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Search Results (1,319)

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Keywords = non-healing wound

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14 pages, 1679 KB  
Article
Pulsed Electromagnetic Fields Modulate Inflammatory and Tenogenic Responses in Human Tenocytes: Insights from Acute and Prolonged Inflammation Models
by Michela Maria Taiana, Paola De Luca, Giulio Grieco, Enrico Ragni, Simona Salati, Antonio Marmotti, Valerio Pascale and Laura de Girolamo
Cells 2026, 15(17), 1529; https://doi.org/10.3390/cells15171529 - 25 Aug 2026
Abstract
Tendinopathy is a prevalent musculoskeletal condition characterised by chronic inflammatory and degenerative changes. Pulsed electromagnetic fields (PEMFs) represent a promising biophysical therapeutic modality, yet their effects across different inflammatory states of tendinopathy remain poorly characterised. To evaluate PEMF biological effects on human tenocytes, [...] Read more.
Tendinopathy is a prevalent musculoskeletal condition characterised by chronic inflammatory and degenerative changes. Pulsed electromagnetic fields (PEMFs) represent a promising biophysical therapeutic modality, yet their effects across different inflammatory states of tendinopathy remain poorly characterised. To evaluate PEMF biological effects on human tenocytes, three in vitro models differing in IL-1β dose and duration were tested: acute low-dose (0.1 ng/mL, 96 h), acute high-dose (1 ng/mL, 96 h), and prolonged (0.1 ng/mL, 9 days). At the transcriptional level, PEMFs significantly reduced IL-6 and IL-8 mRNA overexpression in the acute low-dose model and CCL2 upregulation in the prolonged model. At the secretome level, PEMFs reduced GM-CSF and IL-8 secretion in the acute high-dose model, and suppressed CCL2 and CCL5 protein secretion in the prolonged model. MMP activity was not modulated by PEMFs in any condition. PEMFs consistently increased tenocyte proliferation across both the acute models. Finally, in wound healing assays, non-inflamed tenocytes exposed to PEMFs showed significantly enhanced wound closure compared to IL-1β-treated cells across all models; in the acute low-dose model, PEMFs also significantly improved wound closure in IL-1β-treated cells at an early timepoint, whereas no such effect was observed in cells exposed to high-dose or prolonged inflammation. PEMFs exert context-dependent effects, promoting healing primarily during acute or mild inflammation. These findings suggest that the inflammatory stage of tenocytes may influence PEMF responsiveness in vitro, highlighting the importance of considering this variable in the design of future clinical studies evaluating PEMF therapy for tendinopathy. Full article
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26 pages, 8507 KB  
Article
In Vitro Study for Combating Multidrug-Resistant Pathogens via a Facile Sustained Release of Benzoic Acid and Parabens from PMMA/PCL Nanofibrous Membrane
by Reham M. Goda, Alaa A. Omar, Ibrahim A. Maghrabi, Mohamed F. El-Badawy, Islam M. Bendary, Mohamed M. Shohayeb and Mohamed Abd El-Gawad El-Sayed Ahmed
Pathogens 2026, 15(9), 880; https://doi.org/10.3390/pathogens15090880 - 22 Aug 2026
Viewed by 186
Abstract
The global threat of multidrug-resistant infections requires new approaches for its management. A blend of polymethyl methacrylate (PMMA) and poly(ε-caprolactone) (PCL) electrospun nanofibrous membrane was utilised as a scaffold to sustain the release of three broad-spectrum antiseptics to combat multidrug-resistant (MDR) microorganisms. The [...] Read more.
The global threat of multidrug-resistant infections requires new approaches for its management. A blend of polymethyl methacrylate (PMMA) and poly(ε-caprolactone) (PCL) electrospun nanofibrous membrane was utilised as a scaffold to sustain the release of three broad-spectrum antiseptics to combat multidrug-resistant (MDR) microorganisms. The scaffold was characterised by Fourier transform infrared spectroscopy, contact angle, and scanning electron microscopy. The latter revealed a random and smooth structure. The contact angle value of 81.8 ± 1.8 confirmed the hydrophilic nature of the scaffold, which is important for wound healing. The high surface-to-volume ratio of the scaffolds was utilised for loading benzoic acid (BA), methylparaben (MPB), and propylparaben (PPB) which were released during 72 h concentrations ranging between 0.20 and 0.8 mg mL−1. The initial release of antiseptics was high and was then sustained for over 72 h. After 8 h, the burst release was 61.64 ± 4.11% for BA, 41.11 ± 2.98% for MPB and 34.32 ± 3.13% for PPB. The release profile of BA was superior to that of the MPB and PPB. The loaded scaffolds inhibited MDR-resistant methicillin-resistant Staphylococcus aureus, Escherichia coli and Candida albicans and were not cytotoxic to a fibroblast cell line. They inhibited their colonisation by the tested microorganisms to non-detectable counts or at least reduced microbial counts by at least 6–7 logs (p ≤ 0.001) for 72 h. Crystal violet techniques and electron microscopy confirmed colonisation inhibition. Because of their non-cytotoxicity and broad-spectrum antimicrobial activity, the antiseptic-loaded PMMA/PCL nanofibrous scaffolds could be utilised as wound dressings, particularly in non-healing wounds. Full article
(This article belongs to the Section Bacterial Pathogens)
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23 pages, 2593 KB  
Article
Comparative Investigation of Red Wine Concentrates as Multifunctional Skin-Protective Agents
by Gorana Ilić, Ivana Beara, Ljiljana Milovanović, Aleksandra Jovanović, Dragana Dekanski and Andrea Pirković
Pharmaceutics 2026, 18(8), 1034; https://doi.org/10.3390/pharmaceutics18081034 - 20 Aug 2026
Viewed by 225
Abstract
Background/Objectives: Vitis vinifera is a rich source of polyphenolic compounds that are known for their benefits on skin health, including antioxidant, anti-inflammatory, and photoprotective effects. Red wines have shown a positive impact on cardiovascular disease, diabetes, and cancer prevention; however, evidence regarding [...] Read more.
