Wounds Difficult to Heal: An Effective Treatment Strategy

Published on Oct 31, 2017in Current Vascular Pharmacology2.672
· DOI :10.2174/1570161115666170301122216
Raffaele Capoano10
Estimated H-index: 10
,
Rita Businaro18
Estimated H-index: 18
(Sapienza University of Rome)
+ 9 AuthorsSerafino Ricci15
Estimated H-index: 15
Sources
Abstract
OBJECTIVE: Treatment of wounds difficult to heal concerns 50% of the elderly population in Italy and is therefore an extreme relevance social burden. The present study shows how the treatment with autologous leuco-platelets reduces the healing time of wounds improving the functional recovery. PATIENTS AND METHODS: One hundred patients with ulcers of the legs were divided in two groups: 1) 50 patients treated with conventional therapies; 2) 50 patients treated with autologous leuco-platelet concentrate (LPC) and HYAFF as a scaffold. RESULTS: After 2 months a 49% reduction of the wound area was observed in the second group and in a remarkable share (about 65%) wound reduction was obtained in 15 days (4 LPC dressings). On the contrary, patients treated only by simple medications, showed a longer healing time and a greater percentage of failures. Morphometric analysis of bioptic samples obtained from the edge as well as from the bottom of the lesions obtained from the LPC group, detected an abundant presence of neoformed capillaries, characterized by a cubic, "reactive endothelium", close to the site of leuco-platelet infiltration. CONCLUSIONS: These results suggest that healing was promoted not only by limiting bacterial infections but also by the release of chemiotatic and proangiogenetic factors from leukocytes and platelets, improving the neoformation of capillaries.
📖 Papers frequently viewed together
1 Citations
References29
Newest
#1Sophia Khan (Rowan University)H-Index: 2
#2Miguel Villalobos (Rowan University)H-Index: 2
Last. Ping Zhang (Rowan University)H-Index: 2
view all 8 authors...
Objective Adipose-derived stem cells (ASCs) are a potential adult mesenchymal stem cell source for restoring endothelial function in patients with critical limb ischemia. Fibroblast growth factor 2 (FGF2) and vascular endothelial growth factor (VEGF) play a major role in angiogenesis and wound healing. This study evaluated the effects of FGF and VEGF on the proliferation, migration, and potential endothelial differentiation of human ASCs with regards to their use as endothelial cell substitutes....
28 CitationsSource
#1Shaurya Jhamb (JCU: James Cook University)H-Index: 1
#2Venkat N. Vangaveti (JCU: James Cook University)H-Index: 11
Last. Usman H. Malabu (JCU: James Cook University)H-Index: 15
view all 3 authors...
Diabetic Foot Ulcers (DFUs) are major complications associated with diabetes and often correlate with peripheral neuropathy, trauma and peripheral vascular disease. It is necessary to understand the molecular and genetic basis of diabetic foot ulcers in order to tailor patient centred care towards particular patient groups. This review aimed to evaluate whether current literature was indicative of an underlying molecular and genetic basis for DFUs and to discuss clinical applications. From a mol...
47 CitationsSource
#1Rita Businaro (Sapienza University of Rome)H-Index: 18
#2Mariangela Corsi (Sapienza University of Rome)H-Index: 7
Last. Elena De Falco (Sapienza University of Rome)H-Index: 19
view all 11 authors...
New civil wars and waves of terrorism are causing crucial social changes, with consequences in all fields, including health care. In particular, skin injuries are evolving as an epidemic issue. From a physiological standpoint, although wound repair takes place more rapidly in the skin than in other tissues, it is still a complex organ to reconstruct. Genetic and clinical variables, such as diabetes, smoking, and inflammatory/immunological pathologies, are also important risk factors limiting the...
8 CitationsSource
#1Joshua S. Boateng (University of Greenwich)H-Index: 26
#2Ovidio Catanzano (University of Greenwich)H-Index: 11
Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behin...
315 CitationsSource
#1Constanza Martínez (UC: Pontifical Catholic University of Chile)H-Index: 11
#2Patricio C. Smith (UC: Pontifical Catholic University of Chile)H-Index: 22
Last. Verónica A. Palma Alvarado (University of Chile)H-Index: 1
view all 3 authors...
Platelet degranulation allows the release of a large amount of soluble mediators, is an essential step for wound healing initiation, and stimulates clotting and angiogenesis. The latter process is one of the most critical biological events observed during tissue repair, increasing the growth of blood vessels in the maturing wound. Angiogenesis requires the action of a variety of growth factors that act in an appropriate physiological ratio to assure functional blood vessel restoration. Platelets...
