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Frequency of clinical cases of dogs with massive skin losses is very high in urban areas of Pakistan following road accidents, sharp objects exposure and attack by other dog. These cases need intensive veterinary assistance for safe and speedy healing of wounds. Recently, skin of Nile tilapia fish (Oreochromis niloticus) is internationally gaining hype in medical field as biological dressing to boost dermatological reconstruction process. Nile tilapia skin is a recent research trend and a very limited research data is available on this topic for both human and animal subjects. This study was conducted at Department of Small Animal Clinical Sciences, University of Veterinary and Animal Sciences (UVAS), Lahore, Pakistan considering the wound healing promoter properties of Nile tilapia skin as a biological dressing for dogs with massive skin losses. Aim of this study was to evaluate Nile tilapia fish skin as wound healing promoter biological dressing following sutured and non-sutured application techniques. For this study 10 clinical cases of dogs were randomly selected as per set criteria and divided into groups A and B comprising 5 dogs each. Consent document was signed by each dog owner for volunteer participation in this study. Nile tilapia skin was collected from fresh subjects and treated with 10% povidone-iodine for 10-15 minutes to prepare biological dressing. In group A, biological dressing was sutured on wound (non-absorbable silk suture material) on the area with dermal loss. In group B, biological dressing was applied in a wrap manner on area of dermal loss without application of sutures. Wound healing was evaluated grossly and histologically on days 0, 7 and 14. Statistical analysis of comparison between groups A and B revealed that application of Nile tilapia skin derived biological dressing in wrap fashion results in fast and complication-free wound healing as compared to sutured tilapia biological dressing in dogs. [ABSTRACT FROM AUTHOR]

The orderly regulation of immune inflammation and promotion of the regeneration of skin vessels and fibers are key to the treatment of diabetic skin injury (DSI). Although various traditional polypeptide biological dressings continue to be developed, their efficacy is not satisfactory. In recent years, plant-to-mammal regulation has provided an effective approach for chronic wound management, but the development of effective plant-based treatments remains challenging. The development of exosomes from Chinese herbs is promising for wound healing. In this study, plant exosomes derived from lemons (Citrus limon) were extracted, and their biological efficacy was verified. Lemon exosomes regulated the polarization reprogramming of macrophages, promoted the proliferation and migration of vascular endothelial cells and fibroblasts, and thus promoted the healing of diabetic wounds. To solve the problems of continuous drug delivery and penetration depth, Lemon Exosomes were loaded into a hydrogel constructed of Gelatin Methacryloyl (GelMA) and Dialdehyde Starch (DAS) that closely fits to the skin, absorbs water, swells, and is moist and breathable, effectively promoting the sustained and slow release of exosomes and resulting in excellent performance for diabetic wound healing. Our GelMA-DAS-Lemon Exosomes hydrogel (GelMA/DAS/Exo hydrogel) patch represents a potentially valuable option for repairing diabetic wounds in clinical applications. [ABSTRACT FROM AUTHOR]

Aligned electrospinning membranes (Align) have demonstrated the potential to enhance wound healing by establishing a regenerative microenvironment surrounding the wound; However, the precise mechanism underlying its facilitation of healing remains unclear. To elucidate aligned electrospun fiber membrane's role in accelerating wound healing and improving its quality, we conducted a comprehensive analysis. Firstly, in vivo experiments confirmed that Align promotes wound healing. Through combined bulk RNA sequencing and single-cell RNA sequencing, we identified that MMP12+ macrophages exhibit high expression of MMP12 during the early stage of wound remodeling, thereby inhibiting fibroblast migration and reducing scar formation after wound closure. Finally, both in vitro and in vivo experiments further validated the role of MMP12 in promoting wound healing and suppressing fibroblast migration. Our findings reveal that Align effectively enhances skin wound healing by upregulating MMP12 expression while inhibiting fibroblast migration. These insights provide valuable knowledge on how Align promotes efficient scar-free wound healing and serve as a theoretical foundation for developing more effective biological dressings. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the therapeutic efficacy of minimally invasive dermabrasion for deep second-degree facial burn wounds during the early postburn phase. Methods: A total of 35 patients with deep second-degree facial burns underwent minimally invasive debridement using a hydrosurgery system within 2–4 days post-injury. Subsequently, the wounds were covered with human biological dressings. The wound infection rate, healing time, and overall healing quality following debridement were monitored. Result: In this cohort of 35 patients, no infections were reported after debridement. The average healing time for these wounds was significantly shorter than that of those treated with standard surgical excision. Clinical observations indicated that minimally invasive dermabrasion was associated with a lower infection rate and reduced healing time. After 6 months, scar assessment using the Vancouver Scar Scale showed that the average score for wounds treated with minimally invasive techniques was lower than those treated with standard surgical excisional technique. Conclusions: This research indicates that minimally invasive debridement during the early postburn stage can effectively reduce wound infection rates, shorten healing times, and minimize the occurrence of scar hyperplasia and contracture deformities. Therefore, minimally invasive dermabrasion is valuable in treating deep second-degree facial burn wounds. [ABSTRACT FROM AUTHOR]

Introduction: Radiation dermatitis (RD) is a frequent toxicity during radiotherapy (RT) for head and neck cancer (HNC). We report the first use of KeraStat® Cream (KC), a topical, keratin-based wound dressing, in patients with HNC receiving RT. Methods: This pilot study randomized HNC patients treated with definitive or postoperative RT (≥60 Gy) to KC or standard of care (SOC), applied at least twice daily during and for 1-month after RT. Outcomes of interest included adherence to the assigned regimen (at least 10 applications per week of treatment), clinician- and patient-reported RD, and skin-related quality of life. Results: 24 patients were randomized and completed the study. Most patients had stage III-IV disease and oropharynx cancer. Median RT dose was 68 Gy; the bilateral neck was treated in 19 patients, and 18 patients received concurrent chemotherapy. Complete adherence was observed in 7/12 (SOC) vs. 10/12 (KC, p = 0.65).  Adherence by patient-week was 61/68 versus 64/67, respectively (p = 0.20). No differences in RD were observed between groups. Conclusion: A randomized trial of KC versus SOC in HNC patients treated with RT is feasible with good adherence to study agent. An adequately powered randomized study is warranted to test the efficacy of KC in reducing RD. [ABSTRACT FROM AUTHOR]

