삼출액과 감염이 동반된 창상의 치료에 있어 은 함유 카르복시메틸 셀룰로즈 드레싱의 역할

이지혁,이은상,강소라 대한성형외과학회 2007 Archives of Plastic Surgery Vol.34 No.3

Purpose: Wound healing is a result of complex processes whose components, such as cells, extracellular matrix, proteolytic enzymes, and their inhibitors receive effects from immune compartments, cytokines, chemokines, and growth factors. Impairment of normal physiologic response to wounding makes nonhealing chronic wounds. Wound infection and exacerbated proteolytic process may induce uncontrolled tissue degradation or exudates formation, which may result in the development of a nonhealing chronic wound. Thus proper management of wound infection and exudates is critical to prevent and treat nonhealing wound. The aim of this study is to evaluate effects of Aquacel AG, silver-containing carboxymethylcellulose dressing on treatment for exudative infected wound. Methods: The study included 31 patients with nonhealing wound. Wound was dressed with Aquacel AG. The effect of dressing was investigated by serial bacterial culture and wound exudates assessment. Each infection and exudates control time was determined and statistically analyzed.Results: Wound infection and exudates were effectively managed using Aquacel AG dressing. Mean infection and exudates control time were 3.4±1.2 and 5.7±1.4 weeks, respectively. Statistical analysis of the data indicated that infection control time correlated positively to age and exudates control time (p<0.05). Conclusion: There is as yet no ideal dressing for the topical treatment of chronic nonhealing wound. But silver-containing carboxymethylcellulose dressing can be used effectively for exudative, infected nonhealing wound.

PDGF(Platelet-derived growth factor)가 창상 치유에 미치는 영향에 대한 연구

이두형,홍성표,송지영 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.5

PDGF(Platelet-derived Growth Factor), one of the growth promoting factors, has reported to have the chemotactic and mitogenic effects forfibroblast and to stimulate the rate of collagen deposition. In the diabetic patient, PDGF may be present in the suboptimal level and the diabetic wound healing is usually delayed. This study was conducted to clarify the effect of PDGF in the normal and diabetic wound healing. 36 diabetic Wistar rats which diabetes is induced with streptozotocin and 20 nondiabetic Wistar rats were divided into 4 groups, the diabetic full thickness wound group, the diabetic split thickness wound group, the normal full thickness wound group and the normal split thickness wound group. Authors created two full thickness wounds on the back of rats in full thickness wound group and two split thickness wounds on the back of rats in split thickness wound group. The upper wound was used as the experimental wound which was managed with the PDGF cream and the lower wound was used as the control wound which was managed with the silvadene cream. The results are as followings; 1. In the normal full thickness wound group, the wound contraction was faster in the experimental wound than in the control wound(P<0.001). 2. In the diabetic full thickness wound group, the wound contraction was faster in the experimental wound than in the control wound(P<0.001). 3. In the normal and diabetic split thickness wound group the experimental wounds showed a little faster epithelization than the control wounds with no statistical difference(P>0.05). 4. In the normal and diabetic full thickness wound groups, the fibroblast proliferation, the capillary ingrowth and the granulation tissue formation were markedly increased in the experimental wound compared with those of the control wound. And the collagen fibers in the experimental wound were arranged in the regular fashion. As a result topical application of PDGF can induce the wound contraction and the formation of granulation tissue in the normal and diabetic wounds.

Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

김범회 한의병리학회 2011 동의생리병리학회지 Vol.25 No.5

The purpose of this study was to investigate the wound healing effects of Danggwieumja (DG), which is commonly used for skin inflammation, skin wound, skin pruritus, and chronic hives etc. The 1.5 cm × 1.5 cm full-thickness skin wound was induced to two groups, DG (n=16) and Saline (n=16) group. The DG extract and Saline were orally administrated daily for 15 days after skin wound induction. Then, the body weight of rats and the congestion indices were daily measured for 15 days after skin wound induction. The wound contractions and epithelizations were also measured. The wound contractions were daily measured for 15 days after wound induction and wound epithelizations were measured for 8 days from day 7 after wound induction. For evaluating angiogenesis, the immunoreactivities of vWF and VEGF protein were measured immunohistochemistrically on day 15. In results, although the percentage increases in mean body weight of rats in the DG and Saline groups hve no significant differences, DG extract decreased the time of wound healing and congestion around wound, and improved wound contraction and epithelization. The contraction percentage of DG group was significantly increased on day 5 (P<0.05) and day 7 (P<0.01) than that of Saline group. DG group showed significant increase of wound epithelization on day 7 (P<0.05) as compared to Saline group. Moreover, DG extract reduced the inflammation of skin dermis and promoted the growth of vascular vessels of dermis by accelerating vascular endothelial growth factor (VEGF) protein. These results suggest that DG has the beneficial effects on skin incision wound and can be the suitable wound healing agent for various surgical wounds.

Recent Advancements in Smart Bandages for Wound Healing

Ventaka Ramesh Ragnaboina,장태민,한성근,황석원 한국센서학회 2023 센서학회지 Vol.32 No.6

Wound healing is a complex and dynamic process, making the accurate and timely assessment of skin wounds a crucial aspect ofeffective wound care management, especially for chronic wounds. Unlike conventional wound dressings that simply cover the woundarea once some form of medicine is administered onto the wound, recent studies have introduced versatile approaches to smart wounddressings capable of interacting with wound fluids to monitor physicochemical and pathological parameters to determine the woundhealing status. Such electrochemical wound dressings can be integrated with on-demand, closed-loop drug delivery or stimulation systemsand ultimately expanded into an ideal technological platform for the prevention, treatment, and management of skin wounds orillnesses. This article briefly reviews the wound healing mechanism and recent strategies for effective wound care management. Specifically,this review discusses the following aspects of smart wound dressings: sensor-integrated smart bandages to detect wound biomarkers,smart bandages developed to accelerate wound healing, and wireless, closed-loop automatic (on-demand) wound healingsystems. This review concludes by providing future perspectives on effective wound care management.

제 1형 콜라겐 판이 전층피부결손의 창상치유에 미치는 영항

이의태,한상벽,박경찬,방사익,김석화,서활,박흥식,현원석,오태석 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Wound healing is a natural process proceeded by connective tissue deposition, epithelialization, and wound contraction. Excessive wound contraction causes postoperative scar contractures. Although full thickness skin grafts are known to inhibit wound contraction. the precise mechanism has not been determined. Up to now, dermis is thought to be the essential component of inhibition of contraction. To assess the effect of type Ⅰcollagen-the major component of dermis-upon wound contraction, we compared the wound healing of open wound with that of collagen sheet applied wound. Two full thickness skin defects were created on the back of adult male Sprague-Dawley rats. After the application of a thin sheet of type Ⅰ collagen upon one defect in each rat, the area of both wounds in relation to original wound area(day 0) was serially measured at 2, 4, 6.10, and 21 days postoperatively. The difference in the mean area ratios between two groups was then compared using Wilcoxon rank sums test. In addition, we performed histological examination of serial punch biopsies taken at 2,4,6,10, and 21 days postoperatively. During the 3 weeks period, the decrease in the area of collagen sheet applied wound was greater than that of open wounds. For the first 10 days, there was a significant difference (p<0.053 or less) in the mean wound areas between the two groups and histological examination revealed the presence of continuous epithelialization between the collagen sheet and wound bed at the wound margin. By the end of three weeks, no significant difference could be found(p=0.1842)in mean wound area ratios. Thus, the application of thin type Ⅰ collagen sheet upon full thickness skin defects in rats does not inhibit wound contraction, but it promotes both wound contraction and epithelialization and results in rapid wound healing.

Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

Kim, Bum-Hoi The Physiological Society of Korean Medicine and T 2011 동의생리병리학회지 Vol.25 No.5

The purpose of this study was to investigate the wound healing effects of Danggwieumja (DG), which is commonly used for skin inflammation, skin wound, skin pruritus, and chronic hives etc. The 1.5 cm ${\times}$ 1.5 cm full-thickness skin wound was induced to two groups, DG (n=16) and Saline (n=16) group. The DG extract and Saline were orally administrated daily for 15 days after skin wound induction. Then, the body weight of rats and the congestion indices were daily measured for 15 days after skin wound induction. The wound contractions and epithelizations were also measured. The wound contractions were daily measured for 15 days after wound induction and wound epithelizations were measured for 8 days from day 7 after wound induction. For evaluating angiogenesis, the immunoreactivities of vWF and VEGF protein were measured immunohistochemistrically on day 15. In results, although the percentage increases in mean body weight of rats in the DG and Saline groups hve no significant differences, DG extract decreased the time of wound healing and congestion around wound, and improved wound contraction and epithelization. The contraction percentage of DG group was significantly increased on day 5 (P<0.05) and day 7 (P<0.01) than that of Saline group. DG group showed significant increase of wound epithelization on day 7 (P<0.05) as compared to Saline group. Moreover, DG extract reduced the inflammation of skin dermis and promoted the growth of vascular vessels of dermis by accelerating vascular endothelial growth factor (VEGF) protein. These results suggest that DG has the beneficial effects on skin incision wound and can be the suitable wound healing agent for various surgical wounds.

Feature Article : Wound Dressings for Wound Healing and Drug Delivery

( Gyeong Hae Kim ),( Yun Mi Kang ),( Kkot Nim Kang ),( Da Yeon Kim ),( Hyun Jung Kim ),( Byung Hyun Min ),( Jae Ho Kim ),( Moon Suk Kim ) 한국조직공학과 재생의학회 2011 조직공학과 재생의학 Vol.8 No.1

Since skin is what protects our body from the external environment, skin wounds cause inconveniences in life and lead to post-trauma sequela and stress. When the skin is wounded, it is healed through a series of pro-cesses, such as via the haemostasis/inflammation phase, migration phase, proliferation phase, and maturation phase, during which time exudate containing various growth factors is released at the wound. Wound dressings we reemployed by dry dressing in the past, and this process heals the wound by drying it and creating crust, but, recently, wet dressings have been used in locations where appropriate temperature and humidity are maintained. Also, besides wet dressings, drug delivery systems and tissue engineering have been used recently for wound treatment, both of which utilize wound dressing products, such as hydrocolloid, alginate, hydrogel, foam, and biological dressings. And now, reaching beyond the existing role of just protecting the wound, wound dressings for drug delivery systems con-taining drugs and growth factors are being researched so that they can be used for difficult wound treatments, suchas chronic wounds or burns. This article reviews the developments of various wound dressings that have been madeto date.

창상치유 과정에서의 pH 변화

정재훈,이상우,장학,민경원 대한성형외과학회 2008 Archives of Plastic Surgery Vol.35 No.3

Purpose: For a proper wound care, the correct evaluation of wound is very important. Usually the evaluation of wound was subjective, and as a result, wound care was empirical. There were many attempts to objectify the wound evaluation, and one of them was measurement of the wound pH. The purpose of this study is to observe the wound pH changes during wound healing phase. Methods: From 2005 to 2007, we measured the pH values of 6 acute wounds, which were split thickness skin graft donor sites. In addition, we measured the pH values of 18 chronic wounds, which were 17 pressure sores and 1 tuberculosis ulcer. After pH meter (SkinCheck1?, Hanna Instruments, Italy) was calibrated, wound pH was checked. Wound was cleansed with saline gauze and dressed with polyurethane foam dressing(Medifoam?, Biopol, Korea). Results: In split thickness skin graft donor sites, the pH raised(mean pH value: 7.45→7.62) when the wound was on the process of healing(*p=0.027, analysis of Wilcoxon signed-rank test). If wound became re-epithelialised, the pH value dropped to that of normal skin. However, we could not find a relation between time and the pH values in chronic wound. Conclusion: We could observe the consistent wound pH changes during wound healing phase in acute wound.

