The MARSI types were predominantly mechanical (70.3%): skin stripping (41.3%), skin tear (26.1%), and tension injury or blister (2.9%). CONCLUSIONS MARSI is a common event in adult intensive care units, and most risk factors are modifiable. Preventive actions are potentially capable of reducing incidence, optimising financial resources, and improving clinical results.
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Affiliation(s)
- Oleci P Frota
- School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
| | - Jéssica N Pinho
- School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Marcos A Ferreira-Júnior
- School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Elaine C F B Sarti
- School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Fabiana M Paula
- School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Danielle N Ferreira
- Hospital Universitário Maria Aparecida Pedrossian, Campo Grande, Mato Grosso do Sul, Brazil
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14
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Stelling-Férez J, López-Miranda S, Gabaldón JA, Nicolás FJ. Oleanolic Acid Complexation with Cyclodextrins Improves Its Cell Bio-Availability and Biological Activities for Cell Migration. Int J Mol Sci 2023; 24:14860. [PMID: 37834307 PMCID: PMC10573973 DOI: 10.3390/ijms241914860] [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: 09/07/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Wound healing is a complex process to restore skin. Plant-derived bioactive compounds might be a source of substances for the treatment of wounds stalled in a non-resolving stage of wound healing. Oleanolic acid (OA), a pentacyclic triterpene, has shown favorable wound healing properties both in vitro and in vivo. Unfortunately, OA cannot be solubilized in aqueous media, and it needs to be helped by the use of dimethyl sulfoxide (DMSO). In this paper, we have shown that cyclodextrins (CDs) are a good alternative to DMSO as agents to deliver OA to cells, providing better features than DMSO. Cyclodextrins are natural macromolecules that show a unique tridimensional structure that can encapsulate a wide variety of hydrophobic compounds. We have studied the cyclodextrin-encapsulated form of OA with OA/DMSO, comparing their stability, biological properties for cell migration, and cell viability. In addition, detailed parameters related to cell migration and cytoskeletal reorganization have been measured and compared. Our results show that OA-encapsulateds compound exhibit several advantages when compared to non-encapsulated OA in terms of chemical stability, migration enhancement, and preservation of cell viability.
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Affiliation(s)
- Javier Stelling-Férez
- Department of Nutrition and Food Technology, Health Sciences PhD Program, Universidad Católica de San Antonio Murcia (UCAM), Campus de los Jerónimos n°135, Guadalupe, 30107 Murcia, Spain; (J.S.-F.); (S.L.-M.); (J.A.G.)
- Regeneration, Molecular Oncology and TGF-β, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain
| | - Santiago López-Miranda
- Department of Nutrition and Food Technology, Health Sciences PhD Program, Universidad Católica de San Antonio Murcia (UCAM), Campus de los Jerónimos n°135, Guadalupe, 30107 Murcia, Spain; (J.S.-F.); (S.L.-M.); (J.A.G.)
| | - José Antonio Gabaldón
- Department of Nutrition and Food Technology, Health Sciences PhD Program, Universidad Católica de San Antonio Murcia (UCAM), Campus de los Jerónimos n°135, Guadalupe, 30107 Murcia, Spain; (J.S.-F.); (S.L.-M.); (J.A.G.)
| | - Francisco José Nicolás
- Regeneration, Molecular Oncology and TGF-β, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, 30120 Murcia, Spain
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15
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Vuorinen M, Ram F. Effectiveness of moisturiser for the prevention of skin tears in older adults residing in long-term care facilities: a clinical review. Br J Community Nurs 2023; 28:S14-S18. [PMID: 37643116 DOI: 10.12968/bjcn.2023.28.sup9.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
In long-term care facilities the treatment of skin tears often takes a lot of nursing time, is costly and can negatively impact the residents' quality of life. The purpose of this clinical review was to investigate whether the application of moisturising lotion is beneficial in skin tear reduction in older adults residing in long-term care facilities. A literature review of original studies investigating the effect of moisturising lotion on skin tears in older adults (65+ years) was conducted. Results indicate that a minimum of twice daily application of moisturising lotion with neutral pH can reduce skin tears by 50% compared to usual care. Therefore, routine skin moisturising is recommended as one component of a skin tear prevention programme for this demogrpahic.
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Affiliation(s)
- Minna Vuorinen
- Clinical Nurse Educator, Oceania Healthcare, New Zealand
| | - Felix Ram
- Director, Center of Excellence for Person-Centered Aged Care, Oceania Healthcare, New Zealand
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16
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Bora L, Iftode A, Muț AM, Vlaia LL, Olteanu GE, Muntean D, Dehelean CA, Buda V, Coneac GH, Danciu C. Stability Profile and Clinical Evaluation of an Innovative Hydrogel Containing Polymeric Micelles as Drug Delivery Systems with Oregano Essential Oil against Fibroepithelial Polyps. Pharmaceuticals (Basel) 2023; 16:980. [PMID: 37513892 PMCID: PMC10386020 DOI: 10.3390/ph16070980] [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: 06/16/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Skin tags, also known as fibroepithelial polyps (FPs) or acrochordons, are soft, pigmented excrescences, with a prevalence of 50-60% in the population, occurring especially in the fourth decade of life. To date, FPs have been efficiently eliminated using minimum invasive methods such as surgical removal, cauterization, laser irradiation, and cryosurgery. Over-the-counter treatments are also of interest for patients due to their non-invasive character, but their clinical efficiency has not been clearly demonstrated. This study was designed in order to evaluate the efficacy of a modern-pharmaceutical-formulation-type poloxamer-based binary hydrogel, having Origanum vulgare L. essential oil (OEO-PbH) as an active ingredient in the management of FPs. The formulation has been shown to possess good qualities in terms of stability and sterility. Non-invasive measurements revealed changes in some physiological skin parameters. An increase in transepidermal water loss (TEWL) and erythema index was noted, while skin surface water content (SWC) decreased during eight weeks of treatment. The macroscopic evaluation revealed that the FPs dried and shrunk after topical treatment with OEO-PbH. Clinically, patients presented a lowering of the number of lesions on the treated area of 20-30% after one month of treatment and around 50% after the second month. Histopathological examination suggests that topical treatment with OEO-PbH may induce histological changes in the epidermis, dermis, and fibrovascular cores of FPs, including a loss of thickness, reduced size and number of blood vessels, and low cellularity. These changes may contribute to the observed reduction in size of FPs after treatment with OEO-PbH.
