• 생명과학회지
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• 제29권3호
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• pp.382-393
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• 2019

상처 치료는 전세계 인류에 영향을 미치는 보건 산업계의 관심사다. 당뇨병과 같은 대사증후군 유병률 증가로 상처에 의한 합병증의 위험이 높아지고 상처치유의 복잡함 때문에 상처의 치료와 관리가 어렵다. 전통적 상처 드레싱은 제한된 보호기능을 제공하며, 상처 드레싱의 치료 능력을 향상시키기 위해 생체고분자 기반의 드레싱들이 개발되고있다. 생체고분자는 생분해성이 뛰어나고 생체적합성이 좋으며 효과적인 상처 관리에 중요한 항균, 항염증, 지혈, 세포증식, 혈관성 활동 등 다양한 효과가 있다. 키토산, 셀룰로오스, 콜라겐, 히알루론산, 알긴산 등의 여러 생체고분자가 이미 상처치유제로 활용되고 있으며 생체고분자를 다른 고분자, 생체활성 분자 및 약물과 결합하여 생리학적 문제 없이 흉터를 최소화하는 새로운 상처 드레싱이 개발되고 있다. 본 논문에서는, 향후의 연구와 활용을 위한 현재의 생체고분자의 상처처리에 대해 알아보았다.

• Archives of Plastic Surgery
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• 제40권5호
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• pp.496-504
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• 2013

Background Amniotic-fluid-derived stem cells and amniocytes have recently been determined to have wound healing effects, but their mechanism is not yet clearly understood. In this study, the effects of amniotic fluid stem cells and amniocytes on wound healing were investigated through animal experiments. Methods On the back of Sprague-Dawley rats, four circular full-thickness skin wounds 2 cm in diameter were created. The wounds were classified into the following four types: a control group using Tegaderm disc wound dressings and experimental groups using collagen discs, amniotic fluid stem cell discs, and amniocyte discs. The wounds were assessed through macroscopic histological examination and immunohistochemistry over a period of time. Results The amniotic fluid stem cell and amniocyte groups showed higher wound healing rates compared with the control group; histologically, the inflammatory cell invasion disappeared more quickly in these groups, and there was more significant angiogenesis. In particular, these groups had significant promotion of epithelial cell reproduction, collagen fiber formation, and angiogenesis during the initial 10 days of the wound healing process. The potency of transforming growth factor-${\beta}$ and fibronectin in the experimental group was much greater than that in the control group in the early stage of the wound healing process. In later stages, however, no significant difference was observed. Conclusions The amniotic fluid stem cells and amniocytes were confirmed to have accelerated the inflammatory stage to contribute to an enhanced cure rate and shortened wound healing period. Therefore, they hold promise as wound treatment agents.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.121-126
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• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• Macromolecular Research
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• 제12권2호
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• pp.219-224
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• 2004

In this work, we prepared hydrogels for wound dressing from a mixture of poly(vinyl alcohol) (PVA) and alginate using the $\^$60/Co ${\gamma}$-ray irradiation technique. We examined the physical properties of these hydrogels, including gelation, water absorptivity, and gel strength, to evaluate the applicability of these hydrogels for wound dressings. The biocompatibility of these hydrogels was also evaluated in vitro, in cultures of mouse fibroblasts, and in vivo, by subcutaneous implantation studies in rats. The gel content and strength increased upon increasing the radiation dose and upon decreasing the concentration of alginate. The degree of swelling was inversely proportional to the gel content and strength. The degree of cytotoxicity of the ${\gamma}$-ray-treated hydrogels was ca. 60% compared to the (－) control (serum) after 1 day of incubation. When the incubations were prolonged up to 2 days, the toxicity of all the samples decreased remarkably and reached that of the control. Subcutaneous implantation studies in rats indicated that foreign body reactions occurring around the implanted hydrogels were moderate and became minimal upon increasing the implantation time.

