Optimal use of an occlusive dressing to enhance healing. Effect of delayed application and early removal on wound healing

Eaglstein, William H.

doi:10.1001/archderm.124.3.392

Cited by 50 publications

(47 citation statements)

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“…Occlusive dressings promote the early re-epithelialization of skin wounds (8)(9)(10)(11)(12)13). Varghese et al (15) demonstrated that the oxygen tension beneath occlusive dressings covering human skin wounds is very low, and yet these dressings promote re-epithelialization when used within the first 24 h after wounding (8)(9)(10)(11)(12)13).…”

Section: Discussionmentioning

confidence: 99%

“…Varghese et al (15) demonstrated that the oxygen tension beneath occlusive dressings covering human skin wounds is very low, and yet these dressings promote re-epithelialization when used within the first 24 h after wounding (8)(9)(10)(11)(12)13). Ambient oxygen tension at the surface of chronic wounds without occlusive dressings has been measured and found to be 18-21 mmHg ‫ف(‬ 3%) (4,54).…”

Section: Discussionmentioning

confidence: 99%

“…These dressings promote re-epithelialization and wound closure compared with wounds allowed to air-dry (8)(9)(10)(11)(12), but must be used early after wounding to induce rapid re-epithelialization in vivo (13). Wounds allowed to air-dry have oxygen tensions between 1-4% at the surface where keratinocytes are migrating (4,14).…”

Section: Introductionmentioning

confidence: 99%

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Hypoxia increases human keratinocyte motility on connective tissue.

O’Toole¹,

Marinkovich²,

Peavey³

et al. 1997

J. Clin. Invest.

115

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Re-epithelialization of skin wounds depends upon the migration of keratinocytes from the cut margins of the wound and is enhanced when human keratinocytes are covered with occlusive dressings that induce hypoxia. In this study, two independent migration assays were used to compare cellular motility on connective tissue components under normoxic or hypoxic conditions. Human keratinocytes apposed to collagens or fibronectin exhibited increased motility when subjected to hypoxic (0.2 or 2% oxygen) conditions compared with normoxic (9 or 20% oxygen) conditions. When compared with normoxic cells, hypoxic keratinocytes exhibited increased expression and redistribution of the lamellipodia-associated proteins (ezrin, radixin, and moesin). Furthermore, hypoxic keratinocytes demonstrated decreased secretion of laminin-5, a laminin isoform known to inhibit keratinocyte motility. Hypoxia did not alter the number of integrin receptors on the cell surface, but did induce enhanced secretion of the 92-kD type IV collagenase. These data demonstrate that hypoxia promotes human keratinocyte motility on connective tissue. Hypoxia-driven motility is associated with increased expression of lamellipodia proteins, increased expression of collagenase and decreased expression of laminin-5, the locomotion brake for keratinocytes. (

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypoxia increases human keratinocyte motility on connective tissue.

O’Toole¹,

Marinkovich²,

Peavey³

et al. 1997

J. Clin. Invest.

115

View full text Add to dashboard Cite

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“…It was suggested that a wound dressing has to be applied within two hours of wounding and for at least twenty-four hours to efficiently promote reepithelialization [shown in pigs: (Eaglstein et al 1988)]. The mechanism for this effect remains unclear and this observation has yet to be replicated.…”

Section: Effects Of Wound Dressings On Reepithelializationmentioning

confidence: 99%

Cellular mechanisms of skin repair in humans and other mammals

Rittié

2016

J. Cell Commun. Signal.

238

167

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The increased incidence of non-healing skin wounds in developed societies has prompted tremendous research efforts on the complex process known as Bwound healing^. Unfortunately, the weak relevance of modern wound healing research to human health continues to be a matter of concern. This review summarizes the current knowledge of the cellular mechanisms that mediate wound closure in the skin of humans and laboratory animals. The author highlights the anatomical singularities of human skin vs. the skin of other mammals commonly used for wound healing research (i.e. as mice, rats, rabbits, and pigs), and discusses the roles of stem cells, myofibroblasts, and the matrix environment in the repair process. The majority of this review focuses on reepithelialization and wound closure. Other aspects of wound healing (e.g. inflammation, fibrous healing) are referred to when relevant to the main topic. This review aims at providing the reader with a clear understanding of the similarities and differences that have been reported over the past 100 years between the healing of human wounds and that of other mammals.

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“…Evidence from 2 small, nonrandomized LOE 2 trials in volunteers 208,209 and supportive evidence from 1 LOE 2 human study of other wound types 210 and 3 LOE 5 well-designed animal studies [211][212][213] demonstrated significantly shorter healing time of abrasions treated with any occlusive dressing or topical antibiotic versus no dressing or topical antibiotic.…”

Section: Consensus On Sciencementioning

confidence: 97%

Part 13: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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The International First Aid Science Advisory Board identified 38 questions in first aid practice that had not been subjected to an evidence review process or that needed to be updated since the 2005 process. Two or more members of the International First Aid Science Advisory Board volunteered to independently review the scientific literature and complete an evidence-based review worksheet summarizing the literature (see Part 2 of this supplement for additional information). After the evidence was presented to the full board, a draft consensus summary of the scientific evidence and a draft consensus treatment recommendation were developed and represented at a subsequent meeting. Thus, each question, evidence-based review, draft summary of science, and draft treatment recommendation was presented and discussed on 2 separate occasions, and a Consensus on Science and Treatment Recommendation was reached by the Board. This document is a report of the group's consensus.As in 2005, the worksheets revealed the continuing paucity of scientific evidence to support specific first aid interventions. Very little research is being conducted in first aid, and most of the recommendations are extrapolations from research and experience in other medical venues, animal studies, and case series. It is hoped that this document will be a stimulus to future research in first aid. First Aid for Medical Emergencies SummaryThe medical questions addressed include poisoning, anaphylaxis, oxygen administration, and aspirin administration for a suspected coronary event.No changes were recommended for first aid management of acute poisoning.In reviewing epinephrine administration for anaphylaxis, evidence was found that laypeople and some medical and prehospital professionals are unable to recognize the signs and symptoms of anaphylaxis and therefore cannot, without training, make an independent decision to administer epinephrine with an auto-injector or to administer a second dose if the first is not effective. This issue takes on added importance in view of legislation in some jurisdictions that permits these actions.No evidence was found, except in decompression injuries, to support the routine administration of oxygen by first aid providers.The administration of aspirin to a victim experiencing chest discomfort is problematic. The literature is clear on the benefit of early administration of aspirin in an acute coronary event, except when there is a clear contraindication, such as aspirin allergy or a bleeding disorder. Less clear, however, is whether first aid providers can recognize the signs and symptoms of an acute Consensus on ScienceThere are no human studies on the effect of treating oral caustic exposure with dilution therapy. One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies 3-7 demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid. Treat...

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Optimal use of an occlusive dressing to enhance healing. Effect of delayed application and early removal on wound healing

Cited by 50 publications

References 0 publications

Hypoxia increases human keratinocyte motility on connective tissue.

Hypoxia increases human keratinocyte motility on connective tissue.

Cellular mechanisms of skin repair in humans and other mammals

Part 13: First Aid

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