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Affiliation(s)
- Larisa Bora
- Department of Pharmacognosy, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Andrada Iftode
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Toxicology and Drug Industry, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Ana Maria Muț
- Department II-Pharmaceutical Technology, Formulation and Technology of Drugs Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Lavinia Lia Vlaia
- Department II-Pharmaceutical Technology, Formulation and Technology of Drugs Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Gheorghe-Emilian Olteanu
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Toxicology and Drug Industry, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Center for Research and Innovation in Personalized Medicine of Respiratory Diseases, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Delia Muntean
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Microbiology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Multidisciplinary Research Center on Antimicrobial Resistance, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Cristina Adriana Dehelean
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Toxicology and Drug Industry, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Valentina Buda
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Department of Clinical Pharmacy, Communication in Pharmacy and Pharmaceutical Care, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Georgeta Hermina Coneac
- Department II-Pharmaceutical Technology, Formulation and Technology of Drugs Research Center, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Corina Danciu
- Department of Pharmacognosy, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluation, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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17
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Parmeshwar N, Barnes LL, Dugan CL, Patterson AK, Lem M, Piper M. Evaluation of Microvascular Autologous Breast Reconstruction in Patients Older Than 60 Years. Ann Plast Surg 2023; 91:96-100. [PMID: 37347181 DOI: 10.1097/sap.0000000000003557] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
BACKGROUND While free-flap breast reconstruction becomes more common, it is still approached with caution in older patients. Outcomes in the elderly population have not been well characterized, especially with regard to donor-site sequalae. This study compares microvascular autologous breast reconstruction outcomes in patients older and younger 60 years. METHODS A single-institution retrospective review was performed for microvascular autologous breast reconstruction from January 2004 through January 2021. Demographic, intraoperative, and postoperative variables, including breast flap and donor-site complications, were evaluated. RESULTS Five hundred forty-five breast free flaps were identified, of which 478 (87.8%) were performed on patients younger than 60 years (mean, 46.2 years) and 67 (12.2%) older than 60 years (mean, 64.8 years; P = 0.000). Hyperlipidemia was significantly higher in older patients (19.4% vs 9.6%, P = 0.016). Mean operative time was 46.3 minutes faster in the older cohort ( P = 0.030). There were no significant differences in free-flap loss, venous congestion, takeback, hematoma, seroma, wound healing, or infection. Interestingly, there were significantly more total breast flap complications (28.5% vs 16.4%, P = 0.038) and higher rates of fat necrosis (9.6% vs 1.5%, P = 0.026) in the younger cohort. Significantly more abdominal donor-site complications (43.3% vs 21.3%, P = 0.000) were seen in the older people, with increased wound breakdown ( P = 0.000) and any return to the operating room (20.9% vs 9.8%, P = 0.007). Older patients were also significantly more likely to require surgical correction of an abdominal bulge or hernia (10.4% vs 4%, P = 0.020). The mean follow-up was 1.8 years. CONCLUSIONS Our data showed no worsening of individual breast flap outcomes in the older people. However, there were significantly more abdominal complications including surgical correction of abdominal bulge and hernia. This may be related to the inherent qualities of tissue aging and should be taken into consideration for flap selection. These results support autologous breast reconstruction in patients older than 60 years, but patients should be counseled regarding potentially increased abdominal donor-site sequelae.
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Affiliation(s)
- Nisha Parmeshwar
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco
| | - Laura L Barnes
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco
| | - Catherine L Dugan
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco
| | - Anne K Patterson
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco
| | - Melinda Lem
- University of California, Irvine, School of Medicine, Irvine, CA
| | - Merisa Piper
- From the Division of Plastic Surgery, Department of Surgery, University of California, San Francisco, San Francisco
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18
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Ansaf RB, Ziebart R, Gudapati H, Simoes Torigoe RM, Victorelli S, Passos J, Wyles SP. 3D bioprinting-a model for skin aging. Regen Biomater 2023; 10:rbad060. [PMID: 37501679 PMCID: PMC10369216 DOI: 10.1093/rb/rbad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/16/2023] [Accepted: 06/04/2023] [Indexed: 07/29/2023] Open
Abstract
Human lifespan continues to extend as an unprecedented number of people reach their seventh and eighth decades of life, unveiling chronic conditions that affect the older adult. Age-related skin conditions include senile purpura, seborrheic keratoses, pemphigus vulgaris, bullous pemphigoid, diabetic foot wounds and skin cancer. Current methods of drug testing prior to clinical trials require the use of pre-clinical animal models, which are often unable to adequately replicate human skin response. Therefore, a reliable model for aged human skin is needed. The current challenges in developing an aged human skin model include the intrinsic variability in skin architecture from person to person. An ideal skin model would incorporate innate functionality such as sensation, vascularization and regeneration. The advent of 3D bioprinting allows us to create human skin equivalent for use as clinical-grade surgical graft, for drug testing and other needs. In this review, we describe the process of human skin aging and outline the steps to create an aged skin model with 3D bioprinting using skin cells (i.e. keratinocytes, fibroblasts and melanocytes). We also provide an overview of current bioprinted skin models, associated limitations and direction for future research.
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Affiliation(s)
- Ryeim B Ansaf
- Department of Biology, Colorado State University Pueblo, Pueblo, CO 81001, USA
| | - Rachel Ziebart
- Mayo Clinic Alix School of Medicine, Rochester, MN 55905, USA
| | | | | | - Stella Victorelli
- Mayo Clinic Department of Physiology and Biomedical Engineering, Rochester, MN 55905, USA
- Mayo Clinic Robert and Arlene Kogod Center on Aging, Rochester, MN 55905, USA
| | - Joao Passos
- Mayo Clinic Department of Physiology and Biomedical Engineering, Rochester, MN 55905, USA
- Mayo Clinic Robert and Arlene Kogod Center on Aging, Rochester, MN 55905, USA
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Hayes C, Fox A, Scott-Thomas J, Graham Y. Pressure ulcer prevention in practice. Br J Community Nurs 2023; 28:S14-S21. [PMID: 37262096 DOI: 10.12968/bjcn.2023.28.sup6.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pressure ulcer avoidance in the context of care has the potential to improve the quality and longevity of lives for those living in residential and non-residential care home settings. This paper reports on an educational intervention in the North East of England, which focused on the initial benchmarking of self-reported knowledge levels of healthcare workers, who regularly work with people living within this context. Using a longitudinal study design, a series of three questionnaires were used to collate data from research participants. The study revealed a disparity between what healthcare workers perceived their knowledge to be versus what it was, in terms of application to practice at the front line of patient care. The study reveals that confidence levels in dealing with pressure ulceration had been significantly altered by the training session that was being implemented. It also raised concerns on the methodological approaches being used in the education and training of care staff, which should ideally lead them to be proactive with patients in their care. The study provides an insight into the need for a strategic and targeted approach to pressure ulceration avoidance education, which is tailored to individual learning needs through supervision and mentorship as part of clinical education.
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Affiliation(s)
- Catherine Hayes
- Professor of Health Professions Pedagogy and Scholarship, University of Sunderland, Faculty of Health Sciences and Wellbeing
| | - Ann Fox
- Executive Director of Nursing, NHS Sunderland CCG
| | - Jeanette Scott-Thomas
- Executive Director of Nursing, Quality and Patient Safety at South Tyneside Clinical Commissioning Group
| | - Yitka Graham
- Associate Professor of Health Services Research and Head of the Helen McCardle Nursing and Research Care Institute
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Qiu Y, Fernández-García B, Lehmann HI, Li G, Kroemer G, López-Otín C, Xiao J. Exercise sustains the hallmarks of health. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:8-35. [PMID: 36374766 PMCID: PMC9923435 DOI: 10.1016/j.jshs.2022.10.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/10/2022] [Accepted: 09/02/2022] [Indexed: 05/23/2023]
Abstract
Exercise has long been known for its active role in improving physical fitness and sustaining health. Regular moderate-intensity exercise improves all aspects of human health and is widely accepted as a preventative and therapeutic strategy for various diseases. It is well-documented that exercise maintains and restores homeostasis at the organismal, tissue, cellular, and molecular levels to stimulate positive physiological adaptations that consequently protect against various pathological conditions. Here we mainly summarize how moderate-intensity exercise affects the major hallmarks of health, including the integrity of barriers, containment of local perturbations, recycling and turnover, integration of circuitries, rhythmic oscillations, homeostatic resilience, hormetic regulation, as well as repair and regeneration. Furthermore, we summarize the current understanding of the mechanisms responsible for beneficial adaptations in response to exercise. This review aimed at providing a comprehensive summary of the vital biological mechanisms through which moderate-intensity exercise maintains health and opens a window for its application in other health interventions. We hope that continuing investigation in this field will further increase our understanding of the processes involved in the positive role of moderate-intensity exercise and thus get us closer to the identification of new therapeutics that improve quality of life.