Background/Objectives: Vitis vinifera is a rich source of polyphenolic compounds that are known for their benefits on skin health, including antioxidant, anti-inflammatory, and photoprotective effects. Red wines have shown a positive impact on cardiovascular disease, diabetes, and cancer prevention; however, evidence regarding their effects on skin biology remains scarce. This study evaluated red wine concentrates obtained from Cabernet Sauvignon and Merlot varieties, selected based on their previously demonstrated biological activities, to identify the samples with the highest potential for skin health applications by assessing their inhibitory activity against skin-related enzymes (tyrosinase, elastase, and collagenase), along with their effects on HaCaT cells, including cytotoxic, antioxidant, anti-inflammatory, and wound healing activities. Methods: Enzyme inhibition studies were based on spectrophotometric methods; the MTT and CV assays were carried out to test the cytotoxicity, and the DCFH-DA assay was employed to evaluate the antioxidant activity of the wine concentrates; wound healing potential was examined by the cell scratch assay, and anti-inflammatory activity was investigated using ELISA and qPCR analyses. PCA of the samples and their biological activity was performed as well. Results: Examined red wine concentrates exhibited significant enzyme inhibitory activity and showed no cytotoxicity on HaCaT cells up to the concentration of 50 μg/mL; the samples stimulated cell migration, inhibited intracellular ROS production in AAPH-stressed keratinocytes, and selectively modulated TNF-α-induced inflammatory responses, reducing IL-8 secretion while enhancing certain cytokine transcripts, underscoring the complexity of their bioactive effects. Conclusions: Red wine concentrates showed significant potential as skin-beneficial agents, demonstrating strong antiaging, marked cellular antioxidant effects and wound healing activity when applied at non-cytotoxic concentrations. Multivariate analysis revealed distinct bioactivity profiles among the wine concentrates. Full article
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26 pages, 6049 KB  
Article
Comparative Dermatological Bioactivities of Chlorophylized and Dechlorophylized Centella asiatica Extracts
by Narawadee Rujanapun, Kulawadee Malee, Wuttichai Jaidee, Subhadip Banerjee, Thidarat Duangyod, Pravaree Phuneerub, Sorraya Champakam, Geoffrey A. Cordell and Rawiwan Charoensup
Cosmetics 2026, 13(4), 212; https://doi.org/10.3390/cosmetics13040212 - 20 Aug 2026
Viewed by 133
Abstract
Centella asiatica (L.) Urb. (Apiaceae) is widely incorporated into dermatological and wound-healing formulations, where dechlorophylization is commonly used to improve extract stability, although its biological consequences are not fully understood. In this study, an ethanolic extract of C. asiatica leaves (CAE) was compared [...] Read more.
