고관절 전치환술 시행 환자에서 수술전후 영양상태와 상처치유 지연과의 관계

서근택 ( Kuen Tak Suh ),김승욱 ( Seung Wook Kim ),유총일 ( Chong Il Yoo ) 대한고관절학회 1995 Hip and Pelvis Vol.7 No.2

In total hip arthroplasty, there is alarmingly high frequency of the subclinical perioperative malnutrition which is easily neglected. Nutritional status has a close relationship with the normal wound healing mechanism. So it is important to determine the most sensitive index for detecting perioperative nutritional depletion. We performed study about the relation between the perioperative nutritional status and the delayed wound healing after total hip arthroplasty. For this study, we reviewed 74 cases of total hip arthroplasties and analysed various indices of nutritional status. Following results were obtained: 1. Delayed wound healing complicated 18 of the 74(24.3%) total hip arthmplasties. 2. There was significant trend for patients with delayed wound healing to be older than those with normal wound healing(67.3 years versus 54.7 years; p<0.05). Delayed wound healing group also had tendency to be more obese than normal healing group(p<0.05). 3. Statistically significant perioperative nutritional indices which were related to the delayed wound healing were the serum albumin level and the serum transferrin level(P<0.05). 4. Moderate to severe albumin depletion were observed in 13 cases preoperatively and all of them had delayed wound healing. Preoperatively, moderate to severe transferrin depletion were observed in 23% of normal healing group and 83% of delayed wound healing group. 5. Postoperatively, 90% and 89% of all 74 cases were found to have at least moderate serum albumin and transferrin depletion respectively. 6. The patients with delayed wound healing had complete wound healing until 24 days after surgery except three patients complicated wound infection.

Human Adipose Mesenchymal Stem Cell-Derived Exosomes: A Key Player in Wound Healing

허준석,Kim Sinyoung,Yang Chae Eun,Choi Youjeong,송승용,Kim Hyun Ok 한국조직공학과 재생의학회 2021 조직공학과 재생의학 Vol.18 No.4

Background: Human adipose-derived mesenchymal stem cells (AMSCs) are an attractive resource for wound healing because their regenerative capacity improves injury repair. Recently, stem cell-derived exosomes have been shown to play a positive role in stem cell-based therapies. However, the effects of exosomes derived from AMSCs (AEXOs) on wound healing are unclear. In this study, we aimed to examine the role of AEXOs in attenuating inflammation and explore their effects in normal wound healing. Methods: We isolated exosomes from AMSCs and established a cellular model of inflammation by treatment with the inflammatory cytokines, interferon gamma and tumor necrosis factor alpha, to determine whether AEXOs can inhibit inflammation. We examined the wound healing effects of AEXOs in in vitro wound healing models and performed a miRNA array to understand the role of AEXOs in inflammation and wound healing. Results: A significant difference was observed in wound closure and the expression of anti-inflammatory and wound-healing-related factors between control and AEXO-treated cells. Conclusion: Our results showed that besides alleviating the inflammation response, AEXOs also promote wound healing. Thus, AEXOs represent a novel, stem-cell-based, therapeutic strategy for wound healing. Background: Human adipose-derived mesenchymal stem cells (AMSCs) are an attractive resource for wound healing because their regenerative capacity improves injury repair. Recently, stem cell-derived exosomes have been shown to play a positive role in stem cell-based therapies. However, the effects of exosomes derived from AMSCs (AEXOs) on wound healing are unclear. In this study, we aimed to examine the role of AEXOs in attenuating inflammation and explore their effects in normal wound healing. Methods: We isolated exosomes from AMSCs and established a cellular model of inflammation by treatment with the inflammatory cytokines, interferon gamma and tumor necrosis factor alpha, to determine whether AEXOs can inhibit inflammation. We examined the wound healing effects of AEXOs in in vitro wound healing models and performed a miRNA array to understand the role of AEXOs in inflammation and wound healing. Results: A significant difference was observed in wound closure and the expression of anti-inflammatory and wound-healing-related factors between control and AEXO-treated cells. Conclusion: Our results showed that besides alleviating the inflammation response, AEXOs also promote wound healing. Thus, AEXOs represent a novel, stem-cell-based, therapeutic strategy for wound healing.