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Affiliation(s)
- Yan Qiu
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Benjamin Fernández-García
- Health Research Institute of the Principality of Asturias (ISPA), Oviedo 33011, Spain; Department of Morphology and Cell Biology, Anatomy, University of Oviedo, Oviedo 33006, Spain
| | - H Immo Lehmann
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Guoping Li
- Cardiovascular Division of the Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Guido Kroemer
- Centre de Recherche des Cordeliers, Equipe labellisée par la Ligue contre le cancer, Université de Paris Cité, Sorbonne Université, Inserm U1138, Institut Universitaire de France, Paris 75231, France; Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, Villejuif 94805, France; Institut du Cancer Paris CARPEM, Department of Biology, Hôpital Européen Georges Pompidou, AP-HP, Paris 75015, France.
| | - Carlos López-Otín
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo 33006, Spain; Centro de Investigación Biomédica en Red Enfermedades Cáncer (CIBERONC), Oviedo 33006, Spain.
| | - Junjie Xiao
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China.
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21
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Aging and Wound Healing of the Skin: A Review of Clinical and Pathophysiological Hallmarks. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122142. [PMID: 36556508 PMCID: PMC9784880 DOI: 10.3390/life12122142] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022]
Abstract
Aging is a universal process that can cause diminished function of organs and various diseases. The most striking consequences of aging can be seen visibly on the skin, which acts as a barrier against various external insults. Aging of the skin consists of intrinsic and extrinsic processes that work in concert and influence each other. Intrinsic aging involves biochemical degenerative processes that gradually takes place with age. Extrinsic aging are biochemical processes driven by external influences that lead to aging. There are significant morphological changes at all levels in aged skin that have a profound effect on the characteristics of the skin. Even though skin is subjected to damage by external insults, it is equipped with a healing capability in order to restore its normal structure and function. However, aging has a significant impact on the skin's healing function by prolonging the inflammatory phase and increasing the production of reactive oxygen species (ROS). This shifts the healing process towards having more protein degradation, which can lead to chronic wound healing with an abundance of complications.
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22
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Zhao R, Wang G, Xie H. Subcutaneous Face and Neck Lift With Prefabricated Skin Excision: A Practical Technique With Favorable Results in Young and Middle-Aged Chinese Patients. Dermatol Surg 2022; 48:1317-1323. [PMID: 36449874 DOI: 10.1097/dss.0000000000003631] [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: 03/16/2022] [Accepted: 09/26/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Subcutaneous face and neck lift is a popular procedure in Chinese face and neck rejuvenation. However, there are limited studies focusing on the details and evaluation of this technique. OBJECTIVE To introduce our subcutaneous face and neck lift technique with prefabricated skin excision, evaluating the efficacy with patient reported FACE-Q Scale. In addition, to investigate on skin excision and patient's satisfaction under different circumstances. MATERIALS AND METHODS One hundred forty-five consecutive patients were identified who underwent subcutaneous face and neck lift with our technique. Online FACE-Q Scale was assessed for patients' satisfaction 6 months postoperatively. The skin excision and FACE-Q Scale were compared among different subgroups. RESULTS Fifty-eight patients completed the FACE-Q. Patients demonstrated high satisfaction overall and felt 8.8 years younger than their actual age. Intraoperative skin excision data verified the practicality of the prefabricated technique. There was a constant trend with patients' satisfaction among different age groups. The preliminary comparison between the facial bone reduction group and the general group revealed no significant difference. CONCLUSION The subcutaneous face and neck lift technique with prefabricated skin excision is an effective technique with favorable results in young and middle-aged Chinese patients. LEVEL OF EVIDENCE IV. Evidence obtained from a retrospective cohort analytic study.
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Affiliation(s)
- Runlei Zhao
- All authors are affiliated with the Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
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23
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UV-induced senescence of human dermal fibroblasts restrained by low-stiffness matrix by inhibiting NF-κB activation. ENGINEERED REGENERATION 2022. [DOI: 10.1016/j.engreg.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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24
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Mulligan KM, O'Connell KA, da Silva A, Szeto MD, Sivesind TE, Cowdell F, Dyson J, Dellavalle RP. From the Cochrane library: Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings. J Am Acad Dermatol 2022; 87:1428-1431. [PMID: 35944812 DOI: 10.1016/j.jaad.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/19/2022] [Accepted: 08/03/2022] [Indexed: 11/19/2022]
Affiliation(s)
| | - Katie A O'Connell
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alexandra da Silva
- College of Medicine, California Northstate University, Elk Grove, California
| | - Mindy D Szeto
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Torunn E Sivesind
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Fiona Cowdell
- Faculty of Health Education and Life Sciences, Birmingham City University, Edgbaston, Birmingham, United Kingdom
| | - Judith Dyson
- Faculty of Health Education and Life Sciences, Birmingham City University, Edgbaston, Birmingham, United Kingdom
| | - Robert P Dellavalle
- Department of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
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25
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Johnstone G, Joe A, Dickins M, Lowthian JA. Use of home care services by older Veterans and dependants in Melbourne, Australia, 2007-2016. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2022. [DOI: 10.3138/jmvfh-2021-0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
LAY SUMMARY Military service has an impact on health and well-being across the life course. However, there is little research on older Veterans and dependants who use home care to enable them to remain living in the community. The authors analysed data from a Melbourne, Australia, home care organization’s electronic care records to explore the differences between clients supported by the Department of Veterans’ Affairs and clients in the general home nursing population. Results showed the greater needs of and complexity of care utilized by Veterans and dependants. Funding structures and support services need to account for these needs in older age.
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Affiliation(s)
- Georgina Johnstone
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Victoria, Australia
| | - Angela Joe
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Victoria, Australia
| | - Marissa Dickins
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Victoria, Australia
| | - Judy A. Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Melbourne, Victoria, Australia
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26
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Carver CH, Mullis S, Fitzgerald KH. Seating and Wheeled Mobility Clinicians Contribute to the Wound Care Team. Phys Med Rehabil Clin N Am 2022; 33:789-803. [PMID: 36243470 DOI: 10.1016/j.pmr.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Many know that the wound care team consists of physicians and nurses with specialized training. Many may not know of physical therapists (PT) or occupational therapists (OT) with training in seating and wheeled mobility who address skin injuries in people who are full-time wheelchair users. PTs/OTs address the fit and use of their wheelchair to their body and look at their daily function while looking for causes of skin injury otherwise not seen and can help prevent them in the future. Therefore, this makes PTs and OTs with this expertise a valuable part of the wound care team.
