Enhanced wound healing -
Local anaesthetic will be given before the examination. Removing dead skin surgically. Local anaesthetic will be given. Closing large wounds with stitches or staples. Dressing the wound. The dressing chosen by your doctor depends on the type and severity of the wound.
In most cases of chronic wounds, the doctor will recommend a moist dressing. Relieving pain with medications. Pain can cause the blood vessels to constrict, which slows healing. If your wound is causing discomfort, tell your doctor. The doctor may suggest that you take over-the-counter drugs such as paracetamol or may prescribe stronger pain-killing medication.
Treating signs of infection including pain, pus and fever. The doctor will prescribe antibiotics and antimicrobial dressings if necessary. Take as directed. Reviewing your other medications. Some medications, such as anti-inflammatory drugs and steroids, interfere with the body's healing process.
Tell your doctor about all medications you take including natural medicines or have recently taken. The doctor may change the dose or prescribe other medicines until your wound has healed. Using aids such as support stockings. Use these aids as directed by your doctor.
Treating other medical conditions, such as anaemia, that may prevent your wound healing. Prescribing specific antibiotics for wounds caused by Bairnsdale or Buruli ulcers. Skin grafts may also be needed. Recommending surgery or radiation treatment to remove rodent ulcers a non-invasive skin cancer.
Improving the blood supply with vascular surgery, if diabetes or other conditions related to poor blood supply prevent wound healing.
Self-care suggestions Be guided by your doctor, but self-care suggestions for slow-healing wounds include: Do not take drugs that interfere with the body's natural healing process if possible. For example, anti-inflammatory drugs such as over-the-counter aspirin will hamper the action of immune system cells.
Ask your doctor for a list of medicines to avoid in the short term. Make sure to eat properly. Your body needs good food to fuel the healing process.
Include foods rich in vitamin C in your diet. The body needs vitamin C to make collagen. Fresh fruits and vegetables eaten daily will also supply your body with other nutrients essential to wound healing such as vitamin A, copper and zinc. It may help to supplement your diet with extra vitamin C.
Keep your wound dressed. Wounds heal faster if they are kept warm. Try to be quick when changing dressings. Exposing a wound to the open air can drop its temperature and may slow healing for a few hours.
Don't use antiseptic creams, washes or sprays on a chronic wound. These preparations are poisonous to the cells involved in wound repair. Have regular exercise because it increases blood flow, improves general health and speeds wound healing.
Ask your doctor for suggestions on appropriate exercise. Manage any chronic medical conditions such as diabetes. Do not smoke. See your doctor Check your wound regularly. See your doctor immediately if you have any symptoms including: bleeding increasing pain pus or discharge from the wound fever.
Always see your doctor if you have any concerns about your wound. Where to get help In an emergency, call triple zero Your GP doctor NURSE-ON-CALL Tel. MacLellan, D. Give feedback about this page. Was this page helpful? Yes No. View all skin. Related information.
From other websites External Link Health Translations - How to dress a wound. Content disclaimer Content on this website is provided for information purposes only. Reviewed on: Finally, increasing the microbial ROS production makes the Escherichia coli susceptible to antibiotics Brynildsen et al.
Biomaterial-based wound dressings are ideal for loading drugs or antibiotics due to their tunable properties and release kinetics. Chitosan microspheres loaded with silver sulfadiazine encapsulated in PEG fibrin gels showed robust antimicrobial activity against S. aureus and Pseudomonas aeruginosa Seetharaman et al.
Streptomycin has been loaded into polyethylene oxide PEO polymer composite films Pawar et al. Similarly, ciprofloxacin has been loaded into electrospun polyurethane and dextran dressings Unnithan et al.
Many other antibiotic agents have been loaded into various natural, synthetic, or composite wound dressings. There is a revived interest, and recent academic and industrial research spending has increased with the goal of developing efficient and targeted antimicrobial drugs that have enhanced uptake, reduced degradation, and metabolic mimicry to increase uptake.
Apart from antimicrobials, many small molecule drugs and intermediates have been delivered using biomaterial-based systems Hubbell, The drug 1,4-dihydrophenonthrolinonecarboxylic acid 1,4-DPCA , which is a prolyl hydroxylase PHD inhibitor was loaded in a locally injectable hydrogel to achieve controlled delivery of the drug over 4—10 days Zhang et al.
This stabilized the constitutive expression of hypoxia-inducible factor-1α HIF-1α protein, an important factor in wound healing and angiogenesis. A summary of the biomaterials currently in clinical usage is shown in Table 2. The most commonly used wound dressings are thin flexible sheets of transparent polyurethane with adhesive backing.