PVA/PVP Nanofibres Incorporated with Ecklonia cava Phlorotannins Exhibit Excellent Cytocompatibility and Accelerate Hyperglycaemic Wound Healing

Phang Shou Jin,Teh Huey Xhin,Looi Mee Lee,Fauzi Mh Busra,Neo Yun Ping,Arumugam Bavani,Kuppusamy Umah Rani 한국조직공학과 재생의학회 2024 조직공학과 재생의학 Vol.21 No.2

Background: Diabetic foot ulcer (DFU) is a major debilitating complication of diabetes. The lack of effective diabetic wound dressings has been a significant problem in DFU management. In this study, we aim to establish a phlorotannin-incorporated nanofibre system and determine its potential in accelerating hyperglycaemic wound healing. Methods: The effective dose of Ecklonia cava phlorotannins (ECP) for hyperglycaemic wound healing was determined prior to phlorotannin nanofibre fabrication using polyvinyl-alcohol (PVA), polyvinylpyrrolidone (PVP), and ECP. Vapour glutaraldehyde was used for crosslinking of the PVA/PVP nanofibres. The phlorotannin nanofibres were characterised, and their safety and cytocompatibility were validated. Next, the wound healing effect of phlorotannin nanofibres was determined with 2D wound scratch assay, whereas immunofluorescence staining of Collagen-I (Col-I) and Cytokeratin-14 (CK-14) was performed in human dermal fibroblasts (HDF) and human epidermal keratinocytes (HEK), respectively. Results: Our results demonstrated that 0.01 μg/mL ECP significantly improved hyperglycaemic wound healing without compromising cell viability and proliferation. Among all nanofibres, PVA/PVP/0.01 wt% ECP nanofibres exhibited the best hyperglycaemic wound healing effect. They displayed a diameter of 334.7 ± 10.1 nm, a porosity of 40.7 ± 3.3%, and a WVTR of 1718.1 ± 32.3 g/m2/day. Besides, the FTIR spectra and phlorotannin release profile validated the successful vapour glutaraldehyde crosslinking and ECP incorporation. We also demonstrated the potential of phlorotannin nanofibres as a non-cytotoxic wound dressing as they support the viability and proliferation of both HDF and HEK. Furthermore, phlorotannin nanofibres significantly ameliorated the impaired hyperglycaemic wound healing and restored the hyperglycaemic-induced Col-I reduction in HDF. Conclusion: Taken together, our findings show that phlorotannin nanofibres have the potential to be used as a diabetic wound dressing. Background: Diabetic foot ulcer (DFU) is a major debilitating complication of diabetes. The lack of effective diabetic wound dressings has been a significant problem in DFU management. In this study, we aim to establish a phlorotannin-incorporated nanofibre system and determine its potential in accelerating hyperglycaemic wound healing. Methods: The effective dose of Ecklonia cava phlorotannins (ECP) for hyperglycaemic wound healing was determined prior to phlorotannin nanofibre fabrication using polyvinyl-alcohol (PVA), polyvinylpyrrolidone (PVP), and ECP. Vapour glutaraldehyde was used for crosslinking of the PVA/PVP nanofibres. The phlorotannin nanofibres were characterised, and their safety and cytocompatibility were validated. Next, the wound healing effect of phlorotannin nanofibres was determined with 2D wound scratch assay, whereas immunofluorescence staining of Collagen-I (Col-I) and Cytokeratin-14 (CK-14) was performed in human dermal fibroblasts (HDF) and human epidermal keratinocytes (HEK), respectively. Results: Our results demonstrated that 0.01 μg/mL ECP significantly improved hyperglycaemic wound healing without compromising cell viability and proliferation. Among all nanofibres, PVA/PVP/0.01 wt% ECP nanofibres exhibited the best hyperglycaemic wound healing effect. They displayed a diameter of 334.7 ± 10.1 nm, a porosity of 40.7 ± 3.3%, and a WVTR of 1718.1 ± 32.3 g/m2/day. Besides, the FTIR spectra and phlorotannin release profile validated the successful vapour glutaraldehyde crosslinking and ECP incorporation. We also demonstrated the potential of phlorotannin nanofibres as a non-cytotoxic wound dressing as they support the viability and proliferation of both HDF and HEK. Furthermore, phlorotannin nanofibres significantly ameliorated the impaired hyperglycaemic wound healing and restored the hyperglycaemic-induced Col-I reduction in HDF. Conclusion: Taken together, our findings show that phlorotannin nanofibres have the potential to be used as a diabetic wound dressing.