Centella asiatica (L.) Urb. (Apiaceae) is widely incorporated into dermatological and wound-healing formulations, where dechlorophylization is commonly used to improve extract stability, although its biological consequences are not fully understood. In this study, an ethanolic extract of C. asiatica leaves (CAE) was compared with a dechlorophylized C. asiatica extract (DCAE) in terms of cytotoxicity, wound-healing, anti-inflammatory, and antimicrobial activities, complemented by network pharmacology analysis. DCAE exhibited improved cytocompatibility, remaining non-cytotoxic up to 100 µg/mL, whereas CAE showed cytotoxic effects above 25 µg/mL. In contrast, CAE demonstrated superior wound-healing performance, reducing the residual wound area to 21.77% compared with 36.81% for DCAE and inducing higher Ki67 expression (1.94-fold versus 1.58-fold). These findings suggest that chlorophyll-associated constituents may contribute to keratinocyte proliferation and re-epithelialization. Although DCAE was enriched in pentacyclic triterpenes, including asiatic acid, asiaticoside, madecassic acid, and madecassoside, it showed stronger anti-inflammatory effects by more effectively suppressing CXCL10, IL-6, TNF-α, and IL-8 expression. Both extracts displayed weak antibacterial activity but moderate antifungal effects against Candida albicans, likely mediated through membrane disruption. Network pharmacology further indicated that wound-healing activity is associated with the regulation of COL1A1 and VEGFA through quercetin, kaempferol, and asiatic acid by way of the PI3K-Akt and MAPK signaling pathways, whereas anti-inflammatory effects involve modulation of PTGS2 and TNF through the NF-κB and IL-17 pathways. Overall, DCAE enhances cytocompatibility and anti-inflammatory activity, while CAE retains stronger regenerative capacity. These findings support the rational design of tailored formulations for specific dermatological applications, such as promoting wound repair or alleviating chronic skin inflammation. Full article
(This article belongs to the Section Cosmetic Formulations)
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15 pages, 549 KB  
Article
Flowable Porcine Urinary Bladder Matrix in Wounds Complicated by Tunneling and Undermining: A Multicenter Prospective Study
by Malachy E. Asuku, Hannah Baker, Saarah Mohammedi, Weiwei Xu, Marcie Jaffee, Jessica L. Evans, Yifei Dai, Claire Witherel, Yi Duan-Arnold, Kristy L. Hawley, Michael Cripps, Jeffrey W. Shupp and Alisha Oropallo
J. Clin. Med. 2026, 15(16), 6432; https://doi.org/10.3390/jcm15166432 - 20 Aug 2026
Viewed by 243
Abstract
Objective: This multicenter, prospective, single-arm study evaluated the safety and preliminary clinical performance of a flowable porcine urinary bladder matrix (UBM) particulate for managing tunneling and undermining features in complex wounds. These features are associated with delayed healing, chronic inflammation, and infection risk. [...] Read more.
Objective: This multicenter, prospective, single-arm study evaluated the safety and preliminary clinical performance of a flowable porcine urinary bladder matrix (UBM) particulate for managing tunneling and undermining features in complex wounds. These features are associated with delayed healing, chronic inflammation, and infection risk. Flowable UBM enables targeted delivery into wound tunnels and cavities. Method: Twenty-five subjects from 3 United States (U.S.) sites were enrolled, with 21 meeting protocol criteria for analysis (15 with undermining and 6 with tunneling wounds). Participants received flowable UBM applied directly to tunneling or undermining areas, along with additional UBM particulate or sheet forms applied to the wound surface. The primary endpoint was the percentage reduction in tunneling volume or undermining depth at 12 weeks, with secondary assessment of reduction in overall wound volume. Safety was evaluated through evaluation of device-related adverse events. Results: At 12 weeks, 90.5% of wounds demonstrated positive response, with mean ± standard deviation and median reduction in tunneling or undermining dimensions of 84.6 ± 29.3% and 100.0%, respectively. Complete resolution of these features occurred in 52.4% of wounds (53.3% in undermining and 50.0% in tunneling wounds) with higher closure rates in non-pressure wounds compared to pressure injuries. No device-related adverse events were reported. Conclusions: Overall, flowable UBM was well tolerated and associated with favorable clinical trajectories demonstrated by reduction in tunneling and undermining dimensions; however, comparative effectiveness cannot be inferred from this limited single-arm pilot study. Further controlled studies are needed to confirm comparative effectiveness and optimize clinical use. Full article
(This article belongs to the Section General Surgery)
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17 pages, 13160 KB  
Article
Patient-Reported Symptom Changes Following Breast Implant Explantation with Total Capsulectomy: A Prospective Case Series of 50 Patients
by Kostadin Gigov, Ivan Ginev, Petra Kavradzhieva and Mariya Miteva
Healthcare 2026, 14(16), 2603; https://doi.org/10.3390/healthcare14162603 - 19 Aug 2026
Viewed by 150
Abstract
Background: Breast implant illness (BII) is a constellation of non-specific systemic and local symptoms—including fatigue, joint pain, cognitive dysfunction, and autoimmune-like manifestations—attributed to silicone breast implants. Although BII remains a controversial clinical entity, accumulating evidence suggests symptom improvement following implant removal; however, causal [...] Read more.