BACKGROUND: Hydrogels have become a research hotspot due to their unique advantages in the biomedical field due to their superior mechanical and biological properties. At present, related research involves tissue engineering, wound dressing and so on. OBJECTIVE: To review the advantages and properties of hydrogels and the research progress of their application in the repair of oral and maxillofacial defects, discuss the current limitations and challenges of hydrogels in application and promotion, and provide new ideas for future research directions. METHODS: Relevant literature was searched in PubMed, CNKI, and WanFang database by computer. The search terms were "hydrogel, oral and maxillofacial defects, mechanical properties, tissue engineering, wound dressing" in Chinese and "hydrogel, oral and maxillofacial defects, mechanical properties, guided tissue regeneration, wound dressing" in English. Preliminary screening was carried out by reading titles and abstracts, and articles not related to the topic of the article were excluded. According to the inclusion and exclusion criteria, 108 articles were finally included for the result analysis. RESULTS AND CONCLUSION: (1) The hydrogel has good biological activity, mechanical controllability, and stimulation response. (2) Polymer, metal, and ceramic hydrogel composites have appropriate mechanical properties, biodegradability, and controlled release rate, which are suitable for maxillofacial bone tissue engineering. (3) Fibrin-based hydrogel could fill the hollow nerve conduit through the nerve defect area and promote the regeneration and growth of axons to restore the function of maxillofacial nerve. (4) Controlling the interaction between nanomaterials and hydrogels can improve the formation of muscle fiber oriented structure to promote maxillofacial muscle tissue regeneration. (5) Polysaccharide hydrogel has gradually become the first choice for repairing irregular periodontal defects due to its ability to control drug delivery, carry bioactive molecules, and combine with other materials to produce the best scaffold matching the extracellular matrix. (6) Calcium phosphate or calcium carbonate-based hydrogels can be used to fill irregular or fine tissue defects and remineralize hard tissues. The self-assembled hydrogels are simple to prepare and have good biological activity. (7) Salivary gland-derived extracellular matrix-like gel is expected to participate in the treatment of many salivary gland diseases. (8) Hydrogels can be used as wound dressings in combination with biological adhesives, acellular biomaterials, antimicrobials, antioxidants, or stem cells to treat various wounds. (9) Fibrin-based hydrogel has the most potential in the repair of oral and maxillofacial defects. It has excellent biocompatibility, flexibility, and plasticity. It can combine with cells, extracellular matrix proteins, and various growth factors, and promote the osteogenic differentiation of mesenchymal stem cells, axon regeneration and growth, angiogenesis, myotube differentiation, salivary gland tissue regeneration, and periodontal tissue regeneration. It has a broad prospect in the repair of oral and maxillofacial defects. However, its therapeutic effect depends on the function of the substance carried. The complex preparation process, its safety and long-term efficacy, and the special anatomical oral and maxillofacial structure is the problem that hinders its promotion, which also provides directions for future research. [ABSTRACT FROM AUTHOR]

Background: Despite advances made in combustiology, the method and timing of wound closure remain a matter of debate. There are 2 decisive factors in engraftment of a full-thickness skin graft: infection degree and level of wound bed vascularization. Reasons for unsuccessful engraftment are insufficient hemostasis, late surgery, and exposed subcutaneous fat. Full-thickness skin grafting for wounds of various origins optimizes improvement of long-term cosmetic and functional results of surgery.Objective: To improve treatment results in patients with wounds of various etiologies by improving methods of full-thickness skin autografting.Materials and methods: This study was conducted in the Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1 (Krasnodar, Russian Federation) and analyzed data from 64 patients (age, 18-65 years) who underwent full-thickness skin autografting. The patients were grouped based on the surgery type.In group 1 (23 patients with acute burn injury), granulation tissue was excised, and the wound defect was closed using a full-thickness skin autograft. In group 2 (21 patients with scar deformities of the skin), scar tissue was excised, and full-thickness skin autografting was performed. Group 3 (20 patients with traumatic skin detachment without bone injury) underwent skin grafting by the Krasovitov method.Results: Time to engraftment in group 1 was median 10.0 (7.5; 15.0) days; in group 2, 15.0 (13.0; 18.0) days, and in group 3, 28 (14.8; 44.3) days. We found statistically significant differences when comparing the groups using the Kruskal-Wallis test (P < .0001).Conclusions: New developed methods for full-thickness skin autografting in patients with granulation tissue and scar deformities can significantly increase the treatment effectiveness.

For porous dressing production through 3D printing, it is challenging to adjust the printability of ink while balancing its bioactivity. The present study introduces an example of a modular construction method for heterogeneous granular ink. Gelatin microspheres (gelatin‐MSs) are assembled by poly (gallic acid)‐coated zinc‐containing nano‐hydroxyapatite (ZnHA‐NP/p(GA)), and further cooperate with Ag+ to form a kind of granular inks. The three modules including gelatin‐MS, ZnHA‐NP/p(GA), and Ag have their own functions: The viscoelastic gelatin‐MS module is the essential component that realizes ink extrusion. The ZnHA‐NP/p(GA) module not only forms reversible interactions with gelatin‐MS that realize the assembly but also takes the responsibility of reactive oxygen species‐scavenging and anti‐inflammatory. The Ag module not only interacts with ZnHA‐NP/p(GA) module to promote the stability but also exhibits strong antibacterial property. The gelatin‐MS size, p(GA)‐coating duration, ZnHA‐NP/p(GA) content, and Ag content are optimized to yield a nano‐micro granular ink for bioactive porous dressing preparation that is used to significantly promote the healing of refractory wounds. Therefore, this method allows particles with different structures and bio‐functions that serve as modules to assemble into inks, realizing the balance of printability and biological functions for dressing manufacturing. [ABSTRACT FROM AUTHOR]

Tracheal stenosis (i.e., the abnormal narrowing of the trachea) can occur due to a variety of inflammatory and infectious processes as well as due to therapeutic procedures undertaken by the patient. The most common cause of tracheal obstruction in patients has been prolonged intubation. Depending on the extent of the stenosis and its exact location, the surgical insertion of a tracheal stent is the only option for addressing this issue. The Montgomery T-tube implant is a valuable tracheal stent made from medical-grade silicone that provides a functional airway while supporting the tracheal mucosa. However, its performance is subject to gradual deterioration due to biofilm colonization of the stent's inner wall, which may explain the discomfort claimed by many patients and clinical failures. Recently, cold atmospheric plasmas (CAPs) have emerged as an alternative technology to many conventional medical procedures, such as wound healing, skin treatment, decontamination of medical devices, etc. Here, we report on plasma-induced surface modification of the inner wall of a T-tube implant, considering future biomedical applications. To generate the plasma, we employed a cold atmospheric pressure plasma jet in gas helium, which was directly inserted into the T-tube implant. To assess the treatment uniformity, the degree of surface modification and its extension along the stent's inner wall was analyzed using different process parameters. [ABSTRACT FROM AUTHOR]

With the continuous progress of biomedical technology, biomaterial coatings play an important role in improving the performance of medical devices and promoting tissue repair and regeneration. The application of natural medicine to biological materials has become a hot topic due to its diverse biological activity, low toxicity, and wide range of sources. This article introduces the definition and classification of natural medicines, lists some common natural medicines, such as curcumin, allicin, chitosan, tea polyphenols, etc., and lists some biological activities of some common natural medicines, such as antibacterial, antioxidant, antitumor, and other properties. According to the different characteristics of natural medicines, physical adsorption, chemical grafting, layer-by-layer self-assembly, sol–gel and other methods are combined with biomaterials, which can be used for orthopedic implants, cardiovascular and cerebrovascular stents, wound dressings, drug delivery systems, etc., to exert their biological activity. For example, improving antibacterial properties, promoting tissue regeneration, and improving biocompatibility promote the development of medical health. Although the development of biomaterials has been greatly expanded, it still faces some major challenges, such as whether the combination between the coating and the substrate is firm, whether the drug load is released sustainably, whether the dynamic balance will be disrupted, and so on; a series of problems affects the application of natural drugs in biomaterial coatings. In view of these problems, this paper summarizes some suggestions by evaluating the literature, such as optimizing the binding method and release system; carrying out more clinical application research; carrying out multidisciplinary cooperation; broadening the application of natural medicine in biomaterial coatings; and developing safer, more effective and multi-functional natural medicine coatings through continuous research and innovation, so as to contribute to the development of the biomedical field. [ABSTRACT FROM AUTHOR]