These dressings are transparent, allowing clinicians to visualize the skin and are also permeable to water vapor, O 2 , CO 2 , but impermeable to bacteria and water. Thus apart from wound healing, they are widely used in sealing the vascular access devices, especially in catheters and saline drip since they are highly elastic and conform to the body contours.
The widespread usage of these thin films, impregnated with chlorhexidine, has reduced the incidence of central line infections significantly Jeanes and Bitmead, They are also used in superficial wounds, partial-thickness wounds, sutured wounds, donor graft sites, granular wounds, slough-covered wounds with minimal drainage and lacerations or abrasions Stashak et al.
However, these dressings are ineffective in wounds with high moisture and exudate content since they have minimum absorptive capacity and thus can cause tissue maceration.
They should not be used in highly infected wounds and places where the skin is sensitive or fragile because the skin might tear while removing the dressing. In many cases, excessive exudate secretion is detrimental to the wound healing process.
Polyurethane absorptive foam dressings have been developed with a hydrophilic surface to interface with the wound, while the hydrophobic surface faced outside environment.
These dressings are permeable to gas, but not to bacteria and other pathogens. Unlike the films, these dressings are highly absorptive and are used in wounds with minimal to heavy exudates, granulating or slough-covered partial-thickness wounds, donor sites, minor burns, diabetic ulcers, and venous insufficiency ulcers Banks et al.
Foam dressings impregnated with methylene blue have also been used for a bacteriostatic effect Coutts et al. The advantages of foam dressings are their ease of use, remarkable absorptive capacity, and availability in various degrees of adhesivity and occlusivity. However, the absorptive aspect of polyurethane foams makes them inappropriate for dry or eschar-covered wounds and arterial ulcers.
Hydrocolloids such as pectin, gelatin, and carboxymethyl cellulose along with adhesives and polymers are used to prepare wafers in thin dressings. These dressings contain hydrophilic colloidal particles with a strong adhesive backing that only need a small area of intact skin to secure, eliminating the need for taping over the dressing Hutchinson and McGuckin, These dressings have moderate absorptive capacity but are highly occlusive and are effective barrier against urine, stool, and microbes.
Thus, they are used in partial and full-thickness wounds, granular and necrotic wounds, sacral and coccygeal pressure ulcers, minor burns, and venous insufficiency ulcers.
Hydrogels are extensively used in preparing wound dressings. There are many hydrogels in clinical use both in wet and dry lyophilized forms. Glycerin-based wound dressings with high water content are available in sheets, gels, or impregnated gauzes Baum and Busuito, These are highly moistened and thus absorb minimal amount of fluid but donate moisture to dry wounds.
These dressings are permeable to gas and water and are almost always non-adhesive and require secondary bandages. Therefore, these are mainly used for minimally draining wounds, superficial and partial-thickness wounds, softening eschared wounds by moisture and provide padding to decrease shear forces on the wounds Kirsner, However, the glycerin dressings are contraindicated in heavily draining wounds and infected wounds.
Another class of hydrogel wound dressings that are widely used is the alginate-based dressings. Alginic acid is extracted from seaweed, converted into sodium salts, and cross-linked with calcium.
These dressings are hydrophilic to provide a moist wound environment and are highly absorptive if delivered in a lyophilized form. Since these dressings are highly permeable and non-occlusive, a secondary dressing is needed to keep them in place Gu et al.
Alginate hydrogels can be fashioned as both sheets for the surface wounds and ropes for the deep wounds. They also are versatile in providing a delivery platform and can be impregnated with silver, honey, and sodium chloride for additional antimicrobial and hyperosmotic properties.
Thus, these dressings are used in moderate to highly draining wounds, partial- and full-thickness draining wounds, and infected wounds Kirsner, However, they are contraindicated in dry or minimally draining or eschar-covered wounds, arterial ulcers, and exposed deeper structures tendon, joint capsule, or bone.
The most common structural protein in the animal world, collagen, has been used extensively to create hemostatic biosynthetic dressings. The collagen fragments in the dressings induce cell proliferation and chemotaxis while reducing matrix MMP activity Ruszczak, MMPs are tissue proteases or endopeptidases that are zinc containing, calcium dependent, and are crucial for wound remodeling phase because they preferentially break down ECM components in the skin Birkedal-Hansen et al.
