Basic and Clinical Research in Wound Healing

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Biomedical Engineering and Materials".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 11208

Special Issue Editor


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Guest Editor
1. Department of Plastic Surgery and Hand Surgery, Gemeinschaftskrankenhaus Havelhoehe, 14089 Berlin, Germany
2. Department of Plastic Surgery and Hand Surgery, Burn Center, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
Interests: wound healing; macrophage migration inhibitory factor (MIF); carbon monoxide intoxication; integrative medicine

Special Issue Information

Dear Colleagues,

Wound healing in general is a complex but normal physiological process. However, due to multiple underlying diseases, it can be problematic, leading to, e.g., chronic wounds, which are associated with high patient morbidity and high costs of wound care. Many different strategies have been developed to deal with this problem, rendering wound healing an emerging field in today's scientific landscape.

This Special Issue addresses a broad spectrum of research in wound healing, from in vitro and in vivo experiments including the field of tissue engineering, to clinical studies and therapeutic applications. Original research articles as well as review articles are highly appreciated.

Dr. Gerrit Grieb
Guest Editor

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Keywords

  • wound healing
  • clinical research in wound healing
  • in vitro experiments in wound healing
  • in vivo experiments in wound healing
  • cytokines in wound healing
  • chronic wounds
  • pressure sores/ulcers
  • scar formation

Published Papers (9 papers)

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Editorial

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2 pages, 175 KiB  
Editorial
Basic and Clinical Research in Wound Healing
by Gerrit Grieb
Biomedicines 2023, 11(5), 1380; https://doi.org/10.3390/biomedicines11051380 - 06 May 2023
Cited by 1 | Viewed by 823
Abstract
Wound healing in general is a complex physiological process [...] Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)

