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The construction of wound repair discipline system with Chinese characteristics is a process of continuous optimization and improvement. Due to the different conditions and the situations that vary widely from region to region and from hospital to hospital, various forms of wound repair specialty or consortium will exist within a period of time and to a extent plays a key role in promoting the construction of the wound repair discipline system with Chinese characteristics. This article introduced several kinds of construction modes of wound repair specialty or regional alliance of wound repair specialty in recent years. Their successful experience is worth learning and drawing lessons from.

Hardly any other field of application of artificial intelligence (AI) needs more ethics by design than medicine; however, if a deep integration of ethical principles succeeds there is a chance of "deep healing", for each individual and also for medicine and the healthcare system itself. Thus, AI in medicine could also become a blueprint for how AI should enter society and culture., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Non-thermal plasma (NTP) application in medicine is a dynamically developing interdisciplinary field. Despite the fact that basics of the plasma phenomenon have been known since the 19th century, growing scientific attention has been paid in recent years to the use of plasma in medicine. Three most important plasma-based effects are pivotal for medical applications: (i) inactivation of a broad spectrum of microorganisms, (ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and (iii) inactivation of cells by initialization of cell death with higher plasma intensity. In this review, we explain the underlying chemical processes and reactive species involvement during NTP in human (or animal) tissues, as well as in bacteria inactivation, which leads to sterilization and indirectly supports wound healing. In addition, plasma-mediated modifications of medical surfaces, such as surgical instruments or implants, are described. This review focuses on the existing knowledge on NTP-based in vitro and in vivo studies and highlights potential opportunities for the development of novel therapeutic methods. A full understanding of the NTP mechanisms of action is urgently needed for the further development of modern plasma-based medicine.

Objective: We developed and evaluated an online learning module for teaching wound care basics to junior medical learners, which was assessed for its ability to increase theoretical knowledge of wound care, and medical learners' perceptions on the use of an online module to teach wound care practices., Design: Between February 2022 to November 2022, participants were enrolled into our unblinded, matched-pair single-arm study. Participants completed a pre- and postquiz prior to and after completing the online module, respectively. Scores on the pre- and postquiz were matched by participant and evaluated for improvement. The online module was composed of free text, animated videos with voiceovers, pictorial examples, and tables, as well as unscored knowledge checks, covering the categories of i) normal wound healing physiology, ii) describing wounds/assessment of wounds, iii) choosing dressings for wounds, and iv) addressing and understanding wound aetiologies, including diabetic, arterial, and venous ulcers., Setting: Participants were enrolled at the University of Toronto in Toronto, Canada., Participants: Participants were recruited from the undergraduate medicine and physician assistant programs at the University of Toronto. Students were provided with information on how to participate in the study through email and in-person recruitment. Thirty-three participants entered the study, and 23 participants completed the study., Results: Across all participants, the prequiz to postquiz score increase averaged 13.29%, representing a statistically significant increase (p = 0.0000013). Ten of the 20 questions and all question categories had a statistically significant increase in the postquiz scores. All respondents found the module very useful (67%) or extremely useful (33%) for learning wound care, and 67% were very satisfied overall with the quality of the module, with the remainder (33%) of respondents somewhat satisfied., Conclusions: Online learning modules are effective at increasing wound care knowledge in junior medical learners, with high satisfaction amongst learners., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

This article explores the professional project for an emergent subaltern specialist community of wound healing clinicians. Drawing on the literature on professions and boundary work, it examines how wound healing clinicians challenge the perception of their work as 'dirty' and seek its transformation into a specialism of 'woundology'. The article is based on an ethnography of a UK multidisciplinary team of doctors and nurses with an interest and expertise in wound healing, who work as clinical academics and provide wound care services in outpatient clinics. It demonstrates that wound healing clinicians vindicate their professional status by seeking to enthral the medical community in 'dirty wound care' as a focused clinical specialty of 'woundology'. Through training nurses to do medical wound care work, educating clinicians from other specialties about wounds and undertaking wound research, wound healing clinicians assert the professional boundaries of their specialism and its fit with mainstream medicine without embellishing the dirty aspects of their work., (© 2020 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).)

