Abstract:A variety of factors, both intrinsic and extrinsic, may influence the healing of wounds. Some of these influences are environmental in nature and subject to advantageous manipulation by the practitioner. In this article, the role of humidity, temperature, infection and oxygen tension on the process of wound healing will be discussed.
“…A wound is defined as a break in the continuity of tissue caused by violence or trauma, and is considered healed if the wounded or inflamed tissue is restored to its normal condition [1]. Wound healing is influenced by both intrinsic and extrinsic factors [1,2,3,4]. Homeostasis and inflammation, proliferation and maturation or remodeling are the distinct, overlapping phases involved in wound healing [3].…”
Section: Introductionmentioning
confidence: 99%
“…Altered or impaired wound healing, as observed in chronic wounds, is marked by an interruption of this process [3]. The presence of bacteria and bacterial products, such as endotoxins, can affect each of the healing processes and impede their orderly progression [4]. The pH within the wound milieu directly and indirectly influences all biochemical reactions involved in the healing process [5].…”
Background/Aims: Wound healing is a complex regeneration process involving the degradation and reassembly of connective tissues and skin layers. Previous studies have shown that pH plays a significant role in both the direct and indirect regulation of cellular processes in the wound, which, in turn, affect the wound healing process. However, the effects of pH on the collagen breakdown component of wound healing have yet to be investigated. Therefore, we investigated the induction of accelerated collagen breakdown by pH imbalance in the skin. Methods: Na+/H+ exchanger and metalloproteinase (MMP)-1 were analyzed spectrophotometrically, and the expression of collagen type-I-alpha-1 (COL1A1) and mitogen-activated protein kinase (MAPK) was measured by Western blotting. Results: Accelerated collagen breakdown induced by extracellular basic pH via the overproduction of reactive oxygen species (ROS) and MAPK signaling was examined in skin fibroblasts and in a three-dimensional human skin equivalent system. Basic pH (>7.50) upregulated MMP-1 and downregulated COL1A1 levels via ROS generation and MAPK signaling pathways. Acidic pH (<6.04) slightly upregulated MMP-1 and slightly downregulated COL1A1 levels via ROS generation and the p38 signaling pathway. Conclusion: Our results indicate that skin pH is an important effector of collagen formation in wound healing. This finding will aid in the development of new pH-targeted therapeutic strategies.
“…A wound is defined as a break in the continuity of tissue caused by violence or trauma, and is considered healed if the wounded or inflamed tissue is restored to its normal condition [1]. Wound healing is influenced by both intrinsic and extrinsic factors [1,2,3,4]. Homeostasis and inflammation, proliferation and maturation or remodeling are the distinct, overlapping phases involved in wound healing [3].…”
Section: Introductionmentioning
confidence: 99%
“…Altered or impaired wound healing, as observed in chronic wounds, is marked by an interruption of this process [3]. The presence of bacteria and bacterial products, such as endotoxins, can affect each of the healing processes and impede their orderly progression [4]. The pH within the wound milieu directly and indirectly influences all biochemical reactions involved in the healing process [5].…”
Background/Aims: Wound healing is a complex regeneration process involving the degradation and reassembly of connective tissues and skin layers. Previous studies have shown that pH plays a significant role in both the direct and indirect regulation of cellular processes in the wound, which, in turn, affect the wound healing process. However, the effects of pH on the collagen breakdown component of wound healing have yet to be investigated. Therefore, we investigated the induction of accelerated collagen breakdown by pH imbalance in the skin. Methods: Na+/H+ exchanger and metalloproteinase (MMP)-1 were analyzed spectrophotometrically, and the expression of collagen type-I-alpha-1 (COL1A1) and mitogen-activated protein kinase (MAPK) was measured by Western blotting. Results: Accelerated collagen breakdown induced by extracellular basic pH via the overproduction of reactive oxygen species (ROS) and MAPK signaling was examined in skin fibroblasts and in a three-dimensional human skin equivalent system. Basic pH (>7.50) upregulated MMP-1 and downregulated COL1A1 levels via ROS generation and MAPK signaling pathways. Acidic pH (<6.04) slightly upregulated MMP-1 and slightly downregulated COL1A1 levels via ROS generation and the p38 signaling pathway. Conclusion: Our results indicate that skin pH is an important effector of collagen formation in wound healing. This finding will aid in the development of new pH-targeted therapeutic strategies.
“…Neonatal rat aortic smooth muscle cells (NRASMC) were cultured in the presence of trace elements (Zn2+, Cu2+, Fe2+ and Mn2+), various amino acids, and vitamins (A, B complex, and C) known to enhance cell proliferation and collagen production [7,8]. Trace elements, amino acids, various vitamins and other factors were tested in culture in order to examine the individual effect of the compound on collagen production and cell growth (Table 1).…”
Using the method of directed collagen gel shrinkage, we have been fabricating heart valves and mitral valve chordae [1,2,3]. The principle involves mixing solubilized collagen with the appropriate cells. When the collagen-cell mixture is neutralized, soluble collagen reassembles into fibrils and a gel is created. When the gel is mechanically constrained, the collagen fibrils align in the direction of constraint. The generation of tensile force during contraction is crucial for the formation of highly aligned, compacted collagenous constructs. So far, inappropriate mechanical properties have been one of the main limitations of most collagen-based tissue equivalents. In this study, we focused on providing both biomechanical and biochemical stimuli to increase cellular proliferation, matrix synthesis, and hence improve the mechanical properties of the collagen constructs. We explored a number of holder materials and configurations, with an objective to maximize the lateral compaction of our constructs. We designed a bioreactor that can provide controlled static tension to our collagen constructs. We also developed a nutrition-fortified medium that includes trace elements (Zn2+, Cu2+, Fe2+ and Mn2+), various amino acids, and vitamins (A, B complex, and C). Our ultimate goal was to combine biomechanical and biochemical stimuli, and enhance the mechanical strength of our collagen constructs.
“…). After placement of the graft, the nylon mesh is shown being peeled away from the graft The appearance of the split‐thickness graft on the ulcer at the end of the procedure A new layer of nylon mesh impregnated with a thin film of polymyxin‐bacitracin ointment to prevent infection and dehydration is then applied in a generous size over the entire graft‐ulcer area, further covered with sterile gauze, and finally wrapped with a Kerlix® roll and an elastic bandage from toes to knee with even pressure to insure stable support of the graft and to assist in venous circulation of blood. No sutures are used.…”
Section: Clinical Appearance Of An Ulcer Over the Left Medial Malleolmentioning
The placing of split-thickness skin grafts on chronic ulcers on legs in the usual way is tedious and time consuming. An effective technique that is simply and quickly done is described and illustrated herein. At least two weeks of hospitalization is required to insure complete healing.
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