Keloids are an overgrowth of fibrotic tissue outside the original boundaries of an injury and occur secondary to defective wound healing. Keloids often have a functional, aesthetic, or psychosocial impact on patients as highlighted by quality-of-life studies. Our goal is to provide clinicians and scientists an overview of the data available on laser and light-based therapies for treatment of keloids, and highlight emerging light-based therapeutic technologies and the evidence available to support their use. We employed the following search strategy to identify the clinical evidence reported in the biomedical literature: in November 2012, we searched PubMed.gov, Ovid MEDLINE, Embase, and Cochrane Reviews (1980-present) for published randomized clinical trials, clinical studies, case series, and case reports related to the treatment of keloids. The search terms we utilized were ‘keloid(s)’ AND ‘laser’ OR ‘light-emitting diode’ OR ‘photodynamic therapy’ OR ‘intense pulsed light’ OR ‘low level light’ OR ‘phototherapy.’ Our search yielded 347 unique articles. Of these, 33 articles met our inclusion and exclusion criteria. We qualitatively conclude that laser and light-based treatment modalities may achieve favorable patient outcomes. Clinical studies using CO2 laser are more prevalent in current literature and a combination regimen may be an adequate ablative approach. Adding light-based treatments, such as LED phototherapy or photodynamic therapy, to laser treatment regimens may enhance patient outcomes. Lasers and other light-based technology have introduced new ways to manage keloids that may result in improved aesthetic and symptomatic outcomes and decreased keloid recurrence.

Diabetic foot ulcers represent a significant source of morbidity in the U.S., with rapidly escalating costs to the health care system. Multiple pathophysiological disturbances converge to result in delayed epithelialization and persistent inflammation. Serotonin (5-hydroxytryptamine [5-HT]) and the selective serotonin reuptake inhibitor fluoxetine (FLX) have both been shown to have immunomodulatory effects. Here we extend their utility as a therapeutic alternative for nonhealing diabetic wounds by demonstrating their ability to interact with multiple pathways involved in wound healing. We show that topically applied FLX improves cutaneous wound healing in vivo. Mechanistically, we demonstrate that FLX not only increases keratinocyte migration but also shifts the local immune milieu toward a less inflammatory phenotype in vivo without altering behavior. By targeting the serotonin pathway in wound healing, we demonstrate the potential of repurposing FLX as a safe topical for the challenging clinical problem of diabetic wounds.

The prevalence of infection in chronic wounds is well documented in the literature but not optimally studied due to the drawbacks of current methodologies. Here, we describe a tractable and simplified ex vivo human skin model of infection that addresses the critical drawbacks of high costs and limited translatability. Wounds were generated from excised abdominal skin from cosmetic procedures and cultured, inoculated with Staphylococcus aureus strain UAMS‐1, or under aseptic conditions. After three days, the infected wounds exhibited biofilm formation and significantly impaired reepithelialization compared to the control. Additionally, promigratory and proreparative genes were significantly downregulated, while proinflammatory genes were significantly upregulated, demonstrating molecular characterizations of impaired healing as in chronic wounds. This model allows for a simplified and versatile tool for the study of wound infection and subsequent development of novel therapies.

Abstract. Understanding the mechanism of angiogenesis could help to decipher wound healing and embryonic development and to develop better treatment for diseases such as cancer. Microengineered devices were developed to reveal the mechanisms of angiogenesis, but monitoring the angiogenic process nondestructively in these devices is a challenge. In this study, we utilized a label-free imaging technique, ultrahigh-resolution optical coherence microscopy (OCM), to evaluate angiogenic sprouting in a microengineered device. The OCM system was capable of providing ∼1.5-μm axial resolution and ∼2.3-μm transverse resolution. Three-dimensional (3-D) distribution of the sprouting vessels in the microengineered device was imaged over 0.6 × 0.6 × 0.5 mm 3 , and details such as vessel lumens and branching points were clearly visualized. An algorithm based on stretching open active contours was developed for tracking and segmenting the sprouting vessels in 3-D-OCM images. The lengths for the first-, second-, and third-order vessels were measured as 127.8 AE 48.8 μm (n ¼ 8), 67.3 AE 25.9 μm (n ¼ 9), and 62.5 AE 34.7 μm (n ¼ 10), respectively. The outer diameters for the first-, second-, and thirdorder vessels were 13.2 AE 1.0, 8.0 AE 2.1, and 4.4 AE 0.8 μm, respectively. These results demonstrate OCM as a promising tool for nondestructive and label-free evaluation of angiogenic sprouting in microengineered devices.