Research

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13 pages, 1960 KiB  
Article
Technological and Physical–Chemical Evaluation of Cotton Gauzes Impregnated with Semisolid Preparations for Wound Healing
by Fabrizio Villapiano, Ritamaria Di Lorenzo, Rosa Sparaco, Elisa Magli, Francesco Frecentese, Sonia Laneri, Alessandra D’Orsi, Valeria Nele, Marco Biondi, Laura Mayol, Virginia Campani, Vincenzo Santagada and Giuseppe De Rosa
Biomedicines 2024, 12(4), 777; https://doi.org/10.3390/biomedicines12040777 - 01 Apr 2024
Viewed by 544
Abstract
Chronic wounds are marked by an extended healing period during which damaged tissues fail to undergo orderly and timely repair. Examples of chronic wounds encompass venous ulcers, pressure ulcers, and diabetic foot ulcers. The process of wound healing is complex and dynamic, relying [...] Read more.
Chronic wounds are marked by an extended healing period during which damaged tissues fail to undergo orderly and timely repair. Examples of chronic wounds encompass venous ulcers, pressure ulcers, and diabetic foot ulcers. The process of wound healing is complex and dynamic, relying on the interplay and response among various cells and mediators. In this study, four marketed wound dressing products based on cotton gauzes impregnated with different semisolid products (namely Betadine® 10%, Connettivina® Bio Plus Fitostimoline® Plus, and Non-Ad® gauzes) have been characterized for their physicochemical properties and ex vivo behaviors. More in detail, the pH and rheological features of semisolid formulations impregnating the gauzes were analyzed along with their ability to adhere to the gauzes. The most promising ones were selected and compared in ex vivo experiments on fresh pig skin. The pH measurements showed an acidic environment for all the tested solutions, albeit with variations in mean values, ranging from 2.66 to 4.50. The outcomes of rheological studies demonstrated that all the semisolid preparations impregnating the gauzes exhibited a pseudoplastic behavior, with significant differences in the pseudoplasticity index across the preparations, which is likely to influence their ability to adhere to the gauze. A rheological study in oscillatory mode revealed rheological behavior typical of a viscous solution only for the cream impregnating non-paraffin gauzes. The other products exhibited rheological behavior typical of a weak gel, which is expected to be advantageous as regards the capability of the semisolid preparation to create and maintain the space within the wound and to provide protection to the injured tissue. Results of ex vivo experiments demonstrated that Fitostimoline® Plus was more effective than Connettivina® Bio Plus in promoting both skin hydration and energy. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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10 pages, 823 KiB  
Article
Oxygen Saturation Increase in Ischemic Wound Tissues after Direct and Indirect Revascularization
by Austėja Račytė, Gabija Pikturnaitė, Tomas Baltrūnas, Evaldas Kalvaitis, Gediminas Vaitėnas, Arminas Skrebūnas, Vaida Baltrūnienė and Kęstutis Ručinskas
Biomedicines 2024, 12(2), 367; https://doi.org/10.3390/biomedicines12020367 - 05 Feb 2024
Viewed by 658
Abstract
Background: The primary approach for treating ischemic wounds is restoring oxygen supply to the ischemic region. While direct angiosomal revascularization is often associated with better post-operative wound healing and limb salvage, its superiority over non-angiosomal revascularization remains controversial. This study aimed to compare [...] Read more.
Background: The primary approach for treating ischemic wounds is restoring oxygen supply to the ischemic region. While direct angiosomal revascularization is often associated with better post-operative wound healing and limb salvage, its superiority over non-angiosomal revascularization remains controversial. This study aimed to compare intraoperative tissue oxygen saturation changes in ischemic zones following either direct or indirect revascularization in below-the-knee arteries. Methods: This prospective observational study included patients undergoing direct and indirect below-the-knee endovascular revascularizations. Assignment to the groups was not randomized. Near-infrared spectroscopy was used to monitor rSO2 changes near the ischemic wounds intraoperatively. The changes were compared between the groups. Results: 15 patients (50%) underwent direct angiosomal revascularization, while an equal number of patients underwent indirect revascularization. Overall, a statistically significant increase in regional oxygen saturation was observed after revascularization (p = 0.001). No statistically significant difference was found between the direct and indirect revascularization groups (p = 0.619). Conclusions: This study revealed a minor difference in the oxygen saturation increase between the angiosomal and non-angiosomal revascularization groups. Such a finding indicates that the clinical significance of angiosomal revascularization is negligible and might be concealed by confounding factors, such as the vessel diameter and outflow impact on the restenosis rate. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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14 pages, 11674 KiB  
Article
Gender Differences in Post-Operative Human Skin
by Barbara Gawronska-Kozak, Marta Kopcewicz, Sylwia Machcinska-Zielinska, Katarzyna Walendzik, Joanna Wisniewska, Justyna Drukała, Tomasz Wasniewski, Joanna Rutkowska, Piotr Malinowski and Michał Pulinski
Biomedicines 2023, 11(10), 2653; https://doi.org/10.3390/biomedicines11102653 - 27 Sep 2023
Viewed by 1379
Abstract
Although the impact of age, gender, and obesity on the skin wound healing process has been extensively studied, the data related to gender differences in aspects of skin scarring are limited. The present study performed on abdominal human intact and scar skin focused [...] Read more.
Although the impact of age, gender, and obesity on the skin wound healing process has been extensively studied, the data related to gender differences in aspects of skin scarring are limited. The present study performed on abdominal human intact and scar skin focused on determining gender differences in extracellular matrix (ECM) composition, dermal white adipose tissue (dWAT) accumulation, and Foxn1 expression as a part of the skin response to injury. Scar skin of men showed highly increased levels of COLLAGEN 1A1, COLLAGEN 6A3, and ELASTIN mRNA expression, the accumulation of thick collagen I-positive fibers, and the accumulation of α-SMA-positive cells in comparison to the scar skin of women. However, post-injured skin of women displayed an increase (in comparison to post-injured men’s skin) in collagen III accumulation in the scar area. On the contrary, women’s skin samples showed a tendency towards higher levels of adipogenic-related genes (PPARγ, FABP4, LEPTIN) than men, regardless of intact or scar skin. Intact skin of women showed six times higher levels of LEPTIN mRNA expression in comparison to men intact (p < 0.05), men post-injured (p < 0.05), or women post-injured scar (p < 0.05) skin. Higher levels of FOXN1 mRNA and protein were also detected in women than in men’s skin. In conclusion, the present data confirm and extend (dWAT layer) the data related to the presence of differences between men and women in the skin, particularly in scar tissues, which may contribute to the more effective and gender-tailored improvement of skin care interventions. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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15 pages, 3309 KiB  