Protein-based wound dressings have garnered increasing interest in recent years owing to their distinct physical, chemical, and biological characteristics. The intricate molecular composition of proteins gives rise to unique characteristics, such as exceptional biocompatibility, biodegradability, and responsiveness, which contribute to the promotion of wound healing. Wound healing is an intricate and ongoing process influenced by multiple causes, and it consists of four distinct phases. Various treatments have been developed to repair different types of skin wounds, thanks to advancements in medical technology and the recognition of the diverse nature of wounds. This review has literature reviewed within the last 3–5 years—the recent progress and development of protein in wound dressings and the fundamental properties of an ideal wound dressing. Herein, the recent strides in protein-based state-of-the-art wound dressing emphasize the significant challenges and summarize future perspectives for wound healing applications. The graphical abstract illustrates different factors for protein-based dressing, wound healing phases, various responsive factors, and fundamental properties for an ideal wound dressing for wound healing applications. [ABSTRACT FROM AUTHOR]

Background: Burn wounds require optimal medical management due to associated psycho-emotional and socioeconomic impacts and severe pain. The use of synthetic and biological dressings improves healing and reduces burn wound complications. The present study aimed to compare the outcomes of using human amniotic membrane (hAM) dressings and conventional silver sulfadiazine (SSDZ) ointment dressings in the management of second-degree burn wounds. Methods: Fifty patients who participated in this clinical trial were divided into two groups via simple randomization. All the enrolled patients, who had burnt in the last 24 h, had thermal damage mechanisms and were suffering from less than 20% second-degree heat-burn wounds on the skin surface. The target group (n = 25) was treated with hAM, and the control group (n = 25) was treated with SSDZ ointment. The researcher-designed checklist was used to determine the clinical performance in the follow-up assessments on days 7, 14, and 30. Results: No significant differences were detected in terms of sex, age, or percentage of burn wounds (p > 0.05). Wound epithelialization at days 7, 14, and 30, scar formation, wound pigmentation, pain severity, analgesia requirements, and hospital stay length (on day 30) were significantly lower in the target group (treated with hAM) than in the control group (treated with SSDZ ointment) (p < 0.05). However, treatment costs in the target group ($170) were significantly higher than those in the control group ($71) (p < 0.001). Conclusion: Despite its higher cost, hAM, as a technology-based therapy dressing, demonstrates superiority over SSDZ ointment in terms of wound healing and pain management. [ABSTRACT FROM AUTHOR]

Introduction: This study compared the benefits of amnion dressing (biological dressing) + silver sulfadiazine cream with standard silver sulfadiazine cream dressings in treating deep second- and third-degree acute burn wounds. Methods: This prospective clinical trial was conducted on 50 patients with deep second- and third-degree burns who were admitted to Taleghani Hospital in Ahvaz, Iran. Participants were divided into two groups: the first one comprised subjects who received silver-amnion biological dressing (silver sulfadiazine 1%) and the second group consisted of patients treated with standard silver sulfadiazine cream dressings. Results: In the amnion-silver group, the average time required for graft readiness was eight days, compared to 11 days in the standard dressing group, which indicated a 27% reduction in recovery time. The treatment costs in the amnion-silver group were 20.8 Euro compared to 26.3 Euro for the standard dressing group, reflecting a 21% cost reduction. Narcotic consumption in the amnion-silver group was zero, but the average narcotic use in the standard dressing group was 50 mg of pethidine, revealing a 100% reduction. Based on the visual analog scale (VAS), the mean pain intensity was 4 in the amnion-silver group and 5.5 in the standard dressing group. Patient satisfaction was 85% in the amnion-silver group versus 60% in the standard dressing group. No infections were reported in the amnion-silver group, while three cases were observed in the standard dressing group. Conclusion: The results of the present study indicate that amnion-silver dressing can be an effective and economical treatment option for wound healing. In the amnion-silver group versus standard group, a considerable reduction in recovery time was observed, which was also reflecting a cost reduction. Furthermore, the mean pain intensity was lower in the amnion-silver group than the standard dressing group. Patient satisfaction was higher in the amnion-silver group. [ABSTRACT FROM AUTHOR]

Bone grafting in oral and maxillofacial surgery has evolved significantly due to developments in materials science, offering innovative alternatives for the repair of bone defects. A few grafts are currently used in clinical settings, including autografts, xenografts, and allografts. However, despite their benefits, they have some challenges, such as limited availability, the possibility of disease transmission, and lack of personalization for the defect. Synthetic bone grafts have gained attention since they have the potential to overcome these limitations. Moreover, new technologies like nanotechnology, 3D printing, and 3D bioprinting have allowed the incorporation of molecules or substances within grafts to aid in bone repair. The addition of different moieties, such as growth factors, stem cells, and nanomaterials, has been reported to help mimic the natural bone healing process more closely, promoting faster and more complete regeneration. In this regard, this review explores the currently available bone grafts, the possibility of incorporating substances and molecules into their composition to accelerate and improve bone regeneration, and advanced graft manufacturing techniques. Furthermore, the presented current clinical applications and success stories for novel bone grafts emphasize the future potential of synthetic grafts and biomaterial innovations in improving patient outcomes in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

This article discusses the use of 3D biomodelling and surgical guides for the treatment of small subungual glomus tumors. A custom-made surgical guide was created using 3D technologies and MRI imaging to enhance preoperative planning and surgical precision. The use of 3D technologies, such as biomodelling and 3D printing, allowed for the accurate excision of the tumor with minimal disruption to the nail apparatus, reducing the risk of recurrence and post-surgical complications. The article also highlights the potential of 3D technologies in improving early detection, surgical management, and preoperative diagnosis of subungual glomus tumors. [Extracted from the article]

Background: Early necrosectomy with immediate or delayed skin grafting is the gold standard in treatment of burn injuries. Despite all advances in active surgical treatment of burn patients, the optimal time of necrosectomy as well as methods and timing of skin grafting remain the subject of debate among burn surgeons. Reliability and practicality of methods to determine the viability of affected skin tissues act as a limiting factor to advances in surgical strategies for early treatment of burn injuries.Objective: To improve methods of early surgical treatment of patients with deep burns using biological dressings.Materials and methods: Our study analyzed treatment outcomes of 34 patients (age, 18 to 60 years) diagnosed with third-degree burn wounds of different localizations involving 5%-20% of body surface area (according to ICD-10). Group 1 included 18 (53%) patients who underwent skin grafting right after surgical removal of necroses; biological dressings (Chitopran) were applied. Group 2 comprised 16 (47%) patients who also underwent early surgical treatment (autografting), but autografts were covered with synthetic dressings (Voskopran).Results: We found that in group 1 the average time to engraftment after skin grafting followed by Chitopran application was 5.0 (5.0-6.0) days. In group 2, the average time to engraftment after skin grafting followed by Voskopran application was 6.0 (6.0-6.3) days. The statistical data demonstrated that biological dressings had an advantage over synthetic ones in terms of time to engraftment.Conclusions: We can conclude that biological dressings have an advantage over synthetic ones in surgical treatment of partial thickness and deep burn wounds.