• 대한족부족관절학회지
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• 제18권1호
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• pp.1-7
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• 2014

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

• 폴리머
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• 제28권2호
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• pp.194-200
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• 2004

돼지의 소장 점막하 조직은 면역반응이 없는 재료로 널리 사용되고 있다. 본 연구에서는 소장 점막하 조직을 1-ethyl-(3,3-dimethyl aminopropyl) carboimide hydrochloride(EDC)를 이용하여 경화시켰으며 동시에 스폰지 형태로 제조하여 조직공학적 담체와 상처 드레싱재료로서의 응용 가능성을 검토하였다. 다세포 구성분을 제거한 소장 점막하 조직 분말을 3% 아세트산에 용해하여 일정한 형태의 몰드 내에 붓고 동결 건조하였다 이 소장 점막하 조직 스폰지를 여러 농도의 EDC용액에 침지하여 가교반응을 실시하였다 이를 전자주사 현미경, 시차 주사열량계, 적외선 분광분석기, 다공도 테스트 및 흡수성 실험을 수행하여 특성을 결정하였다. 소장 점막하 조직 스폰지는 경화제의 농도가 50mM 이상에서 물리적 특성이 우수한 것으로 판단되었다. 일련의 실험을 통하여 경화된 소장 점막하 조직 스폰지가 조직공학적 담체와 상처치료 드레싱재료로 유용하게 사용될 수 있음을 확인하였다.

• Journal of Veterinary Science
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• 제24권3호
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• pp.44.1-44.17
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• 2023

Background: Antibiotic resistance is a significant public health concern around the globe. Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. Objective: This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. Methods: Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. Results: The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). Conclusions: Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

• Journal of Microbiology and Biotechnology
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• 제27권4호
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• pp.747-758
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• 2017

Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, ${{\small}L}$-Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and ${{\small}L}$-Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureus. This new ${{\small}L}$-Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.257-263
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• 2013

Purpose: The purpose of this study was to investigate the effect of Ulmus root-bark dressing in fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) of induced pressure ulcers in rats. Methods: 54 male Sprague-Dawley rats were used and randomly divided into 2 groups. The rats were anesthetized and pressure ulcers were induced at 140 mmHg for three hours, using a personally-designed pressing apparatus. Ulmus dressing was applied in the experimental group (n=27) and saline gauze dressing in the control group (n=27). Each of the dressings was changed every other day, and after a month, the wounds were examined by microscopy biweekly for 20 weeks. Results: After 4 weeks, the epidermis of the wounds was recovered, but inflammatory infiltration of the dermis was remained. After 6 weeks, inflammatory cells were diminished and the number of capillaries was decreased. Examined by immunofluorescence staining, the FGF positive cells in the experimental group changed negatively after 18 weeks, but the control group still existed even after 20 weeks. VEGF positive cells in the experimental group also changed negatively after 20 weeks, but the control group still existed. Conclusion: The findings of this study demonstrate that Ulmus dressing is effective in minimizing scar formation and inflammatory reaction by decreasing FGF and VEGF in the terminal phase of wound healing.

• Archives of Plastic Surgery
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• 제44권2호
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• pp.117-123
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• 2017

Background Upper extremity soft tissue defects with complete circumferential involvement are not common. Coupled with the unique anatomy of the upper extremity, the underlying etiology of such circumferential soft tissue defects represent additional reconstructive challenges that require treatment to be tailored to both the patient and the wound. The aim of this study is to review the various options for soft tissue reconstruction of complete circumferential defects in the upper extremity. Methods A literature review of PubMed and MEDLINE up to December 2016 was performed. The current study focuses on forearm and arm defects from the level at or proximal to the wrist and were assessed based on Tajima's classification (J Trauma 1974). Data reviewed for analysis included patient demographics, causality, defect size, reconstructive technique(s) employed, and postoperative follow-up and functional outcomes (when available). Results In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 14 unique articles were identified for a total of 50 patients (mean=28.1 years). Underlying etiologies varied from extensive thermal or electrical burns to high impact trauma leading to degloving or avulsion, crush injuries, or even occur iatrogenically after tumor extirpation or extensive debridement. Treatment options ranged from the application of negative pressure wound dressings to the opposite end of the spectrum in hand transplantation. Conclusions With the evolution of reconstructive techniques over time, the extent of functional and aesthetic rehabilitation of these complex upper extremity injuries has also improved. The proposed management algorithm comprehensively addresses the inherent challenges associated with these complex cases.