Negative Pressure Wound Therapy and Other New Therapies for Diabetic Foot Ulceration

Isaac, Adam L; Armstrong, David G.

doi:10.1016/j.mcna.2013.03.015

Cited by 29 publications

(17 citation statements)

References 56 publications

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“…[119][120][121][122][123] Since the early studies of Morykwas et al and Argenta and Morykwas that demonstrated the numerous attributes of NPWT, a very large body of evidence has been published supporting the clinical efficacy of this very important biophysical modality. 121,[124][125][126][127][128][129] Clinical trials have been conducted in the ensuing years that have proven the superiority of NPWT over standard therapy for managing open amputation wounds, DFUs, VLUs, and other wounds. [130][131][132] As an adjunct to standard chronic wound care, NPWT very efficiently manages wound drainage and can provide expedited granulation tissue development, wound area contraction/reduction, preparation for delayed closure or grafting, or primary healing.…”

Section: Negative Pressure Wound Therapymentioning

confidence: 99%

Challenges in the Treatment of Chronic Wounds

Frykberg

Banks

2015

Advances in Wound Care

1,823

1,429

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Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients.Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing.Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based.Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.

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Section: Negative Pressure Wound Therapymentioning

confidence: 99%

Challenges in the Treatment of Chronic Wounds

Frykberg

Banks

2015

Advances in Wound Care

1,823

1,429

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“…This treatment regimen represents a classic strategy used for the treatment of human wounds (51). In this model, full-excisional wounds (ø 3 cm) extending to the fascia are generated on the back of pigs.…”

Section: Wound Healing Model and Itraq-tails Analysis Of Woundmentioning

confidence: 99%

In Vivo Assessment of Protease Dynamics in Cutaneous Wound Healing by Degradomics Analysis of Porcine Wound Exudates

Sabino

Hermes

Egli

et al. 2015

Molecular & Cellular Proteomics

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Proteases control complex tissue responses by modulating inflammation, cell proliferation and migration, and matrix remodeling. All these processes are orchestrated in cutaneous wound healing to restore the skin's barrier function upon injury. Altered protease activity has been implicated in the pathogenesis of healing impairments, and proteases are important targets in diagnosis and therapy of this pathology. Global assessment of proteolysis at critical turning points after injury will define crucial events in acute healing that might be disturbed in healing disorders. As optimal biospecimens, wound exudates contain an ideal proteome to detect extracellular proteolytic events, are noninvasively accessible, and can be collected at multiple time points along the healing process from the same wound in the clinics. In this study, we applied multiplexed Terminal Amine Isotopic Labeling of Substrates (TAILS) to globally assess proteolysis in early phases of cutaneous wound healing. By quantitative analysis of proteins and protein N termini in wound fluids from a clinically relevant pig wound model, we identified more than 650 proteins and discerned major healing phases through distinctive abundance clustering of markers of inflammation, granulation tissue formation, and re-epithelialization. TAILS revealed a high degree of proteolysis at all time points after injury by detecting almost 1300 N-terminal peptides in ϳ450 proteins. Quantitative positional proteomics mapped pivotal interdependent processing events in the blood coagulation and complement cascades, temporally discerned clotting and fibrinolysis during the healing process, and detected processing of complement C3 at distinct time points after wounding and by different proteases. Exploiting data on primary cleavage specificities, we related candidate proteases to cleavage events and revealed processing of the integrin adapter protein kindlin-3 by caspase-3, generating new hypotheses for protease-substrate relations in the healing skin wound in vivo.

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“…Negative pressure wound therapy is useful for treating wounds, such as diabetic foot. [11] However, there is little evidence that it can be used for gas-forming infections in the early period. In our opinion, it is inappropriate to control infection and inhibit aerogenic bacteria.…”

Section: Discussionmentioning

confidence: 99%