80 CitationsSource
#1Akira Kasuya (Hamamatsu University)H-Index: 9
#2Yoshiki Tokura (Hamamatsu University)H-Index: 48
Abstract Wound healing is a well-orchestrated process, where numerous factors are activated or inhibited in a sequence of steps. Immediately after the infliction of damage, the repair of wound stars. The initial step is an inflammatory change with activation of innate immunity, which is followed by proliferation phase, including fibroplasia, angiogenesis and re-epithelialization. Pathological impairment of wound healing process may lead to persistent ulceration as seen in diabetic patients. Vari...
90 CitationsSource
#2Myrte StokH-Index: 1
Last. M. GeerkensH-Index: 1
view all 3 authors...
Impaired wound healing is the result of the interplay between patient-related factors, wound-related factors, skill and knowledge of the healthcare professional and resources and treatment-related factors. The study of wound-related factors learns us that healing is a very complex biologic process. Both ‘seed’ (differentiated and stem cells) and ‘soil’ (e.g. cytokines/chemokines, growth factors, matrix components) are essential for effective wound healing. Tissue engineering for chronic wounds h...
9 CitationsSource
#1Matthias Augustin (UHH: University of Hamburg)H-Index: 48
Chronic wounds such as leg ulcers, diabetic or ischemic foot ulcers and pressure ulcers are a heterogeneous group of chronic tissue defects which share the stagnation of wound healing due to an underlying disease. Most patients suffer from marked reductions of quality of life, including pain, physical discomfort, functional limitations, social burden as well as psychological distress. In some countries, a negative socioeconomic impact for the patients is another strain. Most patients complain ab...
8 CitationsSource
#1Elisabetta Profumo (ISS: Istituto Superiore di Sanità)H-Index: 27
#2Brigitta Buttari (ISS: Istituto Superiore di Sanità)H-Index: 25
Last. Rachele Riganò (ISS: Istituto Superiore di Sanità)H-Index: 31
view all 6 authors...
Atherosclerosis has been clearly demonstrated to be a chronic inflammatory disease of the arterial wall. Both cells of the innate and the acquired immune system, particularly monocytes and T lymphocytes, are implicated in the atherogenic process, producing different cytokines with pro- and anti-inflammatory effects. The majority of pathogenic T cells involved in atherosclerosis are of the Th1 profile, that has been correlated positively with coronary artery disease. Many studies conducted to eva...
18 CitationsSource
#1Fu-peng LiuH-Index: 1
#2Jianjun DongH-Index: 10
Last. Lin LiaoH-Index: 10
view all 11 authors...
Background Amputation-free survival (AFS) has been recommended as the gold standard for evaluating No-Option Critical Limb Ischemia (NO-CLI) therapy.Early-phase clinical trials suggest that autologous bone-marrow derived cells (BMCs) transplantation may have a positive effect on patients with NO-CLI,especially decreasing the incidence of amputation.However,the BMCs therapeutic efficacy remains controversial and whether BMCs therapy is suitable for all CLI patients is unclear.Methods We conducted...
16 Citations
Cited By4
Newest
#1Linda TognettiH-Index: 10
Last. Pietro Rubegni (UNISI: University of Siena)H-Index: 24
view all 13 authors...
Source
#1Raffaele CapoanoH-Index: 10
#2Rita BusinaroH-Index: 18
Last. Bruno SalvatiH-Index: 13
view all 7 authors...
Source
#1Rita Businaro (Sapienza University of Rome)H-Index: 18
#1Rita Businaro (Sapienza University of Rome)H-Index: 6
Last. Elena De Falco (Sapienza University of Rome)H-Index: 19
view all 14 authors...
Neuropeptide Y (NPY), a powerful neurotransmitter of the central nervous system, is a key regulator of angiogenesis and biology of adipose depots. Intriguingly, its peripheral vascular and angiogenic powerful activity is strictly associated to platelets, which are source of clinical hemoderivates, such as platelet lysate (PL), routinely employed in several clinical applications as wound healing, and to preserve ex vivo the progenitor properties of the adipose stromal cells pool. So far, the pres...
8 CitationsSource
#1Rachel Forster (Edin.: University of Edinburgh)H-Index: 7
#2Fania Pagnamenta (Newcastle upon Tyne Hospitals NHS Foundation Trust)H-Index: 3
Background It is estimated that people in industrialised countries have a 1% chance of suffering from a leg ulcer at some time in their life. The majority of leg ulcers are associated with circulation problems; poor blood return in the veins causes venous ulcers (around 70% of ulcers) and poor blood supply to the legs causes arterial ulcers (around 22% of ulcers). Treatment of arterial leg ulcers is directed towards correcting the poor arterial blood supply, for example by correcting arterial bl...
7 CitationsSource