Wound Repair and Regeneration最新文献

Decubitus ulcers are common, hard-to-heal skin ulcers characterised by a high incidence, rapid progression, and a tendency to recur after healing. However, data on the burden and trends of this disease are limited. This study aimed to analyse the epidemiological characteristics and disease burden of decubitus ulcers from 1990 to 2021, and predict their future trends from 2022 to 2050. We retrieved decubitus ulcers data from 204 countries and regions worldwide from the Global Burden of Disease Study 2021 between 1990 and 2021. We analysed the prevalence, incidence, disability-adjusted life years (DALYs), age-standardised rates (ASRs), and estimated annual percentage changes at the global, regional, and national levels. Additionally, we examined global trends by age, sex, and socio-demographic index (SDI). Finally, we used the autoregressive integrated moving average and exponential smoothing models to predict future trends of the disease burden from 2022 to 2050. Globally, from 1990 to 2021, the incidence and prevalence of cases, deaths, and DALYs associated with decubitus ulcers revealed an increasing trend, while the corresponding ASRs exhibited a decreasing trend. Among all age groups, the elderly had the highest incidence, prevalence, and mortality rates. Regionally, high-income North America had the highest age-standardised incidence and prevalence rates; Southern Sub-Saharan Africa had the highest age-standardised death rate; and Eastern Sub-Saharan Africa had the highest age-standardised DALY rate. In terms of SDI, regions with a higher SDI had the highest age-standardised incidence and prevalence rates, while their mortality rates and DALYs were lower. By integrating the prediction results from the two models, we found that the incidence and prevalence of cases, deaths, and DALYs for both sexes will continue to increase from 2022 to 2050. However, the ASRs are expected to remain relatively stable in the future.

Facial symptoms of systemic sclerosis (SSc)-such as reduced skin elasticity, fibrosis and microstomy-significantly impact quality of life. In recent years, autologous fat grafting has emerged as a promising treatment for these issues, but determining the optimal timing and techniques for fat injection remains a challenge for surgeons. Our study aimed to perform a systematic review of the available literature to establish a standardised protocol for this procedure. We reviewed all relevant studies published up to 18 August 2023, focusing specifically on diffuse facial scleroderma. In addition to clinical reports, we included articles discussing the pathophysiological mechanisms behind the effects of adipose stem cells. A total of 18 articles were analysed, revealing a range of methods and timelines for the procedure. The volume of fat injected varied from 6 cc for perioral treatment to 72 cc for a full-face approach, with treatment intervals ranging from one session per year to one every 3 months. On average, around 50% of the fat was reabsorbed within 6 months. Adipose stem cells were identified as a key factor in both tissue regeneration and fat resorption rates. This review supports the effectiveness of autologous fat grafting for facial scleroderma, emphasising the role of adipose stem cells. For optimal results, two procedures spaced 3-6 months apart, followed by annual maintenance, are recommended. Consistent fat volumes in different facial areas are essential to achieve longer-lasting outcomes and minimise resorption.

Chronic wounds (CW) are a major public health problem. Acellular fish skin grafts (AFSG) are increasingly used in advanced wound care, but data on their effectiveness and costs in real-world settings are scarce. We therefore retrospectively analysed the wound surface area (WSA), pain scores, and AFSG-related costs in patients with CW over a 12-week follow-up period. In this single-centre observational study, we analysed two datasets of 34 (full dataset) and 22 (WSA-dataset) CW patients treated with AFSG in a university hospital. Of 34 AFSG-treated patients (mean age 75.9 ± 11.4 years, 44.0% females) with 50 CW of various aetiologies (median ulcer duration 32 weeks), 66.6% experienced pain improvement at 12 weeks. Of 22 patients, 19 (86.4%) showed a mean reduction in WSA of -60.7% ± 143.8% (p = 0.0025); 36.4% of CW were healed. AFSG-related costs were 1232.3 EUR/patient and 130.4 EUR/reduced cm² (n = 22), which was 6.5 times more cost-effective compared to previous study results using living cellular skin substitutes. During 12 weeks of follow-up in a real-world setting, AFSG resulted in reduced WSA in most patients, improved pain in two-thirds, and healed CW in one-third. AFSG may be more cost-effective than other products, but prospective head-to-head comparisons are needed.

