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Chronic wounds may develop when there is a delay or disturbance in one of the stages of the healing process, presenting challenging financial, clinical, and quality-of-life costs. Therefore, continuous efforts have been made to develop dressings that optimise wound healing. In recent years, nanotechnology has revolutionised wound care, enabling the development of innovative materials with high efficiency that positively impact the healing process. Nanoparticles have been extensively used in wound dressings because of their specific properties, such as a high surface area-to-volume ratio, increased surface reactivity, and improved biocompatibility, representing a unique tissue repair tool. This review article addresses advances in the use of organic nanoparticles in the field of skin regeneration, considering papers published in the last 5 years, and highlighting the effects of this class of materials on the wound healing process. The analysis of the literature shows that the materials being considered are carbon-based and organic materials, including polymeric, cellulosic, lipid, and liposome nanoparticles, which are covered in this review (inorganic nanoparticles are not considered). Furthermore, important aspects to prevent the development of chronic wounds are presented, as well as general characteristics of wounds, the healing process, and their particularities.
Leishmania spp. are intracellular protozoan parasites responsible for leishmaniasis, a globally prevalent vector-borne disease transmitted by phlebotomine sandflies. Within vertebrate hosts, the parasites preferentially infect macrophages and dendritic cells, leading to cell lysis and the formation of disfiguring lesions. Current treatment regimens are hampered by high toxicity, prolonged administration protocols, and severe side effects, underscoring the need for safer and more effective therapeutic alternatives. Mesenchymal stem cells (MSCs), multipotent non-haematopoietic progenitors with fibroblast-like characteristics, possess self-renewal capacity and the ability to differentiate into various functional cell types. Their intrinsic immunomodulatory and antimicrobial properties have positioned MSCs as promising candidates for combating infectious diseases, including leishmaniasis. This review systematically synthesises experimental evidence on the effects of MSCs on Leishmania parasites and the associated lesions, investigates the potential healing mechanisms of MSCs in the context of Leishmania infection, and outlines future research directions in this evolving field. A comprehensive literature search—spanning Scopus, PubMed, Web of Science, and Google Scholar up to 31 May 2024—identified 11 relevant studies: eight from Iran, two from Brazil, and one from Turkey. While Brazilian investigations utilised L. amazonensis, the others focused primarily on L. major, a leading cause of cutaneous leishmaniasis (CL). Across these studies, MSC-based therapy has shown immunomodulatory and antiparasitic effects, influenced by factors such as cell dosage, timing, route of administration, and the parasite burden. Despite promising findings, variability in experimental designs and outcomes highlights the early and exploratory stage of MSC application in CL therapy. Rigorous and standardised research is urgently needed to validate the therapeutic potential of MSCs and to support their clinical translation for leishmaniasis treatment.
This study investigated the relationship between clinician assessments and the AI-generated scores, highlighting how correlations vary based on clinician expertise. It also explored the proportion of tissue types identified by clinicians relative to AI assessments and assess the inter-clinician agreement in quantifying tissue types, identifying variations based on clinician experience. A cross-sectional survey used purposive, non-random sampling to recruit 50 wound care clinicians. Participants reported their specialisation and experience level before identifying and quantifying granulation, slough, eschar, and epithelialisation in nine wound images. An AI model analysed the same images for comparison. Experienced clinicians and wound care specialists reported higher confidence in assessments. Inter-clinician agreement was moderate–good for granulation and slough (ICC: 0.763–0.762) and moderate–excellent for eschar (ICC: 0.910), but moderate–poor for epithelialisation (ICC: 0.435). Clinicians strongly correlated with AI for granulation, slough, and eschar (r = 0.879, 0.955 and 0.984, respectively). Epithelialisation was more challenging, with a 60% identification rate and moderate correlation with AI (r = 0.579). AI-generated scores aligned with clinician assessments for granulation, slough, and eschar. However, epithelialisation, which is crucial for objectively measuring healing progress, showed greater variability, suggesting that AI could improve the reliability of its assessment, potentially leading to more consistent wound evaluation to guide treatment decisions.
Complex magnetic fields (CMFs) represent an emerging frontier in regenerative medicine, offering significant potential for innovative therapeutic strategies. This review examined both the theoretical foundations and practical applications of CMFs, focusing on their roles in tissue regeneration and antifungal activity. A comprehensive review of electronic databases (PubMed, Scopus, and Embase) identified seven pivotal studies on in vitro models concerning the CMF topic. Although the number of studies is limited, they collectively highlighted the promising therapeutic potential of CMFs in enhancing wound healing, reducing oxidative stress, and neuroinflammation in diabetic neuropathy, positively influencing mitochondrial function, modulating immune responses, promoting cellular communication, inhibiting the growth and adhesion of Candida albicans to medical surfaces, and enhancing dental pulp stem cell proliferation under inflammatory conditions. These findings suggested that CMFs may offer an eco-sustainable approach, effectively targeting pathogens while preserving human cell integrity. While the current body of research is insightful, it remains in its early stages. To fully leverage the therapeutic potential of CMFs, more comprehensive studies are needed to refine their application and confirm their effectiveness across diverse clinical scenarios. This is essential for integrating CMFs into clinical practice, where they promise to revolutionise treatment approaches.
