Regeneration of injured skin and peripheral nerves requires control of wound contraction, not scar formation

Yannas, Ioannis V.; Tzeranis, Dimitrios S.; So, Peter T. C.

doi:10.1111/wrr.12516

Cited by 80 publications

(70 citation statements)

References 62 publications

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“…Wound healing involves the processes of regeneration, contraction, and scar formation. The force of contraction orients the myofibroblasts and collagen fibers, which contribute to scar formation . Full thickness wounds retain at most 80% of their function and strength at closure.…”

Section: Discussionmentioning

confidence: 99%

Preliminary investigation of honey‐doped electrospun scaffolds to delay wound closure

et al. 2019

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Manuka honey is an ancient remedy to improve wound healing; however, an effective delivery system is needed to facilitate extended release of honey into wounds. We developed an electrospun dermal regeneration template consisting of a poly (ε‐caprolactone) (PCL) scaffold embedded with 1%, 5%, 10%, or 20% manuka honey. In vitro studies demonstrated that honey PCL scaffolds were not toxic to macrophages, and they allowed for macrophage infiltration into the scaffolds. Vascular endothelial growth factor (VEGF), a marker of angiogenesis, was released by macrophages cultured with scaffolds and macrophage/scaffold conditioned media promoted endothelial cell tube formation in an angiogenesis assay. In a full thickness murine wound model, the scaffolds prevented rapid wound contraction. In vivo, cells infiltrated the scaffolds by post‐wounding day 7, but the honey scaffolds did not affect collagen deposition at that time. In summary, preliminary studies investigating the effect of honey on tissue repair show that scaffolds prevent rapid wound contraction, allow for cell infiltration, and promote angiogenesis. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B:2620–2628, 2019.

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Section: Discussionmentioning

confidence: 99%

Preliminary investigation of honey‐doped electrospun scaffolds to delay wound closure

et al. 2019

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“…After severe trauma, in the adult mammal occurs a wound constriction and scar formation. An appropriate control of wound contraction can induce the regeneration of wounded skin [20]. More specifically it has been observed that the regeneration of the highest quality is induced under wound conditions the contraction was inhibited [21].…”

Section: Short Commentarymentioning

confidence: 99%

A Short Commentary about Efficacy of an Flowable Matrix in the Treatment of Diabetic Foot Ulcers

Campitiello¹,

Mancone²,

A³

et al. 2017

Clin Res Foot Ankle

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The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra Life Science Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in sixty patients with diabetic foot ulcers (Grades 3 Wagner ulcer). A randomized clinical trial was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-seven cases of diabetic foot ulcers were equally and randomly divided into two groups: in a group treated with a wet dressing and expected closure by secondary intention; in another group the lesions were filled with Integra Flowable Wound Matrix and surgical wound edges were either approximated with stitches. The complete healing rate valued at 6 weeks, in the whole study population was 69.56% (Integra Flowable Wound Matrix group, 86.95%, control group, 52.17%; P=0.001). Amputation and re-hospitalization rates were higher in the control group compared to Integra Flowable Wound Matrix group. Therefore, the difference was statistically significant.This new porous matrix, allows a closure for the first intention of the lesion by reducing healing time and the demolition surgery. An advanced wound matrix is not associated with side effects, is well tolerated. Ease of use, absence of adverse effects, and a minimal invasive approach by primary intention closure of the lesion, make it appropriate in the management diabetic foot ulcers.Keywords: Diabetic foot ulcers; Tunneling lesions; Biomaterial; Flowable matrix Short CommentaryPatients with diabetes can develop many different foot complications. Even ordinary injures can get worse and lead to serious complications. Without early and optimal intervention, the wound can rapidly deteriorate, leading to amputation of the affected limb. A diabetic foot ulcer is a critical event in the life of a person with diabetes and is one of the complications of diabetes that can cause life threatening. Diabetic foot ulcers have a major economic impact as well; data have shown diabetic foot ulcers (DFUs) are a major cause of hospitalization for patients with diabetes.

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“…It has been suggested that appropriate disruption of this barrier by a scaffold could enhance injury repair processes . For example, porous collagen scaffolds can induce regeneration in skin wounds in a manner that correlates with a decrease in the rate of wound contraction, similar to regeneration induced in peripheral nerves . In addition, mechanical force transmission and mechanosensing of cells within tissues generate changes in the shape of the injured tissue, such as size modification, and tissue patterning, by modulating various cell functions .…”

Section: Introductionmentioning

confidence: 99%

Modulation of scar tissue formation in injured nervous tissue cultivated on surface‐engineered coralline scaffolds

et al. 2017

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Following traumatic brain injury, there is no restoration of the lost nervous tissue, mainly due to the formation of a scar. One promising strategy to overcome this hurdle is grafting scaffolds that can disturb the scar blockade, enabling cell invasion into the wound. The aragonite skeleton of corals is useful scaffolds for testing this strategy, being supportive for neural cells in culture. The purpose of this work was to check if a contact between a coralline scaffold and an injured nervous tissue affects scar formation and if this effect can be regulated by engineering the scaffold's surface topology. To address that, hippocampal slices were cultivated on a coral skeleton having two distinct surface shapes: (1) intact skeleton pieces (ISP): porous, microrough surface; (2) grained skeleton (GS): nonporous, macrorough surface. On ISP, slices deformed by engulfing the scaffold's outer surface without penetrating the pores, yet, they preserved their coherence. By contrast, on GS slices were flat, but broken into interconnected small segments of tissue. In addition, whereas on ISP astrocytes were significantly more active and diffusely distributed, on GS reactive astrocytes tightened into a single <90 μm wide scar-like stripe at the slice's periphery. Hence, by grafting coralline scaffolds of predesigned surface roughness and porosity into brain wounds, control over scar tissue formation can be gained, providing an opportunity for cell migration and damage repair. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2295-2306, 2018.

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Regeneration of injured skin and peripheral nerves requires control of wound contraction, not scar formation

Cited by 80 publications

References 62 publications

Preliminary investigation of honey‐doped electrospun scaffolds to delay wound closure

Preliminary investigation of honey‐doped electrospun scaffolds to delay wound closure

A Short Commentary about Efficacy of an Flowable Matrix in the Treatment of Diabetic Foot Ulcers

Modulation of scar tissue formation in injured nervous tissue cultivated on surface‐engineered coralline scaffolds

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