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Effect of limited access dressing on surface pH of chronic wounds

Plastic and Aesthetic Research 2015年第1期2卷 257-260页

作者： Pramod Kumar thittamaranahalli muguregowda honnegowda Department of Plastic Surgery King Abdulaziz Specialist HospitalSakaka 42421Al-JoufSaudi Arabia Department of Plastic Surgery and Burns Kasturba Medical CollegeManipal 576104KarnatakaIndia

Aim:Changes in the pH of chronic wounds can inhibit the optimal activity of various enzymes in the wound environment,thereby delaying wound *** aim of the present study is to monitor the effect of limited access dressing(LAD)on the pH on the surface of chronic ***:A total of 140 patients with chronic wounds of more than 4 weeks duration were divided into two groups by simple randomization:a LAD group(n=64)and a conventional dressing group(n=76).Fifty-six participants(22 in the LAD group and 34 in the conventional dressing group)were lost to follow-up or withdrawn from the ***:In the LAD group(n=42),the mean age was 38.3±10.56 years(range:12-60 years),and the mean wound size at the time of admission was 28 cm^(2)(range:19-40 cm^(2)).In the conventional dressing group(n=42),the mean age was 35.3±14.0 years(range:17-65 years),and the mean wound size at the time of admission was 26 cm^(2)(range:18-39 cm^(2)).Patients treated with LAD showed a significant decrease in the mean±standard deviation pH when compared with the conventional dressing group(0.83±0.52 vs.0.41±0.26,P=0.048).Conclusion:LAD reduces the chronic wound surface pH to a level required for the optimal function of various *** could be a factor that exerts a beneficial effect on wound healing.

关键词： Chronic wounds limited access dressing negative pressure wound therapy wound surface pH

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Role of angiogenesis and angiogenic factors in acute and chronic wound healing

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Plastic and Aesthetic Research 2015年第1期2卷 243-249页

作者： thittamaranahalli muguregowda honnegowda Pramod Kumar Echalasara Govindarama Padmanabha Udupa Sudesh Kumar Udaya Kumar Pragna Rao Department of Plastic Surgery and Burns Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Plastic Surgery King Abdulaziz Specialist HospitalSakaka 42421Al-JoufSaudi Arabia Department of Biochemistry Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Surgery District Government HospitalUdupi 576108KarnatakaIndia

Angiogenesis plays a crucial role in wound healing by forming new blood vessels from preexisting vessels by invading the wound clot and organizing into a microvascular network throughout the granulation *** dynamic process is highly regulated by signals from both serum and the surrounding extracellular matrix *** endothelial growth factor,angiopoietin,fibroblast growth factor and transforming growth factor-beta are among the potent angiogenic cytokines in wound *** endothelial cell ECM receptors are critical for morphogenetic changes in blood vessels during wound *** particular integrin(αvβ3)receptors for fibrin and fibronectin,appear to be required for wound angiogenesis:αvβ3 is focally expressed at the tips of angiogenic capillary sprouts invading the wound clot,and any functional inhibitors ofαvβ3 such as monoclonal antibodies,cyclic RGD peptide antagonists,and peptidomimetics rapidly inhibit granulation tissue *** spite of clear knowledge about influence of many angiogenic factors on wound healing,little progress has been made in defining the source of these factors,the regulatory events involved in wound angiogenesis and in the clinical use of angiogenic stimulants to promote repair.

关键词： Angiogenic factors endothelium extracellular matrix protein granulation tissue wound healing

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Histopathological study of chronic wounds modulated by intermittent negative pressure therapy under limited access dressing

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Plastic and Aesthetic Research 2015年第1期2卷 272-276页

作者： thittamaranahalli muguregowda honnegowda Pramod Kumar Rekha Singh Swarna Shivakumar Pragna Rao Hemanth K.Prasad Sudesh Kumar Udaya Kumar Echalasara Govindarama Padmanabha Udupa Department of Plastic Surgery and Burns Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Plastic Surgery King Abdulaziz Specialist HospitalSakaka 42421Al-JoufSaudi Arabia Department of Pathology Vydehi Institute of Medical Sciences and Research CenterBengaluru 560066KarnatakaIndia Department of Pathology Apollo HospitalsBengaluru 560066KarnatakaIndia Department of Biochemistry Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Surgery Government District HospitalUdupi 576101KarnatakaIndia