Polydeoxyribonucleotides Improve Diabetic Wound Healing in Mouse Animal Model for Experimental Validation

권태린,한성원,김종환,이병철,김재민,홍지연,김범준 대한피부과학회 2019 Annals of Dermatology Vol.31 No.4

Background: Wound healing mechanisms is believed to have effects similar to wound healing disorders in diabetic patients, including abnormal inflammatory cells, angiogenesis disorders, and reduced collagen synthesis. Therefore, reestablishment of structural and promoted angiogenesis could be beneficial to promote wound healing process. Objective: Therefore, we investigated whether the polydeoxyribonucleotide (PDRN) that was self-production in Korea, could be useful as an intradermal injection for promoting wound healing. Also, we validate for wound healing effect of PDRN using healing-impaired (db/db) mice. Methods: In this study, we confirmed the effects of PDRN by creating wound models in in vitro and in vivo model. Using an in vitro wound healing assay, we observed that PDRN stimulated closure of wounded monolayers of human fibroblast cells. PDRN (8.25 mg/ml) or phosphate-buffered saline (0.9% NaCl) was injected once daily into the dermis adjacent to the wound for 12 days after skin injury. Results: Time course observations revealed that mice treated with PDRN showed accelerated wound closure and epidermal and dermal regeneration, enhanced angiogenesis. The wound area and depth decreased at 3, 6, 9, and 12 days after skin injury. Histological evaluation showed an increase of vascular endothelial growth factor, CD31, and collagen fibers in the PDRN group compared with the control group, indicating that PDRN was effective in the treatment of delayed wound healing caused by diabetes. Conclusion: This study suggests that our PDRN has a wound healing effect in transgenic animal models with cells and diabetes through angiogenesis.

Polydeoxyribonucleotides Improve Diabetic Wound Healing in Mouse Animal Model for Experimental Validation

( Tae-rin Kwon ),( Sung Won Han ),( Jong Hwan Kim ),( Byung Chul Lee ),( Jae Min Kim ),( Ji Yeon Hong ),( Beom Joon Kim ) 대한피부과학회 2019 Annals of Dermatology Vol.31 No.4

Background: Wound healing mechanisms is believed to have effects similar to wound healing disorders in diabetic patients, including abnormal inflammatory cells, angiogenesis disorders, and reduced collagen synthesis. Therefore, reestablishment of structural and promoted angiogenesis could be beneficial to promote wound healing process. Objective: Therefore, we investigated whether the polydeoxyribonucleotide (PDRN) that was self-production in Korea, could be useful as an intradermal injection for promoting wound healing. Also, we validate for wound healing effect of PDRN using healing-impaired (db/db) mice. Methods: In this study, we confirmed the effects of PDRN by creating wound models in in vitro and in vivo model. Using an in vitro wound healing assay, we observed that PDRN stimulated closure of wounded monolayers of human fibroblast cells. PDRN (8.25 mg/ml) or phosphate-buffered saline (0.9% NaCl) was injected once daily into the dermis adjacent to the wound for 12 days after skin injury. Results: Time course observations revealed that mice treated with PDRN showed accelerated wound closure and epidermal and dermal regeneration, enhanced angiogenesis. The wound area and depth decreased at 3, 6, 9, and 12 days after skin injury. Histological evaluation showed an increase of vascular endothelial growth factor, CD31, and collagen fibers in the PDRN group compared with the control group, indicating that PDRN was effective in the treatment of delayed wound healing caused by diabetes. Conclusion: This study suggests that our PDRN has a wound healing effect in transgenic animal models with cells and diabetes through angiogenesis. (Ann Dermatol 31(4) 403∼413, 2019)