Article
Quantitative Insights and Visualization of Antimicrobial Tolerance in Mixed-Species Biofilms
by Mandy Dittmer, Florian H. H. Brill, Andreas Kampe, Maria Geffken, Julian-Dario Rembe, Raphael Moll, Ifey Alio, Wolfgang R. Streit, Eike Sebastian Debus, Ralf Smeets and Ewa Klara Stuermer
Biomedicines 2023, 11(10), 2640; https://doi.org/10.3390/biomedicines11102640 - 26 Sep 2023
Cited by 1 | Viewed by 920
Abstract
Biofilms are a major problem in hard-to-heal wounds. Moreover, they are composed of different species and are often tolerant to antimicrobial agents. At the same time, interspecific synergy and/or competition occurs when some bacterial species clash. For this reason, the tolerance of two [...] Read more.
Biofilms are a major problem in hard-to-heal wounds. Moreover, they are composed of different species and are often tolerant to antimicrobial agents. At the same time, interspecific synergy and/or competition occurs when some bacterial species clash. For this reason, the tolerance of two dual-species wound biofilm models of Pseudomonas aeruginosa and Staphylococcus aureus or Enterococcus faecium against antimicrobials and antimicrobial dressings were analyzed quantitatively and by confocal laser scanning microscopy (CLSM). The results were compared to findings with planktonic bacteria. Octenidine-dihydrochloride/phenoxyethanol and polyhexamethylene biguanide (PHMB) irrigation solutions showed a significant, albeit delayed reduction in biofilm bacteria, while the PHMB dressing was not able to induce this effect. However, the cadexomer-iodine dressing caused a sustained reduction in and killed almost all bacteria down to 102 cfu/mL within 6 days compared to the control (1010 cfu/mL). By means of CLSM in untreated human biofilm models, it became evident that P. aeruginosa dominates over E. faecium and S. aureus. Additionally, P. aeruginosa appeared as a vast layer at the bottom of the samples, while S. aureus formed grape-like clusters. In the second model, the distribution was even clearer. Only a few E. faecium were visible, in contrast to the vast layer of P. aeruginosa. It seems that the different species avoid each other and seek their respective niches. These mixed-species biofilm models showed that efficacy and tolerance to antimicrobial substances are nearly species-independent. Their frequent application appears to be important. The bacterial wound biofilm remains a challenge in treatment and requires new, combined therapy options. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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10 pages, 954 KiB  
Article
Comparative Clinical Study of Suprathel® and Jelonet® Wound Dressings in Burn Wound Healing after Enzymatic Debridement
by Wolfram Heitzmann, Mitja Mossing, Paul Christian Fuchs, Jan Akkan, Harun Seyhan, Gerrit Grieb, Christian Opländer and Jennifer Lynn Schiefer
Biomedicines 2023, 11(10), 2593; https://doi.org/10.3390/biomedicines11102593 - 22 Sep 2023
Cited by 1 | Viewed by 1079
Abstract
Following the enzymatic debridement of deep dermal burns, the choice of wound dressing is crucial for providing an adequate environment and suitable conditions for rapid wound healing. As Suprathel® and fatty gauze (Jelonet®) are the most commonly used dressings in [...] Read more.
Following the enzymatic debridement of deep dermal burns, the choice of wound dressing is crucial for providing an adequate environment and suitable conditions for rapid wound healing. As Suprathel® and fatty gauze (Jelonet®) are the most commonly used dressings in burn centers, the aim of this study is to compare Suprathel® and Jelonet® in the treatment of deep dermal burns after enzymatic debridement with respect to wound healing, patient comfort, and pain. A total of 23 patients with deep dermal burns of the hand or foot (mean total body surface area of 4.31%) were included in this prospective, unicentric, open, comparative, and intra-individual clinical study. After enzymatic debridement, wounds were divided into two areas: one was treated with Suprathel® and the other with Jelonet®. Suprathel® remained on the wounds without dressing changes while Jelonet® was regularly changed. Wound healing, infection, bleeding, exudation, time for dressing changes, and pain were documented (from days 2 to 48) after injury. Satisfactory results were obtained in 22 cases; only one patient had to undergo a second debridement followed by skin grafting. No significant difference in time to final wound healing could be observed (18–19 d). Patients reported significantly less pain during the dressing changes for Suprathel® compared to Jelonet®. Furthermore, the wound areas treated with Suprathel® showed significantly less exudation and bleeding. Wound infections rarely occurred in both groups. In conclusion, the authors found that both wound dressings could be used to achieve safe and rapid wound healing after the enzymatic debridement of deep dermal burns of the hands and feet. However, compared to Jelonet®, Suprathel® showed superior results in terms of patient comfort and pain reduction. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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13 pages, 2562 KiB  
Article
Laser in the Treatment of Atonic Wounds
by Maur Sebastian Horgos, Ovidiu Laurean Pop, Mircea Sandor, Ioan Lucian Borza, Rodica Negrean, Felicia Marc, Klaudia Major, Liliana Sachelarie, Carmen Grierosu and Anca Huniadi
Biomedicines 2023, 11(7), 1815; https://doi.org/10.3390/biomedicines11071815 - 24 Jun 2023
Cited by 2 | Viewed by 1598
Abstract
Atonic wounds represent a major health problem, being frequently encountered in medical practice with consequences that have a negative impact on the patient’s daily life as well as their general condition. In this study, a brand laser with a 12-watt probe was used [...] Read more.
Atonic wounds represent a major health problem, being frequently encountered in medical practice with consequences that have a negative impact on the patient’s daily life as well as their general condition. In this study, a brand laser with a 12-watt probe was used to stimulate patients’ wounds. We involved in this study a group of 65 patients, which was compared with a group of 30 patients, the latter not receiving this laser therapy. The data were accumulated from the questionnaire of subjective assessment of the laser impact on patients’ condition as well as from the local evolution. We noticed the improvement of the local symptomatology which was found to be more effective in the patients from the study group compared to the reference group. The beneficial and positive effects, mainly on the symptoms but also on the local evolution of atonic wounds, can be observed in our study. We consider that this therapy is of major importance considering the lower costs both from the shortening of hospitalization and the long-term use of various substances. The early reintegration of patients into daily life is an important benefit for them. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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Review

