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Immunoelectron microscopic localization of actin in migrating cells during planarian wound healing.

Wound repair in planarians is mainly characterized by two cell-migratory events involving the epidermis adjacent to the wound and its basement membrane. The first event is the migration of epidermal cells to cover the wound surface; the second one is the migration of newly differentiating replacement epidermal cells from the parenchyma to the epidermis. In addition to these events, migration of fixed parenchymal cells is observed during wound healing. All migrating cells were characterized by the presence of actin, as shown by the results obtained by means of indirect immunolocalization with fluorescent and electron microscopy. Migrating cells were heavily labeled with gold particles, which clustered at the level of cell-matrix and cell-cell contacts.

Actins↗

The molecular and clinical impact of hepatocyte growth factor, its receptor, activators, and inhibitors in wound healing.

Wound healing involves a number of cellular and molecular events, many of which are controlled by soluble growth factors. In the process of healing, hepatocyte growth factor, a cytokine known to act as mitogen, motogen, and morphogen, has been postulated to play multiple roles during several stages of this complex biological process. Produced primarily by stromal fibroblasts, hepatocyte growth factor regulates angiogenesis, vascular permeability, cell migration, matrix deposition and degradation, and other biological processes. The current article discusses recent progress in understanding the multiple roles played by this growth factor in tissue repair.

Hepatocyte Growth Factor↗

Obstructive jaundice and wound healing.

Wound healing was studied in 95 jaundiced patients and 123 anicteric patients using skin prolylhydroxylase activity as an index of collagen synthesis. The mean (s.d.) value of skin prolylhydroxylase activity in jaundiced patients was significantly lower than that of controls in the preoperative period (40.1(19.2) versus 369.2(32.2) c.p.m./mg protein, respectively, P less than 0.001). Before operation there was a significant difference between patients with benign or malignant obstruction of the biliary tree (55.0(12.3) versus 25.2(10.4) c.p.m./mg protein, respectively, P less than 0.05). In patients with benign obstruction skin prolylhydroxylase activity returned to normal values (326.3(53.1) c.p.m./mg protein, P less than 0.001 versus preoperative values), while in patients with malignant lesions skin prolylhydroxylase activity increased significantly with respect to the preoperative period (25.2(10.4) versus 82.9(14.3) c.p.m./mg protein, P less than 0.01) but was still below normal values. Abdominal wound dehiscence was more common in jaundiced patients (six of 95) than in the anicteric group (two of 123). This complication appeared to be associated with a low skin prolylhydroxylase activity.

Adult↗

Studies in fetal wound healing, VII. Fetal wound healing may be modulated by hyaluronic acid stimulating activity in amniotic fluid.

Fetal wound healing occurs rapidly and without inflammation, fibrosis, or scar formation. It is a process fundamentally different from adult wound healing. The mechanisms that underlie such unique healing properties are unknown. However, hyaluronic acid, a glycosaminoglycan component of the extracellular matrix, is prominent throughout the course of fetal wound healing, and is thought to play a major role in the healing process. Amniotic fluid contains high levels of hyaluronic acid. Amniotic fluid also contains a number of potent growth factors that are critical for fetal development. In this report, a new factor in amniotic fluid that stimulates deposition of hyaluronic acid is described. This activity is measured in an in vitro assay system in which cultured fibrosarcoma cells are used as indicator cells. Amniotic fluid thus provides two separate mechanisms for the deposition of hyaluronic acid. One is by exogenous application directly onto fetal skin wounds; the second is by providing a factor to increase the production of hyaluronic acid endogenously, by stimulating cells around the wound site. The resulting hyaluronic acid-rich area may support the ability of the fetal wound to heal with its unique properties.

Amniotic Fluid↗

[Study on the molecular mechanisms involved in the increased collagen synthesis by platelet-derived wound healing factors during wound healing in alloxan-induced diabetic rat].