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27
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Chen G, Chen H, Zeng X, Zhu W. Stem cell-derived exosomal transcriptomes for wound healing. Front Surg 2022; 9:933781. [PMID: 36034367 PMCID: PMC9417542 DOI: 10.3389/fsurg.2022.933781] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/01/2022] [Indexed: 12/02/2022] Open
Abstract
Wound healing is a complex and integrated process of the interaction of various components within the injured tissue. Accumulating evidence suggested that stem cell-derived exosomal transcriptomes could serve as key regulatory molecules in wound healing in stem cell therapy. Stem cell-derived exosomal transcriptomes mainly consist of long noncoding RNAs (lncRNAs), microRNAs (miRNAs), circular RNAs (circRNAs) and messenger RNAs (mRNAs). In this article we presented a brief introduction on the wound repair process and exosomal transcriptomes. Meanwhile, we summarized our current knowledge of the involvement of exosomal transcriptomes in physiological and pathological wound repair process including inflammation, angiogenesis, and scar formation.
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Affiliation(s)
- Guiling Chen
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- National Institute of Stem Cell Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
| | - Hankun Chen
- Research and Development Department, Guangzhou Qinglan Biotechnology Company Limited, Guangzhou, China
| | - Xiang Zeng
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- National Institute of Stem Cell Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- Correspondence: Xiang Zeng Wei Zhu
| | - Wei Zhu
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
- Correspondence: Xiang Zeng Wei Zhu
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29
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Bandeira da Silva CV, da Costa Silva RS, Serna González CV, Hevia Campos HM, Woo K, Nogueira PC, Gouveia Santos VLCD. Epidemiología de los desgarros de piel: revisión bibliográfica. J Wound Care 2022; 31:7-18. [PMID: 36789899 DOI: 10.12968/jowc.2022.31.latam_sup_6.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objetivo: Identificar y describir la epidemiología de los desgarros de piel (DP) en el contexto latinoamericano. Método: Revisión bibliográfica de estudios epidemiológicos publicados entre 1946 y mayo de 2021, en inglés, español y portugués, consultados en texto completo. Para la búsqueda, se utilizaron descriptores correspondientes a la estrategia PCC: Población (adultos), Concepto (epidemiología de los DP) y Contexto (hospitalario e institucional). Los estudios fueron recuperados de las bases de datos Scielo, Lilacs, Embase, Cinahl, Medline y BDEnf, y evaluados por dos revisores independientes. Los instrumentos STROBE y Newcastle-Ottawa fueron usados para evaluar la calidad de estudios de prevalencia e incidencia, respectivamente. Resultados: En total, 21 publicaciones fueron incluidas (siete de ellas, de origen latinoamericano). La prevalencia, reportada en 16 estudios, estuvo entre 0,97 y 28,7%. La incidencia, reportada en cinco estudios, varió entre 3,8 y 40%. Los factores de riesgo asociados al desarrollo de DP fueron: historia previa de la lesión, puntajes bajos en la escala de Braden, dependencia para actividades básicas de la vida diaria, y edad avanzada. En América latina, Brasil se destaca como el país con mayor número de publicaciones (n=5; 23,8%). Conclusión: La mayoría de los DP pueden ser considerados eventos adversos evitables, por lo tanto, los valores de incidencia y prevalencia encontrados son elevados. La caracterización de la situación epidemiológica de los DP posibilita la creación de protocolos y políticas públicas para su prevención y detección precoz. Conflicto de interés: Todos los autores son miembros del International Skin Tears Advisory Panel (ISTAP). CVBS es consultora técnica. CVSG es conferencista. KW es miembro del Canadian Pressure Injury Advisory Panel, consultor en centros de heridas en Canadá, y conferencista para varias empresas internacionales en la industria del cuidado de las heridas.
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Affiliation(s)
- Cinthia V Bandeira da Silva
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Rayanne S da Costa Silva
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Carol V Serna González
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Heidi M Hevia Campos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Escuela de Enfermería, Universidad Andres Bello, Viña del Mar, Chile
| | - Kevin Woo
- Escuela de Enfermería, Universidad de Queens (Queen's University), Kingston, Ontario, Canadá
| | - Paula C Nogueira
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Vera L Conceição de Gouveia Santos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
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30
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Bandeira da Silva CV, da Costa Silva RS, Serna González CV, Hevia Campos HM, Woo K, Nogueira PC, Gouveia Santos VLCD. Epidemiología de los desgarros de piel: revisión bibliográfica. J Wound Care 2022; 31:7-18. [PMID: 36787945 DOI: 10.12968/jowc.2022.31.latam_sup_6a.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Objetivo: Identificar y describir la epidemiología de los desgarros de piel (DP) en el contexto latinoamericano. Método: Revisión bibliográfica de estudios epidemiológicos publicados entre 1946 y mayo de 2021, en inglés, español y portugués, consultados en texto completo. Para la búsqueda, se utilizaron descriptores correspondientes a la estrategia PCC: Población (adultos), Concepto (epidemiología de los DP) y Contexto (hospitalario e institucional). Los estudios fueron recuperados de las bases de datos Scielo, Lilacs, Embase, Cinahl, Medline y BDEnf, y evaluados por dos revisores independientes. Los instrumentos STROBE y Newcastle-Ottawa fueron usados para evaluar la calidad de estudios de prevalencia e incidencia, respectivamente. Resultados: En total, 21 publicaciones fueron incluidas (siete de ellas, de origen latinoamericano). La prevalencia, reportada en 16 estudios, estuvo entre 0,97 y 28,7%. La incidencia, reportada en cinco estudios, varió entre 3,8 y 40%. Los factores de riesgo asociados al desarrollo de DP fueron: historia previa de la lesión, puntajes bajos en la escala de Braden, dependencia para actividades básicas de la vida diaria, y edad avanzada. En América latina, Brasil se destaca como el país con mayor número de publicaciones (n=5; 23,8%). Conclusión: La mayoría de los DP pueden ser considerados eventos adversos evitables, por lo tanto, los valores de incidencia y prevalencia encontrados son elevados. La caracterización de la situación epidemiológica de los DP posibilita la creación de protocolos y políticas públicas para su prevención y detección precoz. Conflicto de interés: Todos los autores son miembros del International Skin Tears Advisory Panel (ISTAP). CVBS es consultora técnica. CVSG es conferencista. KW es miembro del Canadian Pressure Injury Advisory Panel, consultor en centros de heridas en Canadá, y conferencista para varias empresas internacionales en la industria del cuidado de las heridas.
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Affiliation(s)
- Cinthia V Bandeira da Silva
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Rayanne S da Costa Silva
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Carol V Serna González
- Programa de Posgrado en Enfermería en la Salud del Adulto (PROESA). Escuela de Enfermería, Universidad de San Pablo (Escola de Enfermagem da Universidade de São Paulo), San Pablo, Brasil.,Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Heidi M Hevia Campos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Escuela de Enfermería, Universidad Andres Bello, Viña del Mar, Chile
| | - Kevin Woo
- Escuela de Enfermería, Universidad de Queens (Queen's University), Kingston, Ontario, Canadá
| | - Paula C Nogueira
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
| | - Vera L Conceição de Gouveia Santos
- Grupo de Investigación en Estomaterapia. Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil.,Departamento de Enfermería Médico-quirúrgica, Escola de Enfermagem, Universidade de São Paulo, San Pablo, Brasil
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31
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Mohammed Y, Holmes A, Kwok PCL, Kumeria T, Namjoshi S, Imran M, Matteucci L, Ali M, Tai W, Benson HA, Roberts MS. Advances and future perspectives in epithelial drug delivery. Adv Drug Deliv Rev 2022; 186:114293. [PMID: 35483435 DOI: 10.1016/j.addr.2022.114293] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/12/2022]
Abstract
Epithelial surfaces protect exposed tissues in the body against intrusion of foreign materials, including xenobiotics, pollen and microbiota. The relative permeability of the various epithelia reflects their extent of exposure to the external environment and is in the ranking: intestinal≈ nasal ≥ bronchial ≥ tracheal > vaginal ≥ rectal > blood-perilymph barrier (otic), corneal > buccal > skin. Each epithelium also varies in their morphology, biochemistry, physiology, immunology and external fluid in line with their function. Each epithelium is also used as drug delivery sites to treat local conditions and, in some cases, for systemic delivery. The associated delivery systems have had to evolve to enable the delivery of larger drugs and biologicals, such as peptides, proteins, antibodies and biologicals and now include a range of physical, chemical, electrical, light, sound and other enhancement technologies. In addition, the quality-by-design approach to product regulation and the growth of generic products have also fostered advancement in epithelial drug delivery systems.
