Dissertations / Theses on the topic 'Wound therapy'
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Coutin, Julia Viviana. "Cefazolin Concentration in Surgically Created Wounds Treated with Negative Pressure Wound Therapy Compared to Surgically Created Wounds Treated with Nonadherent Wound Dressings." Thesis, Virginia Tech, 2014. http://hdl.handle.net/10919/49112.
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Our objective was to compare cefazolin concentrations in biopsied tissue samples collected from surgically created wounds treated with negative pressure wound therapy to those collected from surgically created wounds treated with nonadherent dressings. The study design was a prospective, controlled, experimental study. The animal population included 12 female spayed beagles. We hypothesized there would be a difference between the cefazolin concentrations of wounds treated with negative pressure wound therapy when compared to the cefazolin concentrations of wounds treated with nonadherent dressings.
Surgical methods were as follows: Full thickness cutaneous wounds were created on each antebrachium (n=24). Following surgery, cefazolin (22 mg/kg) was administered intravenously to each of the dogs and continued every 8 hours during the study. The right wound was randomly assigned to group I or group II while the wound on the contralateral antebrachium was assigned to the other group. Group I wounds were treated with negative pressure wound therapy (NPWT) and group II wounds were treated with nonadherent dressings for 3 days. Dressings were changed and tissue biopsies obtained from wound beds at 24-hour intervals for both groups. Cefazolin wound tissue and plasma concentrations were measured by liquid chromatography mass spectrometry (LC-MS/MS). Blood samples for measuring plasma cefazolin concentrations were collected prior to biopsy sampling. At the time of surgery and at each bandage change, wound beds were swabbed and submitted for aerobic and anaerobic culture.
Our results revealed that after initiating cefazolin treatment, wound tissue antibiotic concentrations between treatment groups were not significantly different at any sampling time. Similarly, after initiating cefazolin treatment, plasma cefazolin concentrations were not significantly different at any sampling time for individual dogs.
We concluded that using a canine experimental model, NPWT treatment of surgically created wounds does not statistically impact cefazolin tissue concentrations when compared to conventional nonadherent bandage therapyMaster of Science
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Kairinos, Nicolas. "The biomechanics of negative-pressure wound therapy." Doctoral thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/10809.
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Includes references.Despite the success of negative-pressure wound therapy, its mechanism of action remains unclear. The common perception that it reduces tissue pressure and increases perfusion has recently been challenged following the observation that tissue necrosis can be caused as a result of its application. A programme of research has been conducted to clarify how tissue pressure changes during negative-pressure wound therapy and the resultant effect thereof on perfusion. The cause for conflicting evidence from other studies was also investigated.
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Adams, Titus Sam Turner. "Topical negative pressure therapy in wound healing : a research tool to study neutrophil-mediated wound pathophysiology in acute dermal wounds." Thesis, University of Bristol, 2003. http://hdl.handle.net/1983/02226e50-d53c-40e4-a38a-cede0dc8161f.
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Topical Negative Pressure therapy is in widespread use in the management of acute and chronic cutaneous wounds. The mechanisms of action are not fully understood, but are likely to be multifactorial. Experience of this therapy is based on a number of clinical series, case reports and some animal studies. There is a lack of direct evidence to determine its mechanisms of action and to support its clinical efficacy in human wound healing. This problem stems partly from difficulties in applying selective negative pressure to open exudative wounds. A new approach was required in applying this technology to wound surfaces in consenting patients. This thesis describes the design and validation of 'standard' and 'irrigation' devices that were used to apply Topical Negative Pressure to one part of a wound thus allowing intra-patient control. As a novel research tool, the irrigation device provided an opportunity to collect wound fluid from the surface of the wound for biochemical analysis. Paired wound biopsies of Topical Negative Pressure treated and control wounds were obtained. This thesis has demonstrated that Topical Negative Pressure (with intermittent suction) modulated the acute donor site wound and partial thickness burn wound during the first 48 hours of injury, by altering the distribution of inflammatory neutrophils in the dermis. Using a cycle of periods of suction-on and suction-off, Topical Negative Pressure increased the removal of Neutrophil Elastase from the wound during suction, in addition to its endogenous plasma-derived inhibitor, a1-Protease Inhibitor. Using this new device on human wounds has provided a means of understanding mechanisms in Topical Negative Pressure therapy, and has demonstrated its use as a research tool in the collection and analysis of wound fluid
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Kesl, Shannon Lynn. "Metabolic Therapy for Age-Dependent Impaired Wound Healing." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6104.
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Chronic wounds represent an under-acknowledged socioeconomic epidemic, affecting 1.8 million new patients per year and costing the US health care system upwards of $25 billion annually. This substantial cost is rapidly growing due to a disproportionate occurrence in the ever-aging population. Key features associated with age-related impairment of wound healing include limited energy and nutrient exchange, unremitting inflammations, increased reactive oxygen species (ROS), and diminished blood flow. Most chronic wound therapies target specific molecular mechanisms; however, there are often multiple mitigating factors that prevent normal wound closure. This is likely one reason most wound therapies are minimally effective. In the standard American diet, carbohydrates are broken down for fuel (glucose). While fasting, starvation, and calorie or carbohydrate restriction, beta-oxidation of stored fats in the liver produces ketone bodies (primarily acetoacetate (AcAc) and β-hydroxybutyrate (βHB) to serve as energy metabolites for extra-hepatic tissues. In addition to enhancing metabolic physiology, ketone bodies have recently been discovered to have signaling properties that are independent of their function as energy metabolites. Here we present the evidence for a novel method of inducing therapeutic ketosis via exogenous ketone supplementation to promote enhanced ischemic wound healing in young and aged Fischer 344 rats. Preliminary mechanistic studies demonstrated that exogenous ketone supplementation enhanced wound healing via increasing proliferation and migration, decreasing lactate production, and decreasing ROS production as well as affecting inflammatory cytokines and growth factors. We conclude that exogenous ketone supplementation will be an effective, cost efficient, low toxicity therapy to promote enhancement of wound healing in an aged population.
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Cho, Hongkwan. "Nanofiber-based therapy for diabetic wound healing: a mechanistic study." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1352402217.
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Hallen, Michael Ryan. "Commercialization of a Novel Wound Therapy and Scar Prevention Product." Case Western Reserve University School of Graduate Studies / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1378942204.
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Childress, Beverly Bibera. "Nitric oxide metabolites in wound fluids from pressure ulcers on v.a.c.(tm) therapy." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0005140.
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Thesis (Ph.D.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 84 pages. Includes Vita. Includes bibliographical references.
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Simonson, Caitlin Judith. "Stem Cell Therapy in the Wound Healing Process in a Murine Model." Thesis, The University of Arizona, 2010. http://hdl.handle.net/10150/146217.
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Byrnes, C. K. "Success and limitations of gene therapy with growth factors to enhance cutaneous wound healing." Thesis, Queen's University Belfast, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.273166.
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Mendoza, Garcia Jenifer Guadalupe. "The role of photodynamic therapy in wound healing and scarring in human skin." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/the-role-of-photodynamic-therapy-in-wound-healing-and-scarring-in-human-skin(134fe004-9311-4f5d-a0c9-33efe9239960).html.
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The skin acts as a protective barrier, is crucial for thermoregulation and also forms part of the sensory, immunological and endocrine system. Therefore skin preservation is paramount to preserving life. The loss of skin homeostasis, through injury, initiates the wound healing process where the final outcome is the formation of a scar. Scar treatment remains a challenge, despite a plethora of treatments, resulting in a poor outcome and sub-optimal response to existing therapies. Photodynamic therapy (PDT) has been used to treat oncologic conditions affecting the skin. Its action depends on a photosensitiser and a specific light source. Aminolevolinic acid (5ALA) and its methyl ester (MALA) are commonly used pro-drugs of the photosensitiser protoporphyrin IX (PpIX), which in combination with red light produces reactive oxygen species (ROS). ROS will cause different responses such as cell death and tissue destruction. There is limited clinical evidence emerging for the use of PDT in treating wound healing and pathological skin scarring. For this reason, further investigations are required to better understand the role of PDT in adult human skin wound healing and skin scarring. The aim of this investigation was to evaluate the accumulation of PpIX after exposure to 5ALA or MALA, phototoxicity of red light arrengment, citotoxicity, cell death inducction, ROS generation and a gene related analysis post-PDT in keloid fibroblasts compared to normal skin fibroblasts. Optimization of a wound healing organ culture (WHOC) model and evaluation of re-epithelialization, cell death, proliferation, extracellular matrix arreangment (ECM) and a related gene analysis after 5ALA-PDT ex vivo. General histology, cell death, proliferation, ECM rearrengment and a gene related analysis after PDT in skin scarring ex vivo. This investigation found PpIX accumulation higher with MALA compared to 5ALA. Phototoxicity and cytotoxicity was site specific within the lesion and increased proportionately to fluence rates. ROS generation leads to the decrease of cytoproliferation and increased apoptosis and necrotic cell death, COLI, COLIII an HSP70 were found down-regualted. Ex vivo wound geometry, system of support and growth media were optimized in a human wound healing organ culture (WHOC). WHOCs treated with 5ALA-PDT (20 J/cm2), showed an advancing re-epithelialization tongue 3.5 folds longer, which were highly proliferative, showing increased CK14 and p16 levels. The neo-epidermis was fully differentiated and neo-collagen was present. PCNA, p16, COLI, COLIII, MMP3, MMP19 and alpha-SMA were significantly more expressed in the dermis. MALA/5ALA-PDT (40 J/cm2) applied to striae alba, fine line, hypertrophic and keloid scars ex vivo coused an increased of apoptosis while proliferation decreased, matrix components were found to be re-organised, both according to the severity of the scar. COLI and COLIII genetic expression decreased while MMP3 and tropoelastin increased significantly. However, no statistically significant difference was observed between 5ALA and MALA-PDT treatments. In conclusion, this thesis shows that cytotoxicity post-PDT in KD fibroblasts is dependent on the lesional site within the scar, a precursor of intracellular photosensitiser and fluence. PDT in wound healing ex vivo shows increased re-epithelialization and ECM reconstruction and remodelling. Finally, in dermal fibrosis morphological and cellular effects of the application of PDT correlate with the degree and severity of dermal fibrosis. In view of this, PDT may be ideal for treating abnormal skin scarring and improving human cutaneous wound healing.