Aim:Negative pressure wound therapy(NPWT)has achieved widespread success in the treatment of chronic ***,its effects have been only partially explored,and investigations have generally concentrated on the wound-dressing interface;a detailed histopathological description of the evolution of wounds under NPWT is still *** present study was performed to investigate the effect of a limited access dressing(LAD)which exerts intermittent NPWT in a moist environment on chronic ***:A total of 140 patients were randomized into 2 groups:LAD group(n=64)and conventional dressing group(n=76).By histopathological analysis of the granulation tissue,the amount of inflammatory infiltrate,necrotic tissue,angiogenesis,and extracellular matrix(ECM)deposition was studied and compared to determine healing between the 2 ***:After 10 days of treatment,histopathological analysis showed a significant decrease in necrotic tissue with LAD compared to the conventional dressing group(mean±standard error,11.5±0.48 vs.10.1±0.30,P=0.007),the number of inflammatory cells(12.6±0.60 vs.8.63±0.35,P=0.018),a significant increase in new blood vessels(12.8±0.58 vs.9.3±0.29,P=0.005)and ECM deposit(13.3±0.50 vs.9.6±0.24,P=0.001).Conclusion:LAD exerts its beneficial effects on chronic wound healing by decreasing the amount of necrotic tissue and inflammatory cells while increasing the amount of ECM deposition and angiogenesis.

关键词： Angiogenesis chronic wounds extracellular matrix granulation tissue inflammatory cell limited access dressing necrotic tissue negative pressure wound therapy

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A comparative study to evaluate the effect of limited access dressing on diabetic ulcers

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Plastic and Aesthetic Research 2015年第1期2卷 266-271页

作者： thittamaranahalli muguregowda honnegowda Pramod Kumar Krishnananda Prabhu Ashwini Kumar Pragna Rao E.G.Padmanabha Udupa Shobha Kamath Antony Sylvan D’Souza Krishna Kishore Mahato Department of Plastic Surgery and Burns Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Plastic Surgery King Abdulaziz Specialist HospitalSakaka 42421Al-JoufSaudi Arabia Department of Biochemistry Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Forensic Medicine Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Anatomy Kasturba Medical CollegeManipal 576104KarnatakaIndia Department of Biophysics School of Life SciencesManipal 576104KarnatakaIndia

Aim:Emerging evidence favors the important role of antioxidants,matrix metalloproteinases(MMPs),and nitric oxide(NO)in the healing of diabetic *** is a lack of substantial evidence regarding the effects of negative pressure on antioxidants,MMPs and NO in chronic wounds associated with ***:A total of 55 type 2 diabetic patients with leg ulcers were divided into 2 groups:a limited access dressing(LAD)group(n=27)and a conventional dressing group(n=28).Levels of hydroxyproline,total protein,MMP-2 and MMP-9,NO and antioxidants including reduced glutathione(GSH)and the oxidative biomarker malondialdehyde(MDA)were measured in the granulation tissue at days 0 and *** in levels between the LAD and conventional groups were determined by the Student’s ***:After 10 days of treatment,the LAD *** dressing group showed increase in the levels of hydroxyproline(mean±standard deviation=55.2±25.1 vs.29.2±1,P<0.05),total protein(12.8±6.5 vs.8.34±3.2,P<0.05),NO(1.13±0.52 vs.0.66±0.43,P<0.05),GSH(7.0±2.4 vs.6.6±2.2,P<0.05)and decrease in MMP-2(0.47±0.33 vs.0.62±0.30,P<0.05),MMP-9(0.32±0.20 vs.0.53±0.39,P<0.05)and MDA(6.8±2.3 vs.10.4±3.4,P<0.05).Conclusion:When compared to conventional dressings,LAD induces biochemical changes by significantly increasing the levels of hydroxyproline,total protein,NO and antioxidants levels,and significantly reducing MMPs(MMP-2 and MMP-9)and an oxidative biomarker in diabetic *** biochemical changes are thought to favor diabetic wound healing.

关键词： Antioxidants diabetic wounds hydroxyproline limited access dressing matrix metalloproteinases nitric oxide reactive oxygen species and oxidative stress biomarker total protein

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