Hydrogels are widely used in biological dressing, tissue scaffolding, drug delivery, sensors, and other promising applications owing to their water‐rich soft structures, biocompatibility, and adjustable mechanical properties. However, most of the conventional hydrogels are isotropic. The anisotropic structures existed widely in the organizational structure of plants and animals, which played a crucial role in biological systems. In this work, a method of limited domain swelling to prepare anisotropic hydrogels is proposed. Through spatially controlled swelling, the extension direction of hydrogels can be limited by a tailored mold, further achieving anisotropic hydrogels with concentration gradients. The external solution serves as a swelling solution to promote swelling and extension of the hydrogel matrix in a mold which can control the extension direction. Due to the diversity of external solutions, the method can be applied to prepare a variety of stimulus‐responsive polymers. The limited domain swelling method is promising for the construction of anisotropic hydrogels with different structures and properties. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of cellular versus acellular amnion in patients with superficial facial burns at tertiary care hospital burn center of Punjab. Study Design: Randomized Control Trial. Setting: Department of Burn and Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center, Lahore. Period: 1st September 2020 to 31st December 2021. Methods: A total of 60 patients who fulfilled the inclusion criteria were recruited after the informed consent and were randomly divided into two groups with 30 patients in Group A and 30 patients in Group B. Group A patients had acellular amnion application and Group B had cellular amnion application over the superficial facial burns. The data was noted on a predesigned proforma and analyzed by using IBM-SPSS.Version.25 and was compared in terms of outcome measures. Results: The mean age in Group A and B was 37.7+9.86 and 38.1+9.37(range20-70 years) respectively and mean pain score was 8.5+0.937 in group A and 8.7+0.897 in group B. Hypersensitivity reaction was seen in 13.33% in group A vs 26.67% patients in Group B, infection rate of 8.33% in Group A vs 25% in Group B, Healing in 31.67% vs 18.33% in Group A and B respectively while in Group A the need for skin graft was noted in 8.33% vs 20% in group B patients and the difference was significant statistically (p=0.045). Conclusion: Application of Acellular amnion is better choice than Cellular amnion over facial burns with less hypersensitivity reaction, infection rate, need of skin graft and with improved wound healing. [ABSTRACT FROM AUTHOR]

Objective: This case series examines the use of a multimodal wound matrix (MWM) trialled in a selection of clinical practice settings and on a variety of hard-to-heal wounds. The objective was to evaluate the effects of MWM and its performance in managing such wounds, regardless of clinical setting and ulcer type. Method: Treatment of the MWM was conducted by independent wound care practitioners on wounds that were of >4 weeks duration. Treatment was once a week. Assessment was taken after four weeks and at week 12 of the study to assess percentage area reduction (PAR) compared to baseline measurements taken at the first treatment visit. Complete (100%) re-epithelialisation was also recorded. Results: A total of 63 wounds were treated with MWM, and ulcer types were grouped as: diabetic foot ulcers (n=21); venous leg ulcers (n=18); pressure injuries (n=10); and others (n=14). Of the wounds, 78% had 100% re-epithelialisation, with an average PAR of 57% at four weeks and 86% at 12 weeks. The average time to resolution for those wounds that closed was 7.9 weeks. Conclusion: Results from this series of independent case studies support the application of MWM to potentially benefit healing in hard-to-heal wounds of different aetiologies of any duration and in a variety of clinical settings. [ABSTRACT FROM AUTHOR]

Hydrofluoric acid (HF) is a strongly corrosive, highly toxic, and highly dangerous mineral acid. Burns with over 1% TBSA caused by anhydrous HF can lead to deep tissue damage, hypocalcemia, poisoning, and even death. In recent years, HF has become one of the most common substances causing chemical burns and ranks as the leading cause of death from chemical burns. Herein, we report a rare case with 91% TBSA burns caused by 35% HF. The patient developed complications such as shock, severe hypocalcemia, metabolic acidosis, and respiratory failure. Multidisciplinary team consultation (burns, respiratory medicine, nephrology, infectious disease, and pharmacy) was performed immediately after admission. An individualized diagnosis and treatment plan were developed for the patient. The patient was given intensive care, blood volume monitoring, tracheotomy, fluid resuscitation, continuous blood purification, anti-infective and analgesic treatments, intravenous and percutaneous calcium supplementation, early rehabilitation training, psychological rehabilitation, and other treatments. To prevent the wound from deepening, large-area debridement and skin grafting were performed early after the injury. A large dose of 10% calcium gluconate was injected into the patient in divided doses, and the wound was continuously treated with wet dressings. Multiple surgical debridements, negative pressure wound treatment, biological dressings, and Meek skin grafting were performed. After most of the wounds (approximately 85% TBSA) healed, the patient was discharged from the hospital and continued to undergo dressing changes at a local hospital. The patient was followed up 3 months after discharge. All the wounds healed well, and the patient basically regained functional independence in daily life. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the efficacy of autologous non-cultured non-trypsinized melanocytekeratinocyte grafting (JT) with suction blister membrane as biological dressing in stable vitiligo patches. Material and Methods: The study was conducted at Mathura Das Mathur Hospital (MDM), Jodhpur, on 43 patches of Stable vitiligo. It was a prospective single-arm interventional study. All patients were examined clinically and history and informed consent were taken before starting the procedure. Results: About 95% of patches showed >50% repigmentation with 83.72% having good to excellent repigmentation. About 88% of patches showed good color matches with an excellent decline in Dermatology Life Quality Index (DLQI). No serious complication was observed in the present study. The most common complication observed both in the donor and recipient area was pain. Conclusion: Our study indicates that combining JT with suction blister epidermal grafting is a comparatively effective technique in terms of good repigmentation (≥75% extent of repigmentation), color match, fewer side effects, good patient satisfaction, and DLQI reduction. [ABSTRACT FROM AUTHOR]

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Objective: Diabetic foot ulcers (DFUs) continue to challenge wound care practitioners. This prospective, multicentre, randomised controlled trial (RCT) evaluated the effectiveness of a dehydrated Amnion Chorion Membrane (dACM) (Organogenesis Inc., US) versus standard of care (SoC) alone in complex DFUs in a challenging patient population. Method: Subjects with a DFU extending into dermis, subcutaneous tissue, tendon, capsule, bone or joint were enrolled in a 12-week trial. They were allocated equally to two treatment groups: dACM (plus SoC); or SoC alone. The primary endpoint was frequency of wound closure determined by a Cox analysis that adjusted for duration and wound area. Kaplan–Meier analysis was used to determine median time to complete wound closure (CWC). Results: The cohort comprised 218 patients, and these were split equally between the two treatment groups with 109 patients in each. A Cox analysis showed that the estimated frequency of wound closure for the dACM plus SoC group was statistically superior to the SoC alone group at week 4 (12% versus 8%), week 6 (22% versus 11%), week 8 (31% versus 21%), week 10 (42% versus 27%) and week 12 (50% versus 35%), respectively (p=0.04). The computed hazard ratio (1.48 (confidence interval: 0.95, 2.29) showed a 48% greater probability of wound closure in favour of the dACM group. Median time to wound closure for dACM-treated ulcers was 84 days compared to 'not achieved' in the SoC-treated group (i.e., ≥50% of SoC-treated DFUs failed to heal by week 12; p=0.04). Conclusion: In an adequately powered DFU RCT, dACM increased the frequency, decreased the median time, and improved the probability of CWC when compared with SoC alone. dACM demonstrated beneficial effects in DFUs in a complex patient population. Declaration of interest: This study was funded by Organogenesis Inc., US. JC serves as a consultant and speaker for Organogenesis. RDD serves as a speaker for Organogenesis. OMA and MLS serve as consultants for Organogenesis. The authors have no other conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Long-term diabetes often leads to chronic wounds refractory to treatment. Cell-based therapies are actively investigated to enhance cutaneous healing. Various cell types are available to produce biological dressings, such as adipose-derived stem/stromal cells (ASCs), an attractive cell source considering their abundancy, accessibility, and therapeutic secretome. In this study, we produced human ASC-based dressings under a serum-free culture system using the self-assembly approach of tissue engineering. The dressings were applied every 4 days to full-thickness 8-mm splinted skin wounds created on the back of polygenic diabetic NONcNZO10/LtJ mice and streptozotocin-induced diabetic K14-H2B-GFP mice. Global wound closure kinetics evaluated macroscopically showed accelerated wound closure in both murine models, especially for NONcNZO10/LtJ; the treated group reaching 98.7% ± 2.3% global closure compared to 76.4% ± 11.8% for the untreated group on day 20 (p = 0.0002). Histological analyses revealed that treated wounds exhibited healed skin of better quality with a well-differentiated epidermis and a more organized, homogeneous, and 1.6-fold thicker granulation tissue. Neovascularization, assessed by CD31 labeling, was 2.5-fold higher for the NONcNZO10/LtJ treated wounds. We thus describe the beneficial impact on wound healing of biologically active ASC-based dressings produced under an entirely serum-free production system facilitating clinical translation. [ABSTRACT FROM AUTHOR]