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Tang, Wan-yi Winnie, and 鄧韻怡. "Evidence-based guideline for using negative pressure wound therapy in diabetic foot care." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B46582940.
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Xing, Kai-Lo Dorothy. "Investigations of bacterial uptake of chemical agents having relevance to burn wound therapy." Thesis, Robert Gordon University, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.258954.
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Bukhari, Mamdouh. "In vitro-studies relating to honey as an alternative approach to wound therapy." Thesis, University of Sheffield, 2014. http://etheses.whiterose.ac.uk/6669/.
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A comparative study was made between Manuka honey-the main honey used as an antibacterial agent in medicine and some commercially available honeys. Among 22 types of honey, five types were found to be the most effective and these are Rainforest +30, Manuka +20, Nigella sativa, Oak and New Zealand Rewarewa. Three types of honey showed negative response to Catalase (an enzyme which breaks hydrogen peroxide), namely New Zealand Rewarewa, Manuka +20 and Rainforest +30. Exposure of honey to autoclaving generally leads to a reduction in its antibacterial activity. This suggests that hydrogen peroxide and other antibacterial factors are removed/denatured by autoclaving, but that in the case of Manuka against S. aureus and Rain forest+30 against Ps. aeruginosa, some; unknown, non-destroyed, antibacterial factor remains. The antibacterial effects of honey on Fusobacterium nucleatum (an anaerobic bacterium which is a major cause of mouth abscesses) were studied. Undiluted Manuka honey was again shown to be the most effective antibacterial honey against this pathogen. Three types of bacteria were isolated from honey as contaminants. These were identified using 16SrRNA as: Lysinibacillus fusiformis, Staphylococcus epidermidis and Sporosarcina koreensis; and were respectively isolated from Oak honey, Nigella sativa honey and Manuka honey. Some commercial products containing Manuka honey were tested for their antibacterial efficacy. With the exception of the Manuka Honey Conditioner, all of the products showed antibacterial activity against S. aureus such as Body wash, Shampoo, Manuka oil, Kanuka oil, Manuka Body Wash, bee venom with Manuka honey and Vita Complex. Similar results were obtained when Ps. aeruginosa tested. However, in all cases, the antibacterial effect on both bacteria was more pronounced against S. aureus than it was against Ps. aeruginosa. The antibacterial effect of the three mouth-cleaning products was then tested against some bacterial mouth flora. The Manuka and Aquafresh tooth paste showed inhibition zones for all three bacteria, while the non-honey mouthwash had no effect on bacterial growth. Four types of honey were diluted from 80% to 5% to determine the minimum biofilm eradication concentration (MBEC). At a concentration of 20% all honeys killed both types of biofilm bacteria. Some pathogenic traits such as pyocyanin production and biofilm formation were found to be influenced by a range of honeys. Various wound dressings and wound treatments were tested for their antibacterial activity against planktonic and biofilm of S. aureus and Ps. aeruginosa. Panaderm, a mixture of antibiotics, was the most effective treatment against S. aureus and Ps. aeruginosa. Activon Manuka exhibited marked activity against S. aureus and moderate activity against Ps. aeruginosa. Flamazine showed moderate action against S. aureus and Ps. aeruginosa. The proprietary (non-honey based) hand gel showed weak action on both types of bacteria.
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Bauer, Joseph Alan. "Biochemistry of Nitric Oxide Donors: Therapy Vs. Toxicity." University of Akron / OhioLINK, 1999. http://rave.ohiolink.edu/etdc/view?acc_num=akron1216144696.
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Smith, Annie G., Rachel A. Powis, D. I. Pritchard, and Stephen T. Britland. "Greenbottle (Lucilia Sericata) larval secretions delivered from a prototype hydrogel wound dressing accelerate the closure of model wounds." American Institute of Chemical Engineers (AIChE), 2008. http://hdl.handle.net/10454/4041.
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noThe resurgence of larval biotherapy as a debridement tool in wound management has been accompanied by several clinical reports highlighting concomitant tissue regeneration. Studies employing in vitro cell motility assays have found that purified excretory/secretory (ES) products from Greenbottle larvae (blowfly, Lucilia sericata) are motogenic for human dermal fibroblasts when used as a supplement in culture media. The objective of the present study was to determine whether ES delivered using a prototype hydrogel wound dressing induced similar motogenic effects on fibroblastic (3T3) and epithelial cells (HaCaTs) comprising a scratched-monolayer wound model. Quantitative analysis by MTT assay failed to detect significant mitogenic effects of ES on either cell type. Quantitative image analysis revealed that ES exposure markedly accelerated wound closure through a motogenic effect on both fibroblasts and keratinocytes. Quantitative histochemical analysis detected significantly higher phosphotyrosine (pTyr) expression in ES-exposed cell cultures than in controls; moreover immunocytochemistry revealed conspicuously raised levels of pTyr expression in cells located at the wound margin. By attenuation with a panel of enzyme inhibitors these effects were attributed to the protease components of ES. The present results suggest that controlled delivery of ES as a follow-up to maggot debridement therapy may be an effective therapeutic option for stimulation of tissue regeneration in wound management.
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Bagley, Angus H. "Proteomic and bioinformatic investigation of chronic wounds using non-invasive sampling to assess wound status and pathology." Thesis, Queensland University of Technology, 2022. https://eprints.qut.edu.au/235131/1/Angus_Bagley_Thesis.pdf.
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This project explored the biochemistry of non-healing wounds, with aims of expanding the current knowledge on their associated protein profiles. Changes in the abundance levels of proteins within wound fluids were examined in relation to best-practice treatments, including compression therapy, and wound condition, including infection status and disease burden. A complex statistical methodology was developed to analyse wound proteomic mass spectrometry data. This approach identified a suite of significant and clinically relevant protein targets. These findings may benefit wounds research and clinical practice, as they offer insight into the biochemical impact of best-practice care and the effect on wound healing.
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Modak, Ashin (Ashin Pramod). "Design and development of a smart, self-contained, portable negative pressure wound therapy device." Thesis, Massachusetts Institute of Technology, 2018. http://hdl.handle.net/1721.1/119769.
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Thesis: Ph. D., Massachusetts Institute of Technology, Department of Mechanical Engineering, 2018.Cataloged from PDF version of thesis.
Includes bibliographical references (pages 137-143).
Negative pressure wound therapy (NPWT) is a commonly used treatment in which the application of a low vacuum (-20kPa) is used to accelerate the recovery of chronic, hard-to-heal wounds. Costs of chronic wounds such as diabetic foot ulcers are estimated to be $25 billion, with 6.5 million patients being affected. Improving the portability and efficacy of NPWT devices will allow a larger migration of patients from hospital stays to at-home care. Current portable NPWT devices have severe limitations due to their size, inability to dynamically modulate pressure or handle large volumes of wound exudate. The work in this thesis was to develop a more portable NPWT device in which all functional components are self-contained within the bandage itself. To accomplish this goal, a soft-material, fuel-cell based actuator was designed and incorporated into a self contained, compact pumping mechanism. Additionally graphene-oxide barriers were designed to allow for fluid management at the wound site. The designed bandage was able to maintain negative pressure even at worst-case scenario leak rates (6.7 x 102 mL/s) and an exudate rate of 5.6 x 10-5 mL/s. The contributions from this thesis are a novel, soft-materials based actuator for use in biomedical applications and the further characterization of graphene-oxide barriers.
by Ashin Modak.
Ph. D.
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Yang, Weige. "sFlt-1 gene-transfected fibroblasts : A wound-specific gene therapy inhibits local cancer recurrence." Kyoto University, 2003. http://hdl.handle.net/2433/148677.
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Strauss, Graham L. "Hybrid Fusion Protein for Inhibition of Multiple Proteases for Chronic Wound Healing." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7957.
