Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
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The effects upon skin repair were compared between a homemade bilayer dermal equivalent (BDE), composed of a collagen/chitosan porous scaffold and a silicone membrane, and J-1 acellular dermal matrix (ADM), a commercial ADM that is used widely in China to treat various skin defects. Full-thickness excisional and burn wounds were prepared on the backs of pigs and then treated with the BDE and J-1 ADM. Biopsy specimens were harvested on days 7, 14, and 21 after surgery for gross, biochemical, and molecular examinations. ⋯ However, there was a significant difference in the number of nascent blood vessels formed in the burn wounds after treatment with J-1 ADM compared with BDE. The highest numbers of newly formed and mature blood vessels were present in the J-1 ADM-treated excisional wounds after 21 days. Ultrathin skin grafts were further transplanted on to the regenerated dermis for 28 days, resulting in the repair of the full-thickness wounds and production of a structure similar to normal skin.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized controlled trial of larval therapy for the debridement of leg ulcers: results of a multicenter, randomized, controlled, open, observer blind, parallel group study.
It has been known for centuries that the application of larvae is useful to heal certain wounds by facilitating debridement of necrotic tissue,(1) yet the efficacy of larval therapy continues to be debatable. This study compared the clinical effectiveness of a larval therapy dressing (BioFOAM) with a standard debridement technique (Purilon gel; hydrogel) in terms of time to debridement of venous (VLU) or mixed arterial/venous (MLU) leg ulcers. Data analyses were conducted on 88 subjects. ⋯ There were no statistically significant differences in the clinical condition of the wound bed and surrounding skin by intervention. Subjects in the larvae arm experienced more ulcer-related pain or discomfort than subjects in the hydrogel arm (p < 0.001). This study provided good evidence to show that larval therapy, in the form of a BioFOAM dressing, debrided VLU and MLU considerably more quickly than a hydrogel, although the possibility of resloughing should be closely monitored.
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Major burns represent a challenge in autologous skin coverage and may lead to severe functional and cosmetic sequelae. Dermal substitutes are increasingly becoming an essential part of burn care during the acute phase of treatment. In the long term dermal substitutes improve functional and cosmetic results and thus enhance quality of life. ⋯ Despite the potential of dermal substitutes, further research is required to strengthen scientific evidence regarding their effects and also to develop new technologies and products. Furthermore, dermal substitutes have a pivotal role in future research strategies as they have the potential to provide adequate scaffold for stem cells, tissue engineering, and regenerative medicine with conceivable application of obtaining long-lasting and scarless artificial skin. This review discusses the status quo of dermal substitutes and novel strategies in the use of dermal substitutes with a focus on burn care.
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Chronic cutaneous wounds are a major burden on patients, healthcare providers, and the US healthcare system. This study, carried out in part by the Wound Healing Society's Government Regulatory Committee, aimed to evaluate the current state of National Institutes of Health funding of cutaneous wound healing-related research projects. National Institutes of Health Research Portfolio Online Reporting Tools Expenditures & Results system was used to identify wound healing projects funded by the National Institutes of Health in the 2012 fiscal year. ⋯ New applications and pre-existing applications accounted for 39.6 and 55.0% of the awarded grants, respectively. Grants awarded to investigators affiliated with universities accounted for 68.1% of grants and 25.3% were to investigators in the private sector. This analysis of current National Institutes of Health funding may facilitate more transparency of National Institutes of Health-allocated research funds and serve as an impetus to procure additional support for the field of wound healing.