The overview provides basic information on non-thermal plasma, its properties, and methods of its generation. It gives examples of its use in the inactivation of bacteria including biofilms, fungi, and prions. Related applications in human medicine, namely in wound healing, antitumor therapy, dental medicine, and dermatomycosis therapy are also mentioned.

Synthetic surfactants are becoming increasingly unpopular in many applications due to previously disregarded effects on biological systems and this has led to a new focus on replacing such products with biosurfactants that are biodegradable and produced from renewal resources. Microbially derived biosurfactants have been investigated in numerous studies in areas including: increasing feed digestibility in an agricultural context, improving seed protection and fertility, plant pathogen control, antimicrobial activity, antibiofilm activity, wound healing and dermatological care, improved oral cavity care, drug delivery systems and anticancer treatments. The development of the potential of biosurfactants has been hindered somewhat by the myriad of approaches taken in their investigations, the focus on pathogens as source species and the costs associated with large-scale production. Here, we focus on various microbial sources of biosurfactants and the current trends in terms of agricultural and biomedical applications., (© 2019 The Society for Applied Microbiology.)

Plasma medicine comprises the application of physical plasma directly on or in the human body for therapeutic purposes. Three most important basic plasma effects are relevant for medical applications: i) inactivation of a broad spectrum of microorganisms, including multidrug-resistant pathogens, ii) stimulation of cell proliferation and angiogenesis with lower plasma treatment intensity, and iii) inactivation of cells by initialization of cell death with higher plasma treatment intensity, above all in cancer cells. Based on own published results as well as on monitoring of relevant literature the aim of this topical review is to summarize the state of the art in plasma medicine and connect it to redox biology. One of the most important results of basic research in plasma medicine is the insight that biological plasma effects are mainly mediated via reactive oxygen and nitrogen species influencing cellular redox-regulated processes. Plasma medicine can be considered a field of applied redox biology., (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Abstract The balance of stem cell populations is essential for the maintenance, renewal, and repair of the mammalian epidermis. Here, we report that CD4, which is a typical marker of helper T cells, monocytes, macrophages, and dendritic cells, is also expressed on murine K5+ keratinocytes. Lineage tracing of CD4+ cells reveals that their epidermal progeny has self-renewal abilities and clonogenic potential. The progeny of CD4+ epidermal cells contributes to epidermal renewal and progressively colonizes the interfollicular epidermis and hair follicles with age, thereby developing to all epidermal lineages. Wound healing studies furthermore show that the progeny of CD4+ epidermal cells accumulates at wound sites. Finally, using CD4 knockout mice we demonstrate that CD4 expression is essential for maintaining fast-cycling epidermal stem cells during homeostasis and that CD4 loss mitigates the age-related decline in wound repair capacity. Collectively, our data support the conclusion that CD4 expression is required for long-term maintenance of the epidermal stem cell balance.

Abstract Tail docking and ear tagging are common husbandry practices in lambs, but little is known about subsequent wound healing or how it may be affected by performing both procedures concurrently. Our objectives were to: (1) describe wound healing following tail docking and ear tagging, and (2) compare healing of ear wounds in docked and undocked lambs. Within 28 female Polypay twin pairs, one lamb was docked using a rubber ring between 1 and 2 days of age and the other lamb’s tail was left intact. Tags were attached to both ears of all lambs. We photographed tail and ear wounds twice weekly until weaning (mean ± SD; 64 ± 5 days of age). Tail wounds took 43 ± 9 days to heal (range: 30–60 days). Pus, a sign of infection, was present at least once in 89% of tail wounds and was associated with delayed healing. Only 49% of ear wounds had healed by weaning, and tail docking did not predict the probability of healing. Pus and sanguineous exudate (i.e., bleeding) were present at least once in 21% and 96% of ear wounds, respectively. Pus was not associated with the probability of ear wound healing, but ears with more frequent bleeding were less likely to have healed by weaning. The duration of healing and likelihood of infection following both procedures raise welfare concerns and suggest refinements or alternatives are warranted.