TGF-β의 길항제인 Decorin이 백서 태자의 반흔 형성에 미치는 영향

신극선,유원민,곽혁준 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.8

Adult wounds heal with scar-tissue formation, whereas fetal wounds heal without scarring and with a lesser inflammatory and cytokine response. The unique fetal wound repair process is not dependent on the sterile, aqueous intrauterine environment. The differences between fetal and adult wound healing appear to reflect processes intrinsic to fetal tissue, such as the unique fetal fibroblast, a more rapid and ordered deposition and turnover of tissue components, and, particularly, a markedly reduced inflammatory infiltrate and cytokine profile. Among these cytokines, the transforming growth factor-β(TGF-β) is a growth factor which plays an important role in the regulation of cell growth and differentiation. The fibrosis characteristic of adult wound repair may be associated with TGF-βexcess. Recent experimental studies have focused on the specific anti-TGF-β strategies for scarless wound healing. Decorin, a proteoglycan, is known to regulate TGF-β. This factor antagonizes the action of TGF-βin tissues. However, little is known about the functions of this factor in vivo. The objects of the present study were to analyze the effects of TGF-β, an important regulatory molecule in adult healing events, and the effects of decorin, known inhibitor against TGF-β, on the fetal tissue response following wounding. Fetal cellular and extracellular matrix response to injury were evaluated by treating the wound with TGF-β and decorin in fetal rat at 14 days gestation (term = 21 days). Histologic response and histomorphometric analysis two to eight weeks later were compared between TGF-βonly treated wound and TGF-βwith decorin treated wound. The histologic finding of the TGF-β treated wound was characterized by an early acute inflammatory response : by week 6 fibroblasts and collagen were predominant. In contrast, TGF-β with decorin treated wound had no remarkable histologic evidence of acute inflammation or fibroblast penetration and few collagen was deposited. These observations demonstrate that the fetal response becomes adultlike with fibroblast proliferation and collagen accumulation when TGF-βis added, thus documenting the responsiveness of the fetal system to adult repair signals. Such responsiveness thus suggests a critical difference in the fetal wound environment. Fetal repair may proceed in the absence of trophic factors like TGF-β, thus accounting for optimal "healing" in the absence of excessive fibrosis. And these observations also confirmed the inhibitory action of decorin against TGF-β in rat fetus model. We can suggest that the decorin minimize the inflammatory response and subsequent cellular proliferation in wound healing process, thus eventually prevent collagen deposition and scar tissue formation.

Electrospun zwitterionic nanofibers with in situ decelerated epithelialization property for non-adherent and easy removable wound dressing application

Unnithan, Afeesh Rajan,Ghavami Nejad, Amin,Sasikala, Arathyram Ramachandra Kurup,Thomas, Reju George,Jeong, Yong Yeon,Murugesan, Priya,Nasseri, Saeed,Wu, Dongmei,Park, Chan Hee,Kim, Cheol Sang Elsevier 2016 Chemical Engineering Journal Vol.287 No.-

<P><B>Abstract</B></P> <P>Wound care management is a serious issue among the medical practitioners due to its varying complexity and various materials were tested for fast relief and easy removal. In this regard zwitterionic polymer based wound dressing membranes are the key point of attraction. Here we prepared a novel zwitterionic poly (carboxybetaine-co-methyl methacrylate) (CBMA) copolymer based nanomembranes using the electrospinning technique for the wound dressing application. The study takes advantage of the outstanding chemical properties of zwitterionic CBMA and the morphological efficiency of nanomembranes. The cell attachment studies proved the cell inert nature of thus prepared membranes. Such non cell adherent wound dressing membranes can be applied as the easy removable, no-pain wound dressing bandages. Our results clearly showed that the excellent blood-inert nature can be achieved by the CBMA nanofiber membranes. Therefore, there will be less chance of attaching blood clot with the wound dressing membrane and is extremely significant for the care of patients with large areas of chronic wounds. Additionally the in vivo results showed the formation of new tissues within two weeks, evidence of a complete wound healing material. So our CBMA membrane can be successfully used as a perfect wound dressing material with minimum cosmetic scar.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Non cell adherent wound dressing membranes. </LI> <LI> Easy removable, no-pain wound dressing bandages. </LI> <LI> Blood inert wound dressing membrane, suitable for large areas of chronic wounds. </LI> <LI> Resist microbial biofilm formation and hence provides minimum chance of infection. </LI> <LI> Minimum cosmetic scar due to less cell adsorption on wound dressing membrane. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>