Mechanisms of medicinal plants in the treatment of diabetic wound

Wound repair is noticeably prolonged in a diabetic state due to a faulty inflammatory process and an underlying neuropathy.Several medicinal plants and their products have been of prime importance for the management of wounds over the years.Various mechanisms whereby medicinal plants elicit their action in wound repair are revealed and some plants are proven to be experimentally effective in enhancing wound closure and achieving healing.The mechanisms identified include hyperglycemic control,alleviation of physiological inflammation,controlled oxidative stress,infection control,and influence on gene expression.Information in this review was sourced from research and review articles in electronic databases such as Web of Science,Scopus,PubMed,and Google Scholar.

Application of negative pressure wound therapy after skin grafting in the treatment of skin cancer:A case report

BACKGROUND Skin cancer is a common malignant tumor in dermatology.A large area must be excised to ensure a negative incisal margin on huge frontotemporal skin cancer,and it is difficult to treat the wound.In the past,treatment with skin grafting and pressure dressing was easy to cause complications such as wound infections,subcutaneous effusion,skin necrosis,and contracture.Negative pressure wound therapy(NPWT)has been applied to treat huge frontotemporal skin cancer.CASE SUMMARY Herein,we report the case of a 92-year-old woman with huge frontotemporal skin cancer.The patient presented to the surgery department complaining of ruptured bleeding and pain in a right frontal mass.The tumor was pathologically diagnosed as highly differentiated squamous cell carcinoma.The patient underwent skin cancer surgery and skin grafting,after which NPWT was used.She did not experience a relapse during the three-year follow-up period.CONCLUSION NPWT is of great clinical value in the postoperative treatment of skin cancer.It is not only inexpensive but also can effectively reduce the risk of surgical effusion,infection,and flap necrosis.

Discussion on the Application Effect of Simplified Vacuum Sealing Drainage(VSD)in the Treatment of Chronic Refractory Wounds

Objective:To analyze the effect of simplified vacuum sealing drainage(VSD)in the treatment of chronic refractory wounds.Methods:A total of 90 patients with chronic refractory wounds treated from May 2022 to May 2023 were randomly divided into groups.The simplified VSD treatment was employed in group A,and conventional treatment was employed in group B,and the wound healing of both groups were compared.Results:Group A showed better wound healing compared to group B,P<0.05;the wound healing rate,wound healing duration,visual analog scale(VAS)score,wound dressing times and other indicators in group A were better than those in group B,P<0.05.The SF-36 score of group A was higher than that of group B,P<0.05;the complication rate of chronic refractory wounds in group A was no different from that in group B,P>0.05.Conclusion:Simplified VSD treatment is effective in treating patients with chronic refractory wounds,and it reduces the number of wound dressing changes and promote wound healing.

Successful treatment of epithelial downgrowth with endoscopic photocoagulation and intracameral 5-fluorouracil after prolonged limbal wound leak

Dear Editor,Epithelial downgrowth（EDG）is an uncommon and serious complication of intraocular surgery and trauma[1].It is recognized clinically by a translucent membrane on the corneal endothelium or iris.Treatment of EDG is controversial and generally has a low success rate.Recent treatment modalities have been invasive and damaging to the anatomy of the eye[1].

Comparative Evaluation of Different Treatment for Purulent Wounds in Dogs

To compare the healing of purulent wounds with Shilajit dressing vs. Vishnevsky dressing in dogs with purulent wounds of >2 weeks of duration, eight dogs were chosen from same ages in two groups i.e., Shilajit and Vishnevsky dressing group. Dressing was done on every day basis for more than two weeks of follow up period. Main outcome of healing measure was completed at three weeks. Wound healing status was assessed at three days intervals till end of three weeks. Shilajit treated achieved complete decrease in the wound surface area, effect of healing score in Shilajit dressing group in comparison to the Vishnevsky dressing group at p > 0.05 level of significance. Shilajit is highly effective in achieving a characteristic feature of regenerative and granulation healing of purulent wounds as compared to Vishnevsky dressing group in dogs.

Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged.

Management of negative pressure wound therapy in the treatment of diabetic foot ulcers

Diabetic foot(DF) is a common complication of diabetes and the first cause of hospital admission in diabetic patients. In recent years several guidelines have been proposed to reinforce the the management of DF with a notable increase in diabetes knowledge and an overall reduction of amputations. Significant improvements have been reached in the treatment of diabetic foot ulcers(DFUs) and nowadays clinicians have several advanced medications to apply for the best local therapy. Among these, negative pressure wound therapy(NPWT) is a useful adjunct in the management of chronic and complex wounds to promote healing and wound bed preparation for surgical procedures such as skin grafts and flap surgery. NPWT has shown remarkable results although its mechanisms of action are not completely understood. In this paper, we offer a complete overview of this medication and its implication in the clinical setting. We have examined literature related to NPWT concerning human, animal and in vitro studies, and we have summarized why, when and how we can use NPWT to treat DFUs. Further we have associated our clinical experience to scientific evidence in the field of diabetic foot to identify a defined strategy that could guide clinician in the use of NPWT approaching to DFUs.