Background: Breast implant illness (BII) is a constellation of non-specific systemic and local symptoms—including fatigue, joint pain, cognitive dysfunction, and autoimmune-like manifestations—attributed to silicone breast implants. Although BII remains a controversial clinical entity, accumulating evidence suggests symptom improvement following implant removal; however, causal mechanisms and optimal surgical strategies remain uncertain. Objective: The objective was to evaluate the prevalence of BII symptoms and the effect of explantation with en bloc total capsulectomy on symptom resolution in affected women. Methods: A prospective case series of 50 women who underwent explantation with total capsulectomy between 2023 and 2025 was conducted (Level IV evidence). The BII Questionnaire of the American Society for Aesthetic Plastic Surgery (ASAPS) was administered to assess preoperative and one-year postoperative symptom burden. Perioperative data—including implant characteristics, capsular findings, and imaging results—were analyzed. Symptom changes were assessed using descriptive statistics and nonparametric tests. Results: The mean age at explantation was 43 years, with a mean age at implantation of 31 years. Implants were predominantly placed in the retropectoral plane (80%). Intraoperative rupture was identified in 34 patients (68%). At one-year follow-up, a statistically significant reduction in symptom burden was observed, with an 81.7% decrease in mean symptom frequency (preoperative mean: 10.79 vs. postoperative: 1.97; p < 0.001). The most pronounced improvements were noted in chronic fatigue, cognitive impairment, and delayed wound healing. No surgical complications were recorded, and aesthetic outcomes were satisfactory among patients who underwent single-stage mastopexy. Conclusions: Explantation with en bloc total capsulectomy is associated with substantial symptom improvement in women presenting with BII. Although the precise pathophysiology of BII remains elusive, these findings support a patient-centered approach incorporating thorough preoperative evaluation and shared decision-making. Future research should prioritize the development of standardized diagnostic criteria, biomarker validation, and patient subgroup stratification to optimize clinical management and further advance the understanding of BII. Limitations: The absence of a control group precludes causal inference. Objective clinical and immunological assessments were not performed. Patient-reported symptoms were not corroborated by formal clinical evaluation. Most patients were self-referred, introducing referral and expectation bias. The sample size was small. Full article
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29 pages, 1302 KB  
Review
Possible Applications of Cold Atmospheric Plasma in Otorhinolaryngology: A Narrative Review
by José Andrés González Coraspe, Ramón Moreno-Luna, Fabian Görries, Maria Dib, Chia-Jung Busch and Christian Scharf
Antioxidants 2026, 15(8), 1026; https://doi.org/10.3390/antiox15081026 - 17 Aug 2026
Viewed by 215
Abstract
Cold atmospheric plasma (CAP), a non-thermal ionized gas, is gaining attention in biomedicine due to its unique properties such as the generation of reactive oxygen and nitrogen species (RONS), immunomodulatory effects, and selective cytotoxicity. This review explores the potential of CAP as a [...] Read more.
Cold atmospheric plasma (CAP), a non-thermal ionized gas, is gaining attention in biomedicine due to its unique properties such as the generation of reactive oxygen and nitrogen species (RONS), immunomodulatory effects, and selective cytotoxicity. This review explores the potential of CAP as a therapeutic tool in otorhinolaryngology (ORL). CAP has shown promising applications in wound healing, pathogen eradication, and antitumor strategies, particularly in head and neck cancers. Mechanistically, CAP promotes tissue regeneration through redox signaling, stimulates immune cell activity, induces immunogenic cell death, and enhances epithelial proliferation while offering broad-spectrum antimicrobial efficacy. The review also discusses the development of miniaturized CAP delivery systems, including endoscope-integrated plasma jets (e.g., PLASMASKOP), to facilitate clinical use in anatomically complex ORL regions. Given the nascent stage of clinical translation in ORL, the authors highlight the need for interdisciplinary research and device innovation to realize the full therapeutic potential of CAP in this field. Full article
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18 pages, 1034 KB  
Review
Aspects of the Pathogenesis of Skin Complications in the Stump–Prosthesis System in Dynamics: The Role of Bacterial and Mycological Dysbiosis
by Denis V. Shcherbakov, Evgeny E. Achkasov, Ekaterina A. Shashina, George V. Nesterov, Alina I. Lezinova, Tatyana M. Khodykina, Nina A. Ermakova and Oleg V. Mitrokhin
Prosthesis 2026, 8(8), 88; https://doi.org/10.3390/prosthesis8080088 - 17 Aug 2026
Viewed by 318
Abstract
Background: Lower limb exoprostheses often lead to stump dermatological pathologies. The mechanisms by which mechanical microtraumas progress to non-healing ulcerative defects due to dysbiosis remain poorly understood. The objective of this study was to analyze mechanical, inflammatory, and infectious stump skin complications and [...] Read more.