Despite the limited studies, and the need for improved study designs and increased number of randomized controlled trials, wound dressings containing collagen appear to have some benefit in the treatment of diabetic foot ulcers and should be carefully considered by clinicians that manage wounds Holmes et al.
Carboxymethyl cellulose or oxidized regenerated cellulose ORC combined with collagen leads to decreased MMP activity, increased cell proliferation, and chemotaxis Cullen et al. To combine the benefits of different kinds of biomaterial dressings, composite dressings have been designed with multiple layers of different biomaterials Pillay et al.
They are often made of polyurethane or polyester, PTFE, and sometimes contain silicone and petroleum complements. They are applied directly to the wound bed and allow the drainage to pass through.
The middle layer comprises of highly absorptive material that pulls the wound exudate away from the wound but keeps the environment moist. This reduces skin maceration due to excess moisture and reduces bacterial growth and improves autolytic debridement.
The top most or outermost layer is highly occlusive in nature and protects the wound from infection Wittaya-areekul and Prahsarn, ; Elsner et al. These multilayer dressings can be used as both primary and secondary dressings. Apart from standard wound dressings, biomaterials have been used to develop skin protectants Hoggarth et al.
Skin protectants are often applied to the wound and periwound skin. They prevent maceration of the periwound skin by wound fluid and also prevent rashes and skin breakdown in areas of leakage Hoggarth et al. Skin sealants are liquid-based poly-vinyl-methyl PVM polymers that form a protective waterproof, breathable, transparent layer on the skin on drying Kemp, This protects the periwound skin from moisture, adhesives, and shear stress.
Skin sealants work well with adhesive dressing application. The moisture barriers comprise of creams or ointments containing petrolatum, dimethicone, and zinc oxide. Some also contain antifungal miconazole especially useful in treating intertrigo inflammation of skin folds Zehrer et al.
Moisturizers are more hydrophilic creams, lotions, or gels that donate moisture to the wound or periwound skin. Keratolytics soften the hard scales and calluses and hyperkeratotic lesions and include salicylic acid, urea, ammonium lactate creams Zehrer et al.
However, these keratolytics can cause skin maceration if overused. A central constituent of the nanotechnology industry is engineered NPs. The number of consumer products containing NPs is growing at a rapid pace and is expected to reach 10, by the year NPs have emerged as a new class of therapeutics in the last couple of decades due to their ability to be targeted and low toxicity.
NPs are generally defined as particles ranging from 1 to nm in size. These small particles often have different physical and chemical properties from bulk materials. These properties may include alterations in melting points, specific surface areas, specific optical properties, mechanical strengths, and specific magnetizations.
These unique properties make them attractive for various industrial and medical applications. Nanoparticles have become significant in the regenerative medicine field in the last two decades McLaughlin et al. Many biological processes happen at through mechanisms that fundamentally act at the nanometer scale.
Thus, materials such as NPs can be used as unique tools for drug delivery, imaging, sensing, and probing biological processes Wang and Wang, In the context of wound healing, the special properties of NPs like electric conductivity, antimicrobial activity, high surface to volume ratio, swelling, and contraction make NPs versatile resources.
In the following sections, we will specifically talk about various NP-based therapeutics that are either undergoing preclinical development or in current clinical use. The NP-based wound therapies under development are summarized in Table 3.
Silver nanoparticles AgNPs are the most widely studied among metal NPs. These NPs have been shown to enhance healing in a full-thickness excisional wound model in mice Liu et al.
Dressings impregnated with AgNPs have also been shown to be effective in wound healing in normal and diabetic mice Tian et al. The antimicrobial properties of silver have been exploited in toxicity evaluation in human ASCs Samberg et al.
In addition, AgNPs have also been shown to be anti-inflammatory in a peritoneal adhesion model Wong et al. Recently, the safety and efficacy of collagen-coated AgNPs encapsulated in collagen hydrogels was shown in primary human skin fibroblasts and keratinocytes; while antimicrobial properties were shown against S.
aureus, Staphylococcus epidermidis, E. coli , and P. aeruginosa Alarcon et al. To gain insight on the health and environmental impact of AgNPs, they were tested on zebrafish models Asharani et al.
This may support a non-specific action of AgNPs on all cell types including the wounded host cells. Magnesium fluoride MgF 2 NPs Lellouche et al. coli and S. Topical application of water-soluble cerium oxide NPs Nanoceria accelerates the healing of full-thickness dermal wounds in mice Chigurupati et al.