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Many diseases display a multitude of relevant factors that contribute to the persistence of the disease and difficulty treating it. The multifactorial characteristics of some diseases lead to the requirement of combination of treatments in order to restore health. The latter may necessitate the mixing of treatments, medications, and therapeutics to first halt the disease, then assist the human body in returning itself to a state of normality. For example, chronic wounds exhibit this multifactor characteristic in which there exist many factors that lead to the body’s inability to properly heal in a timely manner. This presents a further threat to the body, such as exposure to infection and long-term pain. In this example, it is important to look at the ultimate cause of a chronic wound, which may be due to presence of other diseases impairing the body’s ability to properly heal. This may include diabetes, initial antibiotic-resistant infection, autoimmune disorders, and poor vasculature. Furthermore, the mentioned causes for chronic wounds may have associations with one another in a single case of a chronic wound. Treating each interrelated cause with drug combinations may run the risk of adverse side effects or further complications due to mixing drugs in a systemic method.
The goal of this study is to develop a point-specific, protein-based therapy that incorporates a single-protein molecule with multifunctional characteristics based on what we know about chronic wounds and infections, as a proof of concept of multifunctional proteins. Multifunctionality of a single therapeutic molecule is desirable because it may eliminate the unknowns of how differing individual chemical or protein therapies may interact when simply mixed. In addition, examples of peptides, such as antimicrobial peptides, are known to have synergy, and creating a single protein platform that consists of two synergistic peptides could be of value in the making of a protein with greater activity by guaranteeing that the synergistic peptides are local to one another. Furthermore, broad spectrum activity can be obtained by combining two differing peptides.
This proof of concept was accomplished by targeting two proteinases that are upregulated in chronic wounds: Matrix Metalloproteinase-2 (MMP-2) and Neutrophil Elastase. Recombinant DNA techniques were used to create a fusion protein that incorporates an inhibitor of MMP-2, which is a β-Amyloid Precursor Protein-derived Inhibitory Peptide (APP-IP), and PMP-D2, an inhibitor of Neutrophil Elastase. PMP-D2 was joined to the N-terminus of an Elastin-like peptide, while the APP-IP was joined to the C-terminus of the same Elastin-like peptide. Elastin-like peptides (ELPs) are commonly used as a backbone for recombinant protein production as their distinct thermoresponsive characteristics provide adequate protein purification using an inverse transition cycling [3]. In addition, ELPs can serve as point-specific drug delivery platforms with a transition temperature (Tt) near that of normal body temperature causing low diffusivity [3]. Therefore, when ELPs are applied to a site at their Tt, they will aggregate, which provides diffusional limitations of the protein in the application site, and may decrease the reapplication rate needed for a therapeutic, as well as eliminate adverse side effects by retaining the protein to the specific application site.
From this dual fusion, the final resulting protein is PMP-D2٠ELP٠APP-IP. This protein was tested for its inhibitory activity of both MMP-2 and Neutrophil Elastase. It was hypothesized that the fusion protein, PMP-D2٠ELP٠APP-IP, would inhibit MMP-2 just as effectively as APP-IP·ELP unaccompanied by PMP-D2, as well as effectively inhibit Neutrophil Elastase to the same degree as PMP-D2·ELP unaccompanied by APP-IP.
Furthermore, an additional dually fused ELP fusion protein was currently made with two synergistic antimicrobial peptides fused to each end of the ELP. The two antimicrobial peptides used were human-derived LL37 and insect-derived Cecropin A. This novel fusion peptide contains synergistic increase in antibacterial activity in which preliminary data suggests.
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Al-mzaiel, Anwar J. "Mechanisms by which hyperbaric oxygen therapy may resolve inflammation in chronic wounds." Thesis, University of Plymouth, 2013. http://hdl.handle.net/10026.1/1945.
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Hyperbaric oxygen (HBO) therapy is the intermittent inhalation of 100% oxygen at a pressure greater than one atmosphere absolute. It is an effective treatment for various inflammatory conditions, including chronic wounds which are characterized by an excessive influx of neutrophils and their prolonged persistence at the wound site. Neutrophil apoptosis and clearance have been shown to be required for resolution of inflammation. The mechanisms by which HBO aids wound healing are well documented, but its effects on cellular inflammatory response are not well understood particularly with respect to neutrophils. The hypothesis presented in this thesis is that increased oxygenation via HBO assists chronic wound healing by enhancing non-inflammatory neutrophil defences and cell death through apoptosis. An investigation was carried out into the effects of HBO on neutrophil antimicrobial function and apoptosis using differentiated HL-60 cells as an in vitro neutrophil model. The data clearly showed that a single HBO treatment for 90 min caused an increase in the oxidative burst activity of neutrophil-like cells as shown by increased NBT staining, superoxide (cytochrome c reduction) and H2O2 production (Kruskal-Wallis, P < 0.05), and phagocytosis of Staphylococcus aureus. HBO treatment displayed a pro-apoptotic effect, enhancing caspase 3/7 activity both in the presence and absence of a TNF-α stimulus (Kruskal-Wallis, P < 0.05) and causing morphological changes (observed using Giemsa and SYBR® Safe staining) associated with apoptosis. Although no consistent pattern was observed, both hyperoxia and pressure alone seemed to contribute to both the increase in antimicrobial activity and the increase in apoptosis induced by HBO in these neutrophil-like cells (Chapters 4 and 5). HBO-enhanced neutrophil clearance by macrophages was investigated using bovine neutrophils and monocyte-derived macrophages (MDMФ). A single 90 min HBO exposure significantly increased the clearance of fresh and 22 h-aged neutrophils by MDMФ (two-way ANOVA, P < 0.05), suggesting an increase in phosphatidylserine (PS) exposure in apoptotic neutrophils after HBO treatment (Chapter 6). Importantly, a long-term repetitive exposure to HBO in patients with chronic wounds caused a significant decrease in the antioxidant enzyme defence system (one-way repeated measures ANOVA, P < 0.05), plasma TNF-α and IL-1β after 30 HBO sessions, with down regulation of expression of the anti-apoptotic factors, NF-B and Bcl-2 (Chapter 7). These findings may go some way towards explaining the effectiveness of HBO treatment not only for chronic wounds but also for other inflammatory conditions that may be affected by this treatment.
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Daulton, Donna Lynn. "Using Optimal Control Theory to Optimize the Use of Oxygen Therapy in Chronic Wound Healing." TopSCHOLAR®, 2013. http://digitalcommons.wku.edu/theses/1232.
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Approximately 2 to 3 million people in the United States suffer from chronic wounds, which are defined as wounds that do not heal in 30 days time; an estimated $25 billion per year is spent on their treatment in the United States. In our work, we focused on treating chronic wounds with bacterial infections using hyperbaric and topical oxygen therapies.
We used a mathematical model describing the interaction between bacteria, neutrophils and oxygen. Optimal control theory was then employed to study oxygen treatment strategies with the mathematical model. Existence of a solution was shown for both therapies. Uniqueness was also shown for hyperbaric therapy. We then used a forward-backward sweep method to find numerical solutions for the therapies. We concluded by putting forth ideas for how this problem could progress toward finding applicable treatment strategies.
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Lagan, Kathleen M. "Wound management in podiatry : use of Low Intensity Laser Therapy (LILT) and combined phototherapy/LILT." Thesis, University of Ulster, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287134.
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Preisz, Emilia, and Nathalie Berg. "Undertrycksbehandling av sår – påverkan på patientens livskvalitet och hälsa : En litteraturstudie." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-36049.
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Introduktion: Olika typer av sår skapar stort lidande för den drabbade och Negative Pressure Wound Therapy (NPWT) är en behandlingsmetod som utvecklats för att effektivisera sårläkningsprocessen. Livskvaliteten och hälsan påverkas av såret och dess utveckling, vilket gör omvårdnaden vid sårbehandling grundläggande för patientens välmående. Syfte: Syftet var att belysa hur Negative Pressure Wound Therapy påverkar patientens livskvalitet och hälsa. Metod: Polit och Beck (2012) niostegsmodell användes för litteraturstudien. Artikelsökningarna gjordes i två olika databaser samt manuella sökningar och resultatet grundades på tolv artiklar som genomgick en kvalitetsgranskning. Resultat: Fem teman identifierades påverka patientens upplevelse av behandlingen. Behandlingen påverkar den fysiska förmågan att leva ett dagligt liv och tenderar att framkalla smärta vid omläggning. Behandlingen tenderar även att på ett psykiskt påfrestande sätt påverka både det allmänna välmåendet och det sociala livet. Kunskap och information, hos både personal och patient, visades ha en inverkan på patientens livskvalitet och hälsa. Slutsats: Denna avancerade sårbehandling påverkar patientens livskvalitet och hälsa. Behandlingen innebär en fysisk påfrestning där patienten behöver bära runt på en behandlingsmaskin samt uppleva smärta. Det innebär också en psykisk påfrestning som ger utryck i stress, oro och rädsla samt en risk för isolering i det sociala livet. Det är därför av största vikt att vårdpersonal införskaffar sig och tillgodoser patientens behov av information och kunskap för att förutsättningar för en optimal omvårdnad ska kunna skapas.