토기에서 고압산소치료가 허혈귀의 혈류와 창상치유에 미치는 영향

안상태,임풍,김인중 大韓成形外科學會 1995 Archives of Plastic Surgery Vol.22 No.1

Local oxygen supply is important in the healing of problem wounds aggrevated by tissue hypoxia. Hyperbaric oxygen has been used to treat chronic leg ulcers and reported to be benificial in the skin flap survival and wound healing in animal experiments. An objective data and exact mechanism of hyperbaric oxygen in the treatment of ischemic wounds has not yet been defined in an animal model. To study the effects of hyperbaric oxygen on blood flow and wound healing in ischemic condition, two experiments were designed. Using 48 rabbits, we made one ear ischemic and the other ear control which had two full-thickness ulcer wounds on their ventral surfaces. In experiment Ⅰ, rabbits were treated daily with hyperbaric oxygen until wounds were epithelized completely. Blood flow was evaluated by dextran perfusion method. Wound healing was evaluated by measuring the time required to epithelize the wounds competely. In experiment Ⅱ, rabbits were treated daily with hyperbaric oxygen for two weeks. Blood flow was measured using hydrogen clearance method(Ameflow). Wound healing wass evaulated by measuring diameter of epithelial defects. The results were as follows ; 1. The results obtained from experiment Ⅰand Ⅱ were the same trend despite different methods of evaluation in blood flow and wound healing. 2. In the normal ears, blood flow was not affected by oxygen treatment. Wound healing was improved in the oxygen treated animal compared to the control. 3. Blood flow and wound healing were impaired markedly in the ischemic ears compared to the normal ears. 4. In the ischemic ears, blood flow and wound healing were improved markedly after the oxygen treatment for two or more weeks. In conclusion, restored blood flow induced by hyperbaric oxygenation does a major role in an improvement of wound healing in the ischemic condition.

Engineering pharmaceutical nanocarriers for photodynamic therapy on wound healing: Review

Shanmugapriya, Karuppusamy,Kang, Hyun Wook Elsevier S.A. 2019 Materials Science and Engineering C Vol. No.

<P><B>Abstract</B></P> <P>In the present scenario, promising efforts have been improved by the researchers towards the development of nanocarriers that can be challenge fundamental tasks in photodynamic therapy (PDT) for wound management. In the past few years, nanotechnology-based therapy has attracted good attention with the advancement of nanotechnology such as PDT, chemotherapy, photothermal therapy. PDT has emerged as a promising clinical treatment method for wound healing. In this respect, great effort has been made towards the development of nanocarriers for targeted PDT in wound management. Nowadays, attention is concentrated on the advancement of nanomaterials using innovative methods in wound care for treating wounds with the faster healing effect. In this review, we present and discuss how nanocarriers have arisen as an interesting delivery nanoplatform for effective and consistent PDT. They can be easily delivered photodynamically and can demonstrate healing mechanisms for achieving target wound tissue/cells; therefore, PDT can be used in wound treatment to target cells specifically through release on demand, target-specific delivery, and in vivo labelling imaging. In addition, we also highlighted that the future goal for researchers is the development of biocompatible and biodegradable nanomaterials for all the phases of wound healing.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Development of nanocarriers for PDT in wound healing process is of quite challenge. </LI> <LI> PDT is promising alternative approach for improved wound healing treatment method. </LI> <LI> Biocompatible biomaterials become a dynamic role in each wound healing stages. </LI> <LI> Pharmaceutical nanocarriers can significantly improve the wound healing efficacy. </LI> <LI> Nanocarrier systems may improve in vitro and in vivo applications of wound related. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>

