Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement ac...Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement according to the various color classifications. Methods include combined sharp and hydrogel debridement, combined ultrasonic and enzymatic debridement, ultrasonic debridement combined with surgical debridement and vacuum aspiration on debridement, and other types of debridement. This article also explores why each combined debridement mentioned above can achieve a good effect.展开更多
Diabetic wounds(DWs)are a common complication of diabetes mellitus;DWs have a low cure rate and likely recurrence,thus affecting the quality of patients’lives.As traditional therapy cannot effectively improve DW clos...Diabetic wounds(DWs)are a common complication of diabetes mellitus;DWs have a low cure rate and likely recurrence,thus affecting the quality of patients’lives.As traditional therapy cannot effectively improve DW closure,DW has become a severe clinical medical problem worldwide.Unlike routine wound healing,DW is difficult to heal because of its chronically arrested inflammatory phase.Although mesenchymal stem cells and their secreted cytokines can alleviate oxidative stress and stimulate angiogenesis in wounds,thereby promoting wound healing,the biological activity of mesenchymal stem cells is compromised by direct injection,which hinders their therapeutic effect.Hydrogels form a three-dimensional network that mimics the extracellular matrix,which can provide shelter for stem cells in the inflammatory microenvironment with reactive oxygen species in DW,and maintains the survival and viability of stem cells.This review summarizes the mechanisms and applications of stem cells and hydrogels in treating DW;additionally,it focuses on the different applications of therapy combining hydrogel and stem cells for DW treatment.展开更多
Purpose： To investigate effects of neuro-immuno-modulation on wound healing by observing changes of cytokines and hypothalamic-pituitary-adrenal （HPA） axis hormones in acute stress reaction in rats with wound and c...Purpose： To investigate effects of neuro-immuno-modulation on wound healing by observing changes of cytokines and hypothalamic-pituitary-adrenal （HPA） axis hormones in acute stress reaction in rats with wound and combined local radiation injury. Methods： Sixty female Wistar rats （weighting 200 ± 20 g） were randomly divided into normal control group, wound group and combined wound-local radiation （CWR） group （25 Gy local radiation post wound）, 20 rats in each group. Contents of IL-1β, IL-6 and IFN-γ and IL-4 in serum were measured and changes of adrenocorticotropic hormone （ACTH） and glucocorticoid （GC） in serum were analyzed by using enzyme-linked immunosorbent assay and radioimmunologic assay, respectively at different time points post wound and radiation. Results： （1） The level of IFN-γ, one of the Thl cell cytokines increased significantly at 14 d post CWIL which was markedly higher than that in control group and wound group. However, the level of IL-4, IL-1β and IL-6, one of the Th2 cell cytokines, did not show obvious change. （2） Ratio of Thl/Th2 （IFN-γ/IL-4） in wound group and CWR group increased significantly at 7 d after wound and radiation, which suggested that Thl/Th2 balance drifted to Thl immune response. The ratio of Thl/Th2 in wound group returned to the normal level up to 14 d after the wound and radiation, while the Thl/Th2 ratio in CWR group increased persistently and was much higher than that in control and wound groups. （3） Level of serous ACTH and CC in CWR group increased at 3 d post wound and radiation, and among them, level of CC showed statistically significant increase, which was much higher than that in control and wound groups. Conclusion： Level of serous neurohormone CC in rats increased significantly immediately after wound and radiation; while the level of IFN-γ showed significant increase only up to 14 d after wound and radiation, and the Th1/Th2 imbalance sustained till 28 d post wound and radiation. In order to reduce acute damage caused by CWR, organic immune system and nerve system showed up a marked regulate effects simultaneously and mutually. Nonetheless, the excessive stress induced by CWR causes distur- bance of immunoregulation, which is one of the key reasons for delayed wound healing in CWR.展开更多
文摘Wounds debridement is important for healing of chronic wounds. Combined debridement is a new technique to deal with the complex chronic wounds. This review introduces several topical methods of combined debridement according to the various color classifications. Methods include combined sharp and hydrogel debridement, combined ultrasonic and enzymatic debridement, ultrasonic debridement combined with surgical debridement and vacuum aspiration on debridement, and other types of debridement. This article also explores why each combined debridement mentioned above can achieve a good effect.
基金Supported by the Shenzhen Basic Research Project,No.JCYJ20190807155805818the Foundation of Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument,No.2020B1212060077.
文摘Diabetic wounds(DWs)are a common complication of diabetes mellitus;DWs have a low cure rate and likely recurrence,thus affecting the quality of patients’lives.As traditional therapy cannot effectively improve DW closure,DW has become a severe clinical medical problem worldwide.Unlike routine wound healing,DW is difficult to heal because of its chronically arrested inflammatory phase.Although mesenchymal stem cells and their secreted cytokines can alleviate oxidative stress and stimulate angiogenesis in wounds,thereby promoting wound healing,the biological activity of mesenchymal stem cells is compromised by direct injection,which hinders their therapeutic effect.Hydrogels form a three-dimensional network that mimics the extracellular matrix,which can provide shelter for stem cells in the inflammatory microenvironment with reactive oxygen species in DW,and maintains the survival and viability of stem cells.This review summarizes the mechanisms and applications of stem cells and hydrogels in treating DW;additionally,it focuses on the different applications of therapy combining hydrogel and stem cells for DW treatment.
文摘Purpose： To investigate effects of neuro-immuno-modulation on wound healing by observing changes of cytokines and hypothalamic-pituitary-adrenal （HPA） axis hormones in acute stress reaction in rats with wound and combined local radiation injury. Methods： Sixty female Wistar rats （weighting 200 ± 20 g） were randomly divided into normal control group, wound group and combined wound-local radiation （CWR） group （25 Gy local radiation post wound）, 20 rats in each group. Contents of IL-1β, IL-6 and IFN-γ and IL-4 in serum were measured and changes of adrenocorticotropic hormone （ACTH） and glucocorticoid （GC） in serum were analyzed by using enzyme-linked immunosorbent assay and radioimmunologic assay, respectively at different time points post wound and radiation. Results： （1） The level of IFN-γ, one of the Thl cell cytokines increased significantly at 14 d post CWIL which was markedly higher than that in control group and wound group. However, the level of IL-4, IL-1β and IL-6, one of the Th2 cell cytokines, did not show obvious change. （2） Ratio of Thl/Th2 （IFN-γ/IL-4） in wound group and CWR group increased significantly at 7 d after wound and radiation, which suggested that Thl/Th2 balance drifted to Thl immune response. The ratio of Thl/Th2 in wound group returned to the normal level up to 14 d after the wound and radiation, while the Thl/Th2 ratio in CWR group increased persistently and was much higher than that in control and wound groups. （3） Level of serous ACTH and CC in CWR group increased at 3 d post wound and radiation, and among them, level of CC showed statistically significant increase, which was much higher than that in control and wound groups. Conclusion： Level of serous neurohormone CC in rats increased significantly immediately after wound and radiation; while the level of IFN-γ showed significant increase only up to 14 d after wound and radiation, and the Th1/Th2 imbalance sustained till 28 d post wound and radiation. In order to reduce acute damage caused by CWR, organic immune system and nerve system showed up a marked regulate effects simultaneously and mutually. Nonetheless, the excessive stress induced by CWR causes distur- bance of immunoregulation, which is one of the key reasons for delayed wound healing in CWR.