Background: Aplasia cutis congenita (ACC) is a rare congenital skin defect characterized by a focal or extensive absence of the epidermis, dermis, and occasionally, subcutaneous tissue. When the wound caused by this defect is wide or deep, various treatments are used, including skin grafting. The amniotic membrane (AM) is a biological dressing that facilitates re‐epithelialization as it contains mesenchymal cells and numerous growth factors. Objective: To report the efficacy of AM dressings in treating the skin defects of ACC. Method: This study was conducted on five neonates diagnosed with ACC born between 2018 and 2022, referred to the Children's Medical Center in Tehran, Iran. AM dressings were applied on wounds larger than 1 cm2. The wounds were assessed weekly and, if required, an additional AM dressing was applied. Results: The skin defects gradually re‐epithelialized after application of the AM. The complete healing process took around 3.5 weeks on average. No hypertrophic scarring was observed. Conclusion: The application of AM dressing resulted in satisfactory cosmetic outcomes, with no hypertrophic scar formation. Complete healing occurred in all cases except one. The length of the hospital stay ranged from 2 to 6 weeks, depending on the size of the wound. [ABSTRACT FROM AUTHOR]

Burn wound regeneration is a complex process, which has many serious challenges such as slow wound healing, secondary infection, and inflammation. Therefore, it is essential to utilise appropriate biomaterials to accelerate and guide the wound healing process. Bacterial cellulose (BC), a natural polymer synthesised by some bacteria, has attracted much attention for wound healing applications due to its unique properties including excellent physicochemical and mechanical properties, simple purification process, three‐dimensional (3D) network structure similar to extracellular matrix, high purity, high water holding capacity and significant permeability to gas and liquid. BC's lack of antibacterial activity significantly limits its biomedical and tissue engineering application, but adding antimicrobial agents to it remarkably improves its performance in tissue regeneration applications. Burn wound healing is a complex long‐lasting process. Using biomaterials in wound treatment has shown that they can satisfactorily accelerate wound healing. The purpose of this review is to elaborate on the importance of BC‐based structures as one of the most widely used modern wound dressings in the treatment of burn wounds. In addition, the combination of various drugs, agents, cells and biomolecules with BC to expand its application in burn injury regeneration is discussed. Finally, the main challenges and future development direction of BC‐based structures for burn wound repair are considered. The four most popular search engines PubMed/MEDLINE, Science Direct, Scopus and Google Scholar were used to help us find relevant papers. The most frequently used keywords were bacterial cellulose, BC‐based biocomposite, wound healing, burn wound and vascular graft. [ABSTRACT FROM AUTHOR]

Plant seeds can harbour pathogens that limits crop growth and productivity. This study isolated, characterised and evaluated native Trichoderma harzianum for antagonism against five (Alternaria alternata, Aspergillus oryzae, Bipolaris oryzae, Curvularia lunata and Fusarium verticillioides) fungal pathogens isolated from rice seeds. Evaluation was through simultaneous inoculation, a pathogen against the biocontrol agent, using the dual culture method in a PDA growth medium. Results confirmed the T. harzianum isolate had 98.27% pairwise identity with T. harzianum P39 (KX381171.1. accession number). The isolate showed increasing percentage inhibition, against all the pathogens, with increasing days after inoculation. The highest values ranged from 53.02%, A. oryzae to 70.06%, F. verticillioides (the least and most susceptible respectively). The overall inhibition percentages of A. alterata and B. oryzae (12th day after inoculation) were not significantly different from that of F. verticillioides. Trichoderma harzianum P39 can be formulated as biological seed dressing agent. [ABSTRACT FROM AUTHOR]

Bacterial cellulose (BC) is a promising biomaterial that has been widely used for wound healing. However, the lack of antimicrobial properties limits its biological applications. Herein, a BC-based wound dressing with a biological antimicrobial agent was developed. The process involved in situ cultivation of BC by adding carboxymethyl cellulose (CMC), subsequently it was combined with cationic antibacterial agent ε-poly-L-lysine (PLL) through covalent bonding with CMC. The prepared hydrogel showed a nano-porous structure, proper mechanical properties (120 kPa) and desired swelling capacity (over 1000%). It also exhibited superior antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) bacteria. From in vitro biological experiments, BC/CMC/PLL presented good biocompatibility containing cell proliferation and cell spreading. The resulting BC/CMC/PLL will be one of the competitive wound dressings for preventing infection. [ABSTRACT FROM AUTHOR]

Restoring the physiological function of the damaged skin is crucial due to its undeniable protective role as well as its aesthetic aspects. Herein, a novel bilayer freeze-dried scaffold comprised of allograft collagen and glycosaminoglycan (Col-GAG; the biocompatible inner layer) adhered to silicone (mechanically reinforcing component) utilizing gelatin as the bio-glue was prepared to benefit from each origin (human-derived and synthetic) advantages. The structural characterizations of the scaffolds were analyzed by X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), tensile stress test, water uptake behavior, and Water Vapor Permeability (WVP). Also, the scaffolds' cytocompatibility was assessed by culturing human dermal fibroblasts (HDF) on the samples. Furthermore, the in vivo functionality was performed by implanting the scaffolds in male mice and observing the cellularization as well as neovascularization by Hematoxylin and Eosin (H&E) staining and CD31 marker. Based on the results, the potentially amorphous scaffolds were three-dimensional (3D) porous with randomly oriented interconnected pores suitable for cellular ingrowth. The application of the silicone layer resulted in resisting the extra osmotic pressure of water molecules by decreasing the water uptake ratio to 59.2 ± 0.33%, maintaining the WVP at an approximate rate of 0.1–10 mg/cm2hr, and boosting the tensile strength to 1.66 ± 0.12 MPa. The grafts provided an optimum environment for cell attachment and presented cellular viability upper than 70% after 72h. In vivo assessment exhibited improved perivascular localization, with the cell migration rate approximating 64%. The outcomes indicated that the achieved scaffold holds promise as an ideal wound dressing. [ABSTRACT FROM AUTHOR]