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32
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Walker M. Human skin through the ages. Int J Pharm 2022; 622:121850. [PMID: 35623487 DOI: 10.1016/j.ijpharm.2022.121850] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/27/2022]
Abstract
As the largest organ of the human body the skin offers a protective role, providing a tough but pliable covering that provides the major barrier between the internal organs and the environment. It actively regulates water loss and is both oxygen and carbon dioxide permeable, and influences temperature regulation and immunological functions through its sensory properties. Both intrinsic and enhanced environmental factors contribute to the progressive deterioration of the skin with increasing age. Cutaneous problems are therefore an unavoidable and inevitable consequence of aging skin, which can prove to be both cosmetically unacceptable to those who succumb to these problems, as well as even life threatening if skin breakdown becomes chronic as is case with leg ulceration. This in turn has major implications for long-term impact on those looking after them (e.g., family, carers, etc.) and a huge burden on the health care system.
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Zaharie RD, Popa C, Schlanger D, Vălean D, Zaharie F. The Role of IL-22 in Wound Healing. Potential Implications in Clinical Practice. Int J Mol Sci 2022; 23:3693. [PMID: 35409053 PMCID: PMC8998254 DOI: 10.3390/ijms23073693] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/14/2022] Open
Abstract
Wound healing is a complex process that is mediated and influenced by several cytokines, chemokines, and growth factors. Interleukin-22 (IL-22) is a cytokine that plays a critical role in tissue regeneration. Our study is a systematic review that addressed the implications of IL-22 in the healing of wounds caused by external factors. Thirteen studies were included in our review, most of them being experimental studies. Three clinical studies underlined the potential role of IL-22 in day-to-day clinical practice. IL-22 plays a central role in wound healing, stimulating the proliferation, migration, and differentiation of the cells involved in tissue repair. However, overexpression of IL-22 can cause negative effects, such as keloid scars or peritoneal adhesions. The results of the presented studies are promising, but further research that validates the roles of IL-22 in clinical practice and analyzes its potential implication in surgical healing is welcomed.
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Affiliation(s)
- Roxana Delia Zaharie
- Gastroenterology Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania;
- Gastroenterology Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Călin Popa
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Diana Schlanger
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Dan Vălean
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
| | - Florin Zaharie
- Surgery Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, Street Emil Isac No. 13, 400023 Cluj-Napoca, Romania; (D.V.); (F.Z.)
- Surgery Department, Regional Institute of Gastroenterology and Hepatology “Prof. Dr. O. Fodor”, Street Croitorilor No. 19–21, 400162 Cluj-Napoca, Romania
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Lalieu R, Raap RB, van Hulst R. Hyperbaric oxygen therapy: when pressure is good for diabetic foot ulcers. Br J Community Nurs 2022; 27:S6-S12. [PMID: 35274985 DOI: 10.12968/bjcn.2022.27.sup3.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The diabetic foot ulcer (DFU) as a common complication of diabetes. Even with adequate treatment, up to 35% of these ulcers do not heal. This is due to the effect of aging, repeated ischemia-reperfusion (IR) injury, bacterial colonisation of the wound and chronic hypoxia. All wound-healing processes are highly dependent on oxygen, so hyperbaric oxygen therapy (HBOT) can be employed to improve wound healing and correct the four pathophysiological factors for chronic wounds. It is, in fact, internationally recognised as a treatment option for non-healing DFUs. Several trials and systematic reviews have been performed on its efficacy, which show a positive trend towards increased wound healing and reduced amputation risk. Some controversy exists due to contradictory results in these studies, which may be due to grouping patients with and without peripheral arterial occlusive disease (PAOD) together. Side effects are usually mild and transient, and the treatment is considered safe.
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Affiliation(s)
- Rutger Lalieu
- Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands, and Amsterdam University Medical Centers, location AMC, Department of Anaesthesiology
| | - René Bol Raap
- Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands
| | - Rob van Hulst
- Amsterdam University Medical Centers, location AMC, Department of Anaesthesiology and Hyperbaric Department
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Composite Membrane Dressings System with Metallic Nanoparticles as an Antibacterial Factor in Wound Healing. MEMBRANES 2022; 12:membranes12020215. [PMID: 35207136 PMCID: PMC8876280 DOI: 10.3390/membranes12020215] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/26/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023]
Abstract
Wound management is the burning problem of modern medicine, significantly burdening developed countries’ healthcare systems. In recent years, it has become clear that the achievements of nanotechnology have introduced a new quality in wound healing. The application of nanomaterials in wound dressing significantly improves their properties and promotes the healing of injuries. Therefore, this review paper presents the subjectively selected nanomaterials used in wound dressings, including the metallic nanoparticles (NPs), and refers to the aspects of their application as antimicrobial factors. The literature review was supplemented with the results of our team’s research on the elements of multifunctional new-generation dressings containing nanoparticles. The wound healing multiple molecular pathways, mediating cell types, and affecting agents are discussed herein. Moreover, the categorization of wound dressings is presented. Additionally, some materials and membrane constructs applied in wound dressings are described. Finally, bacterial participation in wound healing and the mechanism of the antibacterial function of nanoparticles are considered. Membranes involving NPs as the bacteriostatic factors for improving wound healing of skin and bones, including our experimental findings, are discussed in the paper. In addition, some studies of our team concerning the selected bacterial strains’ interaction with material involving different metallic NPs, such as AuNPs, AgNPs, Fe3O4NPs, and CuNPs, are presented. Furthermore, nanoparticles’ influence on selected eukaryotic cells is mentioned. The ideal, universal wound dressing still has not been obtained; thus, a new generation of products have been developed, represented by the nanocomposite materials with antibacterial, anti-inflammatory properties that can influence the wound-healing process.
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Li J, Zeng X, Yang X, Ding H. Lycopene ameliorates skin aging by regulating the insulin resistance pathway and activating SIRT1. Food Funct 2022; 13:11307-11320. [DOI: 10.1039/d2fo01111e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Lycopene could reverse insulin resistance through SIRT1 during skin aging and promotes microcirculation via the improvement of microvascular neovascularization to protect aging skin.