Chronic ulcer patients form a heterogenous group of patients with various medical backgrounds. Cost-effective targeted treatment necessitates more knowledge about specific features related to different subgroups of ulcer patients. Hence, this study aimed to characterize ulcer patients according to gender and ulcer aetiology. A total of 946 consecutively recorded chronic ulcer patients in the Tampere Wound Registry (TWR) were included and data were gathered from the TWR and patient medical records. Comparisons were made between males and females and patients with venous-, arterial or mixed-, diabetic foot-, pressure- and atypical ulcers. Male patients were found to have diabetes, hypercholesterolemia and obesity significantly more often than females (59.2% vs. 39.6%; p < 0.001, 46.5% vs. 33.3%; p = 0.001, 42.7% vs. 35.9%; p = 0.017 respectively), whereas autoimmune diseases were more common among females (30.6% vs. 15.6%; p < 0.001). Recurrence of ulcers was most common among patients with venous ulcers (p < 0.001) and multimorbidity among those with diabetic foot ulcers (p < 0.001). To conclude, males with chronic ulcers would benefit particularly from lifestyle advice, multidisciplinary treatment should be targeted specifically at those with diabetic and arterial or mixed ulcers and preventive measures at those with venous ulcers.
Background and aims: Bacteria in wounds can lead to stagnation of wound healing as well as to local or even systemic wound infections up to potentially lethal sepsis. Consequently, the bacterial load should be reduced as part of wound treatment. Therefore, the efficacy of simple mechanical wound debridement should be investigated in terms of reducing bacterial colonisation. Patients and methods: Patients with acute or chronic wounds were assessed for bacterial colonisation with a fluorescence camera before and after mechanical wound debridement with sterile cotton pads. If bacterial colonisation persisted, a second, targeted wound debridement was performed. Results: A total of 151 patients, 68 (45.0%) men and 83 (55.0%) women were included in this study. The male mean age was 71.0 years and the female 65.1 years. By establishing a new analysis method for the image files, we could document that the bacterial colonised areas were distributed 21.9% on the wound surfaces, 60.5% on the wound edges (up to 0.5 cm) and 17.6% on the wound surroundings (up to 1.5 cm). One mechanical debridement achieved a significant reduction of bacterial colonised areas by an average of 29.6% in the wounds, 18.9% in the wound edges and 11.8% in the wound surroundings and was increased by performing it a second time. Conclusions: It has been shown that even a simple mechanical debridement with cotton pads can significantly reduce bacterial colonisation without relevant side effects. In particular, the wound edges were the areas that were often most contaminated with bacteria and should be included in the debridement with special attention. Since bacteria remain in wounds after mechanical debridement, it cannot replace antimicrobial therapy strategies, but offer a complementary strategy to improve wound care. Thus, it could be shown that simple mechanical debridement is effective in reducing bacterial load and should be integrated into a therapeutic approach to wounds whenever appropriate.
The combination of hyaluronic acid and iodine (Hyodine) has sparked interest in wound care and could have valuable applications in treating burn injuries. We aimed to provide valuable insight into the potential advantages, limitations, and implications of using Hyodine in burn wound management. We studied 25 male rats to assess the clinical outcomes and wound-healing effects of Hyodine. Each rat received a deep second-degree burn wound on their back using metal stamps. Subsequently, the rats were then randomly split into two groups. The first group was treated with a layer of Hyodine gel, while the second group received Vaseline. The burn sites were photographed on days 1, 7, 14, and 21 using a digital camera. After excision of the burn wounds, histopathology slides were stained and evaluated in terms of the degree of epithelialization, angiogenesis, inflammatory cells' infiltration, and collagen amount and arrangement. Despite a non-significant difference regarding the extent of burn wound area between intervention and control groups in the first day of experiment, the rats that were treated with Vaseline showed a significant decrease compared to those who received Hyodine in the second and third weeks (p = 0.02). On the other hand, epithelialization, pathology score, and collagen synthesis were significantly different between days 7, 14, and 21 of each group. However, collagen arrangement and neovascularization were only significantly different between days 7, 14, and 21 in Hyodine group (p = 0.02 and p = 0.03, respectively). The Hyodine gel may offer beneficial outcomes in patients with a burn wound. Based on our findings, despite a non-significant difference in the extent of burn wound area, using Hyodine revealed a significant improvement in different histopathological variables including neovascularization, and collagen arrangement.
Platelet-rich fibrin (PRF), which is the rich source of growth factors, has been used as an efficient scaffold in tissue engineering and wound healing. In this study, tannic acid as a green cross-linker with different concentrations (0.5%, 1%, 5% and 10%) was used to improve the properties of PRF. The cross-linked gel scaffolds were evaluated by analyses such as scanning electron microscopy, Fourier transform infrared spectroscopy, swelling and degradation, mechanical strength, cell toxicity, cell adhesion and antibacterial test. The results showed that the scaffold structure changes by increasing cross-linker concentration. The swelling rate decreased from 49% to 5% for the samples without the cross-linker and with tannic acid (10%), respectively. The degradation percentage for the cross-linked samples was 8%, which showed a lower degradation rate than the non-cross-linked samples (63%). The mechanical strength of the scaffold with the cross-linker increased up to three times (Young's modulus for the non-cross linked and the cross-linked samples: 0.01 and 0.6 MPa, respectively). Cytotoxicity was not observed up to 10% cross-linker concentration. The cells proliferated well on the cross-linked scaffolds and also showed a good antibacterial effect. In general, tannic acid can improve the physical and mechanical properties of PRF without negatively affecting its biological properties.
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