Despite the advantages of using deceased donor skin in the treatment of burns, it is not easy to obtain these grafts due to low tissue donation rates. In order to discover the social representations of family members of organ donors regarding skin donation and to analyze the convergences and divergences of these representations between family members who consented and those who refused to allow skin to be donated for transplantation, we conducted interviews with 20 family members of organ donors in a situation of brain death. Data were obtained through interviews and submitted to the Collective Subject Discourse Analysis Technique. This study shows that in the opinion of family members who consented and those who did not authorize skin donation, the consideration contains both positive and negative representations, which can have different weights and influence decision-making. This study also highlights, in an unprecedented way, the representation of the animalization of the donor, which can be a reason for the refusal to allow skin to be donated. • Positive and negative representations are found in skin donation and refusal. • Donating skin versus preserving the donor's body image may interfere with donation. • There is the idea of animalization in relation to the extraction of the skin. • The idea of animalization can be disrespectful, thus negatively affecting donation. [ABSTRACT FROM AUTHOR]

As the incidence of diabetic foot ulcers (DFU) increases, better treatments that improve healing should reduce complications of these ulcers including infections and amputations. We conducted a randomized controlled trial comparing outcomes between a novel purified reconstituted bilayer membrane (PRBM) to the standard of care (SOC) in the treatment of non‐healing DFUs. This study included 105 patients who were randomized to either of two treatment groups (n = 54 PRBM; n = 51 SOC) in the intent to treat (ITT) group and 80 who completed the study per protocol (PP) (n = 47 PRBM; n = 33 SOC). The primary endpoint was the percentage of wounds closed after 12 weeks. Secondary outcomes included percent area reduction, time to healing, quality of life, and cost to closure. The DFUs that had been treated with PRBM healed at a higher rate than those treated with SOC (ITT: 83% vs. 45%, p = 0.00004, PP: 92% vs. 67%, p = 0.005). Wounds treated with PRBM also healed significantly faster than those treated with SOC with a mean of 42 versus 62 days for SOC (p = 0.00074) and achieved a mean wound area reduction within 12 weeks of 94% versus 51% for SOC (p = 0.0023). There were no adverse events or serious adverse events that were related to either the PRBM or the SOC. In comparison to the SOC, DFUs healed faster when treated with PRBM. Thus, the use of this PRBM is an effective option for the treatment of chronic DFUs. [ABSTRACT FROM AUTHOR]

There are several classifications that describe the way materials function in the body. Devices that mimic a portion or function of the body in a safe, dependable, cost-effective, and physiologically appropriate way are made using biomaterials. Numerous tools and substances are now employed in the treatment of illness or injury, including everyday objects like tooth fillings, sutures, needles, catheters, plates, and so on. As time goes on, a synthetic substance that functions in close contact with live tissue or replaces a portion of a biological system might be summed up as a biomaterial. A biomaterial is described as "a systemically and pharmacologically inert substance designed for implantation within or incorporation with living things" by the Clemson University Advisory Board for Biomaterials. Materials, whether synthetic or natural, that may be utilized in any system that treats, enhances, or substitutes any organ, tissue, or bodily function for any length of time or on the other hand, a biological substance is one that is created by a biological system, like skin or an artery. [ABSTRACT FROM AUTHOR]

Eschar dermabrasion is an easy, cost‐effective and dependable technique for debriding deep partial‐thickness burn wounds, highly suitable for paediatric scalds. Postoperative dressing plays a crucial role in the subsequent healing process. While allogenic skin (AGS) has long been considered as the optimal coverage for abraded burn wounds by Chinese burn specialists, its clinical application on children has encountered challenges. In recent years, our department has observed promising results in the application of bacterial cellulose dressing on paediatric burn wounds after dermabrasion surgery. This study aimed to retrospectively review qualified cases from the past 5 years and categorize them into two groups: 201 cases in the AGS group and 116 cases in the bacterial cellulose dressing (BCD) group. Upon statistical analysis, no differences were oberved between the groups in terms of demographic information and wound characteristics. However, the BCD group had a significantly longer surgery time (44.3 ± 7.0 min vs. 31.5 ± 6.1 min, p < 0.01) and shorter healing time (19.6 ± 2.2 days vs. 24.4 ± 4.3 days, p < 0.01) compared to the AGS group. Moreover, the BCD group required fewer dressing changes (3.5 ± 0.8 vs. 6.7 ± 2.1, p < 0.01) and demonstrated lower rates of skin grafting (10/116 vs. 46/201, p = 0.036). In conclusion, our findings suggest that the bacterial cellulose material may serve as an optimal coverage option for paediatric abraded scald wounds. [ABSTRACT FROM AUTHOR]

Lyophilized human amniotic membrane (HAM) and silver nanoparticles (AgNPs) have multispectral applications as a biological dressing. The present study focuses on the safety aspects of HAM coated with colistin and AgNPs (HACoN) dressing in relation to its structural and hematological changes. Four dressing groups were designed for the study, HAM, HAM coated with colistin (HACo), HAM coated with AgNPs (HAN), and HAM coated with colistin (HACo) and HACoN. Scanning electron microscopy (SEM) and Fourier-transform infrared spectroscopy (FTIR) were utilized for constitutional analysis. Biological safety was checked by applying HAM of all groups on open excisional burn wounds on Sprague–Dawley rats for 21 days. The skin, kidneys, liver, and spleen were removed, and histological analysis was performed for detailed structural analysis. Oxidative stress was assessed using homogenate from newly generated skin. No structural or biochemical change was observed in any of the study groups as observed by SEM and FTIR. After 21 days of grafting, wounds were healed properly with normal skin, and no anomaly was observed in related to kidneys, spleen, and liver. Some of antioxidant enzymes were increased, while malondialdehyde which is a reactive oxygen species was reduced in the skin tissue homogenate of HACoN group. Impregnation of colistin and AgNPs in combination on HAM has no effects on hematological and structural constitution of HAM. It leaves no obvious change in vital organs of rats and improves oxidative stress and inflammation. Hence, it can be claimed that HACoN is a biologically safe antibacterial dressing. [ABSTRACT FROM AUTHOR]

The introduction of fish skin as a biological dressing for treating burns and wounds holds great promise, offering an alternative to existing management strategies. However, the risk of disease transmission is a significant concern. Therefore, this study aimed to examine how established sterilization and preservation procedures affected fish skin grafts' microbiological and histological properties for long-term usage. Lyophilization of the fish skin graft followed by rehydration in normal saline for 15 min did not change the collagen content. Furthermore, gamma irradiation of the lyophilized fish skin graft at different lengths 5, 10, and 25 KGy showed a significant reduction in microbial growth (aerobic bacteria, aerobic yeasts, and fungi) at 15- and 30 days after the irradiation. However, exposure to 10 KGy was found to be the most effective intensity among the different gamma irradiation lengths since it preserved the collagen fiber content and intensity in the lyophilized fish skin grafts at 15- and 30 days after the irradiation. These findings provide efficient preservation and sterilization methods for long-term usage of the fresh Tilapia skin grafts used for biological dressings. [ABSTRACT FROM AUTHOR]

Introduction: Flavonones show potential application in the treatment of skin disorders, whose performance may be improved by using lipid and polymeric nanocarriers. In this review, a recent approach regarding nanocarriers containing either naringin, naringenin, hesperidin or hesperitin for skin application are discussed. Method: This review approaches the publications from the last 6 years about nanosystems containing Citrus flavonones for cutaneous applications. The articles were selected by searching in Scopus database for nanosystem containing either hesperidin, hesperitin, naringin or naringenin for cutaneous application, research articles written in English and published between 2018 and 2023, and reporting about skin penetration or biological evaluation. Results: Majority of reports employed lipid systems as nanocarriers. Naringenin was the most used flavonone. In relation to skin benefits, improved wound healing, atopic dermatitis treatment and stress oxidative-related diseases are highlighted. Despite the probable benefits, the development of plant-based nanomedicines is complex, which imposes limitations on the development of new pharmaceutical products. Further, the potential of flavonoids in the treatment of skin cancer has been shown. Conclusions: Lipid, polymeric and nanohybrid carriers are employed to deliver flavanones. Due to their antioxidant and anti-inflammatory activities, flavanones bear potential applications in the treatment of different skin disorders. Therefore, there is a promising application of flavanones to the improvement of human health, mainly with their loading into nanocarriers. [ABSTRACT FROM AUTHOR]