The mechanism of action is thought to be the strong antioxidant properties of cerium oxide NPs. Similarly, copper NPs have also been shown to enhance wound healing in excisional wounds of mice Rakhmetova et al. Iron oxide NPs conjugated to thrombin have been used to enhance wound healing compared to free thrombin Ziv-Polat et al.
This was achieved by increasing the stability of thrombin via conjugation to the iron oxide. Gold NPs co-delivered with epigallocatechin gallate and α-lipoic acid significantly accelerated mouse cutaneous wound healing through anti-inflammatory and anti-oxidation effects Leu et al.
Gold NPs conjugated to siRNA-based spherical nucleic acids SNAs have been used for diabetic wounds with ganglioside—monosialic acid 3 synthase GM3S knockdown Randeria et al. GM3S is an enzyme that is overexpressed in diabetic mice and may cause insulin resistance and reduced wound healing.
Gold NPs have also been used with de-cellularized porcine diaphragm as a scaffold for migrating wound cells Cozad et al. Among all the metal NPs, we think that the most promising therapeutic options are the gold and silver NPs because of their versatility.
While silver is antimicrobial and anti-inflammatory, gold can be easily functionalized for precise delivery of drug or cargo. Figure 4. Overcoming insulin resistance to efficiently heal wounds in a diabetic mouse model. A Schematic representation of the gold nanoparticles conjugated to ganglioside—monosialic acid 3 synthase GM3S siRNA called the spherical nucleic acid SNA.
The SNA surface is passivated with oligoethylene glycol for colloidal stability. GM3S is a known target that is overexpressed in diabetic mice and responsible for causing insulin resistance and impeding wound healing. B Confocal images show elimination of GM3 in keratinocytes treated with GM3S SNA lower relative to no treatment NT upper.
Green stained GM3; red stained nuclei. C Macroscopic clinical images of the wounds in a diabetic diet-induced obesity mouse model over the course of 2 weeks with three different treatments.
D Representative histologic images of the treated wounds at day D, dermis; E, epidermis; EG, epidermal gap; GT, granulation tissue. NS, non-sense; NT, non-treated. Reproduced with permission from Randeria et al.
There has been a recent surge in advanced therapeutics targeting the multidrug-resistant microbes using antibiotics linked to NPs, commonly referred to as nanobiotics. New classes of polyacrylate NPs that are conjugated to antibiotics were created to treat MRSA Turos et al.
They consist of water-insoluble N-thiolated beta-lactam antibiotics covalently conjugated to the nanopolymer. These nanobiotics significantly increased antimicrobial activity of the antibiotics in comparison to the non-conjugated antibiotic formulation. Similarly, poly butyl acrylate-styrene NPs conjugated to N-thiolated beta-lactam antibiotic have been prepared with conventional and polymerizable surfactants have showed higher antimicrobial activity while maintaining low toxicity Garay-Jimenez et al.
Gelatin, chitosan, and epigallocatechin gallate NPs have also been incorporated in a polyglutamic acid and gelatin hydrogels containing activated carbon fibers with gentamicin, to create a wound dressing to enhance regeneration and inhibit microbial growth Lin et al.
Vancomycin-modified NPs produced by magnetic confinement are also highly effective against both Gram-positive and Gram-negative bacteria Kell et al. With the rise in antibiotic-resistant bugs, the need for therapies targeting Gram-negative bacteria has become urgent matter, and NP delivery systems may provide a means to enhance the activity of conventional antibiotics in the wound environment.
Nitric oxide NO plays numerous roles in wound healing and can regulate deposition of ECM proteins, cell proliferation, and endothelial function. Incorporation of a functional group of diazeniumdiolate into materials results in the release of biologically active NO when exposed to an aqueous environment DeRosa et al.
There have been several studies showing the increased wound healing rate due to delivery of NO in a wound microenvironment Blecher et al. Biofilms of P. aeruginosa, E. coli, S. aureus, S. It is interesting to note that endogenous NO may actually protect bacteria against antibiotics and other microorganisms Gusarov et al.
NO-mediated resistance is achieved through both the chemical modification of toxic compounds and the alleviation of the oxidative stress imposed by many antibiotics. Thus, inhibition of bacterial NO synthase might be a suitable future target to enhance antimicrobial therapy.
Green synthesis of NPs involves using plant products or extracts that are less expensive and less harmful to the environment than the standard physicochemical methods that are generally used Makarov et al.
Genipin is prepared from geniposide by using the enzyme β-glucosidase, which is extracted from Penicillium nigricans. Genipin cross-linked with chitosan along with PEG and silver NPs are blended into a nanocomposite for enhanced wound healing and high antimicrobial activity Liu et al.