Antibacterial activities of selected medicinal plants in traditional treatment of human wounds in Ethiopia

Objective:To evaluate the activity of selected Ethiopian medicinal plants traditionally used for wound treatment against wound-causing bacteria.Methods:Samples of medicinal plants(Achyranthes aspera,Brucea antidysenteriea,Datura stramonium,Croton macrostachyus,Acokanthera xchimperi.,Phytolacca dodecandra,Milhttia ferruginea,and Solanum incanum)were extracted using absolute methanol and water and tested for their antimicrobial activities against clinical isolates and standard strains of wound-causing bacteria using agar well diffusion and micro titer plate methods.Results:Most of the plant extracts had antibacterial activities,among which Acokanthera schimperi and Brucea antidysenteriea inhibited growth of 100%and 35%of the test organisms,respectively.Methanolic extracts had higher activities compared with their corresponding aqueous extracts.The most susceptible organism to the extracts was Streptococcus pyogens while the most resistant were Escherichia coli and Proteus vulgaris.Conclusions:This finding justifies the use of the plants in wound healing and their potential activity against woundcausing bacteria.Their toxicity level and antimicrobial activity with different extraction solvents should further be studied to use them as sources and templates for the synthesis of drugs to control wound and other disease-causing bacteria.

Mesenchymal stem cell-derived exosomes: Versatile nanomaterials for skin wound treatment

Accumulating studies reveal that mesenchymal stem cells(MSCs)promote skin wound healing mainly through the paracrine effects.Exosomes,one of the crucial paracrine mediators in wound healing,are cell-derived nanosized membranous vesicles containing diverse bioactive cargoes.With the potent ability of modulating skin cell behaviors,MSC-derived exosomes(MSC-Exos)are regarded as a promising nanomaterial for regenerative wound therapy.Under hostile conditions,MSC-Exos are efficient in protecting skin cells from severe damage and restoring their function.According to recent studies,MSC-Exos possess remarkable pro-healing effects in a variety of skin wounds,typically resulting in increased wound closure,inhibited scar tissue formation,and better restoration of skin function.To further enhance the therapeutic potential of MSC-Exos,the development of applicable pretreatment strategies and the optimization of exosome delivery are under intensive investigation.Herein,we summarize current research progress of MSC-Exos for skin wound treatment,with an emphasis on the biological effects of these nanovesicles,the repair mechanisms,and future challenges in clinical translation.

Skin Cancer Treatment by Nanoskin Cellulose: Future Cancer Wound Healing

Cancer cells can be proliferating in a few months and years. It depends on cancer stage. Chemotherapy, immunotherapy and anti-metabolic drugs have been used in order to kill cancer cells and prevent immune system weakly and metastasis. However, such drugs can damage healthy cells too. Natural ways to cancer treatments may help whole body to cancer cells. In this work, it was taking off cancer nodule to skin cancer by surgery and we treat the nodule as wound, using Nanoskin® advance cell therapy (ACT), natural extra cellular matrix which releases nutrients to the skin cancer. Our result shows that the cancer nodule disappears in few weeks in skin, because of natural membrane treatment. In addition, we obtained complete wound healing due anticancer nutrients (beta-glucan) delivery to skin.

Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals

Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.

Potential effect of striatin(DLBS0333),a bioactive protein fraction isolated from Channa striata for wound treatment

Objective:To characterize proteins and other nutrients in striatin(DLBS0333),a bioactive protein fraction isolated from snakehead fish(Channa striata) and to investigate its wound healing activity.Methods:Proteins and other constituents in striatin were characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis,two dimension electrophoresis,immunoblotting assay,spectroscopy and high performance liquid chromatography.The wound healing activity of striatin was studied in vitro using 3T3 fibroblast cells and in vivo using wound-induced animal model.Various parameters related to wound healing process were evaluated.Results:Striatin contained four major bioactive proteins with approximate molecular weight of 8.3,10.9,15.4 and 16.7 kDa.In addition to proteins,striatin also contained amino acids(10 essential and 7 non essential amino acids),fatty acids(palmitic acid,oleic acid,stearic acid,linoleic acid,arachidonic acid),vitamins(vitamin A,vitamin B_6)and other nutrients(carbohydrate,dietary fiber,biotin,choline,inositol,L-carnitine,selenium) which are potential for wound healing and increasing serum albumin level.Treatment with striatin both in vitro and in vivo indicated that striatin enhanced cell proliferation.Wound-induced animal model treated with striatin showed significantly faster wound healing process,as confirmed by wound size and faster serum albumin level recovery.Although striatin does not contain albumin,this bioactive protein fraction may lead to enhanced albumin synthesis in the liver thereby maintaining the blood albumin level.Thus,consuming striatin is a better option to improve albumin levels in diseased condition and the condition of being injured.Conclusions:Striatin(DLBS0333) is a potential natural compound for accelerating wound healing in conditions such as post surgery and post partum,and increasing albumin level.