Abstract Tattoos are widespread in the population. Tattoo inks, which contain a variety of ingredients among them hazardous compounds such as polyaromatic hydrocarbons, heavy metals and nanoparticles and that are made for injection into the skin, are not dermatologically tested. New testing systems for evaluation of biocompatibility of tattoo inks as composite products and the tattooing process itself are needed. This paper describes an in vitro 3D human skin model that was tattooed with black and red ink. Biocompatibility including analysis of cytotoxicity, cytokine release, and gene expression patterns of proinflammatory cytokines, proliferation markers, growth factors and structural components was investigated over a period of 7 days. Tattooing of the 3D skin model resulted in a strong inflammatory reaction comparable to in vivo observations that subsided 4 days after treatment. The subsequent healing phase was detectable in the gene expression patterns. Tattooing with two different tattoo inks resulted in distinguishable inflammatory reactions. The described 3D skin model is a useful tool for evaluation of the biocompatibility of tattoo inks and the tattooing process itself and for characterizing the healing process after tattooing.

Abstract Non-invasive physical plasma (NIPP) has been used effectively for wound healing in human medicine for over two decades. The advantages are that NIPP has few side effects, is painless and gentle on the tissue. The therapeutic effect is mediated by reactive oxygen species (ROS). Based on the biomedical effects known to date, it can be assumed that NIPP can also be used for wound treatment in non-human mammals. In this prospective, non-randomized monocentric clinical trial, 43 European hedgehogs with cut and bite wounds were treated with conventional wound management (CWM: 21 patients) and compared with 22 patients with CWM plus NIPP treatment (CWM + NIPP). Under NIPP treatment, patients showed no signs of pain, stress or discomfort, even after several applications. In 76% of CWM + NIPP patients, three or four NIPP applications were sufficient. In patients in the CWM + NIPP group, wound treatment was completed statistically significantly 6 d earlier (CWM: 19.0 d versus CWM + NIPP: 13.2 d; p = 0.0008). This wildlife clinical trial demonstrates that NIPP can be used to improve wound healing in wild European hedgehogs. It is conceivable that NIPP therapy could also lead to positive effects in other injured wild animals, domestic animals or livestock.

Hydrogen-rich water (HRW) shows excellent antibacterial, anti-inflammatory, antioxidant, and wound-healing properties and plays a positive role in the treatment of various diseases, such as brain injury, kidney injury, and periodontitis. Current studies found that HRW can inhibit periodontopathogenic biofilm formation, inhibit oral connective tissue and bone tissue destruction, and show anti-inflammatory and antioxidant properties in periodontitis. Additionally, HRW can alleviate periodontal tissue damage by inhibiting oxidative stress and up-regulating the expression of antioxidant enzymes, such as glutathione peroxidase and superoxide dismutase. HRW exerts anti-inflammatory effects by regulating the nuclear factor erythroid 2-related factor 2 and mitogen-activated protein kinase pathways, which are closely associated with inflammation. Additionally, HRW inhibits the expression of inflammatory cytokines, such as interleukins, inhibits the growth and proliferation of bacterial plaque biofilms, and down-regulates glycosyltransferases and glucan-binding proteins to prevent bacterial adhesion and subsequent development of periodontitis. Furthermore, HRW has a positive effect on the expression of various cell growth factors, α-smooth muscle actin, and type I collagen, which promotes wound healing. Current clinical studies have demonstrated the biological safety of HRW (to a certain extent) and reported no adverse reactions. However, most studies on HRW in oral diseases are preclinical in vivo and in vitro studies. Therefore, further clinical studies are required to validate the therapeutic significance and optimal therapeutic regimen of HRW in human periodontitis. This article aims to review the therapeutic role and the underlying mechanisms of HRW in periodontitis.