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Affiliation(s)
- Jing Li
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, P. R. China
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430000, Hubei, P. R. China
| | - Xin Zeng
- Nanchong Key Laboratory of Individualized Drug Therapy, Department of Pharmacy, The Second Clinical Medical College of North Sichuan Medical College, Nanchong Central Hospital, Nanchong, China
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430000, Hubei, P. R. China
| | - Xiaolong Yang
- School of Pharmaceutical Sciences, South-Central Minzu University, Wuhan, P. R. China
| | - Hong Ding
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, Wuhan University School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430000, Hubei, P. R. China
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Kingren MS, Starr ME, Saito H. Divergent Sepsis Pathophysiology in Older Adults. Antioxid Redox Signal 2021; 35:1358-1375. [PMID: 34210173 PMCID: PMC8905233 DOI: 10.1089/ars.2021.0056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 12/12/2022]
Abstract
Significance: Both incidence and mortality rates of sepsis significantly increase with advanced age, and the majority of sepsis patients are late middle-aged or older. With the proportion of older adults rapidly increasing in developed countries, age-dependent sepsis vulnerability is an urgent medical issue. Due to an increasing life expectancy, postsepsis complications and health care costs are expected to increase as well. Recent Advances: Older patients suffer from higher sepsis incidence and mortality rates, likely resulting from frequent comorbidities, increased coagulation, dysgylcemia, and altered immune responses. Critical Issues: Despite a large number of ongoing clinical and basic research studies, there is currently no effective therapeutic strategy targeting older patients with severe sepsis. The disparity between clinical and basic studies is a problem, and this is largely due to the use of animal models lacking clinical relevance. Although the majority of sepsis cases occur in older adults, most laboratory animals used for sepsis research are very young. Further, despite the wide use of combination fluid and antibiotic treatment in intensive care unit (ICU) patients, most animal research does not include such treatment. Future Directions: Because sepsis is a systemic disease with multiple organ dysfunction, combined therapy approaches, not those targeting single pathways or single organs, are essential. As for preclinical research, it is critical to confirm new findings using aged animal models with clinically relevant ICU-like medical treatments. Antioxid. Redox Signal. 35, 1358-1375.
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Affiliation(s)
- Meagan S. Kingren
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
| | - Marlene E. Starr
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
- Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Hiroshi Saito
- Aging and Critical Care Research Laboratory, Departments of University of Kentucky, Lexington, Kentucky, USA
- Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky, USA
- Surgery, University of Kentucky, Lexington, Kentucky, USA
- Physiology, University of Kentucky, Lexington, Kentucky, USA
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Leite CDS, Pires OC, Tenis DG, Ziegler JVN, Priolli DG, Rocha T. Effects of dipotassium glycyrrhizinate on wound healing. Acta Cir Bras 2021; 36:e360801. [PMID: 34644769 PMCID: PMC8516426 DOI: 10.1590/acb360801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/08/2021] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Dipotassium glycyrrhizinate (DPG) has anti-inflammatory properties, besides promoting the regeneration of skeletal muscle. However, it has not been reported on skin wound healing/regeneration. This research aimed to characterize the effects of DPG in the treatment of excisional wounds by second intention. METHODS Male adults (n=10) and elderly (n=10) Wistar rats were used. Two circular wounds were excised on the dorsal skin. The excised normal skins were considered adult (GAN) and elderly (GIN) naïve. For seven days, 2% DPG was applied on the proximal excision: treated adult (GADPG) and elderly (GIDPG), whereas distal excisions were untreated adult (GANT) and elderly (GINT). Wound healing areas were daily measured and removed for morphological analyses after the 14th and the 21st postoperative day. Slides were stained with hematoxylin-eosin, Masson's trichrome, and picrosirius red. RESULTS Histological analysis revealed intact (GAN/GIN) and regenerated(GANT/GINT/GADPG/GIDPG) skins. No differences of wounds' size were found among treated groups. Epidermis was thicker after 14 days and thinner after 21 days of DPG administration. Higher collagen I density was found in GIDPG (14th day) and GADPG (21st day). CONCLUSIONS DPG induced woundhealing/skin regeneration, with collagen I, being more effective in the first 14 days after injury.
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Lalieu RC, Akkerman I, van Hulst RA. Hyperbaric Oxygen Therapy for Venous Leg Ulcers: A 6 Year Retrospective Study of Results of a Single Center. Front Med (Lausanne) 2021; 8:671678. [PMID: 34395470 PMCID: PMC8355540 DOI: 10.3389/fmed.2021.671678] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/16/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Venous leg ulcers (VLUs) are common and have a large impact on healthcare budgets worldwide. Hyperbaric oxygen therapy (HBOT) may improve healing of these ulcers. Methods: Retrospective, single-center cohort study between 2013 and 2019. All patients with a VLU from an outpatient clinic providing HBOT and wound care were included. The primary outcome measure was wound healing, determined at discharge from the center. Other outcome measures were improvement in patient related outcome measures (PROMs), as assessed by the EQ-5D-3L questionnaire and including quality of life (QoL) and pain score. Results: Fifty patients were included, 53% female, with a mean age of 73.4 (±12.2). Most wounds (83%) had existed longer than 3 months before starting treatment. Patients received an average of 43 (±20) sessions of HBOT. After treatment, 37 patients (63%) achieved complete or near-complete wound healing. Wound size decreased from a median of 14 cm2 [interquartile range (IQR) 32 cm2] to 0.5 cm2 (IQR 5.3 cm2), a median decrease of 7.5 (IQR 16.2 cm2) in cm2 (94%). Patients mostly reported improvement for all health aspects on the questionnaire. Pain score decreased from 5.7 (±2.5) to 2.1 (±2.2) (p < 0.0001) and health score increased from 57.2 (±15.6) to 69.9 (±18.9) (p = 0.02). Conclusions: Patients with non-healing VLUs may benefit from HBOT to achieve complete or substantial wound healing. We recommend a well-designed randomized clinical trial with a number of patients allowing enough statistical power, and of a reasonable duration, to establish the potential of additional HBOT on hard-to-heal venous ulcers.
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Affiliation(s)
- Rutger C Lalieu
- Hyperbaar Geneeskundig Centrum, Rijswijk, Netherlands.,Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Ida Akkerman
- Independent Researcher, De Nieuwe Delta, Ede, Netherlands
| | - Rob A van Hulst
- Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands.,Department of Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands.,Hyperbaric Department, Amsterdam University Medical Center, Amsterdam, Netherlands
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El Haddi SJ, Kragel M, Klapper A. Creation of skin grafts from traumatic avulsed skin. BMJ Case Rep 2021; 14:14/7/e239545. [PMID: 34266814 DOI: 10.1136/bcr-2020-239545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
As the proportion of geriatric patients increases, so too does the incidence of geriatric trauma. Trauma centres must develop protocols to reduce the risk of complications from injuries in this specialised patient population. From a soft tissue standpoint, open wounds tend to heal slower in these patients and have a significant impact on their quality of life. In this case report, we describe our protocol for managing traumatic skin tears using a combination of traumatic skin grafts and minced expansion grafts with photographic documentation of the healing from significant wounds in an elderly patient involved in a high-energy blunt traumatic injury.