OBJECTIVE: To explore the molecular mechanisms involved in the increased collagen synthesis by platelet-derived wound healing factors (PDWHF) during wound healing in alloxan-induced diabetic rats. METHODS: Thirty-three male SD rats were divided into two groups, the normal (n = 9) (group A) and the diabetic group (n = 24). Two pieces of full-thickness skin with diameter of 1.8 cm were removed from the dorsal site of diabetic rats. PDWHF (100 micrograms/wound) was topically applied to one side of the diabetic wounds (group B) on the operation day and then once a day in the next successive 6 days. Meanwhile, bovine serum albumin (100 micrograms/wound) was applied to the other side of diabetic wound as control group (group C) in the same way. Levels of transforming growth factor-beta 1 (TGF-beta 1) and procollagen I mRNA in wound tissue were inspected by dot blotting. RESULTS: TGF-beta 1 mRNA levels in group B were 4 folds and 5.6 folds compared with those in group C after 5 and 7 days (P < 0.01), however, still significantly lower than those of group A (P < 0.05). There was no significance difference among three groups on the 10th day after wounding. The levels for procollagen I mRNA in group B amounted to 2.1, 1.8 and 2.3 folds of those in group C after 5, 7, and 10 days (P < 0.01), respectively. Compared with those in the group A, procollagen I mRNA levels in the group B were significantly lower after 5 and 7 days (P < 0.05), and no significant difference was observed between group B and A after 10 days. CONCLUSION: One important way for PDWHF to enhance the collagen synthesis in diabetic wound healing is to increase the gene expression of endogenous TGF-beta 1.

Animals↗

Expression of heat shock proteins in mouse skin during wound healing.

Wound healing conditions generate a stressful environment for the cells involved in the regeneration process and are therefore postulated to influence the expression of heat shock proteins (Hsps). We have examined the expression of four Hsps (Hsp27, Hsp60, Hsp70 and Hsp90) and a keratin (keratin 6) by immunohistochemistry during cutaneous wound repair from Day 1 to Day 21 after wounding in the mouse. Hsps were constitutively expressed in normal mouse epidermis and their patterns of expression were modified during the healing process. The changes were not directly linked to the time course of the healing process but rather were dependent on the location of cells in the regenerating epidermis. In the thickened epidermis, Hsp60 was induced in basal and low suprabasal cells, Hsp70 showed a reduced expression, and Hsp90 and Hsp27 preserved a suprabasal pattern with an induction in basal and low suprabasal cells. All Hsps had a uniform pattern of expression in the migrating epithelial tongue. These observations suggest that the expression of Hsps in the neoepidermis is related to the proliferation, the migration, and the differentiation states of keratinocytes within the wound.

Animals↗

The use of artificial dermis in the treatment of chronic and acute wounds: regeneration of dermis and wound healing.

Wounds with large loss of deep tissue can be repaired using a dermis substitute. When wounds have an irregular fund, applying a skin graft on these one can be a failure. Integra Dermal Regeneration Template is a bilaminate material, a collagen chondroitin-sponge overlayed with silicone. It heals wounds where conventional methods of repair fail or are too risk. This study analizes Integra's use for chronic and pathological wounds in 7 patients. Applied to wounds reduces inflammation and protects it from a possible contamination or another injury. Imbibition, fibroblast migration, neovascularization, remodeling and maturation are distinct histologic phases of forming neodermis. Trough the silicon layer is possible to observe the histogenesis: the change in color of the matrix is a predictor of its vascularization. When the color has progressed from pink through pale yellow and finally to peach, the neodermis is fully vascolarized. The postoperative care is minimum. Integra is removed after three weeks regenerating a new dermal tissue. So it can be applied a thin skin graft until healing of all patients.

Acute Disease↗

A histological study of cutaneous thermal wounds using a Clostridium perfringens-derived wound healing substance with wound healing stimulation activity.

We studied the effects of a Clostridium perfringens-derived wound-healing substance (WHS) on the healing of thermal burn wounds. Third-degree burn injuries were inflicted on the back skin of rats. We histologically evaluated the effects of WHS ointments and compared them with those of lysozyme chloride ointment. We observed the formation of dermal collagen fibers and the increase of capillaries in the WHS ointment treated groups. From the results of hematoxylin and eosin staining and silver staining, an increase in capillaries was observed one week after the application of WHS ointment. Three weeks after the application, when the epithelization was in the final stage, capillary formation ceased. In the WHS ointment-applied groups, electron microscopic observation showed that new collagen fibers were regularly formed in the dermis. On the other hand, in the lysozyme chloride ointment-applied groups, new collagen fibers were present, but were irregularly formed. The main wound healing stimulative action of the WHS ointment could be due to its acceleration of new capillary formation.

Animals↗

Full-thickness wounding of the mouse tail as a model for delayed wound healing: accelerated wound closure in Smad3 knock-out mice.