Hyperbaric Oxygen Treatment in a Diabetic Rat Model Is Associated with a Decrease in Blood Glucose, Regression of Organ Damage and Improvement in Wound Healing

Diabetes leads to widespread complications including pancreatic β-cell damage, nephropathy and impaired wound healing. Hyperbaric oxygen therapy (HBOT) has been shown to improve wound healing through induction of stem cell recruitment and the potential to inhibit progression of diabetic complications. We aimed to determine the efficacy of HBOT in wound healing and organ preservation in a diabetic rat model. Diabetes was induced in male Wistar rats (n = 10/group) using streptozotocin (20 mg/kg sc) daily for 3 days. A wound was inflicted on the skin over the back and the rats were given HBOT (2.3 ATA for 1 h/day) for 1, 3, 5, 7 or 10 days or were not treated. Blood glucose, pancreatic β-cell damage, diabetic nephropathy and wound healing progression were assessed. Diabetic rats not treated with HBOT had significantly higher blood glucose levels compared to controls (26.7 ± 3.3 mmol/L vs. 5.8 ± 0.4 mmol/L;P ≤ 0.05). This was associated with significant increase in the percentage of β-cell damage (72% ± 9% vs. 10% ± 2%;P ≤ 0.05) and diabetic nephropathy. HBOT for 3 days and longer in diabetic rats reduced hyperglycemia to control levels. Pancreatic β-cell damage was negligible in rats treated with HBOT for 5 days and longer while diabetic nephropathy was diminished in animals treated for 10 days. Similarly HBOT induced wound healing and accelerated epithelial closure from 5 days of HBOT. In summary, our findings show the efficacy of HBOT in this diabetic rat model. There was significant reduction of hyperglycemia and inhibition of diabetic complications in the form of preservation of pancreatic and kidney structure and accelerated wound healing.

Effect of local ozone treatment on inflammatory cytokine, growth cytokine and apoptosis molecule expression in anal fistula wound

Objective:To study the effect of local ozone therapy on inflammatory cytokine, growth cytokine and apoptosis molecule expression in anal fistula wound.Methods: Patients with low simple anal fistula who received anal fistulectomy in Eighth Hospital of Wuhan between June 2014 and December 2016 were selected and randomly divided into ozone group and control group who received ozone combined with routine treatment and routine treatment respectively. 5 d, 10 d and 15 d after treatment, proper amount of wound granulation tissue was clamped to determine the expression of inflammatory cytokines IFN-γ, TNF-α, IL-1, IL-8 and IL-12, growth cytokines VEGF, FGF-1, FGF-2 and EGF as well as apoptosis molecules Bax, P53 and caspase-3.Results:5 d, 10 d and 15 d after treatment, IFN-γ, TNF-α, IL-1, IL-8, IL-12, VEGF, FGF-1, FGF-2 and EGF protein expression in anal fistula wound of ozone group were significantly higher than those of control group while Bax, P53 and caspase-3 protein expression were significantly lower than those of control group.Conclusion: Local ozone treatment can increase the expression of inflammatory cytokines and growth cytokines and inhibit the expression of apoptosis molecules in anal fistula wound, and it is conducive to wound healing.

The Use of an Innovative Film-Forming Wound Dressing in the Treatment of Radiation Dermatitis during Concomitant Chemotherapy

There is currently no consensus regarding the management of acute cutaneous reactions emerging from a concurrent treatment of radio-and chemotherapy, the goal of this case study series is to provide scientific evidence based on clinical practice regarding the efficacy of a film-forming wound dressing for patients receiving combined cancer therapy, in particular examples where the reactions are expected to be intense. In all the described cases, management of acute skin reactions allowed the cancer therapy to be finalized, instead of being interrupted due to an increase in the severity of the reactions. It has been shown in the current literature that the lack of compliance with treatment plans correlates with poorer clinical outcome. Evidence from the cases presented suggest that the studied dressing is safe and efficacious in the treatment and the prevention of acute cutaneous reactions arising from combined cancer therapy.

