Wound Repair and Regeneration最新文献

This study aimed to develop an acellular dermal matrix derived from tilapia skin and evaluate its potential as a bioscaffold for skin wound repair. Structural and compositional changes before and after decellularisation were assessed through histological staining, electron microscopy and immunological analysis. The matrix exhibited low immunogenicity, preserved extracellular matrix architecture and retained key bioactive components. In vitro, the matrix significantly promoted cell proliferation, migration, and tube formation in human umbilical vein endothelial cells and human foreskin fibroblasts. In vivo, full-thickness skin defect models in Balb/c mice and Bama pigs demonstrated that the tilapia-derived matrix not only accelerated wound closure but also improved the quality of tissue regeneration by enhancing collagen deposition and vascularisation. Compared to the commercial porcine-derived matrix, the fish-derived scaffold exhibited superior regenerative outcomes. Notably, transcriptomic profiling of wound tissue revealed that the matrix modulated a range of biological pathways, including immune regulation, extracellular matrix remodelling and angiogenesis, indicating a multifaceted interaction between the biomaterial and host tissue. These findings underscore the excellent biocompatibility and therapeutic efficacy of the tilapia-derived matrix, supporting its potential as a safe, economical and sustainable bioscaffold for clinical skin repair. The inclusion of a large animal model provides critical translational relevance due to the anatomical and physiological similarity between porcine and human skin, while transcriptomic analysis offers valuable mechanistic insights into matrix-tissue interactions.

Wound-induced hair follicle neogenesis (WIHN), a regenerative process observed in select mammals, involves the formation of new hair follicles following skin injury. Although exhibiting similarities to embryonic hair follicle development, WIHN also presents notable distinctions. Despite considerable efforts to elucidate its underlying mechanisms, several aspects of WIHN remain unclear. A comprehensive understanding of the factors and signalling pathways governing this process holds promise for developing novel therapeutic interventions targeting hairless scar formation in humans.

Early prediction of long-term scar outcomes is essential for guiding clinical decision-making and improving patient satisfaction. This study investigates whether 3-month patient-reported outcomes (PROs) using SCAR-Q domains-psychosocial, appearance and quality of life (QoL)-predict 12-month outcomes, and how these relate to objective scar measures. A prospective cohort of 20 female patients undergoing various surgical procedures completed SCAR-Q and Patient and Observer Scar Assessment Scale (POSAS) evaluations at 3 and 12 months postoperatively. Correlation and linear regression analyses assessed associations and predictive validity between early and late scar outcomes. SCAR-Q QoL scores demonstrated strong predictive validity (R² = 0.49, p < 0.001; ρ = 0.70, p < 0.001), whereas psychosocial and appearance domains showed weak, nonsignificant associations (R² = 0.12 and 0.10, respectively; p > 0.1). Objective scar characteristics-particularly width and height-were significantly correlated with poorer 12-month appearance and psychosocial scores (e.g., ρ = -0.743 for height vs. appearance, p < 0.001; ρ = -0.605 for width vs. psychosocial, p = 0.0047). In point-biserial correlations, wider and taller scars at 3 months were more likely to be rated as 'bad' at 12 months (r ≥ |0.53|, p ≤ 0.016). POSAS and overall opinion scores also significantly improved over time (p < 0.05), but some patients reported increased appearance-related distress despite objective improvements. In conclusion, early QoL assessments reliably predict long-term outcomes, while appearance and psychosocial perceptions may shift over time. These findings support routine use of PROs in early postoperative care to inform personalised interventions and optimise scar management.

An electrochemical bandage (e-bandage) that generates hydrogen peroxide (H₂O₂) through a combination of working, counter and reference electrodes used with an electrolyte-providing hydrogel is being developed for wound infection management. e-Bandage biocidal activity was previously demonstrated using Xanthan gum hydrogel. For clinical use, clinically used hydrogels would be ideal, but their use with the described e-bandage has not been shown. The goal of this work was to evaluate the biocidal activity of off-the-shelf, clinically used hydrogels when used with a 1.77 cm² H₂O₂-producing e-bandage. e-Bandage electrochemical parameters and activity against methicillin-resistant Staphylococcus aureus IDRL-6169 and Acinetobacter baumannii ATCC-17978 biofilms were assessed with six off-the-shelf hydrogels. Variations in hydrogel composition affected electrochemical parameters, which was associated with differences in biocidal activity. Results of this study inform the selection of off-the-shelf hydrogels for use with H₂O₂-producing e-bandages.

The goal of this study was to investigate the effects of an intermittent electrical stimulation (IES) paradigm on the healing of deep tissue pressure injury (DTPI). Electrical stimulation has been extensively studied for the treatment of open wounds, often with amplitudes lower than motor threshold. The effect of electrical stimulation in producing palpable muscle contractions on the treatment of DTPI has not been explored. IES was tested in rats with complete spinal cord injury in which a DTPI was subsequently induced. The goals of the study were to investigate: (i) the natural progression of a DTPI; and (ii) the role of IES in expediting the rate of healing. Three groups of rats were used: (a) a control group in which DTPI is induced, (b) a control group in which stimulation only is applied without the induction of DTPI and (c) an intervention group in which DTPI is induced and IES is applied. Magnetic resonance imaging monitored the extent and progression of injury 1, 3, 5 and 7 days post-induction of injury and/or initiation of IES. Immunohistochemistry assessed the severity of injury and rate of healing by evaluating the presence of inflammatory cells and embryonic myofibres. When applied on day 1 after the induction of DTPI, IES significantly reduced the edema associated with the injury, increased pro- and anti-inflammatory macrophages and increased cell proliferation. It also decreased the overall size of injury. These results suggest that when applied early after the initiation of a DTPI, IES can expedite anti-inflammatory and pro-regenerative events and may be an effective means for treating the injury.