Clinical treatment strategies for musculoskeletal disorders have been a hot research topic. Accumulating evidence suggests that hydrogels loaded with MSC-derived EVs show great potential in improving musculoskeletal injuries. The ideal hydrogels should be capable of promoting the development of new tissues and simulating the characteristics of target tissues, with the properties matching the cell-matrix constituents of autologous tissues. Although there have been numerous reports of hydrogels loaded with MSC-derived EVs for the repair of musculoskeletal injuries, such as intervertebral disc injury, tendinopathy, bone fractures, and cartilage injuries, there are still many hurdles to overcome before the clinical application of modified hydrogels. In this review, we focus on the advantages of the isolation technique of EVs in combination with different types of hydrogels. In this context, the efficacy of hydrogels loaded with MSC-derived EVs in different musculoskeletal injuries is discussed in detail to provide a reference for the future application of hydrogels loaded with MSC-derived EVs in the clinical treatment of musculoskeletal injuries. [ABSTRACT FROM AUTHOR]

Burns are a problem of interest in public health since they generate a high rate of morbidity and mortality worldwide, thermal burns are the most prevalent and can alter the anatomical, functional and aesthetic integrity of the skin, fundamental aspects for the patient’s self-esteem and their ability to reintegrate into society. At review literature about the treatment of these conditions, we find various treatments, including the use of human amniotic membrane, which has had a significant impact on burn management by functioning as a biological scaffold with regenerative and anti-inflammatory qualities. The present article aims to synthesize the current information that describes the applications of human amniotic membranes in burns. We carry out a systematic exploratory review of the literature from 2010 to 2021. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess health care needs, electronic health literacy, mobile phone usage, and intention to use it for self-management purposes by informal caregivers of children with burn injuries. Methods: This cross-sectional research was carried out in 2021 with 112 informal caregivers of children with burns in a burn center in the north of Iran. The data collection tools were questionnaires that included the participants' demographics, their E-Health Literacy, their current mobile phone usage, and their desires for mobile phone use for burn care services. Results: Most informal caregivers had smartphones (83.0%) and Internet access (81.3%). Most participants occasionally used phone calls (63.4%), the Internet (45.5%), and social media (42.9) to receive information about psychosocial disorders, infection control, wound care, pain, itch, physical exercise, and feeding. Most participants have never used some of the mobile phone functionalities to receive burn-related information, such as applications/Software (99.1%) and e-mail (99.1%). Nevertheless, most informal caregivers desire to use mobile applications for self-management purposes in the future (88.4%). The mean eHealth literacy score was 25.01 (SD = 9.61). Informal caregivers who had higher education levels, access to the Internet, and lived in urban areas had higher eHealth literacy (P < 001). Conclusion: The current research delivers beneficial information about the healthcare needs of informal caregivers and their preference to use mobile functionality to receive burns-related healthcare and rehabilitation information post-discharge. This information can help design and implement mobile health (mHealth) interventions to enhance the self-care skills of informal caregivers. [ABSTRACT FROM AUTHOR]

Ablative fractional resurfacing (AFR) can be utilized to improve scar appearance, texture, pain and associated contractures. Non-healing ulcers can also develop in areas of scarring and, in some cases, AFR can be utilized to heal these chronic wounds. We present a case of scarring with non-healing ulceration refractory to wound care, debridement and hydrotherapy successfully healed in four sessions with AFR using a 2940 nm Er:YAG laser. We review the literature on AFR for wound healing including potential mechanisms. AFR can be considered for non-healing ulcers in areas of scarring, once malignancy and infection are ruled out, and has the potential to provide relief for these suffering patients.J Drugs Dermatol. 2020;19(11): doi:10.36849/JDD.2020.5444.

Diabetic ulcers are the second largest complication caused by diabetes mellitus. A great number of factors, including hyperchromic inflammation, susceptible microbial infection, inferior vascularization, the large accumulation of free radicals, and other poor healing-promoting microenvironments hold back the healing process of chronic diabetic ulcer in clinics. With the increasing clinical cases of diabetic ulcers worldwide, the design and development of advanced wound dressings are urgently required to accelerate the treatment of skin wounds caused by diabetic complications. Electrospinning technology has been recognized as a simple, versatile, and cost-reasonable strategy to fabricate dressing materials composed of nanofibers, which possess excellent extracellular matrix (ECM)-mimicking morphology, structure, and biological functions. The electrospinning-based nanofibrous dressings have been widely demonstrated to promote the adhesion, migration, and proliferation of dermal fibroblasts, and further accelerate the wound healing process compared with some other dressing types like traditional cotton gauze and medical sponges, etc. Moreover, the electrospun nanofibers are commonly harvested in the structure of nonwoven-like mats, which possess small pore sizes but high porosity, resulting in great microbial barrier performance as well as excellent moisture and air permeable properties. They also serve as good carriers to load various bioactive agents and/or even living cells, which further impart the electrospinning-based dressings with predetermined biological functions and even multiple functions to significantly improve the healing outcomes of different chronic skin wounds while dramatically shortening the treatment procedure. All these outstanding characteristics have made electrospun nanofibrous dressings one of the most promising dressing candidates for the treatment of chronic diabetic ulcers. This review starts with a brief introduction to diabetic ulcer and the electrospinning process, and then provides a detailed introduction to recent advances in electrospinning-based strategies for the treatment of diabetic wounds. Importantly, the synergetic application of combining electrospinning with bioactive ingredients and/or cell therapy was highlighted. The review also discussed the advantages of hydrogel dressings by using electrospun nanofibers. At the end of the review, the challenge and prospects of electrospinning-based strategies for the treatment of diabetic wounds are discussed in depth. [ABSTRACT FROM AUTHOR]

