Approaches to cutaneous wound healing: basics and future directions

Abstract

The skin provides essential functions, such as thermoregulation, hydration, excretion and synthesis of vitamin D. Major disruptions of the skin cause impairment of critical functions, resulting in high morbidity and death, or leave one with life-changing cosmetic damage. Due to the complexity of the skin, diverse approaches are needed, including both traditional and advanced, to improve cutaneous wound healing. Cutaneous wounds undergo four phases of healing. Traditional management, including skin grafts and wound dressings, is still commonly used in current practice but in combination with newer technology, such as using engineered skin substitutes in skin grafts or combining traditional cotton gauze with anti-bacterial nanoparticles. Various upcoming methods, such as vacuum-assisted wound closure, engineered skin substitutes, stem cell therapy, growth factors and cytokine therapy, have emerged in recent years and are being used to assist wound healing, or even to replace traditional methods. However, many of these methods still lack assessment by large-scale studies and/or extensive application. Conceptual changes, for example, precision medicine and the rapid advancement of science and technology, such as RNA interference and 3D printing, offer tremendous potential. In this review, we focus on the basics of wound treatment and summarize recent developments involving both traditional and hi-tech therapeutic methods that lead to both rapid healing and better cosmetic results. Future studies should explore a more cost-effective, convenient and efficient approach to cutaneous wound healing. Graphical abstract Combination of various materials to create advanced wound dressings.

Progress in developing decellularized bioscaffolds for enhancing skin construction

“…90 In addition, SIS scaffolds contain TGF-β, basic FGF, VEGF, and EGF, can promote angiogenesis, cell growth, and differentiation, thus promoting tissue regeneration. 92 Similar to Meso BioMatrix, OaSIS has been demonstrated to promote cell proliferation, cell migration, and cell infiltration in vitro. This material is processed by decellularization and retains multiple components found in human normal dermis, including collagens (types I, III, IV, and VI), elastin, heparin, hyaluronic acid, chondroitin, laminin, and decorin.…”

“…This material is processed by decellularization and retains multiple components found in human normal dermis, including collagens (types I, III, IV, and VI), elastin, heparin, hyaluronic acid, chondroitin, laminin, and decorin. 92 Similar to Meso BioMatrix, OaSIS has been demonstrated to promote cell proliferation, cell migration, and cell infiltration in vitro. 76 OaSIS is indicated for the management of wounds, 76,93 including diabetic ulcers, venous ulcers, pressure ulcers, vascular ulcers, trauma wounds, and partial-and full-thickness wounds.…”

Lasertherapy as A Strategy for Treatment Healing under Caloric Restriction – Study in Rats

“…Wound healing involves celular events, cytokines and growth factors production on wound, aiming the complete reepithelialization. In inflammatory phase, mediators promote chemotaxis, mainly of neutrophils and macrophages, which are involved in tissue debridement and development of oxidative stress [1]. This is characterized by imbalance between oxidants and antioxidants, due to the excessive production of ROS (reactive oxygen) and RNS (nitrogen) species and the reduced neutralization of these by the antioxidants.…”

Efeito in vitro da celulose oxidada regenerada, colágeno e prata na função dos fibroblastos oriundos de úlcera venosa

“…A úlcera de etiologia venosa ou simplesmente "úlcera venosa" causa ao paciente dor e alterações funcionais que afetam suas atividades diárias, gerando impacto socioeconômico significativo. Estima-se que nos Estados Unidos sejam gastos mais que 2.5 bilhões de dólares por ano para o tratamento de pacientes com úlcera venosa [27][28][29][30] . Clinicamente essa insuficiência venosa se caracteriza por presença de dilatação venosa, veias reticulares, veias varicosas, edema, eczema, lipodermoesclerose, atrofia branca, telangiectasia, alteração da pigmentação do membro, dor e ulceração venosa 32,33,34 .…”

“…Nessa fase proliferativa fibroblastos são predominantes e estimulados a proliferar pela ação de fatores de crescimento do tampão homeostático (principalmente TGF-β e PGGF -fator de crescimento derivado de plaqueta), migrando pela ferida 44,30 . Fibroblastos agora localizados no leito da ferida, estimulados pela secreção dos macrófagos de TGF-β1, se diferenciam em miofibroblastos (célula que possui grandes feixes de actina contendo microfilamentos dispostos ao longo do citoplasma), e começam a produzir colágeno, essa concentração de TGF-β chega ao pico em uma ferida normal por volta do 7 -14 dias 41,46 .…”