Introduction: Fissure-in-ano are a notably prevalent anorectal condition, primarily associated with ulcers and raised anal sphincter spasm. The management options largely focus on promoting wound healing and reducing anal spasm. Medical treatment, which includes a fibre-rich diet and sitz baths, results in the healing of nearly half of the fissure-in-ano. The ulcer of the anal canal is the presenting complaint in this condition. Topical Ayurvedic medicine can be utilised to heal such ulcers. Need of the Study: A review of the literature suggests that T. procumbens exhibits potent wound healing, antioxidant, antimicrobial, anti-inflammatory, procoagulant and immunomodulatory properties. Given that an acute fissure-in-ano presents as an ulcer in the anal canal, this study proposes the use of T. procumbens for its management. A im: To evaluate the efficacy of Jayanti (T. procumbens) cream versus topical Lignocaine and Nifedipine cream in the treatment Materials and Methods: A single-blind, double-arm comparative randomised control trial will be conducted at the Department of Shalyatantra, Mahatma Gandhi Ayurveda College Hospital and Research Centre (MGACHRC), Salod Hirapur (H), Maharashtra, India, from April 2023 to November 2024, with 70 subjects enrolled. In the control group, topical Lignocaine and Nifedipine cream will be applied, while in the interventional group, topical Jayanti (T. procumbens) cream will be applied to the acute fissure-in-ano. The evaluation parameters, including wound healing, anal spasm, per rectal bleeding, pain and itching, will be assessed.

Abstract Understanding how inflammatory cytokines influence profibrogenic wound healing responses in fibroblasts is important for understanding the pathogenesis of fibrosis. TNF-α and IL-13 are key cytokines in Th1 and Th2 immune responses, respectively, while TGF-β1 is the principal pro-fibrotic mediator. We show that 12-day fibroblast culture with TNF-α or IL-13 induces fibrogenesis, marked by progressively increasing type III and VI collagen formation, and that TGF-β1 co-stimulation amplifies these effects. Tofacitinib substantially reduced the formation of ECM proteins in response to IL-13, while fibrogenesis in response to TNF-α or TGF-β1 was marginally inhibited. The in vitro findings were supported by clinical observations in patients with active rheumatoid arthritis, which had elevated serum type III collagen formation, indicating ongoing fibrogenesis during inflammation. After 48–60 weeks of tofacitinib treatment, type III collagen degradation, aswell as formation, were significantly decreased compared to baseline, highlighting dual anti-inflammatory and anti-fibrogenic effects of tofacitinib. In contrast, other anti-inflammatory treatments including methotrexate, adalimumab and tocilizumab demonstrated anti-inflammatory effects only. Our results highlight fibro-inflammatory profiles associated with TNF-α or IL-13 stimulation, both alone and in combination with TGF-β1, and support the use of tofacitinib as an anti-fibrogenic treatment in chronic inflammatory conditions.