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Affiliation(s)
| | - Marjorie Kragel
- Chares E Schmidt School of Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Andrew Klapper
- Department of Surgery, Florida Atlantic University, Boca Raton, Florida, USA.,Department of Plastic and Reconstructive Surgery, Delray Medical Center, Delray Beach, Florida, USA
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Pawar KB, Desai S, Bhonde RR, Bhole RP, Deshmukh AA. Wound with Diabetes: Present Scenario and Future. Curr Diabetes Rev 2021; 17:136-142. [PMID: 32619172 DOI: 10.2174/1573399816666200703180137] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/12/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022]
Abstract
Diabetes is a chronic metabolic disorder of the endocrine system characterized by an increase in blood glucose level. Several factors, such as pancreatic damage, oxidative stress, infection, genetic factor, obesity, liver dysfunction, play a vital role in the pathogenesis of diabetes, which further leads to serious diabetic complications. The diabetic wound is one such complication where the wound formation occurs, especially due to pressure and its healing process is disrupted due to factors, such as hyperglycemia, neuropathy, nephropathy, peripheral vascular disease, reduction of blood flow, atherosclerosis, impaired fibroblast. The process of wound healing is delayed due to different abnormalities like alteration in nitric oxide level, increase in aldose reductase, sorbitol, and fructose. Therefore, diabetic wound requires more time to heal as compared to the normal wound. Healing time is delayed in diabetic wound due to many factors, such as stress, decreased oxygenation supply, infection, decreased blood flow, impaired proliferation and migration rate, impaired growth factor production, impaired keratinocytes proliferation and migration, and altered vascular endothelial mediators. The current treatment for diabetic wounds includes wound patches, oxygenation therapy, hydrogel patches, gene therapy, laser therapy, and stem cell therapy. Medications with phytoconstituents are also one way to manage the diabetic wound, but it is not more effective for quick healing. The objective of this review is to understand the potential of various management options which are available for diabetic wound, with a special focus on biological cells.
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Affiliation(s)
- Kuldeep B Pawar
- Department of Pharmacology, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Pune, India
| | - Shivani Desai
- Department of Pharmacology, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Pune, India
| | | | - Ritesh P Bhole
- Department of Pharmaceutical Chemistry, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Pune, India
| | - Atul A Deshmukh
- Department of Pharmacology, Dr. D.Y. Patil Institute of Pharmaceutical Sciences and Research, Pune, India
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Khan AA, Khan IM, Nguyen PP, Lo E, Chahadeh H, Cerniglia M, Noriega JA. Skin Graft Techniques. Clin Podiatr Med Surg 2020; 37:821-835. [PMID: 32919607 DOI: 10.1016/j.cpm.2020.07.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Management of extensive lower extremity soft tissue and skin loss can be a very difficult to achieve by any surgeon. There can be several associated comorbidities that need to be considered and addressed with these patients. The approach is multifactorial and requires commitment from both the surgeon as well as the patient. There are several protocols that have been formulated throughout the literature addressing soft tissue and skin coverage of the limbs. This article provides a review of the literature and describes the evaluation, harvesting, transplantation, and management of skin grafting techniques to the lower extremities.
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Affiliation(s)
- Arshad A Khan
- Department of Orthopedic Surgery, Indiana University School of Medicine, Gary/Northwest, Gary, IN, USA; SpineTech Neurosurgeons, SpineTech Brain and Spine of South East Texas, Shenandoah, TX, USA.
| | - Isra M Khan
- Chicago Foot and Ankle Deformity Correction Center, Chicago, IL, USA; 111 Vision Park Boulevard, Suite 200, Shenandoah, TX 77384, USA
| | - Phi P Nguyen
- McGowan Medical School, Houston, TX, USA; MIA Plastic Surgery, 4126 Southwest Fwy Suite 999, Houston, TX 77027, USA; MILA Med Spa Group, Houston, TX, USA
| | - Erwin Lo
- University of Texas Medical Branch, Mischer Neuroscience Institute, Houston, TX, USA; Brain and Spine Center of Southeast Texas, 6025 Metropolitan Drive, Suite 205, Beaumont, TX 77706, USA
| | - Hassan Chahadeh
- Vision Park of Surgery Center, 111 Vision Park Boulevard, Suite 200, Shenandoah, TX 77384, USA
| | - Mathew Cerniglia
- Private Practice, 816 Towne Ct Suite 100, Saginaw, TX 76179, USA
| | - James A Noriega
- Department of Surgery, LSU School of Medicine, Our Lady of Lourdes Hospital, 203 West Brentwood Boulevard, Suite 2, Lafayette, LA 70506, USA
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Campbell J, Samolyk M. Skin injury prevention and treatment in the older person: reframing our approach in the community setting. Br J Community Nurs 2020; 25:S6-S26. [PMID: 32886553 DOI: 10.12968/bjcn.2020.25.sup9.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the past, maintaining skin integrity has been synonymous with preventing and treating a single skin injury, namely pressure injury. However, there is growing recognition that this single-injury approach overlooks the multitude of skin injuries that may be sustained by older people. This article proposes that reframing the approach to skin integrity care away from the single-injury focus and towards a comprehensive and holistic paradigm is imperative. Guided by the Skin Safety Model, this article presents a case study illustrating comprehensive skin integrity assessment and care planning for an older person in the community setting. It is hoped that the information presented will guide community nurses in addressing skin injuries experienced by older adults in holistic and comprehensive way.
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Affiliation(s)
- Jill Campbell
- Nurse Researcher, Royal Brisbane and Women's Hospital; Conjoint Senior Research Fellow, School of Nursing, Queensland University of Technology, Australia
| | - Monika Samolyk
- Wound Nurse Consultant, Regional Wounds Victoria, Hume East, Gateway Health, Victoria, Australia
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Senescence and Longevity of Sea Urchins. Genes (Basel) 2020; 11:genes11050573. [PMID: 32443861 PMCID: PMC7288282 DOI: 10.3390/genes11050573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022] Open
Abstract
Sea urchins are a minor class of marine invertebrates that share genetic similarities with humans. For example, the sea urchin species Strongylocentrotus purpuratus is estimated to have 23,300 genes in which the majority of vertebrate gene families are enveloped. Some of the sea urchin species can demonstrate extreme longevity, such as Mesocentrotus franciscanus, living for well over 100 years. Comparing human to sea urchin aging suggests that the latter do not fit within the classic understanding of biological aging, as both long- and short-lived sea urchin species demonstrate negligible senescence. Sea urchins are highly regenerative organisms. Adults can regenerate external appendages and can maintain their regenerative abilities throughout life. They grow indeterminately and reproduce throughout their entire adult life. Both long- and short-lived species do not exhibit age-associated telomere shortening and display telomerase activity in somatic tissues regardless of age. Aging S. purpuratus urchins show changes in expression patterns of protein coding genes that are involved in several fundamental cellular functions such as the ubiquitin-proteasome system, signaling pathways, translational regulation, and electron transport chain. Sea urchin longevity and senescence research is a new and promising field that holds promise for the understanding of aging in vertebrates and can increase our understanding of human longevity and of healthy aging.