The Treatment of Partial-Thickness Burns with a Hydroconductive Wound Dressing: Clinical and Mechanistic Effects

Objectives: Edema in partial-thickness burn wounds can decrease tissue perfusion, increase tissue ischemia, and deepen the burn injury. We report the results of a clinical trial comparing the effectiveness of a hydro-conductive dressing to our standard burn dressing at removing edema fluid from partial-thickness burns and present the proposed mechanisms of action of the hydroconductive dressing. Methods: An internally controlled comparison of two wound dressings was performed on 10 patients with non-contiguous partial-thickness burns. Each patient served as his/her own control. One burn was treated with our standard burn dressing and the other with hydroconductive dressing. Dressings were weighed prior to application, removed at 24 and 48 hours, weighed, and new pre-weighed dressings applied. Weight gain of each dressing at 24 and 48 hours was determined. Statistics were applied using the Student’s paired T-test. The VAS pain scale was measured prior to, during, and after each dressing change. Results: At 24 hours, the hydroconductive dressing had increased 85.6% ± 29.3% in weight compared with 61.3% ± 32.7% for the control (P = 0.053). For the second 24 hour period, the respective numbers were statistically significantly different at 59.7% ± 23.4% vs. 34.2% ± 19.1% (P = 0.038). Averaging the weight gain over the two dressing periods demonstrated that the differences were highly statistically significant as the hydroconductive dressing increased in weight by 71.0% ± 20.3% compared with 44.5% ± 17.4% for the gauze dressing (P = 0.005). VAS scores revealed no statistical differences. Mechanisms of action included capillary, hydroconductive, and electrostatic actions. Conclusions: A hydroconductive dressing designed to draw off excessive wound fluid removes more wound edema fluid than standard burn gauze dressings.

Research progress of compound Baiyu powder in treatment of chronic refractory wounds

Chronic refractory w ounds are common and frequently-seen diseases in surgery.Due to their long course of disease and complex pathogeneses,chronic refractory w ounds arouse high attention in clinic.With the preliminary results of clinical research of their pathogeneses and new treatments achieved,traditional Chinese medicine(TCM),w ith its unique concept,breaks the limitation commonly existing in the methods of w estern medicine,especially obtaining certain achievements in chronic refractory w ounds.This paper review ed the therapeutic effects of compound Baiyu pow der in the treatment of chronic refractory w ounds to prove to be effective,convenient to use and save medical costs.

Wound Treatment Using Growth Factors

Treatment with growth factors is an effective method to promote wound healing. Several growth factors have been used in wound treatment, including basic fibroblast growth factor (bFGF) discovered in the 1970s, platelet-derived growth factor (PDGF), epidermal growth factor (EGF), and bone morphogenetic protein (BMP). In 2001, Kaken Pharmaceutical Co., Ltd. launched Fiblast Spray in Japan. This product is a topical formulation containing recombinant human bFGF. It is used to treat decubitus ulcers and skin ulcers (burn ulcers and leg ulcers). There is increasing interest in its stimulatory effect on wound healing and its inhibitory effect on scar formation. Wound healing is a physiological phenomenon that involves a complex series of integrated cellular and biochemical responses, characterized by phases of hemostasis, inflammation, proliferation, and maturation. However, much of its detailed mechanism remains unknown. There have been many basic research studies on wound healing using cells and experimental animals. If findings can be used from such studies and clinical practice, development of even more effective treatments might be possible.

Application Experience of Moist Wound Healing Theory Combined with Modern New Dressings in the Treatment of Pressure Ulcers

Objective:Research on the effect of moist wound healing theory in a combination with modern new dressing treatment in patients diagnosed with pressure ulcers.Method:Selected 30 patients with pressure ulcers from our hospital,which is Shandong Tai an Municipal Hospital,from January 2019 to January 2021 were divided into experimental group(15 cases,treated with moist wound healing theory combined with modern new dressings)and control group(15 cases,applied conventional treatments).The treatment effect,time of wound edema subsidence,wound healing time,number of dressing changes,granulation tissue growth time,and diameter reduction time were compared between the two groups.Results:The total effective rate of the experimental group(93.33%,14/15)was higher than that of the control group(53.33%,8/15),P<0.05;the time to subsidence of wound edema in the experimental group was(3.11±0.22),and the time for wound healing was(12.78±0.45),the number of dressing changes(7.13±0.34)times,the growth time of granulation tissue(5.43±2.22),the diameter reduction time(6.25±3.75),compared with the control group,P<0.05.Conclusion:In the clinical treatment of patients diagnosed with pressure ulcers,the effective combination of moist healing theory and modern new dressing therapy has significant effects,whereby it speeds up the healing process of the pressure ulcers,and it is proven to be worthy to be promoted for usage.

Negative Pressure Wound Therapy with Multiple Drainage Holes for the Treatment of Pressure Ulcer with Undermining: Case Reports

Noninvasive treatment of pressure ulcers with undermining is often difficult. To decrease the risk of bleeding in such conditions, negative pressure wound therapy (NPWT) has been applied. We treated a pressure ulcer with wide undermining using NPWT after opening drainage holes in the undermined area. This method can reduce the risk of bleeding and promote the rapid closure of the undermined area.