Abstract Background Staphylococcus aureus, a known contributor to non-healing wounds, releases vesicles (SAVs) that influence the delicate balance of host-pathogen interactions. Efferocytosis, a process by which macrophages clear apoptotic cells, plays a key role in successful wound healing. However, the precise impact of SAVs on wound repair and efferocytosis remains unknown. Methods Filtration, ultracentrifugation, and iodixanol density gradient centrifugation were used to purify the bacterial vesicles. Transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and Western blot (WB) were used to characterize the vesicles. Macrophage efferocytosis efficiency was assessed using flow cytometry and confocal microscopy, while efferocytosis at wound sites was analyzed through WB, FACS, and TUNEL staining. Hematoxylin and eosin (H&E) staining and wound size measurements were used to evaluate the wound healing process. Phosphorylation of signaling pathways was detected by WB, and efferocytosis receptor expression was measured using RNA sequencing, qPCR, and flow cytometry. siRNA and pathway inhibitors were used to investigate the roles of key receptors and signaling pathways in efferocytosis. Results We identified SAVs at infected wound sites, linking them to delayed healing of wounds. SAVs inhibit efferocytosis by activating the TLR2-MyD88-p38 MAPK signaling pathway, which regulates efferocytosis receptor genes. This activation promoted cleavage and shedding of MerTK, a crucial receptor for macrophage-driven efferocytosis. Notably, selective inhibition of p38 MAPK prevented MerTK shedding, restored efferocytosis and accelerated wound healing significantly, offering a promising therapeutic approach for chronic, non-healing wounds. Conclusion These findings uncover a novel mechanism in S. aureus-infected wounds, highlighting how the disruption of efferocytosis via the TLR2-MyD88-p38 MAPK-MerTK axis becomes a key force behind impaired healing of wounds. Targeting this pathway could open up a new therapeutic avenue facilitating the treatment of chronic, non-healing skin injuries.

Introduction Skin grafting is an essential reconstructive technique for the healing of deep and extensive burns. Donor site problems are common complications after skin graft surgery. Speeding up the healing process at the donor site using low-level laser therapy helps avoid these problems. Objectives: The purpose of this research was to examine the efficacy of low-level laser therapy in promoting donor site healing in burn patients who underwent skin graft surgery. Methods Forty patients of both genders (16 male, 24 female) aged 20–40 years suffered full-thickness burns with a total body surface area varying from 20 to 35% and had undergone split-thickness skin graft surgery were selected randomly and divided into two equal groups. The low-level laser therapy group (study group) attended three sessions per week for three weeks, while the placebo group (control group) received sham laser treatments. All patients received conventional medical treatment and traditional wound care (dressing). Photography and J Image software were used to measure wound surface area before the treatment (day 1 post-operative), day 11 post-operative, and day 21 post-operative in both groups. Results The study and control groups demonstrated a substantial reduction in wound surface area at day 11 and day 21 post-operative compared with day 1 ( p < 0.001), with the percentage of improvement of 88.69% and 98.73% and 50.18% and 80.22%, respectively. On day 21 compared to day 11 ( p < 0.001), the percentage of improvement was 88.81% and 60.30%, respectively. Between-group comparisons revealed a significant decrease in wound surface area at day 11 and day 21 post-operative in the study group compared to the control group ( p < 0.001). Conclusions Low-level laser therapy is an effective modality for enhancing wound healing of the donor site in burned patients undergoing skin graft surgery.

Skin wound healing involves many cell types in a stepwise process of tissue regeneration. Reepithelialization is an essential characteristic of successful healing. In tissue engineering, mimicking the complex process of injury repair in vitro is challenging and requires the development of advanced skin models. In this study, a simple and reproducible method for wounding three-layered skin models on membranes with different pore sizes (0.4, 1, 3 μm) was established. The model allows the investigation of reepithelialization processes in a more complex environment. Hemalaun-eosin (HE) and 3-[4,5-dimethylthiazole-2-yl]-2,5- diphenyltetrazolium bromide (MTT) staining proved sufficient removal of the epidermis directly after wounding. An increasing pore size of the culture membrane delayed the reepithelialization time. Transepithelial electrical resistance (TEER) measurements provided non-invasive monitoring of reepithelialization, showing increasing values 4 days after wounding for the skin models on 0.4 and 1 μm membranes but not for those on 3 μm membranes. Cytokine quantification of interleukin (IL)-6 and IL-8 complemented the TEER results with increasing levels directly after wounding for all skin models. This skin wounding model could be used to simulate different wounding scenarios and test wound matrix materials. Furthermore, it could be adapted by adding immune cells to resemble the in vivo setup more closely.