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Seghal, Nv-Preet Ashu. "The effect of low level laser therapy on selected cells involved in angiogenesis during wound healing." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.287220.
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Clements, B. Alyson. "Low intensity laser therapy (LILT) and combined phototherapy/LILT : effects upon blood flow and wound healing in humans." Thesis, University of Ulster, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.241724.
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Lengheden, Annelie. "Periodontal implications of calcium hydroxide treatment." Stockholm : Dept. of Oral Diagnosis, Karolinska Institutet, 1994. http://books.google.com/books?id=zfJpAAAAMAAJ.
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Carvalho, Camila Silva de. "Ação da polaridade na estimulação elétrica transcutânea para o tratamento de áreas doadoras de enxertos autógenos em pacientes queimados: estudo clínico randomizado cego." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/17/17152/tde-06042018-101750/.
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O cuidado com as áreas doadoras de enxertos de pele merece constante atenção, visto que desencadeia desconforto por dor e restrição de movimentos. Existem evidências de que a estimulação elétrica pode acelerar a cicatrização de feridas e produzir analgesia, e que diferentes parâmetros físicos podem interferir nas respostas apresentadas. O objetivo do estudo foi avaliar o efeito da polaridade da corrente na cicatrização e na dor. Para tanto foram comparados os efeitos da estimulação elétrica de alta voltagem (EAV), polarizada, e a estimulação elétrica nervosa transcutânea (ENT), despolarizada, no tratamento das áreas doadoras de pacientes queimados. Para tanto, foram avaliados 48 voluntários do sexo masculino randomizados em três grupos: submetidos à estimulação elétrica de alta voltagem (GEAV), média idade de 34,2(±9,8) anos, n=17; submetidos à estimulação elétrica nervosa transcutânea (GENT), com 34(±9,5) anos, n= 16; e não submetido à estimulação elétrica ou grupo controle (GC) média de idade 35(±9,5 anos), n= 15. Os procedimentos terapêuticos foram aplicados nas extremidades da área doadora, no primeiro pós-operatório, até a epitelização completa. As variáveis avaliadas foram avaliação clínica, o tempo (dias) de epitelização, estimado pelo desprendimento do curativo primário sobre a lesão, avaliação da dor pela escala numérica de dor, a temperatura cutânea pela termografia infravermelha, qualidade da cicatriz (book de fotos, escala ® Vancouver, software Image J ). Após a análise dos dados, foi aplicado o teste de Shapiro-Wilk, em seguida o comportamento pré e pós-intervenção intragrupo foi aplicado o teste Wilcoxon. Para comparação entre os grupos foi efetuado teste de Kruskal-Wallis seguido de post-hoc de Dunn, em todos os casos foi utilizado o nível de significância de 5% (p<0,05). Os achados apontam que o tempo de desprendimento do curativo Rayon das áreas doadoras foi significativamente menor para GEAV apresentando (p<0,033). Houve redução significativa da dor (p<0,05) para o GEAV e para o GENT, quando comparado ao GC. A quantidade relacionada a solicitação de analgésicos foi reduzida para os grupos estimulados, com diferença significativa do GEAV versus GC (p<0,002) e GENT versus GC (p<0,001). Não houve diferença significativa na temperatura cutânea entre os grupos. Não houve diferença significativa no escore final da escala Vancouver e nem quantidade de crostas entre os grupos. A polaridade da corrente pode ter influenciado no tempo de epitelização, porém não interferiu na dor e na qualidade da área doadora.The cares with donor areas of skin grafts deserve constant attention, since it triggers discomfort due to pain and movement restriction. There are evidences that electric stimulation may accelerate wound healing and produce pain relief. The objective of this study was to evaluate the effect of electric current polarity on the healing and pain. Therefore, the effects of stimulation on high voltage pulsed current (HVPC) and nervous transcutaneous stimulation (TENS) were compared in the treatment of donor areas of burns victims. Therefore, 48 volunteers of the male sex were randomized between three groups: submitted to high voltage pulsed current stimulation (GHVPC), with 34.2 (± 9.8) years, n=17; submitted to nervous transcutaneous stimulation (GTENS), with 34 (±9.5) years, n=16; and nonsubmitted to stimulation group, or control group (GC), average age of 35 (± 9,5) years, n=15. The therapeutic procedures were applied on the edges of the donor area, at the first postoperative, until complete healing. The evaluated variables were ephitelization time (days), estimated by the unfastening of the primary curative on the wound, evaluation of pain by numerical scale of pain, skin temperature by infrared thermography, scar quality (photo book, Vancouver scale and Image J® software). After data analysis, the Shapiro-Wilk test was applied, and the Wilcoxon test was applied to the before and after intervention. Kruskal-Wallis test followed by Dunn post-hoc was used to compare the groups. In all cases, the significance level of 5% (p<0.05) was used. The findings indicate that the time of release of the Rayon dressing from the donor sites was significantly reduced for GEAV (p <0.033). A reduction of pain relief was significant (p<0.05) for the GEAV and for the GENT, when compared to the GC. Amount the number of solitation for analgesic drugs was decreased for the groups stimulated with significant difference of the GEAV verse GC (p<0.002) and GENT verse GC (p <0.001). Change in cutaneous temperature was not significant between groups. There was no difference significant in score of Vancouver scale and in the number of crusts in the groups. The polarity of the current might have influenced the healing time, however not the pain nor the quality of the donor site.
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Morse, Zachary J. "Dose Response Analysis of Bone Marrow-Derived Mesenchymal Stem Cells for Treatment in Fascial Wound Repair." Youngstown State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1444052561.
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Fors, Filip. "A Versatile Group of Molecules, Can Defensins Make an Impact in Medicine?" Thesis, Linköpings universitet, Institutionen för fysik, kemi och biologi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-157402.
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Antimicrobial peptides are an ancient form of innate defense and is present in all ways of life. In humans they are present as cathelicidins and defensins. Both are important for the immune system and they exhibit activity against viruses, bacteria and fungi. Defensins exhibit less cytotoxicity and are better characterized and are thus more easily developed as therapeutic tools. Defensins are apt at doing a multitude of things, from inhibiting Herpes simplex virus replication and preventing anthrax’ lethality to helping with wound closure and acting as biomarkers for a variety of ailments. Defensins have consistently shown good results in a laboratory setting but have less than exemplary in vivo results. Defensins’ multifunctionality as well as the complex environment in living organisms makes characterizing why defensins are not performing as well in vivo difficult. They can also exhibit negative side-effects such as increasing the infectivity of the HIV and inhibiting anti-viral molecules of the innate immune system. Nevertheless, they exhibit big potential as complementary drugs, adjuvants, biomarkers, wound treatment and much more. Further characterization and development is absolutely necessary in these times of increasing antibiotic resistance.
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Abou, Issa Abdelfatah Shaban. "Effect of Oasis-Ultra Matrix on the Healing Rate of Stage IV Pressure Wounds." Wright State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=wright1464183028.
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Nogueira, Flávio Marques. "Pressão exercida por sistema de pressão subatmosférica usado para fixação de enxerto de pele no tratamento de ferida cutânea. Estudo comparativo entre a tela de poliamida revestida de silicone e a tela de rayon como material de interposição." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-13112017-153849/.