This study tested the hypothesis that diabetic wound treatment with biomimetic pro-angiogenic, proteolytically and mechanically stable RADA16-II peptide nanofibers promotes regenerative wound healing via attenuation of inflammation and stimulation of neovascularization. Two full-thickness excisional dorsal skin wounds were created on 8-10 week old female db/db mice and treated with nanofiber hydrogel or saline (control). Animals were euthanized on days 7, 14, 28, and 56 and their wounds were analysed for morphology, vascularization, strength, and inflammation. We observed that in situ treatment of db/db mouse wounds with nanofiber hydrogel resulted in regenerative healing, indicated by the increased presence of elastin fibrils, restored biomechanical properties, and reestablishment of a mature epidermis complete with basal, suprabasal, and stratified layers compared to saline-treated wounds. Additionally, wounds treated with nanofiber hydrogel exhibited enhanced neovascularization, increased expression of anti-inflammatory cytokine interleukin-10, reduced expression of inflammation markers and transforming growth factor-β1 and -β2, as well as decreased myofibroblast counts. Overall, this novel drug-free approach enables accelerated diabetic wound healing by shifting inflammatory and pro-fibrotic cytokine balance towards factors associated with neovascularization-driven regenerative healing in the wound microenvironment. Our results demonstrate that in situ manipulation of the wound microenvironment using bio-mimetic peptide NF matrix may be a promising strategy for faster and more durable wound closure to improve healing of chronic wounds.

Early identification of chronic wounds is essential for clinical decision-making in wound care. Biofilm infection is a well-known risk factor for delayed healing, while cytokines in the wound microenvironment play critical regulatory roles throughout the healing cascade. This single-centre prospective cohort study enrolled 66 patients with chronic wounds between 2020 and 2023 to evaluate cytokine biomarkers and biofilm detection tools for predicting wound outcomes. Clinical signs of biofilm (CSB) alone demonstrated limited predictive value, with accuracies of 66.7% for 30-day and 45.5% for 90-day healing. In contrast, the Wound Biofilm Detection Kit (WBDK) showed superior performance, achieving predictive accuracies of 92.4% and 60.6% for 30- and 90-day outcomes, respectively, outperforming both CSB and MolecuLight i:X. Cytokine analysis identified serum CRP, wound CRP and wound MCP-1 as significant predictors, with ROC analysis demonstrating good discriminative ability for wound CRP (AUC = 0.863) and wound MCP-1 (AUC = 0.830). A simplified Lasso regression model incorporating diabetes mellitus, peripheral arterial disease, wound location and WBDK grade achieved an AUC of 0.77 and an accuracy of 76% for 90-day outcomes. External validation was performed in 17 additional patients yielding a predictive accuracy of 76.5%, supporting the robustness of the model. These findings highlight the limited reliability of clinical signs alone and emphasise the value of objective biofilm detection and cytokine profiling in wound prognosis. Our high-accuracy prediction model, based on readily accessible clinical variables and WBDK results, may facilitate precision wound care and improve real-time management.

Chronic wounds pose a growing global health challenge. Accurate assessment is essential for monitoring healing, yet traditional two-dimensional methods lack volumetric analysis. Emerging three-dimensional imaging technologies offer enhanced precision, but their clinical validation and prognostic utility remain unclear. This scoping review aimed to map and synthesise the available evidence on the clinical application and predictive potential of three-dimensional wound assessment technologies in adults with chronic wounds. A systematic search was performed across five electronic databases-MEDLINE via PubMed, EMBASE, Web of Science, CINAHL, and IEEE Xplore-to identify peer-reviewed studies published between 2014 and 2024. Eligible studies included original research evaluating the clinical application, reliability, accuracy, or predictive performance of three-dimensional wound assessment technologies. Two independent reviewers performed title/abstract screening, full-text eligibility assessment, and data extraction. Data were synthesised narratively, with emphasis on methodological quality, clinical applicability, and standardisation practices across technologies. Eleven studies were included, encompassing 734 wounds and 307 patients. Technologies evaluated included optical coherence tomography, structured-light scanners, stereophotogrammetry, and smartphone-based structure-from-motion systems. Most platforms demonstrated high reproducibility for surface area measurement (ICC > 0.95) and moderate accuracy for depth and volume. Methodological heterogeneity and limited standardisation of validation protocols hindered cross-platform comparability. No study integrated volumetric metrics into predictive healing models. Three-dimensional wound assessment technologies show strong potential to enhance wound measurement precision, documentation, and non-invasive monitoring. Robust validation frameworks and integration of volumetric metrics into predictive models are needed to realise their clinical value in precision wound care.