The formulated silver NPs using Coleus forskohlii root extract has been shown to be effective in healing full-thickness excision wounds in albino Wistar male rats Naraginti et al.
Silver NPs were produced in octadecylamine-modified montmorillonite clay that was mixed with extracts from Homalomena aromatica then mixed with hyper branched epoxy to create silver nanocomposite for wound healing applications Barua et al. This nanocomposite served as an efficient wound healing scaffold with inherent antimicrobial properties.
Lipid-based NPs have given rise to an entire subfield of lipid nanotechnology Mashaghi et al. Liposomes are versatile drug delivery system due to their ease of protein delivery, biocompatibility, intracellular delivery, modulation of size, charge, and surface properties Safinya and Ewert, It has been shown that the loss of growth factor co-receptors in diabetic diseased state leads to growth factor resistance Das et al.
One method to overcome this resistance is to deliver co-receptors in a proteoliposome along with the growth factors. This was tested in a diabetic mouse model and showed improved diabetic wound healing Das et al. There are various other lipid NPs, which have shown promise for treating peripheral vascular disease and critical limb ischemia, reviewed elsewhere Tu et al.
Solid lipid nanoparticles SLN are a new pharmaceutical delivery system with a solid lipid core stabilized by surfactants, which can solubilize lipophilic molecules. These SLNs have been tested for delivering bioactive molecules such as opioids like morphine Kuchler et al. Exosomes are another form of lipid NPs produced by cells and have been shown to be effective for wound healing Rani and Ritter, Figure 5.
Delivery of co-receptors with growth factors in a lipid nanoliposome to enhance diabetic wound healing. A Protein expression of syndecan-4 in diabetic and non-diabetic human tissue.
B Macroscopic image of the dorsal surface of the mouse with excisional wounds treated for 2 weeks with the treatments. C Quantification of the open wound area over the course of 2 weeks after surgery with the different treatments. D Schematic representation of the co-delivery of syndecan-4 in a nanoliposome with FGF-2 encapsulated in alginate wound dressings and the findings of the study.
A—D are reproduced with permission from Das et al. E Histological sections of wounds with various treatments stained with Hematoxylin and Eosin stain.
F Quantification of the open wound area over the course of 2 weeks after surgery with the different treatments. G Immunofluorescent images of sections of the wound bed stained with alpha smooth muscle actin green , PECAM red , and DAPI blue.
E—G are reproduced with permission from Das et al. Wound dressings loaded with titanium dioxide NPs that are coated with chitosan and pectin are antimicrobial and have been shown to have great wound healing properties Archana et al.
The synergistic effects with the dressing such as antibacterial activity, high swelling properties, high moisture vapor transmission rate, hydrophilic nature, biocompatibility, wound appearance, and enhanced wound closure rate make titanium NPs a suitable candidate for wound healing applications.
Growth factors are important in ensuring healthy wound healing. However, the half-life of the growth factors in the wound microenvironment is significantly reduced because of the presence of various proteolytic enzymes including MMPs Murphy and Nagase, Encapsulation of growth factors in polymer NPs increased stability, preserved bioactivity, and promoted sustained release of the growth factors.
Currently, PDGF-BB is the only growth factor that is FDA approved for diabetic foot ulcers, which makes PDGF-based therapies even more translational. Hyaluronan-based porous NPs enriched with PDGF-BB have been shown to be highly effective for the treatment of ulcers in a placebo-controlled study in rats Zavan et al.
Fibroblast growth factor-2 FGF-2 has been successfully microencapsulated in gelatin preserving biological activity and thus allows for their use in tissue engineering, therapeutic angiogenesis, gene therapy, and drug delivery applications Young et al. EGF is a potent mitogen for keratinocytes, which has been shown to be effective in healing gastric ulcers when delivered through a poly- l -lactic acid-based wound dressing Han et al.
Nanoparticle-based therapies in wound care are relatively new compared to conventional biomaterials that have been used for decades now. Silver has been used since ancient Roman times and now used in biomedical devices de Alwis Weerasekera et al.
Silver NPs or nanocrystals in a topical gel have been used for moist wound care and promote cosmetic healing, have effective antibacterial properties, and play a role in cytokine modulation and suppress inflammation Tian et al.
They are generally indicated for minor cuts, abrasions, lacerations, skin irritations, and first- or second-degree burns. Although the mechanisms underlying the antibacterial actions of silver are still not fully understood, several previous reports showed that the interaction between silver and the constituents of the bacterial membrane caused structural changes and damage to the membranes and intracellular metabolic activity, which might be the cause or consequence of cell death McDonnell and Russell, ; Sondi and Salopek-Sondi, ; Pal et al.