Experimentally induced wounds in animal models are useful in gaining a better understanding of the cellular and molecular processes of wound healing, and in the initial evaluation of the safety and effectiveness of potential therapeutic agents. However, studying delayed healing has proved difficult in animals, whose wounds heal within a few days. In this report, we describe a novel method for establishing mouse wounds that require up to 3 weeks or more for complete closure, and we show the validity of this model in Smad3 null mice, which are known to display accelerated healing. Full-thickness wounds, measuring 0.3 by 1.0 cm, were made down to fascia on the dorsal aspect of the mouse tail in Smad3 knock-out mice and control littermates, approximately 1 cm distal to the body of the animal. The wounds were left to heal by secondary intention and were assessed histologically by computerized planimetry for wound closure at various times after wounding. The wounds in wild-type mice displayed delayed healing, with full closure occurring between 14 and 25 days after wounding. Complete closure of similar wounds in Smad3 null mice healed 30 percent faster (p < 0.01). By immunostaining for ki67, a marker for proliferation, Smad3 null animals also showed increased proliferation of dermal wound cells by day 4 after wounding. Cultured dermal fibroblasts from Smad3 null mice had increased baseline DNA synthesis and, interestingly, an enhanced response to transforming growth factor-beta1. By Western blot analysis, Smad3 null mice fibroblasts showed a compensatory increase in mitogen-activated protein kinase phosphorylation in response to transforming growth factor-beta1, suggesting that mitogen-activated protein kinase overcompensation together with loss of Smad3 may be involved in the modulation of faster healing. We conclude that this novel tail-wounding model may be useful for studying delayed wound closure.

Animals↗

The physiology of wound healing and wound assessment.

Wound healing is a complex and remarkable process that occurs when the body responds to trauma. It requires the interaction of several intricate processes with the ultimate aim being to maintain homeostasis. With advances in surgery and increases in the amount of surgery being undertaken, research into wound healing has become of great importance. Providing the optimum conditions for wounds to heal is of great significance as pressures on nursing and hospital resources become ever greater.

Humans↗

Effect of allopurinol on adriamycin-induced impairment of wound healing.

Use of antineoplastic drugs perioperatively requires an understanding of their potential effects on healing wounds. Adriamycin is an antineoplastic drug with a wide range of antitumor activity. Prior studies have demonstrated that adriamycin impairs skin wound healing but these studies have offered limited explanations for the mechanism of action of the drug vis á vis impairment of healing wounds. In this study we investigated the effect of a xanthine oxidase inhibitor, allopurinol, on adriamycin-induced tissue injury to determine the role oxyradicals might play in reducing wound-breaking strength. Sixty-four Buffalo rats were studied. Eight animals were used to establish drug tolerances. Fifty-six animals were divided into four experimental groups; saline control (2 mL IP), allopurinol control (4.3 mg/kg po), allopurinol-adriamycin (4.3 mg/kg po + 6 mg/kg IV, respectively), and adriamycin (6 mg/kg IV). Animals treated with adriamycin alone had significantly reduced weight at postoperative day (POD) 7 compared to control groups (p less than .025). Bowel-bursting strength (BBS) of the animals treated with adriamycin alone was also significantly decreased at POD 7, compared to controls (p less than .025), and by POD 14 the animals treated with adriamycin alone had a significantly decreased fascial tensile strength, compared to the saline control (p less than .05). At no point did the animals treated with both allopurinol and adriamycin show a significantly decreased weight, BBS, or fascial tensile strength compared to control animals. Allopurinol appeared to protect against adriamycin toxicity on healing wounds. These results suggest that xanthine oxidase and possibly superoxide radicals play an important role in mediating adriamycin toxicity on healing wounds.

Allopurinol↗

Application of expanded polytetrafluoroethylene (ePTFE) tubing to the study of human wound healing.

Wounds are a part of daily life. They range from minor nicks and cuts to the incisions of major surgery. In the sequence of evolution the process of healing arose long before modern science. The events which we are beginning to unravel have occurred routinely for a very long time despite our lack of understanding. We have learned how to nurture healing, but how to modify healing in a positive sense is only an approaching reality. Standardized tests of human healing are a necessary part of future research in wound healing. In the Wound Healing Laboratory we have used tubes of expanded polytetrafluoroethylene (ePTFE) as a tissue-sampling device in small, experimental, needle-stick wounds. Ingrowth into ePTFE is influenced by surface and structural characteristics. These are held constant, and "normal" values can be established and used as a base with which to study effects of various clinical states on healing in humans.

