Effects of limited access dressing in chronic wounds: A biochemical and histological study

Honnegowda, Thittamaranahalli Muguregowda; Kumar, Pramod; Udupa, E. G. Padmanabha; Sharan, Anurag; Singh, Rekha; Prasad, Hemanth K; Rao, Pragna

doi:10.4103/0970-0358.155263

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…Angiogenesis, growth of new blood vessels, supply essential nutrients and oxygen to the damaged tissues and play a crucial part in wound healing [ 29 , 30 ]. Macrophages positively regulate the transition to the proliferation phase of healing [ 31 , 32 ].…”

Section: Wound Healingmentioning

confidence: 99%

Epithelial-Mesenchymal Transition (EMT): The Type-2 EMT in Wound Healing, Tissue Regeneration and Organ Fibrosis

Marconi

Fonticoli

Rajan

et al. 2021

Cells

221

144

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The epithelial–mesenchymal transition (EMT) is an essential event during cell development, in which epithelial cells acquire mesenchymal fibroblast-like features including reduced intercellular adhesion and increased motility. EMT also plays a key role in wound healing processes, which are mediated by inflammatory cells and fibroblasts. These cells secrete specific factors that interact with molecules of the extracellular matrix (ECM) such as collagens, laminins, elastin and tenascins. Wound healing follows four distinct and successive phases characterized by haemostasis, inflammation, cell proliferation and finally tissue remodeling. EMT is classified into three diverse subtypes: type-1 EMT, type-2 EMT and type-3 EMT. Type-1 EMT is involved in embryogenesis and organ development. Type-2 EMT is associated with wound healing, tissue regeneration and organ fibrosis. During organ fibrosis, type-2 EMT occurs as a reparative-associated process in response to ongoing inflammation and eventually leads to organ destruction. Type-3 EMT is implicated in cancer progression, which is linked to the occurrence of genetic and epigenetic alterations, in detail the ones promoting clonal outgrowth and the formation of localized tumors. The current review aimed at exploring the role of EMT process with particular focus on type-2 EMT in wound healing, fibrosis and tissue regeneration, as well as some recent progresses in the EMT and tissue regeneration field, including the modulation of EMT by biomaterials.

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Section: Wound Healingmentioning

confidence: 99%

Epithelial-Mesenchymal Transition (EMT): The Type-2 EMT in Wound Healing, Tissue Regeneration and Organ Fibrosis

Marconi

Fonticoli

Rajan

et al. 2021

Cells

221

144

View full text Add to dashboard Cite

show abstract

“…Collagen is the major component of extracellular tissue which provides support and strength. It is measured by monitoring the concentration of hydroxyproline, that is, synthesized by fibroblasts [33] and is vulnerable to the effects of free radicals. In the present study, after 10 days of therapy, the mean level of hydroxyproline (± SD) was significantly higher in the LAD group as compared to that of the conventional dressing group (LAD vs. conventional = 55.2 ± 25.1 vs. 29.2 ± 13.5 µg/mg of dry weight of tissue, P = 0.000).…”

Section: Discussionmentioning

confidence: 99%

A comparative study to evaluate the effect of limited access dressing on diabetic ulcers

Honnegowda¹,

Kumar²,

Prabhu³

et al. 2015

Plast Aesthet Res

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Aim: Emerging evidence favors the important role of antioxidants, matrix metalloproteinases (MMPs), and nitric oxide (NO) in the healing of diabetic wounds. There is a lack of substantial evidence regarding the effects of negative pressure on antioxidants, MMPs and NO in chronic wounds associated with diabetes. Methods: A total of 55 type 2 diabetic patients with leg ulcers were divided into 2 groups: a limited access dressing (LAD) group (n = 27) and a conventional dressing group (n = 28). Levels of hydroxyproline, total protein, MMP-2 and MMP-9, NO and antioxidants including reduced glutathione (GSH) and the oxidative biomarker malondialdehyde (MDA) were measured in the granulation tissue at days 0 and 10. Changes in levels between the LAD and conventional groups were determined by the Student's t-test. Results: After 10 days of treatment, the LAD vs. conventional dressing group showed increase in the levels of hydroxyproline (mean ± standard deviation = 55.2 ± 25.1 vs. 29.2 ± 1, P < 0.05), total protein (12.8 ± 6.5 vs. 8.34 ± 3.2, P < 0.05), NO (1.13 ± 0.52 vs. 0.66 ± 0.43, P < 0.05), GSH (7.0 ± 2.4 vs. 6.6 ± 2.2, P < 0.05) and decrease in MMP-2 (0.47 ± 0.33 vs. 0.62 ± 0.30, P < 0.05), MMP-9 (0.32 ± 0.20 vs. 0.53 ± 0.39, P < 0.05) and MDA (6.8 ± 2.3 vs. 10.4 ± 3.4, P < 0.05). Conclusion: When compared to conventional dressings, LAD induces biochemical changes by significantly increasing the levels of hydroxyproline, total protein, NO and antioxidants levels, and significantly reducing MMPs (MMP-2 and MMP-9) and an oxidative biomarker in diabetic wounds. These biochemical changes are thought to favor diabetic wound healing.

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“…Ischemia induced anaerobic respiration leads to reduced ATP production, and reduced antioxidant protection [41] . Studies on LAD treated burn wounds [42,43] , diabetic wounds [44] and chronic wounds [45,46] have shown significant reduction in oxidative stress (malondialdehyde level), and significant increase in antioxidants and nitric oxide levels.…”

Section: Protection Of Ischemia Induced Oxidative Damage In Lad Treated Woundsmentioning

confidence: 99%

Secondary damage in trauma and limited access dressing: a review

Kumar¹,

Gupta²,

Gupta³

2020

Plast Aesthet Res

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Secondary damage in trauma may increase morbidity, mortality and the cost of treatment considerably. This article reviews the literature of 46 relevant articles on this topic. We hope to provide a better understanding of the various mechanisms that can lead to secondary damage following major trauma and aim to improve the management of such in trauma patients. We also explore the utility of limited access dressing and its ability to minimize and treat secondary musculoskeletal trauma. Four interdependent cellular mechanisms have been described that contribute and perpetuate secondary tissue damage -lysosomal, protein/enzyme denaturation, membrane permeability and mitochondrial. Systemic changes are mainly due to systemic hypoxia and the systemic inflammatory response syndrome. Limited access dressing appears to be an efficient and cost-effective method for the management of secondary damage, as evidenced by the reduced number of debridements, shorter wound coverage time, and reduction in total length of hospital stay while lowering treatment costs and improving quality of care.

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Effects of limited access dressing in chronic wounds: A biochemical and histological study

Cited by 10 publications

References 30 publications

Epithelial-Mesenchymal Transition (EMT): The Type-2 EMT in Wound Healing, Tissue Regeneration and Organ Fibrosis

Epithelial-Mesenchymal Transition (EMT): The Type-2 EMT in Wound Healing, Tissue Regeneration and Organ Fibrosis

A comparative study to evaluate the effect of limited access dressing on diabetic ulcers

Secondary damage in trauma and limited access dressing: a review

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