Basic amino acid-mediated cationic amphiphilic surfaces for antimicrobial pH monitoring sensor with wound healing effects

Lee Dong Uk,Kim Se-Chang,최동윤,Jung Won-Kyo,Moon Myungjun 한국생체재료학회 2023 생체재료학회지 Vol.27 No.00

Background The wound healing process is a complex cascade of physiological events, which are vulnerable to both our body status and external factors and whose impairment could lead to chronic wounds or wound healing impediments. Conventional wound healing materials are widely used in clinical management, however, they do not usually prevent wounds from being infected by bacteria or viruses. Therefore, simultaneous wound status monitoring and prevention of microbial infection are required to promote healing in clinical wound management. Methods Basic amino acid-modified surfaces were fabricated in a water-based process via a peptide coupling reaction. Specimens were analyzed and characterized by X-ray photoelectron spectroscopy, Kelvin probe force microscopy, atomic force microscopy, contact angle, and molecular electrostatic potential via Gaussian 09. Antimicrobial and biofilm inhibition tests were conducted on Escherichia coli and Staphylococcus epidermidis. Biocompatibility was determined through cytotoxicity tests on human epithelial keratinocytes and human dermal fibroblasts. Wound healing efficacy was confirmed by mouse wound healing and cell staining tests. Workability of the pH sensor on basic amino acid-modified surfaces was evaluated on normal human skin and Staphylococcus epidermidis suspension, and in vivo conditions. Results Basic amino acids (lysine and arginine) have pH-dependent zwitterionic functional groups. The basic amino acid-modified surfaces had antifouling and antimicrobial properties similar to those of cationic antimicrobial peptides because zwitterionic functional groups have intrinsic cationic amphiphilic characteristics. Compared with untreated polyimide and modified anionic acid (leucine), basic amino acid-modified polyimide surfaces displayed excellent bactericidal, antifouling (reduction ~ 99.6%) and biofilm inhibition performance. The basic amino acid-modified polyimide surfaces also exhibited wound healing efficacy and excellent biocompatibility, confirmed by cytotoxicity and ICR mouse wound healing tests. The basic amino acid-modified surface-based pH monitoring sensor was workable (sensitivity 20 mV pH− 1) under various pH and bacterial contamination conditions. Conclusion Here, we developed a biocompatible and pH-monitorable wound healing dressing with antimicrobial activity via basic amino acid-mediated surface modification, creating cationic amphiphilic surfaces. Basic amino acid-modified polyimide is promising for monitoring wounds, protecting them from microbial infection, and promoting their healing. Our findings are expected to contribute to wound management and could be expanded to various wearable healthcare devices for clinical, biomedical, and healthcare applications.

Effect of Gentamicin Collagen Sponge on Wound Healing: In Vivo Study and Assessment of Its Effectiveness against Nosocomial Bacteria

Lee Hye Mi,Park Jin Woo,Young Cheon Na,Yoon chi Sun,Kim Jong Hwan,Park Ji Hye 대한창상학회 2022 Journal of Wound Management and Research Vol.18 No.2