Biocompatible Materials↗

Studies on mRNA expression of basic fibroblast growth factor in wound healing for wound age determination.

We investigated the mRNA expression of basic fibroblast growth factor (bFGF) for wound age determination during dermal, cerebral, hepatic and renal wound healing in mice. The bFGF mRNA expression in the injured skin peaked at 1 h and was detected in epidermal cells, fibroblasts, endothelial cells and neutrophils. In the injured cerebrum the expression increased from 1 h and peaked at 48 h. In the intact cerebrum, bFGF was detected exclusively in the endothelial cells, whereas it was also detected in astrocytes during wound healing. Time-dependent expression of bFGF mRNA in skin and cerebrum was considered to be useful for wound age determination. On the other hand it was suggested that bFGF mRNA in astrocytes could be a vital sign of the acute phase. In hepatic and renal injuries, however, bFGF mRNA expression increased slightly in endothelial cells at 24 h, in neutrophils of the liver and in the glomeruli of the kidneys.

Animals↗

A review of wound healing and wound dressing products.

A brief review of the literature concerning the wound healing process is presented. A synopsis of the physical and physiologic factors that can affect the rate of this process is provided. The authors discuss the importance of the wound dressing in maintaining an optimal environment for wound healing. Modern dressings have specific indications and are frequently comprised of more than one layer. The authors define the contact layers as the layer that comes into intimate contact with the wound surface and has the greatest influence on healing. A description of some of the common products used as the contact layer is presented.

Bandages↗

Science of measurements in wound healing.

Wounds that are slow to heal are poorly understood. Clinicians and researchers have attempted to predict treatment outcomes from simple physical measurements without, as yet, understanding the pathogenesis or the role of complications on chronic wounds. Laboratory studies on tissues from biopsies and wound fluids are essential. These must be associated with carefully conducted physiological measurements before, the significance of measurements in wound healing is established.

Humans↗

Effects of early postoperative chemotherapy on wound healing.

Wound complications were investigated in 100 patients undergoing chemotherapy for epithelial ovarian cancer and compared with wound complications in patients with other gynecologic malignancy who did not receive chemotherapy but were operated on by the same gynecologic oncologists. The incidence of wound complications in the chemotherapy-treated population was 11%. Complications developed with equal frequency regardless of when postoperative chemotherapy was initiated. Thus, chemotherapy did not increase the risk of wound complications despite efforts to begin chemotherapy as soon as possible after cytoreductive surgery. Low postoperative albumin levels (P less than .01), postoperative hemoglobin of 10 g/dL or less (P less than .02), advanced stage of disease (P less than .004), and electrocautery use (P less than .05) were all risk factors for development of wound complications, whereas the frequency of bowel resection and type of fascial or skin closure did not adversely influence the risk. Patients who received chemotherapy and developed wound breakdown actually healed faster than our control population. They healed at the same rate as did obstetric and gynecologic patients from the literature. Because delays in administering chemotherapy postoperatively have been associated with decreased survival, we recommend that chemotherapy for advanced-stage epithelial cancer not be delayed solely because of concern for wound healing.

Antineoplastic Combined Chemotherapy Protocols↗

[Consensus of the German and Austrian societies for wound healing and wound management on vacuum closure and the VAC treatment unit].

Within the framework of the Three-Country Congress on VAC Treatment (Vacuum Assisted Closure Treatment) held on May 16/17 2003 in Salzburg, a Consensus Conference involving members of the Committees of the German and Austrian Societies for Wound Management was convened. In view of the divergence of opinion on the effectiveness of the treatment among the cost carriers, it appeared appropriate for the two Societies for Wound Healing in Germany and Austria to arrive at a consensus on the importance of and the indications for the management of wounds with the vacuum closure method. Since the first clinical applications in the nineteen-forties, both the indication spectrum and the number of applications have increased continually. In addition to diverse vacuum closure systems, there is patented computer-controlled system technology available that is established VAC treatment. Although this is a hospital-based system, it can also be used on an outpatient basis by appropriately trained physicians and nursing staff and in instructed patients. For some indications, vacuum closure and VAC management is considered the treatment of choice, since no equivalent alternative methods are available. A cost-benefit analysis shows that vacuum closure and VAC treatment is cost effective.

Austria↗