Introduction: Periapical lesions resulting from endodontic infections pose challenges due to their inflammatory nature and bone resorption effects. Surgical intervention becomes necessary when conventional treatments fail, aiming to achieve complete wound healing and tissue regeneration. Aim: To compare the efficacy of sticky bone, Platelet-rich Fibrin (PRF) membranes and Guided Tissue Regeneration (GTR) membranes in enhancing healing outcomes following periapical surgeries. Materials and Methods: This prospective, single-centre, randomised clinical trial was conducted in the Department of Conservative Dentistry and Endodontics, Dr. R. Ahmed Dental College and Hospital, Kolkata, West Bengal, India from July 2022 to December 2023 to evaluate the efficacy of sticky bone, PRF membranes and GTR membranes in enhancing healing outcomes following periapical surgeries. The study involved 30 patients with periapical lesions, who were randomly assigned to three groups: Group I (sticky bone alone), Group II (sticky bone+GTR membrane) and Group III (sticky bone+PRF membrane). The study received ethical clearance from the Institutional Ethics Committee. Outcome measures included periapical lesion size reduction and bone density increase, assessed via Cone Beam Computed Tomography (CBCT) over a 12-month follow-up period. Data analysis was performed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows (Version 27.0), employing paired t-tests and one-way Analysis of Variance (ANOVA) with post-hoc Tukey’s tests, with a significance level of 5%. Results: Significant reductions in periapical lesion size were observed in all groups: Group I (p=0.002), Group II (p=0.001) and Group III (p

Abstract Skin microbiota plays an essential role in the development and function of the cutaneous immune system, in the maintenance of the skin barrier through the release of antimicrobial peptides, and in the metabolism of some natural products. With the aim of characterizing changes in the cutaneous microbiota specifically associated with wound healing in the diabetic condition, we performed a 16 S rRNA gene Next Generation Sequencing of skin swabs taken within the ulcer bed of ten diabetic patients before (t0) and after 20 days of therapy (t20) with a fluorescein-based galenic treatment. Considering the twenty most representative genera, we found at t20 an increase of Corynebacterium, Peptostreptococcus, and Streptococcus, and a decrease of Enterococcus, Finegoldia, and Peptoniphilus genera. However, differences were not significant due to the high variability among samples and the small patient cohort. S. aureus was the most abundant species at t0 and was reduced by therapy in four patients. Comparing the microbiome in the ulcer bed and in the perilesional tissue of the same patient at t0, no major differences were observed. Taken together, our data indicate that in the absence of antibiotic-based therapy the healing process of diabetic ulcers is accompanied by changes in the microbiome composition.

Abstract Earthworm, Eudrilus eugeniae cannot survive and regenerate without clitellum segments. In regenerating worms, the clitellum’s epithelial and circular muscular layers are reduced to one-third, and longitudinal cell layers to half. In C2C12 cells, Clitellum Factors (CF − 5, 25 and 50%) and Regenerative Clitellum Factors (RCF − 5, 25, 50, 75%) ameliorate the cell viability up to 20–28% and 30–38% respectively than the control. In contrast, extracts from body segments negatively influence cell viability up to 80%. In a scratch-wound assay, 25% RCF and 5% CF achieved 99.86% and 81.54% wound closure in 24 h, respectively, compared to 40% in controls. RCF and CF also possess enhanced anti-microbial activity against gram + ve bacteria. Western Blotting reveals that Wnt3a, HoxD3 and VEGF were remarkably upregulated in RCF and CF treated samples and their upregulated stemness property is effectively regulated by p53, TCTP, H2AX, Cleaved Caspase-3 proteins. Immunofluorescence data clearly states that Wnt3a and Caspase-3 signals are more profoundly observed in nuclear over cytoplasm in RCF treated samples and H2AX shows less nuclear signals than CF. In in-vivo earthworm model conditions, RCF remarkably promotes the survivability and wound healing ability by promoting the Wnt3a and VEGF expression together with downregulation of Cox2.