Background: Lower limb exoprostheses often lead to stump dermatological pathologies. The mechanisms by which mechanical microtraumas progress to non-healing ulcerative defects due to dysbiosis remain poorly understood. The objective of this study was to analyze mechanical, inflammatory, and infectious stump skin complications and justify the role of bacterial and mycological dysbiosis in blocking tissue regeneration. Methods: A critical narrative review guided by SANRA principles was conducted (PubMed/Scopus, 1980–2026). Data were extracted with a structured query focusing on amputation stumps, prosthetic interfaces, and skin/microbiological complications (dysbiosis, biofilms, and inflammatory markers). Evidence was graded using predefined clinical matrices and integrated through structured evidence collations to synthesize stump–prosthesis pathogenesis. The PRISMA method was not applied due to study heterogeneity. Results: Skin damage dynamics were categorized into three stages: adaptation (up to 12 months), chronic reactive changes (12–24 months), and late proliferative-infectious destruction (>24 months). The sealed liner space creates 100% humidity and alkalization (pH > 6.5). This causes a mycological shift, where resident Malassezia spp. lose dominance to invasive Candida albicans and non-dermatophyte molds (Aspergillus spp., Fusarium spp.). These pathogens form polymicrobial biofilms with Staphylococcus aureus. At the molecular level, delayed regeneration is driven by “frustrated phagocytosis”: macrophages, unable to engulf large fungal hyphae, continuously release reactive oxygen species and enzymes, trapping the wound in the inflammatory phase. Excessive matrix degradation and suppressed angiogenic factors further block epithelialization. Conclusions: The skin under a prosthesis socket forms a unique pathological biotope. Successful regeneration requires preventive mycobiota correction and targeted management of biophysical parameters (pH, humidity) within the “skin–liner” interface. Full article
(This article belongs to the Special Issue Managing the Challenge of Periprosthetic Joint Infection)
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17 pages, 3586 KB  
Article
Comparative Functional Effects of Abemaciclib and Arcyriaflavin A in MYCN-Amplified and Non-Amplified Neuroblastoma Cells: An Exploratory Transcriptomic Study
by Burcu Çerçi, Hatice İlayhan Karahan, Mustafa Soyöz, Melek Pehlivan and İbrahim Pirim
Int. J. Mol. Sci. 2026, 27(16), 7349; https://doi.org/10.3390/ijms27167349 - 17 Aug 2026
Viewed by 159
Abstract
Cyclin-dependent kinase (CDK) inhibitors are promising therapeutic agents for neuroblastoma, particularly in MYCN-amplified tumors; however, the molecular responses associated with CDK inhibition remain incompletely understood. MYCN-amplified BE(2)-C and MYCN-non-amplified SH-SY5Y neuroblastoma cells were treated with Abemaciclib or Arcyriaflavin A. Drug [...] Read more.
Cyclin-dependent kinase (CDK) inhibitors are promising therapeutic agents for neuroblastoma, particularly in MYCN-amplified tumors; however, the molecular responses associated with CDK inhibition remain incompletely understood. MYCN-amplified BE(2)-C and MYCN-non-amplified SH-SY5Y neuroblastoma cells were treated with Abemaciclib or Arcyriaflavin A. Drug responses were evaluated using MTT, Annexin V ELISA, wound healing, colony formation, quantitative real-time PCR, and Western blot analyses. Exploratory transcriptomic profiling was performed by RNA sequencing. Because only one biological replicate was available per condition, transcriptomic analyses were limited to descriptive expression trends and pathway-oriented interpretation rather than statistical differential expression analysis. Both inhibitors reduced cell viability in a dose- and time-dependent manner, with BE(2)-C cells showing greater sensitivity than SH-SY5Y cells. Treatment also increased Annexin V levels, reduced wound closure, impaired clonogenic growth, and decreased CDK4/CDK6 expression, as confirmed by qRT-PCR and Western blotting. Exploratory transcriptomic profiling identified concordant expression trends in genes associated with cell-cycle regulation, DNA replication, and mitotic progression, with broader pathway modulation observed in MYCN-amplified cells. Overall, CDK inhibition suppresses proliferation-associated phenotypes in neuroblastoma and is accompanied by exploratory transcriptomic changes that identify candidate pathways for future validation and mechanistic investigation of MYCN-associated therapeutic responses. Full article
(This article belongs to the Section Biochemistry)
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13 pages, 441 KB  
Communication
Platelet-Rich Plasma in Episiotomy Repair: A Critical Appraisal of a Sparse and Partly Non-Indexed Evidence Base and Rationale for a Randomized Controlled Trial
by Dragos Brezeanu, Ana-Maria Brezeanu, Traian-Virgiliu Surdu, Monica Surdu and Vlad Tica
Life 2026, 16(8), 1339; https://doi.org/10.3390/life16081339 - 15 Aug 2026
Viewed by 192
Abstract
Background: Episiotomy remains one of the most common obstetric procedures worldwide, and suboptimal healing of the perineal wound continues to cause pain, dehiscence, and long-term impairment of postpartum quality of life. Obstetric anal sphincter injury (OASI) carries the greatest risk of severe wound [...] Read more.