However, prolonged exposure to colloidal silver can result in argyria where the skin attains blue gray color from accumulated silver Rice, There are several variations of silver containing creams or gels or ointments that are available from different companies.
Silver NP-based treatments are inexpensive, have low systemic toxicity, and are effective against viral and bacterial infections but have limited effects on enhancing the wound healing process in chronic wound environment Gunasekaran et al. Biomaterials have been used in wound healing since the rise of Egyptian civilization, but NPs have become tremendously important in engineering an effective treatment strategy, only in the last two decades.
Biomaterials have been successfully used in manufacturing clinically approved products for aiding wound healing like films, foams, wafers, hydrogels, hemostatics, sealants, and composite dressings.
However, there are no biomaterials currently approved that release bioactive components like growth factors, cytokines, chemokines, plasmids, recombinant proteins, small molecules, cellular therapy, etc. that directly influence the wound healing cascade.
Here, we reviewed biomaterials used in the clinic and those under preclinical development. We are excited about the potential of the biomaterials undergoing development, specifically those that encapsulate bioactive compounds or cell therapies.
NP therapies on the other hand have not been used widely in clinic barring silver NPs. However, there is a lot of compelling NP therapies that have shown great potential in animal models as we discussed in the paper. With the advent of CRISPR-Cas9 technology, it would be interesting to see how scientists apply this remarkable gene editing technology to engineer the wound microenvironment Jinek et al.
There are many genes that are involved in the regulation of the wound healing process, and wound healing models have been tested only on a few mutant mouse models.
CRISPR-Cas9 technology reduces the time to create a knockout mouse from several months to few weeks, thus enabling researchers to ask various questions. The overall goal would be to achieve fetal wound healing properties in adult wound healing with complete regeneration of hairs and glands, without delay and scarring.
Wound care is a significant economic and social burden on both the patient population and the health-care system at large. In this review, we have discussed the different biomaterial and NP-based wound therapies, which are either in current clinical usage or in preclinical development. Since there is significant variability of presentation of symptoms in the patients, effective wound care therapies need to have a multipronged approach to tackle the complex problems of pain, inflammation, infection caused by resistant bacteria, delayed healing, and associated costs to health systems and populations worldwide.
The precipitous rise in multidrug-resistant bacteria is going to be the biggest challenge for wound care professionals all over the world in this decade. Emerging treatments using biomaterials or NPs to target multiple aspects have great promise for enhancing wound care and will add to the clinical armamentarium to address poorly healing wounds.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acosta, J. Epidermal growth factor intralesional infiltrations can prevent amputation in patients with advanced diabetic foot wounds.
Wound J. PubMed Abstract CrossRef Full Text Google Scholar. Agha, R. A review of the role of mechanical forces in cutaneous wound healing. Aksoy, B. A new experimental delayed wound healing model in rabbits.
Alarcon, E. Safety and efficacy of composite collagen-silver nanoparticle hydrogels as tissue engineering scaffolds. Nanoscale 7, — Alexiadou, K. Management of diabetic foot ulcers. Diabetes Ther. Allison, K. Metabolite-enabled eradication of bacterial persisters by aminoglycosides.
Nature , — American Diabetes, A. Economic costs of diabetes in the U. in Diabetes Care 36, — Andrews, K. Wound management of chronic diabetic foot ulcers: from the basics to regenerative medicine. Ansell, D. Animal models of wound repair: are they cutting it? Archana, D. Evaluation of chitosan nano dressing for wound healing: characterization, in vitro and in vivo studies.
Armstrong, D. Mind the gap: disparity between research funding and costs of care for diabetic foot ulcers.
CrossRef Full Text Google Scholar. Arora, S. Cellular responses induced by silver nanoparticles: in vitro studies. Asharani, P. Toxicity of silver nanoparticles in zebrafish models.
Nanotechnology 19, AshaRani, P. Cytotoxicity and genotoxicity of silver nanoparticles in human cells. ACS Nano 3, — Assembly, W. Global Action Plan on Antimicrobial Resistance.
Geneva: World Health Organization. Google Scholar. Ayello, E. What does the wound say? Why determining etiology is essential for appropriate wound care. Skin Wound Care 18, 98—; quiz — PubMed Abstract Google Scholar.