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21 pages, 2775 KiB  
Review
Cellular and Molecular Processes in Wound Healing
by Montserrat Fernández-Guarino, Maria Luisa Hernández-Bule and Stefano Bacci
Biomedicines 2023, 11(9), 2526; https://doi.org/10.3390/biomedicines11092526 - 13 Sep 2023
Cited by 4 | Viewed by 2149
Abstract
This review summarizes the recent knowledge of the cellular and molecular processes that occur during wound healing. However, these biological mechanisms have yet to be defined in detail; this is demonstrated by the fact that alterations of events to pathological states, such as [...] Read more.
This review summarizes the recent knowledge of the cellular and molecular processes that occur during wound healing. However, these biological mechanisms have yet to be defined in detail; this is demonstrated by the fact that alterations of events to pathological states, such as keloids, consisting of the excessive formation of scars, have consequences yet to be defined in detail. Attention is also dedicated to new therapies proposed for these kinds of pathologies. Awareness of these scientific problems is important for experts of various disciplines who are confronted with these kinds of presentations daily. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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23 pages, 2353 KiB  
Review
Advancements and Insights in Exosome-Based Therapies for Wound Healing: A Comprehensive Systematic Review (2018–June 2023)
by Patrícia Sousa, Bruna Lopes, Ana Catarina Sousa, Alícia Moreira, André Coelho, Rui Alvites, Nuno Alves, Stefano Geuna and Ana Colette Maurício
Biomedicines 2023, 11(8), 2099; https://doi.org/10.3390/biomedicines11082099 - 25 Jul 2023
Cited by 2 | Viewed by 1473
Abstract
Exosomes have shown promising potential as a therapeutic approach for wound healing. Nevertheless, the translation from experimental studies to commercially available treatments is still lacking. To assess the current state of research in this field, a systematic review was performed involving studies conducted [...] Read more.
Exosomes have shown promising potential as a therapeutic approach for wound healing. Nevertheless, the translation from experimental studies to commercially available treatments is still lacking. To assess the current state of research in this field, a systematic review was performed involving studies conducted and published over the past five years. A PubMed search was performed for English-language, full-text available papers published from 2018 to June 2023, focusing on exosomes derived from mammalian sources and their application in wound healing, particularly those involving in vivo assays. Out of 531 results, 148 papers were selected for analysis. The findings revealed that exosome-based treatments improve wound healing by increasing angiogenesis, reepithelization, collagen deposition, and decreasing scar formation. Furthermore, there was significant variability in terms of cell sources and types, biomaterials, and administration routes under investigation, indicating the need for further research in this field. Additionally, a comparative examination encompassing diverse cellular origins, types, administration pathways, or biomaterials is imperative. Furthermore, the predominance of rodent-based animal models raises concerns, as there have been limited advancements towards more complex in vivo models and scale-up assays. These constraints underscore the substantial efforts that remain necessary before attaining commercially viable and extensively applicable therapeutic approaches using exosomes. Full article
(This article belongs to the Special Issue Basic and Clinical Research in Wound Healing)
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