Objective: Simulation training provides an important opportunity to accelerate surgical skills acquisition whilst safeguarding patients. This study compares the suitability of different synthetic skin substitutes for use in surgical simulation training. Design: Data was collected for eight commercially available synthetic skin substitutes and included cost, delivery time, subjective assessment of fidelity by surgeons and trainees, and objective comparison with the biomechanics of human skin was made through cutometry and durometry measurements. Cutometry and durometry data was collected from three healthy adults from the forearm, forehead and back, with measurements being repeated in triplicate. Subjective assessment of skin pad quality was collected using an 8-criteria questionnaire, graded using a 5-point Likert scale for fidelity to normal skin. Results: The questionnaire assessment was completed by 30 trainees and practitioners. Overall, felt pads received the poorest outcomes in all criteria; cutometry and durometry results demonstrate poor similarity to skin, and felt received the lowest scores in the questionnaire, although the cheapest. Foam dressings were similar in both cutometric and durometric properties to skin of the face, back and arm. Clinical outcomes of foam dressings were similar to the most expensive commercial skin pad. Conclusions: Bilaminar foam-based dressings provide a low cost, high fidelity non-biological simulation of skin for surgical training, which is non-inferior to more expensive specifically designed products. Many products designed to act as skin substitutes for surgical simulation fail to adequately replicate the anatomical and mechanical properties of skin. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy. Design: Systematic review and network meta‐analysis. Methods: Articles published from several electronic databases and other resources were selected. Two reviewers independently selected studies, extracted data and assessed the quality of selected studies. Results: Twenty‐five studies that contained data on moist dressings (hydrocolloidal dressing, foam dressing, silver ion dressing, biological wound dressing, hydrogel dressing, polymeric membrane dressing) and sterile gauze dressings (traditional gauze dressings) were included. All RCTs were at a medium to high risk of bias. Moist dressings were found to be more advantageous than the traditional dressings. Hydrocolloid dressings [RR = 1.38, 95% CI (1.18, 1.60)] showed a higher cure rate than sterile gauze dressing and foam dressings [RR = 1.37, 95% CI (1.16, 1.61)]. Silver ion dressings [RR = l.37, 95% CI (1.08, 1. 73)] showed a higher cure rate than sterile gauze dressings. Sterile gauze dressing dressings [RR = 0.51, 95% CI (0.44, 0.78)] showed a lower cure rate compared with polymeric membrane dressings; whereas Sterile gauze dressing dressings [RR = 0.80, 95% CI (0.47, 1.37)] had a lower cure rate compared to biological wound dressings. Foam and hydrocolloid dressings were associated with the least healing time. Few dressing changes were required for moist dressings. [ABSTRACT FROM AUTHOR]

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The numerous health benefits of pectins justify their inclusion in human diets and biomedical products. This review provides an overview of pectin extraction and modification methods, their physico-chemical characteristics, health-promoting properties, and pharmaceutical/biomedical applications. Pectins, as readily available and versatile biomolecules, can be tailored to possess specific functionalities for food, pharmaceutical and biomedical applications, through judicious selection of appropriate extraction and modification technologies/processes based on green chemistry principles. Pectin's structural and physicochemical characteristics dictate their effects on digestion and bioavailability of nutrients, as well as health-promoting properties including anticancer, immunomodulatory, anti-inflammatory, intestinal microflora-regulating, immune barrier-strengthening, hypercholesterolemia-/arteriosclerosis-preventing, anti-diabetic, anti-obesity, antitussive, analgesic, anticoagulant, and wound healing effects. HG, RG-i, RG-ii, molecular weight, side chain pattern, and degrees of methylation, acetylation, amidation and branching are critical structural elements responsible for optimizing these health benefits. The physicochemical characteristics, health functionalities, biocompatibility and biodegradability of pectins enable the construction of pectin-based composites with distinct properties for targeted applications in bioactive/drug delivery, edible films/coatings, nano-/micro-encapsulation, wound dressings and biological tissue engineering. Achieving beneficial synergies among the green extraction and modification processes during pectin production, and between pectin and other composite components in biomedical products, should be key foci for future research. [ABSTRACT FROM AUTHOR]

Introduction: Acute large traumatic wounds require temporary dressing prior to the definitive soft tissue reconstruction, as the physiological derangement during the immediate postinjury period delays the definitive surgical intervention. Selecting an ideal dressing material from numerous available synthetic dressings and skin substitutes poses a challenge. Although amniotic membrane (AM) scaffold has a definitive role in promoting wound healing in burns and chronic wounds, however, its efficacy in acute large traumatic wound is lacking. The present trial aimed to evaluate the safety and efficacy of AM in wound bed preparation before the definitive soft-tissue reconstruction in acute large traumatic wounds. Methods: Sixty patients with acute large traumatic wounds (>10 cm × 10 cm) were divided into two groups (conventional dressing and AM dressing) using simple mixed block randomization. Wounds were assessed using the Bates Jensen Score at various timelines for the signs of early wound healing. The primary outcome was to evaluate the time taken for the wound bed preparation for definitive soft-tissue reconstruction. The secondary outcome was the pain assessment and complications, if any. Results: There was significant reduction in the wound exudate as well as peripheral tissue edema in the intervention group (P = 0.01). AM dressing was significantly less painful (P = 0.01). The incidence of wound infection and need for debridement was decreased in the intervention group. However, the time interval to definitive soft-tissue coverage was statistically insignificant and comparable in both the groups. No adverse reactions were seen in either group. Conclusion: AM dressings are safe and efficacious with significant reduction in wound exudates and peripheral edema. However, these dressings do not hasten the wound maturation as compared to conventional dressings. AM dressings can be used as a less painful alternative to conventional dressing in the management of large acute posttraumatic wounds. [ABSTRACT FROM AUTHOR]

Background: Recently, biological dressings have become popular in treating burn injuries. Fish skin has non-infectious microbiota, high levels of type 1 and type 3 collagen, and a structural property similar to human skin, making it a promising xenograft for managing burn wounds. In this study, we aimed to evaluate the effectiveness of fish skin as a physiological dressing cover in patients with burn injuries. Method: From June 2017 to June 2021, 18 patients who were admitted to our center within 3 days from a thermal injury, burns with a partial thickness of approximately 20% of the total body surface area (TBSA) or complete partial-thickness burns ranging from 5% to 15% of the TBSA, and treated with the Shaour (Lethrinus lentjan) fish skin xenografts were enrolled in this retrospective study. The demographic characteristics of the participants, wound healing process, and final outcome were analyzed. Results: The mean age of the patients was 31.86 ± 9.14 years (range 19-46) which encompassed 12 (66.7%) men and 6 (33.3%) women. Superficial partial-thickness burns were seen in 13 (72.2%) patients, whereas full-thickness burns were seen in five (27.8%) patients. The mean time to 90% epithelialization and 100% epithelialization were 11.05 ± 2.57 days and 17.27 ± 2.05 days, respectively. The mean pain scores were 6.94 ± 0.72 and 5.22 ± 0.64 on days 7 and 15, respectively. Neither negative consequence nor allergic reaction was associated with using the fish skin grafts. The main reduction in the pain score from the first visit (7 days) to the second visit (15 days) was 1.72 ± 0.95 (p, 0.001). Conclusion: Acellular fish skin is a useful tool for wound healing treatment in complete and partial thickness burns. To validate this result, prospective cohort studies with long-term post-procedural follow-up are needed. [ABSTRACT FROM AUTHOR]

The primary objective of this review is to evaluate whether the degree of processing and the clinical utility of commercially available mineralized bone allografts for spine surgery meet the 2020 US Food and Drug Administration's (FDA) guideline definitions for minimal manipulation and homologous use, respectively. We also assessed the consistency of performance of these products by examining the comparative postoperative radiographic fusion rates following spine surgery. Based on the FDA's criteria for determining whether a structural allograft averts regulatory oversight and classification as a drug/device/biologic, mineralized bone allografts were judged to meet the Agency's definitional descriptions for minimal manipulation and homologous use when complying with the American Association of Tissue Banks' (AATB) accredited guidelines for bone allograft harvesting, processing, storing and transplanting. Thus, these products do not require FDA medical device clearance. Radiographic fusion rates achieved with mineralized bone allografts were uniformly high (>85%) across three published systematic reviews. Little variation was found in the fusion rates irrespective of anatomical location, allograft geometry, dimensions or indication, and in most cases, the rates were similar to those for autologous bone alone. Continued utilization of mineralized bone allografts should be encouraged across all spine surgery applications where supplemental grafts and/or segmental stability are required to support mechanically solid arthrodeses. [ABSTRACT FROM AUTHOR]