Banks, V. Evaluation of a new polyurethane foam dressing. Wound Care 6, — Banu, A. Spectrum of bacteria associated with diabetic foot ulcer and biofilm formation: a prospective study. Australas Med. Barua, S. Infection-resistant hyperbranched epoxy nanocomposite as a scaffold for skin tissue regeneration.
Baum, T. Use of a glycerin-based gel sheeting in scar management. Wound Care 11, 40— Bell, B. A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance.
BMC Infect. Birkedal-Hansen, H. Matrix metalloproteinases: a review. Oral Biol. Blair, J. Molecular mechanisms of antibiotic resistance. Blecher, K. Nitric oxide-releasing nanoparticles accelerate wound healing in NOD-SCID mice. Nanomedicine 8, — Boateng, J.
Polyox and carrageenan based composite film dressing containing anti-microbial and anti-inflammatory drugs for effective wound healing.
Branski, L. A review of gene and stem cell therapy in cutaneous wound healing. Burns 35, — Broughton, G. II, Janis, J. The basic science of wound healing. Bryan, L. Effects of membrane-energy mutations and cations on streptomycin and gentamicin accumulation by bacteria: a model for entry of streptomycin and gentamicin in susceptible and resistant bacteria.
Agents Chemother. Brynildsen, M. Potentiating antibacterial activity by predictably enhancing endogenous microbial ROS production. Buchberger, B. The evidence for the use of growth factors and active skin substitutes for the treatment of non-infected diabetic foot ulcers DFU : a health technology assessment HTA.
Diabetes , — Calderini, C. Acta Biomed. Castleberry, S. Self-assembled wound dressings silence MMP-9 and improve diabetic wound healing in vivo. Chakraborty, S. Nanoconjugated vancomycin: new opportunities for the development of anti-VRSA agents.
Nanotechnology 21, Chandika, P. Marine-derived biological macromolecule-based biomaterials for wound healing and skin tissue regeneration. Chien, S. Ischemic rabbit ear model created by minimally invasive surgery.
Wound Repair Regen. Chigurupati, S. Effects of cerium oxide nanoparticles on the growth of keratinocytes, fibroblasts and vascular endothelial cells in cutaneous wound healing.
Biomaterials 34, — Cho, S. Targeted genome engineering in human cells with the Cas9 RNA-guided endonuclease.
Clifford, C. Treating traumatic bleeding in a combat setting. Cong, L. Science , — Coutts, P. Case series of lower-extremity chronic wounds managed with an antibacterial foam dressing bound with gentian violet and methylene blue.
Skin Wound Care 27, 9— Cozad, M. Assessment of decellularized porcine diaphragm conjugated with gold nanomaterials as a tissue scaffold for wound healing. Cullen, B. Cell Biol. Dantes, R. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, JAMA Intern.
Das, S. Syndecan-4 enhances PDGF-BB activity in diabetic wound healing. Acta Biomater. Syndecan-4 enhances therapeutic angiogenesis after hind limb ischemia in mice with type 2 diabetes.
Syndesome therapeutics for enhancing diabetic wound healing. Overcoming disease-induced growth factor resistance in therapeutic angiogenesis using recombinant co-receptors delivered by a liposomal system. Biomaterials 35, — de Alwis Weerasekera, H.
Alarcon, M. Griffith and I. Udekwu Cham: Springer International Publishing , 93— Deonarine, K. Gene expression profiling of cutaneous wound healing. DeRosa, F. Nitric oxide-releasing fabrics and other acrylonitrile-based diazeniumdiolates. Dhanalakshmi, V. Skin and muscle permeating antibacterial nanoparticles for treating Staphylococcus aureus infected wounds.
Part B Appl. DiPietro, L. Wound healing: the role of the macrophage and other immune cells. Shock 4, — Dorsett-Martin, W.
Conn Totowa, NJ: Humana Press , — Dunn, L. Murine model of wound healing. Eckhardt, S. Nanobio silver: its interactions with peptides and bacteria, and its uses in medicine. Elsner, J. Novel biodegradable composite wound dressings with controlled release of antibiotics: microstructure, mechanical and physical properties.
Eming, S. Wound repair and regeneration: mechanisms, signaling, and translation. Evers, L. The biology of burn injury. Fang, R. A review of becaplermin gel in the treatment of diabetic neuropathic foot ulcers. Biologics 2, 1— Fernandez-Montequin, J.
Intralesional administration of epidermal growth factor-based formulation Heberprot-P in chronic diabetic foot ulcer: treatment up to complete wound closure.
Franz, S. Immune responses to implants — a review of the implications for the design of immunomodulatory biomaterials.