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Introdução: O tratamento de feridas cutâneas é difícil e está em contínua mudança. Entre as múltiplas terapias empregadas uma bastante usada é a enxertia de pele autógena. Sabe-se que o sucesso desta técnica depende, em parte, de haver condições adequadas no leito receptor e da qualidade do enxerto de pele retirado. Ainda, tão importante quanto a técnica cirúrgica, é o método para fixação do enxerto de pele ao leito e respectivo cuidado pós-operatório. Tem sido frequente o uso da terapia de feridas por pressão subatmosférica para fixação e integração de enxertos de pele no tratamento de feridas e habitualmente se coloca uma tela entre a esponja e o enxerto. Não há padronização na literatura médica sobre o que utilizar na tela. Objetivo: Comparar duas telas utilizadas e aferir o quanto cada uma interferia na pressão subatmosférica gerada pela unidade de aspiração contínua da terapia de feridas por pressão subatmosférica, por sua vez configurada para gerar um gradiente de pressão de 125 mmHg em relação à pressão atmosférica ambiente. Métodos: Foram realizados inicialmente dois estudos em voluntários normais para aferir a pressão subatmosférica sob a tela de rayon e sob a tela de poliamida, sobre a pele íntegra. Em um grupo de 30 indivíduos, as medidas foram feitas em tempos diferentes, montando-se e desmontando-se todo conjunto da esponja e de determinada tela sucessivas vezes. Em outro grupo de 15 indivíduos, as medidas foram feitas sequencialmente e com as sondas colocadas em conjunto, sendo metade da esponja sobre a tela de rayon e a outra metade sobre a tela de poliamida. A seguir, foi realizado estudo prospectivo com 30 pacientes portadores de feridas complexas, nos quais a terapia de feridas por pressão subatmosférica foi aplicada. Foram utilizadas tela de rayon e tela de poliamida em cada metade da área enxertada sobre a ferida. A pressão subatmosférica foi aferida sob cada tela e sob a esponja. Resultados: Os resultados mostraram diferença estatisticamente significativa entre as pressões sob as duas telas estudadas e em relação à pressão sob a esponja. Houve apenas uma perda completa de enxerto de pele. Conclusão: Concluiu-se que as diferentes telas estudadas reduziram a pressão subatmosférica gerada pelo dispositivo de aspiração contínua da Terapia de Feridas por Pressão Subatmosférica (TFPS) em comparação com a pressão medida como controle.Introduction: Wound care is a difficult and ever changing field. Among many therapies employed, autogenous skin grafting is often used. The quality of the skin graft and appropriate conditions of the recipient bed are paramount for the success of this surgical procedure. Moreover, the method of skin graft fixation and postoperative care are as important as the surgical technique itself. Hence, subatmospheric pressure wound therapy has been used in the process of fixation and integration of skin grafts in the treatment of wounds when there is frequently a layer between the sponge and the graft. Thus far there has been no standardization in the medical literature as to which layer to use. Objective: Compare two layers and measure how much each one alone interfered in the subatmospheric pressure generated by the pump used in subatmospheric pressure wound therapy, when set to generate a pressure gradient of 125 mmHg in relation to the atmospheric pressure of the surroundings. Methods: Two pilot studies were, therefore, undertaken of normal volunteers to ascertain the subatmospheric pressure under the rayon layer, under the polyamide layer and under the sponge. In one pilot study, of a total of 30 individuals, their measurements were taken in different moments and the setting was mounted and unmounted three times. In another, of 15 individuals, the measurements were collected within just one setting, as half of the sponge had rayon underlying it and the other half had polyamide beneath it. Therefore another prospective study was undertaken of 30 patients bearers of complex wounds in which both the rayon and the polyamide layer was used for each half of the skin grafted area The subatmospheric pressure measured under each layer and directly under the sponge (control measure) was assessed. Results: The results showed statistically significant differences between the pressure measured on the two layers studied and the pressure measured under the sponge. There was only one total skin graft loss. Conclusion: In conclusion, it was found that the different layers studied did reduce the subatmospheric pressure generated by the pump used in subatmospheric pressure wound therapy as compared with the respective control measure.
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Virchenko, Olena. "Stimulation of tendon repair by platelet concentrate, CDMP-2 and mechanical loading in animal models." Doctoral thesis, Linköping : Univ, 2007. http://www.bibl.liu.se/liupubl/disp/disp2007/med1005s.pdf.
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Murphy, Kelly Elizabeth. "Mathematical investigation of the interactions between the inflammatory response and mechanical aspects of dermal wound repair." Thesis, Queensland University of Technology, 2011. https://eprints.qut.edu.au/67907/1/Kelly_Murphy_Thesis.pdf.
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Dermal wound repair involves complex interactions between cells, cytokines and mechanics to close injuries to the skin. In particular, we investigate the contribution of fibroblasts, myofibroblasts, TGFβ, collagen and local tissue mechanics to wound repair in the human dermis. We develop a morphoelastic model where a realistic representation of tissue mechanics is key, and a fibrocontractive model that involves a reasonable approximation to the true kinetics of the important bioactive species. We use each of these descriptions to elucidate the mechanisms that generate pathologies such as hypertrophic scars, contractures and keloids.
We find that for hypertrophic scar and contracture development, factors regulating the myofibroblast phenotype are critical, with heightened myofibroblast activation, reduced myofibroblast apoptosis or prolonged inflammation all predicted as mediators for scar hypertrophy and contractures. Prevention of these pathologies is predicted when myofibroblast apoptosis is induced, myofibroblast activation is blocked or TGFβ is neutralised.
To investigate keloid invasion, we develop a caricature representation of the fibrocontractive model and find that TGFβ spread is the driving factor behind keloid growth. Blocking activation of TGFβ is found to cause keloid regression. Thus, we recommend myofibroblasts and TGFβ as targets for clinicians when developing intervention strategies for prevention and cure of fibrotic scars.
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Nussbaum, Ethne Louise. "An investigation into the effects of low intensity laser irradiation on bacterial growth : a possible factor in the effectiveness of laser therapy for wound healing." Thesis, University of Ulster, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.394616.
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Danin, John. "Factors associated with healing of periradicular lesions." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-437-2/.
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Gokavarapu, Venkatamanikanta Subrahmanyakartheek. "Computer Graphics and Visualization based Analysis and Record System for Hand Surgery and Therapy Practice." Wright State University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=wright1464354599.
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Nassu, Mariana Prado 1988. "Utilização de Cochliomyia macellaria F. (Diptera: Calliphoridae) e avaliação de sua densidade larval para uso terapêutico na recuperação de lesões tegumentares." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/317754.
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Orientador: Patricia Jacqueline ThyssenTexto em português e inglês
Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia
Made available in DSpace on 2018-08-25T17:11:16Z (GMT). No. of bitstreams: 1 Nassu_MarianaPrado_M.pdf: 4567544 bytes, checksum: 960ea243ca753828c2fce7d481fa59ff (MD5) Previous issue date: 2014
Resumo: A terapia larval (TL) consiste na aplicação de larvas estéreis de moscas necrófagas (Diptera) sobre lesões crônicas ou infectadas visando promover ou acelerar o processo de cicatrização. Para garantir segurança e sucesso, dois fatores tem de ser alcançados: a esterilidade das larvas que serão utilizadas e a confirmação de que a espécie, durante o seu processo de alimentação, consumirá apenas tecido necrosado. No presente estudo, pretendeu-se avaliar se a espécie Cochliomyia macellaria F. (Calliphoridae), de ampla distribuição em território brasileiro, pode ser uma excelente candidata para aplicação da TL, levando em conta seu comportamento e biologia. Foi avaliada a esterilização e a viabilidade pós-esterilização de larvas de C. macellaria em hipoclorito de sódio (NaClO) a 0,5% por um e por três minutos. Adicionalmente, lesões foram induzidas em ratos Wistar, para avaliar a qualidade e o tempo de cicatrização frente a diferentes tipos de tratamento. Para tanto, foram montados cinco grupos experimentais, sendo que em um deles os animais não foram submetidos a qualquer tipo de tratamento, e em outro foi feito desbridamento mecânico. Também foi avaliada qual a densidade larval (5, 15 ou 25 larvas/cm2) mais apropriada para obter melhor qualidade de cicatrização e, ao mesmo tempo, menor período de aplicação, visando adequar a TL a um atendimento do tipo ambulatorial, isto é, sem internação. O processo de cicatrização foi avaliado qualitativamente (a partir da mensuração de certos parâmetros associados às lesões) e quantitativamente (tempo). Fragmentos de pele foram coletados antes do tratamento e 12 h, 7 dias e 14 dias pós-tratamento, e processados para análise histológica. Em relação ao comportamento, foi observado que os imaturos de C. macellaria se alimentaram apenas de tecido necrosado. O uso de solução de NaClO a 0,5% por três minutos é o mais recomendado para obtenção de larvas estéreis com alta taxa de viabilidade. Não houve diferença significativa nos tempos de cicatrização entre os grupos experimentais. Contudo, foi observado que na relação de 25 larvas/cm2 houve um maior grau de vascularização nos tecidos, quando comparado aos demais tratamentos. Os mecanismos envolvidos nesse processo ainda são desconhecidos, mas concluiu-se que as larvas tem um importante papel na modulação da resposta imunológica do hospedeiro, sendo promissor o seu uso, provavelmente, em maiores densidades do que o preconizado na literatura
Abstract: Larval therapy (LT) is the application of sterile larvae of carrion flies (Diptera) on chronic or infected wounds to promote or accelerate the healing process. To ensure safety and success two aspects must be met: the sterility of the larvae and confirmation that the species consume only necrotic tissue during the feeding process. The present study intended to evaluate whether the species Cochliomyia macellaria F. (Calliphoridae), widely distributed in Brazil, could be a viable candidate for application of LT, taking into account their behavior and biology. Sterilization and post-sterilization viability of larvae of C. macellaria were evaluated after being treated with sodium hypochlorite (NaClO) at 0.5% during one and three minutes. Additionally, lesions were induced in Wistar rats to evaluate the healing quality and healing time against different types of treatment. For that, the rats were divided in five experimental groups, in one of them the animals were not subjected to any treatment and in another only mechanical debridement was performed. It was also evaluated which larval density (5, 15 or 25 maggots/cm2) is the most suitable for better quality of healing and at the same time, shorter period of application, in order to improve the LT to an outpatient care type, that is, without hospitalization. The healing process was assessed qualitatively (from the measurement of certain parameters associated with injuries) and quantitatively (time). Skin fragments were collected before treatment and 12 h, 7 days and 14 days post-treatment, and processed for histological analysis. Regarding the behavior, it was observed that immature C. macellaria fed only of necrotic tissue. The use of NaClO 0.5% solution for three minutes is the most recommended to obtain sterile larvae with high viability rate. There was no significant difference in healing times between the experimental groups. However, it was observed that in the group of 25 maggots/cm2 there was a higher degree of vascularization in tissues, as compared to other treatments. The mechanisms involved in this process are unknown, but it appears that the larvae have an important role in modulating the host immune response, and their use in higher density than that recommended in the literature is probably promising
Mestrado
Relações Antrópicas, Meio Ambiente e Parasitologia
Mestra em Biologia Animal
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Williams, Tasha R. "FABRICATION AND CHARACTERIZATION OF ELECTROSPUN TECOPHILIC SCAFFOLDS FOR GENE DELIVERY." University of Akron / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=akron1193882087.
