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Abstract
INTRODUCTION Chronic wounds are a major drain on healthcare resources and can lead to substantial reductions in quality of life for those affected. Moreover, they often precede serious events such as limb amputations and premature death. In the long run, this burden is likely to escalate with an ageing population and lifestyle diseases such as obesity. Thus far, the identification of beneficial therapeutics against chronic wounds have been hindered by the lack of an ideal chronic wound animal model. Although animal models of delayed healing have been developed, none of these models fully recapitulate the complexity of the human chronic wound condition. Furthermore, most animals do not develop chronic wounds. Only the thoroughbred racehorse develops chronic ulcers. AREAS COVERED In this review, the different characteristics of chronic wounds that highlight its complexity are described. In addition, currently available models reflecting different aspects of chronic wound pathology and their relevance to human chronic wounds are discussed. This article concludes by listing relevant features representative of an ideal chronic wound model. Additionally, alternative approaches for the development of chronic wound models are discussed. EXPERT OPINION Delayed models of healing, including the streptozotocin diabetic model, skin flap model and magnet-induced IR models have emerged. While these models have been widely adopted for preclinical therapeutic testing, their relevance towards human chronic wounds remains debatable. In particular, current delayed healing models often fail to fully incorporate the key characteristics of chronic ulcers. Ultimately, more representative models are required to expedite the advancement of novel therapeutics to the clinic.
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Affiliation(s)
- Mandy Li Ling Tan
- Nanyang Institute of Health Technologies, Interdisciplinary Graduate School, Nanyang Technological University, 639798, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, 308232, Singapore
| | - Jiah Shin Chin
- Lee Kong Chian School of Medicine, Nanyang Technological University, 308232, Singapore
| | - Leigh Madden
- Lee Kong Chian School of Medicine, Nanyang Technological University, 308232, Singapore
| | - David L Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, 308232, Singapore.,Skin Research Institute Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,National Skin Centre, Mandalay Road, Singapore
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Gao Y, Nguyen DT, Yeo T, Lim SB, Tan WX, Madden LE, Jin L, Long JYK, Aloweni FAB, Liew YJA, Tan MLL, Ang SY, Maniya SD, Abdelwahab I, Loh KP, Chen CH, Becker DL, Leavesley D, Ho JS, Lim CT. A flexible multiplexed immunosensor for point-of-care in situ wound monitoring. Sci Adv 2021; 7:7/21/eabg9614. [PMID: 34020961 PMCID: PMC8139589 DOI: 10.1126/sciadv.abg9614] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/31/2021] [Indexed: 05/11/2023]
Abstract
Chronic wounds arise from interruption of normal healing due to many potential pathophysiological factors. Monitoring these multivariate factors can provide personalized diagnostic information for wound management, but current sensing technologies use complex laboratory tests or track a limited number of wound parameters. We report a flexible biosensing platform for multiplexed profiling of the wound microenvironment, inflammation, and infection state at the point of care. This platform integrates a sensor array for measuring inflammatory mediators [tumor necrosis factor-α, interleukin-6 (IL-6), IL-8, and transforming growth factor-β1], microbial burden (Staphylococcus aureus), and physicochemical parameters (temperature and pH) with a microfluidic wound exudate collector and flexible electronics for wireless, smartphone-based data readout. We demonstrate in situ multiplexed monitoring in a mouse wound model and also profile wound exudates from patients with venous leg ulcers. This technology may facilitate more timely and personalized wound management to improve chronic wound healing outcomes.
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Affiliation(s)
- Yuji Gao
- Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
| | - Dat T Nguyen
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore 119077, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Trifanny Yeo
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Su Bin Lim
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Wei Xian Tan
- Nursing, Singapore General Hospital, Singapore 168753, Singapore
| | - Leigh Edward Madden
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Lin Jin
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Ji Yong Kenan Long
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
| | | | | | - Mandy Li Ling Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Shin Yuh Ang
- Nursing, Singapore General Hospital, Singapore 168753, Singapore
| | | | - Ibrahim Abdelwahab
- Department of Chemistry, National University of Singapore, Singapore 117543, Singapore
| | - Kian Ping Loh
- Department of Chemistry, National University of Singapore, Singapore 117543, Singapore
| | - Chia-Hung Chen
- Department of Biomedical Engineering, City University of Hong Kong, 83 Tat Chee Avenue, Kowloon, Hong Kong, China
| | - David Laurence Becker
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore 138648, Singapore
| | - David Leavesley
- Skin Research Institute of Singapore, Agency for Science, Technology and Research (A*STAR), Singapore 138648, Singapore
| | - John S Ho
- Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore 119077, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Chwee Teck Lim
- Institute for Health Innovation & Technology (iHealthtech), National University of Singapore, Singapore 117599, Singapore.
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore
- Mechanobiology Institute, National University of Singapore, Singapore 117411, Singapore
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