Background: Gentamicin collagen sponge (Genta-Coll) reportedly has a hemostatic effect and promotes wound healing. However, it may also interfere with wound healing by causing foreign body reactions. We planned to analyze the effect of Genta-Coll on wound healing by inducing muscle defects in the rectus abdominis muscle of rats. We also assessed the effectiveness of Genta-Coll in preventing surgical site infections (SSIs) using the zone of inhibition tests to determine the sensitivity of pathogenic bacteria. Methods: We created an 8×8-mm muscle defect in both recti abdominis of 15 white Sprague-Dawley rats and distributed them into the control group (no care) and group A (Genta-Coll). Three biopsies were performed for histologic analysis (on days 3, 7, and 27). In the second study, we placed Genta-Coll on Mueller–Hinton agar plates seeded with pathogenic microorganisms commonly responsible for SSIs. The zone of inhibition was measured after 24 and 48 hours of incubation. Results: Group A showed a slightly higher score for foreign body giant cells and inflammation, with no significant difference. Granulation and neovascularization were constantly high in group A, and muscle regeneration was also high in group A. Extracellular matrix formation advanced at a similar pace in both groups. Genta-Coll created a zone of inhibition against all microorganisms except for Candida albicans. The effect lasted without change between 24 and 48 hours. Conclusion: While foreign body reactions and inflammation increased in group A, wound healing was unaffected. Genta-Coll can promote faster wound healing with an anti-bactericidal effect against SSI pathogens. Background: Gentamicin collagen sponge (Genta-Coll) reportedly has a hemostatic effect and promotes wound healing. However, it may also interfere with wound healing by causing foreign body reactions. We planned to analyze the effect of Genta-Coll on wound healing by inducing muscle defects in the rectus abdominis muscle of rats. We also assessed the effectiveness of Genta-Coll in preventing surgical site infections (SSIs) using the zone of inhibition tests to determine the sensitivity of pathogenic bacteria.Methods: We created an 8×8-mm muscle defect in both recti abdominis of 15 white Sprague-Dawley rats and distributed them into the control group (no care) and group A (Genta-Coll). Three biopsies were performed for histologic analysis (on days 3, 7, and 27). In the second study, we placed Genta-Coll on Mueller–Hinton agar plates seeded with pathogenic microorganisms commonly responsible for SSIs. The zone of inhibition was measured after 24 and 48 hours of incubation.Results: Group A showed a slightly higher score for foreign body giant cells and inflammation, with no significant difference. Granulation and neovascularization were constantly high in group A, and muscle regeneration was also high in group A. Extracellular matrix formation advanced at a similar pace in both groups. Genta-Coll created a zone of inhibition against all microorganisms except for Candida albicans. The effect lasted without change between 24 and 48 hours.Conclusion: While foreign body reactions and inflammation increased in group A, wound healing was unaffected. Genta-Coll can promote faster wound healing with an anti-bactericidal effect against SSI pathogens.

A mice model of chronic non-healing wound and the dermal-equivalent for the assistance of re-epithelization process

( Jae Ho Lee ),( Youngkyoung Lim ),( You Jin Lee ),( Jong Yoon Chung ),( Ji Hye Park ),( Jong Hee Lee ),( Dong Youn Lee ),( Joo Heung Lee ),( Jun Mo Yang ) 대한피부과학회 2015 대한피부과학회 학술발표대회집 Vol.67 No.2

Background: Chronic wounds represent a significant burden to patients. Mice wound model is difficult to assess in that fast wound healing and different healing mechanism from human. Objectives: We propose a mouse burn skin model with “dermal equivalent(DE)” for the chronic non-healing wound and set appropriate schedule for wound evaluation in this model. Methods: To simulate chronic wound, we adopted a burn model. Six week-old nude mice are burnt on their back and the damaged skin was punched out at the center with remaining margins of burnt skin. Normal human dermal fibroblast (NHDF) were grown in vitro to build dermal equivalent (DE)”. Twenty four mice were divided into 6 groups according to the DE application and wound healing duration: wound only, wound with DE application, burnt wound only sacrificed at 16th day, burnt wound with DEsacrificed at 16th day, burnt wound only sacrificed at 12th day, and burnt wound with DE sacrificed at 12th day. We measured amount of skin contracture and final re-epithelization thickness to assess the effects of DE on the wound healing. Results: Wound contracture was significantly different in fresh wound groups, but not in both burnt wound groups, implying DE’s effect on wound healing was compromised.Interestingly, re-epithelization thickness was thicker in only DE applied group of burnt wound sacrificed at 12th day. Conclusion: The burn wound model in mice actually delayed wound healing. The wound evaluation should be done at least before 16th day.