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Kamamoto, Fábio. "Estudo comparativo entre o método USP de terapia por pressão negativa e o sistema V.A.C® no tratamento de feridas traumáticas." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-03052017-154110/.
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A terapia de tratamento de feridas por pressão negativa (TPN) não é nova. Ela foi aprovada nos Estados Unidos da América em 1996 e, desde então, tem sido amplamente utilizada em uma grande variedade de ferimentos. Ela tem aplicação no tratamento de feridas agudas e crônicas, e trouxe conforto para pacientes, cuidadores e profissionais da área da Saúde. Uma das indicações desta terapia é no tratamento de feridas decorrentes de trauma. Ela pode ser utilizada como uma \"ponte\" entre o surgimento da lesão inicial e a cirurgia de fechamento definitivo da ferida, naqueles casos em que o fechamento primário não é possível. O grande obstáculo para democratização desse procedimento é o custo. Ele se mantém alto, principalmente nos pacientes que necessitam de um uso prolongado do método. Na tentativa de contornar esse problema, o Hospital Universitário da USP desenvolveu em 2007 uma TPN de baixo custo baseada em uma válvula estabilizadora de pressão (Curavac VX 200®, Ventrix Health Innovation, Brasil) conectada à fonte de vácuo da parede do hospital e a uma cobertura de ferida com gaze estéril selada por filme plástico adesivo. Este estudo comparou essa terapia de baixo custo (grupo USP) com a terapia padrão no Mercado (VAC system®, KCI, San Antonio - Texas) - Grupo VAC em um desenho prospectivo, randomizado, no formato de não inferioridade. Ou seja, o objetivo primário era verificar se o tempo necessário para a ferida estar apta para cirurgia de fechamento definitivo era equivalente nos dois métodos propostos. Foram estudadas, também, a velocidade de crescimento do tecido de granulação e as mudanças na área da ferida, além do custo de cada tratamento. Em relação ao tempo necessário para ferida estar apta para a cirurgia de retalho, o Grupo USP apresentou um resultado de 9,6±4,5 dias. O Grupo VAC apresentou 12,8±8,6 dias. A diferença não foi estatisticamente significante (p=0,379). Em relação ao aumento de tecido de granulação por dia de tratamento, os dois métodos apresentaram resultados semelhantes: USP= 5,79 ± 2,93% e VAC 5,06 ± 5,15% (p=0,408). Em relação à variação de área, os dois grupos apresentaram um aumento: USP 1,13 ±0,80% e VAC 1,12 ± 0,80% (p=0,934). Foi observada uma importante diferença entre os custos do tratamento. O tratamento no Grupo USP custou, em média, R$ 47,89; enquanto o tratamento no grupo VAC, R$ 2.757,40. Conclusão: A terapia USP de tratamento de feridas por pressão negativa não é inferior à terapia VAC system® no tratamento de feridas complexas de origem traumáticaNegative Pressure Wound Therapy (NPWT) was approved by the FDA in 1996 and since then has become widely adopted for a broad range of wounds. NPWT has many indications, both acute and chronic, and has brought great comfort to patients, caregivers, doctors, and nurses. Some authors suggest that NPWT may be used in traumatic wounds when primary closure is not possible after or in between debridements as a bridge to definitive closure. The big real obstacle to this useful procedure is the cost, which remains expensive for prolonged indications, making it unaffordable where these dressings are needed. In 2007 the University of São Paulo developed a low-cost NPWT based in a pressure stabilizer device (Curavac VX 200®, Ventrix Health Innovation, Brazil) connected to the hospital wall-vacuum and a gauzed-sealed dressing. No randomised trial has compared USP Negative Pressure Wound Therapy with the commercial vacuum assisted closure device (VAC system®). Our choice of a non-inferiority trial was based on the expectation that the time necessary for the improvement of the wound bed for patients treated with the USP therapy was no worse than the improvement time for VAC System (primary outcome). The wound bed area variation and granulation tissue growth were also assessed as secondary outcomes. In relation to the time (measured in days) necessary for the wound bed to became ready for the flap surgery, the USP group presented 9,6 ± 4,5 days. The VAC group presented 12,8 ± 8,6 days. The difference was not statistical significant (p=0,379). In relation to granulation tissue increase the two methods of NPWT (USP and VAC) presented very similar results: USP= 5,79( ± 2,93) and VAC 5,06 ( ± 5,15) (p=0,408). Regarding to wound area the both groups presented an increase: USP 1,13 ± 0,80 and VAC 1,12( ± 0,80) p=0,934. We observed an important difference in relation to treatment costs. The USP group treatment cost is about 2% compared with VAC group. Mean Treatment Cost: USP= US$ 15,15; VAC= US$ 872,59. Conclusion: The USP Negative Pressure Wound Therapy was non-inferior to VAC System for the treatment of complex traumatic injuries
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Bokums, Kristaps [Verfasser], and Johannes [Akademischer Betreuer] Hoffmann. "Irrigation suction drainage and negative pressure wound therapy of lower extremity vascular graft infection in ileofemoral region : clinical and economical aspects / Kristaps Bokums ; Betreuer: Johannes Hoffmann." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2018. http://d-nb.info/1163534188/34.
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Borglund, Marina, and Christine Helldén. "Larvterapi versus konventionella metoder i modern sårläkning av svårläkta sår. Effekter och upplevelse. //LARVA THERAPY VERSUS CONVENTIONAL METHODS IN MODERN WOUND HEALING OF ULCERS. EFFECTIVENESS AND EXPERIENCE." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25550.
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Syftet med denna litteraturstudie är att jämföra larvterapi och konventionella metoder vid behandling av svårläkta sår utifrån följande perspektiv: upprensning av sår, duration av sårläkning och patienternas upplevelse. Polit & Becks (2006) modell användes vid arbete med denna litteraturstudie. Sökning av relevant litteratur gjordes i tre databas: PubMed, CINAHL och The Cochrane Library. Relevanta artiklar granskades med hjälp av granskningsprotokollerna modifierade av författarna efter Willman (2006). Nio olika studier har undersökts i denna litteraturstudie. Studierna utreder dels larvterapins effektivitet i upprensning av sår samt larvernas läkningsförmåga och dels hur patienterna upplever larvterapi. Detta sattes i relation till konventionella behandlingsmetoder. Resultaten är positiva i larvterapins favör. Larvterapi är ett effektivt sätt att rensa upp nekrotisk och inflammerad vävnad i svårläkta sår. Såren rensas och läker fortare med få biverkningar jämfört med konventionella behandlingar. Dessutom bildas granulationsvävnad snabbare, vilket är en förutsättning för sårets läkning. Korrekt information och involvering av patienten skapar en positiv attityd i denna behandlingsform. Ett stort behov finns för detta i sårläkningens område pga ökade restriktioner av antibiotikaanvändning och ett önskat minskat lidande hos patienter med svårläkta sår. Det finns stora möjligheter för larvterapin om den fortsätter att utforskas.The aim of this literature study is to compare larva therapy and conventional methods in treatment of ulcers on the basis of the following perspective: debridement of ulcers, duration of wound healing and patients´ experience. Polit & Becks (2006) model was used when working with this literature study. Search of relevant literature was done in three databases: PubMed, CINAHL and The Cochrane Library. Relevant articles were checked with the help of checklists modified of authors after Willman (2006). Nine different studies have been examined. The studies partly investigate the larva therapy’s effectiveness in debridement of ulcers and maggots´ capability in healing and partly how patients experience the larva therapy. This was set in relation to conventional treatment methods. The results are positive in larva therapy’s favour. Ulcers are debrided and healed quicker with few secondary effects compared to conventional treatments. Larva therapy is an effective way to debride necrotic and inflamed tissue in ulcers. Moreover new granulation tissue forms faster which is a condition for wound healing. Correct information and patients´ participation creates a positive attitude for this treatment. There is a big need for this in wound healing because of increased restrictions of use of antibiotics and desired decreased suffering for patients with ulcers. There are many possibilities with larva therapy if it continues to be researched.
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Ciudad, Pedro, Maria I. Vargas, Ana Castillo-Soto, Jefferson R. Sanchez, Oscar J. Manrique, Samyd S. Bustos, Antonio J. Forte, Maria T. Huayllani, Zoila Soto, and J. Antonio Grández-Urbina. "Manejo de heridas traumáticas de difícil cicatrización con colgajos microvasculares." MA Healthcare Ltd, 2020. http://hdl.handle.net/10757/656659.
