No abstract

Therapeutic, III.

No abstract

Thermal imaging detects infrared radiation from an object, producing a thermogram that can be interpreted as a surrogate marker for cutaneous blood flow. To date, high-resolution cameras typically cost tens of thousands of dollars. The FLIR ONE is a smartphone-compatible miniature thermal imaging camera that currently retails at under $200. In a proof-of-concept study, patients and healthy volunteers were assessed with thermal imaging for (1) detecting and mapping perforators, (2) defining perforasomes, and (3) monitoring free flaps. Preoperative, intraoperative, and postoperative thermograms can assist in the planning, execution, and monitoring of free flaps, and the FLIR ONE provides a low-cost adjunct that could be applied to other areas of burns and plastic surgery.

No abstract

No abstract

Diagnostic, II.

We recently developed a bioresponsive dextrin-recombinant human epidermal growth factor (rhEGF) conjugate as a polymer therapeutic with potential for use in the promotion of tissue repair. The aim of these studies was to use patient-derived wound fluid and fibroblasts to evaluate its potential for further development as a treatment for chronic wounds, such as venous leg ulceration, a growing clinical challenge in the aging population. First, the levels of EGF (ELISA assay), alpha-amylase and elastase (enzyme assays) were measured in patient-derived acute and chronic wound fluid. EGF was detected in acute, but not in chronic wound fluid. alpha-Amylase concentrations were higher in acute (188 IU/L), compared to chronic wound fluid (52 IU/L), but both were in the range of human serum levels. Although elastase was present in chronic wound fluid (2.1 +/- 1.2 RFU/min), none was detected in acute wound fluid. Dextrin-rhEGF incubation in chronic wound fluid led to endogenous alpha-amylase-mediated release of rhEGF (ELISA) that was maximal at 48 h. When the migration of HaCaT keratinocytes and of human fibroblasts (isolated from patient-matched, normal skin and chronic dermal wounds) was studied in vitro using the scratch wound assay, enhanced cell migration was observed in response to both free rhEGF and alpha-amylase-activated dextrin-rhEGF conjugate compared to controls. In addition, fibroblasts displayed increased proliferation (normal dermal fibroblasts approximately 160%; chronic wound fibroblasts approximately 140%) following incubation (72 h) with dextrin-rhEGF that had been exposed to physiological levels of alpha-amylase (93 IU/L). These results suggest further preclinical in vivo evaluation of dextrin-rhEGF is warranted to determine whether conjugate pharmacokinetics and rhEGF liberation into such a complex and aggressive environment can still lead to bioactivity.