摘要:The myofibroblast, a major component of granulation tissue, is a key cell during wound healing, tissue repair and connective tissue remodelling. Persistence of myofibroblasts within a fibrotic lesion leads to excessive scarring impairing function and aesthetics. Various wound-healing cytokines can be modulated by topical application of active agents to promote optimal wound healing and improve scar quality. Thus, the myofibroblast may represent an important target for wound-healing modulation to improve the evolution of conditions such as hypertrophic scars. The purpose of this work is to study the modulation of myofibroblasts and integrin αvβ3 in a full thickness wound performed on rabbits treated with different topical agents using: (1) saline, (2) Tegaderm occlusive dressing (3) silver sulfadiazine and (4) moist exposed burn ointment (MEBO). The reepithelialisation was 4 days faster in the MEBO group compared with the other therapies with less oedema formation, delayed contraction, less inflammatory cells and the lowest transepidermal water loss (TEWL) resulting in a soft scar. Although α-smooth muscle actin (α-SMA) was the highest around day 12 in the MEBO group, wound contraction and myofibroblast's activity were the least for the same period probably because of a downregulation of the integrin αvβ3. It seems that the effect of MEBO could be more pronounced on force transmission rather then on force generation. Greater insight into the pathology of scars may translate into non surgical treatments in the future and further work in myofibroblast biology will eventually result in efficient pharmacological tools, improving the evolution of healing and scar formation.
摘要:Introduction:? After partial-thickness skin graft (PTSG) harvesting, a dermal surface is exposed and an iatrogenic wound is created. Application of various agents has been studied for enhancement of healing process in PTSG donor area. The ideal agent should accelerate healing, provide comfort to the patient, not allow infection, and be easily applicable and cheap. Materials and Methods:? The Cochrane Central Register of Controlled Trials, PubMed, Scopus. and EMBASE databases were screened for words (“skin graft” + “donor”), by using time limits between 1989 and 2018. This study involved a total of 5 systematic reviews and 43 original articles which met the inclusion criteria. Articles were reviewed and parameters such as healing time, pain, infection rate, cosmetic result, and cost were extracted. Results:? Systematic reviews favor moist dressing materials over dry ones considering healing time and patient comfort. Hydrocolloids provide rapid wound healing, and dressing changes do not cause any disruption to the newly regenerated epithelium. Alginates seem to have a longer healing time than hydrocolloid materials. Polyurethane films are characterized by rapid epithelialization and painless monitoring as well as low costs. The epithelialization time of MEBO?, a cosmeceutical product, is reported to be faster than polyurethane films. Local and systemic drug applications warrant further research before routine clinical usage. Conclusion:? Dressing materials are the most commonly used and appropriate group according to the studies performed to date. It is seen that moist dressing materials are more favorable. Although there is not a subgroup with a clear superiority, it can be seen that the hydrofiber and polyurethane film groups are one step ahead in terms of ease of use, patient comfort, epithelialization speed, and scar quality. Polyurethane films have a cost advantage to the hydrofiber group.
摘要:第一部分:小鼠慢性创面愈合过程中巨噬细胞极化类型及影响创面愈合关键的信号通路研究目的:经由单细胞转录组测序技术(sc RNA-seq)对小鼠创面内巨噬细胞(Mac)极化类型与成纤维细胞(Fib)、上皮细胞(EC)之间的关系,还有影响创面愈合的主要信号途径展开探讨。方法:经由sc RNA-seq法探究小鼠愈合创面(Wound)与未愈合创面(Un_wound)组织在细胞亚群通讯强度、数量与互作方面的不同表现;对2类创面组织中特异性信号途径及其配体-受体加以明确,同时开展比较分析;并探讨小鼠Wound与Un_wound组织中Monocyte亚群类型及其几类关键亚群类型。结果:(1)小鼠2类创面(Wound、Un_wound)的单细胞质控Counts值皆未显示异常,细胞之间表现出较好的整体关联性。Wound组织中的细胞亚群以皮肤组织干细胞(Tissue SC)、EC、软骨细胞(Chondrocytes)、B细胞(B cells)、单核巨噬细胞(Monocyte)、Fib、内皮细胞(Endo)、角化细胞(KC)与T细胞(T cells)为主;Un_wound组织中相关的细胞亚群以皮肤组织SC、T细胞(T cells)、波纹管细胞(CMP)、Monocyte、神经元细胞(Neurons)、Endo、EC、KC、Fibroblasts、软骨细胞(Chondrocytes)与B细胞(B cells)为主;在Wound组织中,Monocyte同EC、Fib、Tissue sc细胞亚群之间皆存在紧密联系;在Un_wound组织内,就Monocyte同EC、Fib细胞亚群的通讯强度与数目而言,相较Wound组织皆偏低;(2)对于小鼠慢性创面组织Fib与Epithelial这2类细胞亚群,皆会受到Monocyte所含EGF信号途径CXCL1-Akr1信号轴的活化效应影响,CXCL信号途径内的不同配体-受体之间的作用性,对于整个信号途径,CXCL16-Akr6以及CXCL1-Akr1配体受体所具备的价值最高。对单个配体受体在不同细胞通信中的调控功能进行分析的结果显示,Cxcl3-Ark1配体受体于Mac与血管内皮细胞(VEC)的信号关联性更为显著,且更为关键;(3)Monocyte亚群由0、1、2、3、4、5这五类构成,前两类在Wound组织中占据主要位置,CD68与CD162特异性表达亚群存在比较明显的优势,同时CD163标记的Mono...
摘要:Anal fissure is a common complication of the anorectal region and one of the most reported causes of anal pain. Acute anal fissure can be cured by surgery or medical treatment. There is an increase in the use of topical therapy for the treatment of anal fissures. A common topical drug used is Diltiazem (DTZ), a calcium-channel blocker, which relaxes the anal sphincter and thus promotes healing of the anal fissure. Moist exposed burn ointment (MEBO) is an ointment that is effective for the treatment of burns and wound healing and is becoming popular in the treatment of anal fissures.