Background: Episiotomy remains one of the most common obstetric procedures worldwide, and suboptimal healing of the perineal wound continues to cause pain, dehiscence, and long-term impairment of postpartum quality of life. Obstetric anal sphincter injury (OASI) carries the greatest risk of severe wound morbidity among perineal trauma types and is managed with prophylactic antibiotics and adjunctive measures; episiotomy, by contrast, is repaired without a comparable prophylactic package and is far more frequent, so that even a modest per-case complication rate carries a substantial absolute burden. Platelet-rich plasma (PRP), an autologous concentrate rich in growth factors, has demonstrated favourable effects on wound healing and scar quality across several surgical contexts, including caesarean section, raising the question of whether it could similarly benefit episiotomy repair. Methods: We conducted a structured, date-stamped search of PubMed, Scopus and Google Scholar, together with two trial registries (ClinicalTrials.gov, WHO ICTRP), forward and backward citation tracking, and reference-list screening of relevant reviews (final search 24 July 2026), to identify clinical studies of PRP for obstetric episiotomy or intrapartum perineal wound healing. Results: Five primary clinical studies and one systematic review were identified. One single-centre randomized controlled trial of 200 primiparous women, published in a regionally indexed journal covered by neither PubMed nor Scopus, evaluated PRP specifically for episiotomy wound healing and reported significantly lower REEDA, Vancouver and pain scores in the PRP arm; it was not prospectively registered, reported neither a sample-size calculation nor blinded outcome assessment, lost 12% of participants to follow-up, and contains internal inconsistencies in the reported data. The remaining evidence comprises one randomized trial of PRP for postpartum levator ani muscle recovery (a distinct target, with a null result), one non-randomized comparative study in grade III–IV intrapartum perineal laceration repair, two case reports, and one broad systematic review of PRP in pelvic floor disorders in which episiotomy was not analyzed as a distinct entity. Conclusions: PRP for episiotomy healing is therefore not wholly untested, but the single existing randomized trial is small, methodologically limited, not independently replicated, and effectively invisible to conventional database searching. We describe this evidence base and introduce PRP-EpiHeal (ClinicalTrials.gov ID: NCT07669285), designed to provide the first prospectively registered, adequately powered and assessor-blinded randomized evidence on this question, with REEDA scale assessment at six weeks postpartum as the primary outcome. Full article
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10 pages, 3245 KB  
Article
Reliability and Reproducibility of Laser Speckle Contrast Imaging for Assessment of Superficial Perfusion in Patients with High-Risk Feet: A Feasibility Study
by Kathleen J. Finlayson, Emilia Maria Bran Hernandez, Emi Nishiyama, Jane O’Brien and Christina N. Parker
Nurs. Rep. 2026, 16(8), 285; https://doi.org/10.3390/nursrep16080285 - 15 Aug 2026
Viewed by 196
Abstract
Background/Objectives: Healthy macrovascular and microvascular circulation is essential for wound prevention and healing in high-risk feet. While validated methods of assessing lower limb macrocirculation exist, microcirculation assessment often relies on subjective clinical judgement. This study aimed to determine reliability and reproducibility of laser [...] Read more.
Background/Objectives: Healthy macrovascular and microvascular circulation is essential for wound prevention and healing in high-risk feet. While validated methods of assessing lower limb macrocirculation exist, microcirculation assessment often relies on subjective clinical judgement. This study aimed to determine reliability and reproducibility of laser speckle contrast imaging (LSCI) of superficial circulation in the feet of adults attending a high-risk foot clinic. LSCI was undertaken on seven regions of the foot, and then repeated 3–5 min later. Methods: LSCI measures were compared to health and clinical measures using correlations, t-tests or ANOVA, as appropriate, and intra-class correlation coefficients (ICC) used to analyse reliability measures. In a sample of 31 participants, good test–retest reliability was found (3–5 min apart), with ICC from 0.94 (95% CI 0.76–0.98) to 0.99 (95% CI 0.96–0.99). Results: A sub-group of 10 participants were available to test reproducibility one week later, with Cronbach’s alpha ranging from 0.83 to 0.97. Lower LSCI perfusion measures were significantly related to longer ulcer duration, use of a walking aid, and presence of respiratory disease or previous cerebro-vascular accident. Conclusions: These findings support the potential role of LSCI as a non-invasive method to evaluate superficial perfusion in high-risk feet. Full article
(This article belongs to the Special Issue Research Innovations in Skin and Wound Care)
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75 pages, 31832 KB  
Review
Design, Properties and Applications of Multiple Dynamic Hydrogels
by Haofei Yang, Silu Wang, Shehzadi Mehboob and Jianhua Zhang
Materials 2026, 19(16), 3458; https://doi.org/10.3390/ma19163458 - 14 Aug 2026
Viewed by 173
Abstract
Hydrogels are highly hydrated polymeric soft materials that closely mimic the mechanical characteristics of biological soft tissues, offering immense promise for biomedical applications such as tissue engineering, drug delivery, flexible electronics, and wound repair. Conventional hydrogels crosslinked by static covalent bonds suffer from [...] Read more.