Wound care is a multifaceted and collaborative process, and chronic wounds can have significant repercussions on a patient's well-being and impose a financial burden on the healthcare industry. While traditional wound dressings can effectively facilitate healing, their limitations in addressing the intricacies of the wound healing process remain a formidable obstacle. Smart wound dressings have emerged as a promising solution to tackle this challenge, offering numerous advantages over conventional dressings, such as real-time monitoring of wound healing and enhanced wound care management. These advanced medical dressings incorporate microelectronic sensors that can monitor the wound environment and provide timely interventions for accelerated and comprehensive healing. Furthermore, advancements in drug delivery systems have enabled real-time monitoring, targeted therapy, and controlled release of medications. Smart wound dressings exhibit versatility, as they are available in various forms and can be utilised for treating different types of acute or chronic wounds. Ultimately, the development of innovative wound care technologies and treatments plays a vital role in addressing the complexities presented by wounds and enhancing patients' quality of life. This review sheds light on the diverse types of smart dressings and their distinctive features, emphasising their potential in advancing the field of wound care.

ChatGPT can be used as an aid in education, research and clinical management. This study was conducted using the ChatGPT 4.0 program to develop artificial intelligence-supported wound care education material that can be read and understood by patients discharged after surgery. In this methodological study, while creating wound care education material, the education needs of the patients were determined first. Then, the education content was created in the ChatGPT 4 program. Expert opinion was taken for the clarity, applicability, accuracy and quality of the education content. The Turkish readability index of the education material was found to be 68.9 and easily understandable. The Automated Readability Index was found to be 9.29, the Simple Measure of Gobbledygook 7.89, the Flesch-Kincaid 8.07, the Flesch Reading Ease 59.0 and the Average Reading Level Consensus 9.99, which are frequently used in health literature. The PEMAT understandability and applicability score averages were determined 93.90 ± 6.11 (84-100) and 90.20 ± 8.66, respectively. The Global Quality Scale score average was found to be 4.40 ± 0.69. This study reveals that ChatGPT provides understandable, applicable, accurate and high-quality postoperative wound care education material.

Cutaneous wounds can be treated using skin substitutes, but they heal with scarring and absence of skin adnexal structures. We previously demonstrated hair follicle neogenesis in dermal-epidermal composites made of neonatal foreskin human keratinocytes and human dermal papilla cells grafted onto nude mice. A challenge to adapting this approach to graft large areas in humans is that dermal papilla cells lose trichogenicity when expanded in vitro. Herein, a peptide derived from a coiled-coil domain of multimerin-1, TSN6, was evaluated for its effects on graft characteristics and hair follicle formation. In a hair follicle reconstitution assay, TSN6 increased the number of hair fibres by 1.8-fold (p value < 0.05). Dermal-epidermal composites, constructed using late-passage human dermal papilla cells and incubated with TSN6 prior to grafting, retained 14 of 14 grafts for 10-12 weeks, whereas scrambled and vehicle groups kept only 9 of 12 and 13 of 16 grafts, respectively. Histological evaluation of skin grafts showed the presence of human hair follicles in 12 of 14 dermal-epidermal composites in the TSN6 group, 3 of 9 in the scrambled group and 6 of 13 in the vehicle group. The median number and interquartile range of hair follicles was 4.5 (1.8, 10.3) for the TSN6 group, 0 (0, 3.5) for the scrambled group and 0 (0, 3.3) for the vehicle group. TSN6 also increased epidermal thickness, showing a thickness of 127 ± 18 μm for the TSN6 group and 70 ± 28 μm and 94 ± 18 μm for the scrambled and vehicle groups, respectively. In summary, TSN6 increases epidermal thickness and promotes hair follicle neogenesis in a skin substitute.