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Tong T, Yang C, Tian W, Liu Z, Liu B, Cheng J, Cheng Q, Zhou B. Phenotypes and outcomes in middle-aged patients with diabetic foot ulcers: a retrospective cohort study. J Foot Ankle Res 2020; 13:24. [PMID: 32414389 PMCID: PMC7227070 DOI: 10.1186/s13047-020-00386-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/22/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although ageing could increase the risk of delayed healing in diabetic foot ulcers (DFUs) patients, data from middle-aged patients remains greatly limited. The purpose of this study was to explore the clinical phenotypes, outcomes and predictive factors of DFU in middle-aged patients. METHODS A retrospective cohort study conducted with 422 consecutive inpatients with DFUs who visited our hospital between May 2010 and September 2017; participants were recruited and assigned according to age to either the middle-aged group or the elderly group. The Demographics, ulcer characteristics, comorbidities and diabetes complications, laboratory tests, socioeconomic data and final outcomes were collected. Moreover, predictive factors of adverse outcomes in middle-aged DFUs patients were assessed. RESULTS Middle-aged patients were more likely to have worse lifestyle and glucose control, were more likely to have microangiopathy as a complication, and tended to have larger and deeper ulcers; however, these patients also had higher rates of healing and lower rates of mortality and major amputaion than elderly patients. Severe infection,living alone,current smoking cigarettes, and having a high white blood cell count were independent risk factors for adverse outcomes in middle-aged patients. CONCLUSIONS DFUs are relatively common in middle-aged patients with diabetes, and these patients have unique clinical phenotypes and risk profiles. Nonetheless, further investigation is needed to clarify whether intervention targeting these easily recognizable risk factors can improve healing and survival rates in middle-aged DFU patients.
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Affiliation(s)
- Tao Tong
- Department of Endocrinology, Xiangyang No.1 People’s Hospital, Affiliated to Hubei University of Medicine, Xiangyang, 441000 China
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cailian Yang
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenqing Tian
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiping Liu
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Liu
- Department of Burns & Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cheng
- Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qingfeng Cheng
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bo Zhou
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Synthetic Retinoid Seletinoid G Improves Skin Barrier Function through Wound Healing and Collagen Realignment in Human Skin Equivalents. Int J Mol Sci 2020; 21:ijms21093198. [PMID: 32366052 PMCID: PMC7247558 DOI: 10.3390/ijms21093198] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 12/17/2022] Open
Abstract
The outer epidermal skin is a primary barrier that protects the body from extrinsic factors, such as ultraviolet (UV) radiation, chemicals and pollutants. The complete epithelialization of a wound by keratinocytes is essential for restoring the barrier function of the skin. However, age-related alterations predispose the elderly to impaired wound healing. Therefore, wound-healing efficacy could be also considered as a potent function of an anti-aging reagent. Here, we examine the epidermal wound-healing efficacy of the fourth-generation retinoid, seletinoid G, using HaCaT keratinocytes and skin tissues. We found that seletinoid G promoted the proliferation and migration of keratinocytes in scratch assays and time-lapse imaging. It also increased the gene expression levels of several keratinocyte proliferation-regulating factors. In human skin equivalents, seletinoid G accelerated epidermal wound closure, as assessed using optical coherence tomography (OCT) imaging. Moreover, second harmonic generation (SHG) imaging revealed that seletinoid G recovered the reduced dermal collagen deposition seen in ultraviolet B (UVB)-irradiated human skin equivalents. Taken together, these results indicate that seletinoid G protects the skin barrier by accelerating wound healing in the epidermis and by repairing collagen deficiency in the dermis. Thus, seletinoid G could be a potent anti-aging agent for protecting the skin barrier.
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Abstract
Good skin integrity is vital to good health because the skin acts as a barrier to microbes and toxins, as well as physical stressors such as sunlight and radiation. It is well known that the skin loses integrity with the ageing process, and this makes older adults susceptible to pressure injury. Additionally, older skin takes longer to heal where there are injuries or breaks. This article looks at what skin integrity is by briefly outlining the physiology of the skin. It discusses how skin integrity can be impaired, what can be done to maintain skin integrity and skin health, and why skin integrity is important for pressure ulcer prevention. Some of the factors that can make skin care difficult are discussed, in addition to the role of community nurses in helping patients engage in skin care. The article outlines how community nurses can identify when there is skin integrity risk or damage and support patients and carers or relatives, in maintaining skin integrity.
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Affiliation(s)
- Drew Payne
- Community Staff Nurse, Whittington Health NHS Trust, London; Member of the Royal College of Nursing
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Yin Z, Yang B, Ren H. Preventive and Therapeutic Effect of Ganoderma (Lingzhi) on Skin Diseases and Care. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1182:311-321. [DOI: 10.1007/978-981-32-9421-9_14] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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49
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Massella D, Argenziano M, Ferri A, Guan J, Giraud S, Cavalli R, Barresi AA, Salaün F. Bio-Functional Textiles: Combining Pharmaceutical Nanocarriers with Fibrous Materials for Innovative Dermatological Therapies. Pharmaceutics 2019; 11:E403. [PMID: 31405229 PMCID: PMC6723157 DOI: 10.3390/pharmaceutics11080403] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/16/2022] Open
Abstract
In the field of pharmaceutical technology, significant attention has been paid on exploiting skin as a drug administration route. Considering the structural and chemical complexity of the skin barrier, many research works focused on developing an innovative way to enhance skin drug permeation. In this context, a new class of materials called bio-functional textiles has been developed. Such materials consist of the combination of advanced pharmaceutical carriers with textile materials. Therefore, they own the possibility of providing a wearable platform for continuous and controlled drug release. Notwithstanding the great potential of these materials, their large-scale application still faces some challenges. The present review provides a state-of-the-art perspective on the bio-functional textile technology analyzing the several issues involved. Firstly, the skin physiology, together with the dermatological delivery strategy, is keenly described in order to provide an overview of the problems tackled by bio-functional textiles technology. Secondly, an overview of the main dermatological nanocarriers is provided; thereafter the application of these nanomaterial to textiles is presented. Finally, the bio-functional textile technology is framed in the context of the different dermatological administration strategies; a comparative analysis that also considers how pharmaceutical regulation is conducted.
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Affiliation(s)
- Daniele Massella
- ENSAIT, GEMTEX-Laboratoire de Génie et Matériaux Textiles, F-59000 Lille, France.
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino (TO), Italy.
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China.
| | - Monica Argenziano
- Department of Drug Science and Technology, University of Turin, Via P. Giuria 9, 10125 Torino, Italy
| | - Ada Ferri
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino (TO), Italy
| | - Jinping Guan
- College of Textile and Clothing Engineering, Soochow University, Suzhou 215123, China
| | - Stéphane Giraud
- ENSAIT, GEMTEX-Laboratoire de Génie et Matériaux Textiles, F-59000 Lille, France
| | - Roberta Cavalli
- Department of Drug Science and Technology, University of Turin, Via P. Giuria 9, 10125 Torino, Italy
| | - Antonello A Barresi
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino (TO), Italy
| | - Fabien Salaün
- ENSAIT, GEMTEX-Laboratoire de Génie et Matériaux Textiles, F-59000 Lille, France
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Abstract
Ageing leads to a number of skin changes that not only place an older adult at risk of tissue damage, but can present as peri-wound problems for those with existing wounds, for example, incontinence-associated and moisture-associated dermatitis in individuals with pressure ulcers. Older adults with venous disease experience skin changes concomitant with venous hypertension, making the skin more at risk of breakdown, specifically the common complications of lipodermatosclerosis and venous eczema. In individuals with diabetic foot disease, skin changes related to autonomic neuropathy mean patients can experience dry skin that cracks easily, placing them at higher risk of infection. Common to all individuals with wounds requiring some sort of dressing is the risk of medical adhesive-related skin injury, where dressing application and removal need to be of the utmost priority to reduce the risk of injury. This article discusses some of the common peri-wound skin considerations in patients with chronic wounds.
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Affiliation(s)
- Samantha Holloway
- Reader, Programme Director MSc in Wound Healing and Tissue Repair Cardiff University School of Medicine
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