Hydrogels are highly hydrated polymeric soft materials that closely mimic the mechanical characteristics of biological soft tissues, offering immense promise for biomedical applications such as tissue engineering, drug delivery, flexible electronics, and wound repair. Conventional hydrogels crosslinked by static covalent bonds suffer from irreversible network disruption upon mechanical damage and lack active responsiveness to environmental stimuli, severely limiting their practical use. Incorporating both dynamic covalent bonds and dynamic non-covalent interactions endows hydrogels with intelligent features, including self-healing, injectability, and stimuli responsiveness. A single dynamic crosslinking mode often fails to achieve an optimal balance between mechanical robustness and rapid dynamic reversibility, whereas the synergistic integration of multiple dynamic bonds—exploiting their complementarity in kinetics, energy dissipation, and stimuli-responsiveness—has emerged as a cutting-edge strategy to overcome this limitation. Using dynamic non-covalent interactions as the classification framework, this review systematically summarizes recent advances in hydrogels crosslinked by combinations of dynamic non-covalent interactions with dynamic covalent bonds, covering hydrogen bonds, host–guest interactions, metal–ligand interactions, electrostatic interactions, hydrophobic interactions, π–π stacking interactions, and other emerging multiple dynamic crosslinking systems. The design principles, synergistic mechanisms, multifunctional applications, and key challenges and future directions of each system are discussed and prospected. Full article
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21 pages, 2519 KB  
Article
Differential Zoledronate Adsorption by Commercially Available Biphasic Calcium Phosphate Bone Substitutes
by Siri Paulo, Mafalda Laranjo, Ana Margarida Abrantes, Ricardo Jorge Teixo, Diogo A. Fonseca, João Mendes-Abreu, José Pedro Figueiredo, Maria Filomena Botelho, Manuel Marques Ferreira and Arménio Serra
Pharmaceuticals 2026, 19(8), 1281; https://doi.org/10.3390/ph19081281 - 13 Aug 2026
Viewed by 236
Abstract
Background/Objectives: Osteonecrosis of the jaw, a non-healing wound, is a side effect in patients treated with nitrogen-containing bisphosphonates (e.g., zoledronate) after some oral procedures. Considering zoledronate toxicity in surgical wounds and the capacity of calcium phosphate synthetic compounds to adsorb it, the [...] Read more.
Background/Objectives: Osteonecrosis of the jaw, a non-healing wound, is a side effect in patients treated with nitrogen-containing bisphosphonates (e.g., zoledronate) after some oral procedures. Considering zoledronate toxicity in surgical wounds and the capacity of calcium phosphate synthetic compounds to adsorb it, the aim of this work was to demonstrate and elucidate the mechanism underlying this adsorption. Methods: Four different calcium phosphate synthetic bone substitutes were used in this study: AdBone® BCP (0.5–1 mm), Guidor® easy-graft (0.5–1 mm), Maxresorb® (0.5–1 mm) and Maxresorb® (0.8–1.5 mm). The materials were incubated in aqueous zoledronate solutions. Samples of the solutions obtained after 1, 2, 3, 6, 24, 48, 72 and 120 h of conditioning were then analyzed by spectrophotometry to measure their absorbance and subsequently characterized by micro-elemental analysis. Results: All four materials demonstrated time-dependent zoledronate adsorption. AdBone® BCP achieved the most rapid and sustained sequestration, reaching 80% reduction at 24 h and stabilizing at 85% from 72 h onwards without re-release. Maxresorb® formulations showed comparable kinetics through 72 h (70–75%) but exhibited partial re-release at 120 h. Guidor® easy-graft showed negligible adsorption through the first 24 h, consistent with the physical barrier effect of its PLGA coating. Spectrophotometric findings were independently confirmed by elemental analysis. Conclusions: This work confirms zoledronate adsorption by calcium phosphate synthetic biomaterials. Among the tested materials, AdBone® BCP demonstrated the most favorable adsorption profile, with kinetics well matched to the critical window of alveolar wound healing. These findings support the use of biphasic calcium phosphate bone substitutes as a local strategy to reduce free zoledronate bioavailability at the surgical site, potentially lowering the risk of MRONJ in patients undergoing dentoalveolar procedures under bisphosphonate therapy. Full article
(This article belongs to the Special Issue The Pharmacology of Bisphosphonates: New Advances)
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15 pages, 751 KB  
Article
Testing-Yield Mismatch in Inpatient Micronutrient Assessment in Inflammatory Bowel Disease: A Real-World Implementation-Gap Analysis
by Amir Y. Kamel, Christopher Miquel-Chambers, Yasmeen Saker, Devika Dixit, Melanie Rolfe, Zachary D. Johnson, Isabela Hernandez, Thakul Rattanasuwan, Nofel Iftikhar, Naueen Chaudhry, Angela Pham, S. Devi Rampertab and Ellen Zimmermann
Nutrients 2026, 18(16), 2648; https://doi.org/10.3390/nu18162648 - 13 Aug 2026
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Abstract
Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies [...] Read more.