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El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.Objective: Present different flap alternatives when performing microvascular free-flap reconstruction in acute hard-to-heal wounds. Method: A retrospective review of patients whose acute hard-to-heal wounds were treated with microvascular free-flap reconstruction. Data on demographics, wound aetiology, diagnostic, previous treatment, free-flap type, free-flap size, complications and follow up were analysed. Results: A total of 20 patients received microvascular free-flap reconstruction. The median age was 39.5 years. Twenty free-flap reconstructions were performed. These included: 3 cross-leg free flap, 1 cross-leg vascular cable bridge flap, 2 fibula osteocutaneous flap, 6 anterolateral thigh (ALT) flap, 3 thoracodorsal artery perforator (TDAP) flap, 3 fasciomyocutaneous flap, and 2 femoral artery fasciocutaneous flap. A patient required microvascular anastomosis due to hematoma; the rest did not present complications during their postoperative. Previous treatment included negative pressure wound therapy (12 patients) and surgical debridement with silver hydrogel dressings (8 patients). Conclusion: Hard-to-heal wounds can be unresponsive to traditional wound healing practices or local flaps. They often require free-flap reconstruction, using tissues similar to those compromised. Microvascular techniques can be an effective alternative. CONFLICT OF INTEREST None.
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Borgo, Marcela. "Avaliação do processo de reparo de incisões realizadas em tecido cutâneo de ratos e submetidas a laser terapêutico." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/25/25147/tde-18082010-093650/.
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O laser de baixa potência tem sido utilizado após procedimentos cirúrgicos visando acelerar o processo de reparo tecidual. No entanto, embora esse tipo de tratamento ofereça pouco ou nenhum risco à saúde do paciente, sua eficácia ainda é controversa na literatura. Este estudo foi desenvolvido para avaliar o efeito do laser de baixa potência (100 mW) sobre o processo de reparo de incisões cutâneas em dorso de ratos. Incisões de 2 cm de extensão foram confeccionadas no dorso de cinquenta e seis ratos Wistar. Após a sutura, metade dos animais recebeu laser de baixa potência em 3 pontos de aplicação, um no centro e um em cada extremidade da ferida. Em cada ponto, foi administrada uma dose de 35 J/cm2 (laser de InGaAlP, 660 nm, vermelho visível). A outra metade dos animais serviu como controle. Os tecidos incisados foram avaliados microscopicamente, de forma descritiva, em períodos de 6 horas, 2, 7 e 14 dias, levando em consideração o aspecto do revestimento epitelial e do tecido conjuntivo e a magnitude da resposta inflamatória, quando presente. Para os dois primeiros períodos, foi feita também uma avaliação morfométrica, que mensurou a densidade de fibroblastos, fibras colágenas, vasos sanguíneos e células inflamatórias no tecido conjuntivo. Na análise descritiva, as maiores diferenças foram encontradas no período de 6 horas, seguido pelo de 2 dias. Em 6 horas, o grupo tratado com laser apresentou menor resposta inflamatória que o controle e, em alguns espécimes, foi possível evidenciar início de proliferação das células do epitélio nas bordas da ferida. Em 2 dias, alguns espécimes do grupo controle ainda apresentavam células inflamatórias remanescentes, não evidenciadas no grupo laser. Nesse período, foi possível evidenciar também, em alguns espécimes do grupo laser, proliferação de fibroblastos junto às bordas da ferida. Nos períodos de 7 e 14 dias, não foram encontradas diferenças entre os grupos. Na análise morfométrica, a densidade de fibras colágenas e vasos sanguíneos foi maior para o grupo laser do que para o grupo controle em ambos os períodos avaliados, com diferença estatisticamente significante. Com base nos resultados obtidos, concluiu-se que o laser de baixa potência foi capaz de controlar a resposta inflamatória e estimular o processo de reparo tecidual em feridas cutâneas em dorso de ratos.Low-power laser therapy has been used after surgical procedures to improve wound healing. However, although such kind of treatment offers little or no risk to the patient\'s health, its effectiveness remains controversial. This study was developed to evaluate the effect of low-power laser (100 mW) on the healing of skin incisions in rats. Two centimeters incisions were made on the back of fifty-six Wistar rats. After suturing, half of the animals received low-power laser application on three points, one on center and one on each end of the wound. For each point, a dose of 35 J/cm2 (InGaAIP laser, 660 nm, visible red) was administered. The other half of the animals served as control. The incised tissues were evaluated microscopically in a descriptive way in periods of 6 hours, 2, 7 and 14 days, considering the aspects of epithelium and connective tissue and the magnitude of inflammatory response, when present. For the first two periods, it was also done a morphometric evaluation, which measured the density of fibroblasts, collagen fibers, blood vessels and inflammatory cells in the connective tissue. In descriptive analysis, the greatest differences were found in the period of 6 hours, followed by the period of 2 days. In 6 hours, the laser-treated group showed less inflammatory response than control and, in some specimens, it was possible to see the beginning of epithelium proliferation on the edges of the wound. In two days, some specimens of the control group still showed remaining inflammatory cells, not observed in the laser group. In this period, it was also possible to see, in some specimens of the laser group, proliferation of fibroblasts along the edges of the wound. In the periods of 7 and 14 days, no differences were found between the groups. In morphometric analysis, density of collagen fibers and blood vessels was higher for the laser group in both evaluated periods, with statistically significant difference. Based on these results, it was concluded that low-power laser was able to control inflammatory response and stimulate tissue repair in skin wounds in rats.
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Badenes, Marina Martins. "Avaliação da função de DII4 na neoangiogénese tumoral e fisiológica." Bachelor's thesis, Universidade Técnica de Lisboa. Faculdade de Medicina Veterinária, 2009. http://hdl.handle.net/10400.5/2585.
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Dissertação de Mestrado Integrado em Medicina VeterináriaO ligando Delta-like 4 (Dll4), através da via de sinalização Notch, é um potente regulador da angiogénese, sendo expresso na componente arterial da vasculatura. Nos adultos, a sua expressão encontra-se aumentada numa grande variedade de condições patológicas. Neste estágio avaliou-se a regeneração de feridas em murganhos com perda-de-função condicional para Dll4 (Dll4-/-). A mutação Dll4-/- determina um aumento da densidade vascular, mas devido à fraca maturação dos vasos neoformados estes não são totalmente funcionais, têm fraca perfusão e elevada extravasação. Esta experiência inseriu-se num estudo mais alargado, que teve como objectivo determinar a quantidade ideal de inibição da expressão deste gene que resulte num aumento da vascularização sem diminuição de funcionalidade, de modo a tornar a terapia útil em situações que dependam da restauração da função vascular. A primeira área onde a terapia anti-Dll4 se revela promissora é na oncologia. Neste estágio efectuaram-se ensaios terapêuticos com proteína solúvel Dll4, proteína solúvel EphB4 e combinação de ambas, usando como modelo murganhos transgénicos que desenvolvem insulinomas autonomamente, nomeadamente murganhos nos quais, sob o controlo do promotor 1 do gene de insulina II de ratazana, o antigénio tumoral grande do vírus de símio 40 é expresso apenas nas células β das ilhotas de Langerhans do pâncreas (RIP1-Tag2). Os resultados indicaram que ambas as terapias conduzem a uma redução significativa do desenvolvimento tumoral, tendo o efeito mais pronunciado sido obtido mediante a administração combinada das proteínas Dll4 e EphB4.
ABSTRACT - Delta-like ligand 4 (Dll4), an arterial-specific component of the Notch pathway, is a potent regulator of angiogenesis. In adults, the expression of this gene is increased in a variety of pathological conditions. In this internship, we assessed wounds in inducible conditional knock-out mice, Dll4lox/loxFlp-/-Cre+/-. Deletion of Dll4 results in higher vascular density, but due to weak maturation the new vessels are poorly functional with low perfusion and high extravasation. This experiment is included in a larger trial aiming to determine the concentrations at which the Dll4-blocking therapy is capable of inducing an increase in vascularization without decreasing its functionality, making it useful in pathological condition that are dependant on vascular function. Oncology was the first area where anti-Dll4 therapy revealed a promising future. In this internship therapeutic assays were carried out with soluble Dll4 protein, soluble EphB4 protein and combination of both proteins in RIP1-Tag2 transgenic mice, which develop autochthonous insulinomas by the action of simian virus 40 large tumoral antigen (Tag2), which is expressed under the control of the rat insulin II gene promoter 1 (RIP1). Tumor development was largely reduced in all experimental groups with the best results obtained in the group treated with a combination of both proteins.
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Ingrup, Lina, and Åse Lindgren. "Patientens upplevelse av undertrycksbehandling och dess påverkan på livskvalitet - en litteraturstudie." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25757.