Biomaterials 32, — Futrega, K. Treating the whole not the hole: necessary coupling of technologies for diabetic foot ulcer treatment. Trends Mol. Garay-Jimenez, J. Physical properties and biological activity of poly butyl acrylate-styrene nanoparticle emulsions prepared with conventional and polymerizable surfactants.
Nanomedicine 5, — Gokce, E. Resveratrol-loaded solid lipid nanoparticles versus nanostructured lipid carriers: evaluation of antioxidant potential for dermal applications.
Nanomedicine 7, — Griffin, D. Accelerated wound healing by injectable microporous gel scaffolds assembled from annealed building blocks. Griffith, M. Udekwu Cham: Springer International Publishing , — Gu, Q. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 28, — Gunasekaran, T.
Silver nanoparticles as real topical bullets for wound healing. Wound Spec. Gurtner, G. Wound repair and regeneration. Gusarov, I. Endogenous nitric oxide protects bacteria against a wide spectrum of antibiotics.
Han, G. Nitric oxide-releasing nanoparticles accelerate wound healing by promoting fibroblast migration and collagen deposition. Han, K. Preparation and evaluation of poly l -lactic acid microspheres containing rhEGF for chronic gastric ulcer healing. Control Release 75, — Hantash, B.
Adult and fetal wound healing. Hasatsri, S. Randomized clinical trial of the innovative bilayered wound dressing made of silk and gelatin: safety and efficacy tests using a split-thickness skin graft model.
Based Complement. Hetrick, E. Anti-biofilm efficacy of nitric oxide-releasing silica nanoparticles. Biomaterials 30, — Heublein, H. Preclinical and clinical evidence for stem cell therapies as treatment for diabetic wounds. Drug Discov. Today 20, — Hoggarth, A. A controlled, three-part trial to investigate the barrier function and skin hydration properties of six skin protectants.
Ostomy Wound Manage. Holmes, C. Collagen-based wound dressings for the treatment of diabetes-related foot ulcers: a systematic review. Diabetes Metab. Hubbell, J. Hydrogel systems for barriers and local drug delivery in the control of wound healing. Release 39, — Hutchinson, J.
Occlusive dressings: a microbiologic and clinical review. Control 18, — Jacob, D. Are ionic liquids really a boon for the synthesis of inorganic materials? A general method for the fabrication of nanosized metal fluorides.
Jain, J. Silver nanoparticles in therapeutics: development of an antimicrobial gel formulation for topical use. Jang, E. Syndecan-4 proteoliposomes enhance fibroblast growth factor-2 FGF-2 -induced proliferation, migration, and neovascularization of ischemic muscle.
Jeanes, A. Reducing bloodstream infection with a chlorhexidine gel IV dressing. Jinek, M. A programmable dual-RNA-guided DNA endonuclease in adaptive bacterial immunity.
Kang, M. Effect of freeze dried bovine amniotic membrane extract on full thickness wound healing. Kannon, G.
Moist wound healing with occlusive dressings. Karimbux, N. Calor, dolor, rubor, tumor. Kell, A. Vancomycin-modified nanoparticles for efficient targeting and preconcentration of Gram-positive and Gram-negative bacteria.
ACS Nano 2, — Kemp, M. Protecting the skin from moisture and associated irritants. Kim, D. Cutaneous wound healing in aging small mammals: a systematic review. Kim, I. Physicochemical characterization of poly l -lactic acid and poly d , l -lactide-co-glycolide nanoparticles with polyethylenimine as gene delivery carrier.
Kirsner, R. The wound healing society chronic wound ulcer healing guidelines update of the guidelines-blending old with new. Kohanski, M. A common mechanism of cellular death induced by bactericidal antibiotics. Cell , — Kozen, B. An alternative hemostatic dressing: comparison of Celox, HemCon, and QuikClot.
Kuchler, S. SLN for topical application in skin diseases — characterization of drug-carrier and carrier-target interactions. Nanoparticles for skin penetration enhancement — a comparison of a dendritic core-multishell-nanotransporter and solid lipid nanoparticles. Larsson, J.
Long-term prognosis after healed amputation in patients with diabetes. Lellouche, J. Antibiofilm activity of nanosized magnesium fluoride.
Leu, J. The effects of gold nanoparticles in wound healing with antioxidant epigallocatechin gallate and alpha-lipoic acid.
Lew, D. Optimization of UV cross-linking density for durable and nontoxic collagen GAG dermal substitute. Li, N.
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