Background/Objectives: Micronutrient deficiencies are common in inflammatory bowel disease (IBD) and contribute to anemia, impaired wound healing, neurologic injury, and adverse disease outcomes. Major societies, including ESPEN, ACG, and ECCO, recommend nutritional and micronutrient assessment in patients with IBD, yet few studies describe how comprehensively these recommendations are applied during hospitalization. This study aimed to characterize inpatient testing practices for vitamins B1, B6, B12, and zinc in hospitalized IBD patients, quantify deficiency frequency among those tested, and identify gaps between guideline-recommended and actual micronutrient assessment. Methods: A retrospective chart review was performed on adults with Crohn’s disease (CD) or ulcerative colitis (UC) hospitalized for an IBD flare at a tertiary care center. Demographics, comorbidities, and deficiency-associated clinical features were recorded. Yield was defined as the proportion of tested patients meeting institutional deficiency thresholds. Yield for each non-B12 micronutrient was compared with B12 as an internal benchmark. Results: Among 356 patients (285 CD, 71 UC), inpatient micronutrient testing was markedly imbalanced: B12 was tested in 97.2%, whereas B6, B1, and zinc were tested in only 34.8%, 30.6%, and 18.8%, respectively. Among those tested, deficiencies were common: B6 40.3%, zinc 32.8%, B1 22.9%, and B12 9.0%. Each non-B12 micronutrient yielded deficiency significantly more often per test than B12 (all p < 0.001), a testing-yield mismatch interpreted cautiously given selective testing of non-B12 nutrients. Deficiency frequencies did not differ significantly between CD and UC. Clinical contexts included tachycardia and edema (B1); elevated inflammatory markers and thromboembolism history (B6); anemia and neuropathy (B12); and diarrhea and hypoalbuminemia (zinc). Conclusions: Inpatient micronutrient assessment in IBD is heavily skewed toward B12, with B1, B6, and zinc under-tested despite a substantially higher yield of identified deficiency per test. This testing-yield mismatch represents a measurable implementation gap between guideline-recommended comprehensive assessment and actual inpatient practice; whether systematic panel-based assessment improves clinical outcomes warrants prospective evaluation. Full article
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22 pages, 13702 KB  
Article
Three-Dimensional Analysis of Volumetric Changes During Palatal Wound Healing After Soft-Tissue Harvesting
by Viviana Desantis, Marco Brando Mario Paracchini, Fulvio Gatti, Carlo Pezzoli, Elena Maria Varoni and Marco Marcon
Sensors 2026, 26(16), 5088; https://doi.org/10.3390/s26165088 - 11 Aug 2026
Viewed by 266
Abstract
The growing demand for aesthetic and functional outcomes in periodontal and implant procedures has increased the use of connective tissue grafts harvested from the palate. Objective monitoring of the donor site remains challenging because healing involves progressive three-dimensional morphological changes and visible chromatic [...] Read more.
The growing demand for aesthetic and functional outcomes in periodontal and implant procedures has increased the use of connective tissue grafts harvested from the palate. Objective monitoring of the donor site remains challenging because healing involves progressive three-dimensional morphological changes and visible chromatic variations of the mucosal surface. This pilot feasibility study proposes an optical sensing and computer-vision workflow based on longitudinal intraoral scanner acquisitions to quantify palatal wound healing after soft-tissue harvesting. A TRIOS 3 intraoral scanner was used as a non-invasive sensing device to acquire textured three-dimensional datasets of the palatal donor area at baseline, immediately after surgery, and during follow-up at 1 and 2 weeks and at 1 and 3 months. The scanner output, consisting of surface geometry and color information, was processed as multimodal 3D data. The workflow included mesh preprocessing, reference-based registration of serial scans, robust alignment using geometric, normal, and chromatic cues, region-of-interest identification, and signed volumetric difference computation. Sensor-related uncertainty was addressed through an additional in vivo repeatability assessment on healthy volunteers and by comparison with previously published accuracy and precision data for the TRIOS scanner series. The resulting volumetric maps and healing curves enabled objective quantification of local tissue loss, swelling, and progressive recovery over time. Chromatic information from the textured scans was also considered as an additional sensing descriptor of mucosal healing. By integrating intraoral optical sensing, three-dimensional surface reconstruction, multimodal mesh registration, and quantitative volumetric analysis, the proposed approach provides a preliminary non-invasive framework for monitoring palatal donor-site healing. Six patients undergoing palatal soft-tissue harvesting were monitored using a TRIOS 3 intraoral scanner at baseline, immediately after surgery, and during follow-up at 1 and 2 weeks and at 1 and 3 months. Although all clinically evaluated patients exhibited complete clinical re-epithelialization by 3 months, quantitative 3D analysis revealed a persistent residual volumetric deficit, indicating that visual healing does not necessarily correspond to complete soft-tissue volume restoration. This sensor-based methodology may support clinical follow-up, improve the objectivity of soft-tissue assessment, and contribute to the development of digital biomarkers for oral wound healing. Full article
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