Cellular benefits of single-use negative pressure wound therapy demonstrated in a novel ex vivo human skin wound model.

Published on Mar 1, 2021in Wound Repair and Regeneration2.471
· DOI :10.1111/WRR.12888
Holly N. Wilkinson8
Estimated H-index: 8
(Hull York Medical School),
Francesca L. Longhorne (Hull York Medical School)+ 2 AuthorsMatthew J. Hardman34
Estimated H-index: 34
(Hull York Medical School)
Source
Abstract
Negative pressure wound therapy is a widely used treatment for chronic, nonhealing wounds. Surprisingly, few studies have systematically evaluated the cellular and molecular effects of negative pressure treatment on human skin. In addition, no study to date has directly compared recently available single-use negative pressure modalities to traditional negative pressure devices in a controlled setting. Here we developed a novel large-scale ex vivo human skin culture system to effectively evaluate the efficacy of two different negative pressure wound therapy modalities. Single-use and traditional negative pressure devices were applied to human ex vivo wounded skin sheets cultured over a period of 48 hours. Cellular tissue response to therapy was evaluated via a combination of histological analysis and transcriptional profiling, in samples collected from the wound edge, skin adjacent to the wound, and an extended skin region. Single-use negative pressure wound therapy caused less damage to wound edge tissue than traditional application, demonstrated by improved skin barrier, reduced dermal-epidermal junction disruption and a dampened damage response. Transcriptional profiling confirmed significantly less activation of multiple pro-inflammatory markers in wound edge skin treated with single-use vs traditional negative pressure therapy. These findings may help to explain the greater efficacy of sNPWT in the clinic, while offering a noninvasive system to develop improved NPWT-based therapies.
References41
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#1Holly N. Wilkinson (Hull York Medical School)H-Index: 8
#2Matthew J. Hardman (Hull York Medical School)H-Index: 34
Arguably, the two most important causes of pathological healing in the skin are diabetes and ageing. While these factors have historically been considered independent modifiers of the healing process, recent studies suggest that they may be mechanistically linked. The primary contributor to diabetic pathology is hyperglycaemia, which accelerates the production of advanced glycation end products, a characteristic of ageing tissue. Indeed, advanced age also leads to mild hyperglycaemia. Here, we d...
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#1Varuni R. Brownhill (Smith & Nephew)H-Index: 1
#2Elizabeth Mary Huddleston (Smith & Nephew)H-Index: 6
Last. Holly N. Wilkinson (Hull York Medical School)H-Index: 8
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Objective: Traditional negative pressure wound therapy systems can be large and cumbersome, limiting patient mobility and adversely affecting quality of life. PICO™, a no canister single-use system offers a lightweight, portable alternative to traditional negative pressure wound therapy, with improved clinical performance. The aim of this study was to determine the potential mechanism(s) of action of single-use negative pressure wound therapy versus traditional negative pressure wound therapy. A...
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#1Holly N. Wilkinson (Hull York Medical School)H-Index: 8
#2Matthew J. Hardman (Hull York Medical School)H-Index: 34
Wound healing is a complex, dynamic process supported by a myriad of cellular events that must be tightly coordinated to efficiently repair damaged tissue. Derangement in wound-linked cellular beha...
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#1Holly N. Wilkinson (Hull York Medical School)H-Index: 8
#2Sophie E. Upson (Hull York Medical School)H-Index: 1
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Iron is crucial for maintaining normal bodily function with well-documented roles in erythropoiesis, hemostasis, and inflammation. Despite this, little is known about the temporal regulation of iron during wound healing, or how iron contributes to wound biology and pathology. In this study, we profiled tissue iron levels across a healing time-course, identifying iron accumulation during late-stage repair. Diabetic murine wounds displayed significantly reduced iron levels, delayed extracellular m...
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#1Robert S. Kirsner (UM: University of Miami)H-Index: 77
#2Cyaandi DoveH-Index: 7
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: Multicenter, phase-4, randomized, comparative-efficacy study in patients with VLUs or DFUs comparing for noninferiority the percentage change in target ulcer dimensions (area, depth, and volume) a single-use negative pressure wound therapy (s-NPWT) system versus traditional NPWT (t-NPWT) over a 12-week treatment period or up to confirmed healing. Baseline values were taken at the randomization visit. Randomized by wound type and size, 164 patients with non-infected DFUs and VLUs were included....
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#1Maurício José Lopes Pereima (UFSC: Universidade Federal de Santa Catarina)H-Index: 5
#2Rodrigo FeijóH-Index: 5
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Abstract Objective Evaluate the results obtained using a Dermal Regeneration Template (DRT) associated or not with the Negative Pressure Wound Therapy (NPWT) for skin cover in paediatric patients who were victims of burns. Method Retrospective study of a cross-sectional study that evaluated the medical records of children submitted to the application of DRT, associated or not with NPWT, for the treatment of burned children admitted to the Joana de Gusmao Children's Hospital (JGCH) in Florianopol...
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#1Leland Jaffe (RFUMS: Rosalind Franklin University of Medicine and Science)H-Index: 2
#2Stephanie C. Wu (RFUMS: Rosalind Franklin University of Medicine and Science)H-Index: 18
: The current epidemic of diabetes has created a high demand for skilled wound-care professionals. Wound-care treatment begins with an appreciation of the cause of the ulceration and an adherence to the fundamental pillars of wound care. Also critical in the wound management paradigm is the optimization of the wound environment to facilitate the progression through the stages of healing. This can be accomplished through the use of different topical therapies and wound dressings to generate a fav...
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#1Sebastian Borys (Jagiellonian University Medical College)H-Index: 5
#2Jerzy Hohendorff (Jagiellonian University Medical College)H-Index: 7
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BACKGROUND: Diabetes and its complications constitute a rising medical challenge. Special attention should be given to diabetic foot syndrome (DFS) due to its high rate of associated amputation and mortality. Negative pressure wound therapy (NPWT) is a frequently used supportive modality in a diabetic foot with ulcerations (DFUs). DESIGN: Here, we reviewed the current knowledge concerning the tissue and molecular mechanisms of NPWT action with an emphasis on diabetes research followed by a summa...
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#1Ruth Knight (University of Oxford)H-Index: 5
#2Louise Spoors (University of Oxford)H-Index: 2
Last. Susan J. Dutton (University of Oxford)H-Index: 28
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In the context of major trauma, the rate of wound infection in surgical incisions created during fracture fixation amongst patients with closed high-energy injuries is high. One of the factors which may reduce the risk of surgical site infection is the type of dressing applied over the closed incision. The WHIST trial evaluates the effects of negative-pressure wound therapy (NPWT) compared with standard dressings. The WHIST trial is a multicentre, parallel group, randomised controlled trial. The...
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#1Lijuan Zhou (ZJU: Zhejiang University)H-Index: 1
#2Xianqi Zhang (ZJU: Zhejiang University)H-Index: 1
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Abstract Human skin organ culture (hSOC) is a simple but highly instructive and clinically relevant skin research method. It has been used for decades to study the development, differentiation, and function as well as the response to wounding or test agents of intact human skin in the presence of its appendages and all resident cell populations. hSOC has also proven useful in toxicological and oncological studies and studies of skin aging (both chronological aging and photoaging), skin energy me...
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