Tissue engineering for the management of chronic wounds: current concepts and future perspectives

Abstract

Chronic wounds constitute a significant and growing biomedical burden. With the increasing growth of populations prone to dysfunctional wound healing, there is an urgent and unmet need for novel strategies to both prevent and treat these complications. Tissue engineering offers the potential to create functional skin, and the synergistic efforts of biomedical engineers, material scientists, and molecular and cell biologists have yielded promising therapies for non-healing wounds. However, traditional paradigms for wound healing focus largely on the role of inflammatory cells and fail to incorporate more recent research highlighting the importance of stem cells and matrix dynamics in skin repair. Approaches to chronic wound healing centred on inflammation alone are inadequate to guide the development of regenerative medicine-based technologies. As the molecular pathways and biologic defects underlying non-healing wounds are further elucidated, multifaceted bioengineering systems must advance in parallel to exploit this knowledge. In this viewpoint essay, we highlight the current concepts in tissue engineering for chronic wounds and speculate on areas for future research in this increasingly interdisciplinary field.

Mechanoregulation of the Myofibroblast in Wound Contraction, Scarring, and Fibrosis: Opportunities for New Therapeutic Intervention

“…149 This ECM scaffold would likely include Type III collagen-the predominant collagen in granulation tissue-and a mixture of proteoglycans and alternatively spliced cellular FNs. In addition, a source of active TGF-b1 is necessary and could be provided by encoding ''constitutively active'' TGF-b1 in an adenoviral vector, thereby providing a transient transduction for temporally limited expression.…”

Diagnósticos de enfermagem na assistência ambulatorial ao paciente com ferida: mapeamento cruzado [Nursing diagnoses in ambulatory care for wound patients: cross-mapping]

“…Sabe-se que na atualidade cerca de 6,5 milhões de pessoas sofrem com as consequências diretas e indiretas relacionadas às feridas 1 . Entre estas destacam-se a dor, a imobilidade e a incapacidade que, por sua vez, podem impactar a autoestima e a autoimagem.…”

“…2017.20028 a complexidade deste, que é considerado um problema de saúde pública [2][3][4] . Ademais, destaca-se a oneração sofrida pelo paciente e pelo sistema de saúde que, ao tratar as complicações relacionadas às feridas, desembolsam cerca de 25 bilhões de dólares ao ano, nos Estados Unidos 1,5 . Nessa perspectiva, reconhece-se a importância das ações interdisciplinares em saúde, nas quais se inserem o cuidado de enfermagem.…”

Retracted: Use of Decellularized Scaffolds Combined with Hyaluronic Acid and Basic Fibroblast Growth Factor for Skin Tissue Engineering

“…7 In the United States alone, chronic wounds affect about 6.5 million patients and over $25 billion is spent each year on wound-related complications. 8 Wound healing is a complex biological process and involves four continuous and overlapping phases: hemostasis, inflammation, proliferation, and remodeling. [9][10][11] Because the epidermis layer is very thin, the common skin damages often hurt the dermis layer and even the subcutaneous tissue.…”