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Bakgrund: Undertrycksbehandling eller Negative Pressure Wound Therapy (NPWT) är en sårbehandling som ofta används när andra behandlingar inte lyckats med läkningen av det kroniska såret. Flera forskningsstudier stödjer metodens effektivitet gällande sårläkning och bildande av granulationsvävnad, men behandlingens påverkan på patienten och dennes upplevelse av att använda behandlingen är bristfällig.Syfte: Syftet med studien var att beskriva patientens upplevelse av att genomgå undertrycksbehandling av ett sår och om behandlingen påverkar patientens livskvalitet.Metod: Litteraturstudie baserad på kvalitativa artiklar som svarade på huvudsyftet och kvantitativa artiklar som svarade på frågeställningen.Resultat: Informanterna upplevde att NPWT-enheten var ett fokus i behandlingen. Behandlingen var smärtsam och påverkade det dagliga livet och informantens självbild. Informanterna upplevde en brist på information och stöd och en inkonsekvens i vårdpersonalens kunskap och kompetens. Ingen signifikant skillnad i livskvaliteten påvisades vid jämförelse av NPWT och standard sårbehandling.Konklusion: NPWT-behandlingen upplevdes som en krävande sårbehandling där patienten utmanades både fysiskt och psykiskt. Behandlingen innebar mycket eget ansvar, var starkt förknippad med smärta och oro och ångest överskuggade målet med behandlingen.Background: Negative Pressure Wound Therapy (NPWT) is a wound therapy, often used, when other therapies fail to heal the chronic wound. Several research studies support the effectiveness of the method regarding wound healing and granulation tissue formation, but the effect of treatment on the patient and his experience of using the treatment is lacking. Aim: The aim of the study was to describe the patient´s experience of undergoing negative pressure wound therapy and if the treatment affects the patient´s quality of life. Method: Literature review based on qualitative articles that responded to the main objective and quantitative articles that answered the research question. Results: The informants felt that the NPWT device was a focus in the treatment. The treatment was painful and affected the daily life and the informant´s self-image. The informants experienced a lack of information and support, and an inconsistency in the nursing staffs knowledge and skills. No significant difference in the quality of life were proved by comparing NPWT and standard wound treatment.Conclusion: NPWT treatment was perceived as a demanding wound treatment where the patient was challenged both physically and mentally. Treatment entailed a lot of own responsibility, was highly associated with pain and worry and anxiety overshadowed the goal of treatment.
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Nóbrega, Fernando José de Oliveira. "Estudo histológico da ação do laser e da terapia fotodinâmica no processo de reparação de feridas cutâneas em ratos tratados com corticóide /." Araçatuba : [s.n.], 2005. http://hdl.handle.net/11449/96162.
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Orientador: Valdir Gouveia GarciaBanca: Nivaldo Antonio Parizotto
Banca: Álvaro Francisco Bosco
Resumo: O processo de reparo de feridas em indivíduos imunossuprimidos pelo uso de medicação corticóide representa um problema para a área da saúde. Diversos tipos de tratamento têm sido propostos para se obter uma melhor qualidade no processo de reparo, dentre esses destaca-se o uso do laser em baixa intensidade e, mais recentemente, a terapia fotodinâmica (PDT), representada pela associação do laser com drogas fotossensibilizadoras, como o Azul de Toluidina O (TBO). O propósito deste trabalho foi avaliar, histologicamente, a ação do laser em baixa intensidade e da PDT no processso de reparo em feridas cutâneas em ratos tratados com corticóide. Foram utilizados 90 ratos, nos quais foi criada, com o auxílio de um punch, uma ferida de 8 mm de diâmetro na porção média da região dorsal. Os animais foram divididos em 5 grupos: grupo 1 (n=18): os animais não receberam nenhum tipo de tratamento, tanto local quanto sistêmico; grupo 2 (n=18): os animais receberam corticóide sistêmico e nenhum tratamento local; grupo 3 (n=18): os animais receberam sistemicamente o mesmo tratamento do grupo 2, sendo as feridas tratadas com laser de baixa intensidade; grupo 4 (n=18): os animais receberam o mesmo tratamento sistêmico do grupo 2, sendo as feridas tratadas com irrigação de TBO; e grupo 5 (n=18): os animais receberam o mesmo tratamento do grupo 4, sendo as feridas tratadas imediatamente após a sua execução, com laser em baixa intensidade. Os animais, em número de 06 (seis) para cada grupo, foram sacrificados nos períodos de 3, 7 e 14 dias após a execução dos procedimentos terapêuticos. As peças foram processadas para análise histológica e coradas pela técnica da hematoxilina e eosina (H&E) e Tricômico de Masson. Os resultados mostraram que o grupo 2 promoveu um retardo na reparação tecidual em todos os períodos experimentais... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The process of wounds repair in immunosuppressed individuals for the use of corticoid therapy represents a problem for the area of health. Several treatment types have been proposed to obtain a better quality in the repair process. Among those, the use of low level laser may be emphasized and, more recently, the photodynamic therapy (PDT), represented by the association of that laser with photosensibilized drugs like toluidine blue O (TBO). The aim of this study was to evaluate, histologically, the action of the laser and of PDT in the repair process in cutaneous wounds in rats treated with corticoid. Ninety rats were used, in which was created, with the aid of a punch of 8 mm diameter, a wound in the medium portion of the dorsal region. The animals were divided in 5 groups: group 1 (n=18): the animals didn't receive any treatment type, local or systemic; group 2 (n=18): the animals received systemic corticoid and any local treatment; group 3 (n=18): the animals received systemically the same treatment of the group 2, being the wounds treated with low level laser; group 4 (n=18): the animals received the same systemic treatment of groups 2, being the wounds treated with irrigation of TBO; and group 5 (n=18): the animals received the same treatment of the group 4, being the wounds immediately treated after their execution with laser. The animals, in number of 06 (six) for each group, were sacrificed in the periods of 3, 7 and 14 days after the execution of the therapeutic procedures. The pieces were processed for histologic analysis and colored for the technique of hematoxylin-eosin (H&E) and Masson trichrome stains. The results showed that the group 2 promoted a retard in the tissue repair in all the experimental periods; the group 3 presented a more accelerated repair process than the group 4, as well as the group 5 was presented... (Complete abstract click electronic access below)
Mestre
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Perea, Gil Isaac. "Cell-enriched engineered cardiac grafts improve heart function and promote cardiac regeneration: a novel therapy for myocardial infarction." Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/454716.
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El infarto de miocardio es una de las enfermedades cardiovasculares de mayor incidencia y mortalidad entre la población mundial. A pesar de los diferentes tratamientos empleados, a día de hoy ninguno de ellos consigue revertir las secuelas postinfarto ni una completa recuperación de la función cardíaca. En este sentido, la ingeniería tisular cardíaca se presenta como una alternativa válida a las terapias actuales, combinando el uso de matrices de soporte con células terapéuticas. Sin embargo, la elección tanto de la matriz como del linaje celular óptimos aún no han sido completamente dilucidados. Así, nuestra hipótesis de trabajo plantea que el uso de matrices derivadas de miocardio y pericardio descelularizados, repoblados con células progenitoras derivadas de tejido adiposo cardíaco (ATDPCs cardíacas), como terapia para el infarto de miocardio, promueve la regeneración cardíaca y mejora la función cardíaca. Para abordar dicha hipótesis, se establecieron los siguientes objetivos: 1. Caracterizar las propiedades inmunomoduladoras de las ATDPCs cardíacas; 2. Generar matrices descelularizadas a partir de tejido miocárdico y pericárdico; 3. Recelularizar las matrices descelularizadas con ATDPCs cardíacas, generando constructos de bioingeniería miocárdicos (o EMG-ATDPC) y pericárdicos (o EPG-ATDPC) respectivamente; y analizar el comportamiento celular de las ATDPCs cardíacas sembradas en dichas matrices; y 4. Evaluar los efectos ejercidos por el EMG-ATDPC y el EPG-ATDPC en el modelo porcino de infarto de miocardio. A partir de los resultados obtenidos en la presente tesis, se obtuvieron las siguientes conclusiones: 1. Las ATDPCs cardíacas no inducen activación de linfocitos T y, además, reducen su actividad proliferativa cuando dichos linfocitos han sido previamente estimulados. Además, las ATDPCs cardíacas también limitan la secreción de citoquinas proinflamatorias por parte de los linfocitos T, indicando una baja inmunogenicidad por parte de las ATDPCs cardíacas. 2. La caracterización de las matrices de miocardio y pericardio descelularizados demuestra la total ausencia de núcleos y residuos celulares, confirma la preservación de las propiedades mecánicas y estructurales de la matriz, e identifica las principales proteínas matriciales típicas de tejido cardíaco, recreando el microambiente cardíaco fisiológico. 3. Las matrices cardíacas descelularizadas permiten su recolonización mediante ATDPCs cardíacas, reteniéndolas viables en su interior y manteniendo su potencial vasculogénico. La densidad y migración celular, así como la preservación del potencial cardiomiogénico por parte de las ATDPCs cardíacas, son dependientes del tipo de matriz cardíaca empleada. 4. La implantación de los constructos EMG-ATDPC y EPG-ATDPC promueve una mejora en la función cardíaca, disminuye el tamaño de infarto, limita la fibrosis ventricular, e induce tanto neovascularización como neoinervación en la zona de infarto y en la propia matriz. En conclusión, los constructos EMG-ATDPC y EPG-ATDPC son herramientas útiles para el tratamiento del infarto de miocardio, demostrando su potencial cardioregenerativo en modelo porcino, mostrándose viable su traslación hacia uso clínico.Myocardial infarction is one of the cardiovascular diseases with highest incidence and mortality worldwide. Despite the different treatments employed nowadays, none of them succeeded in reversing post-infarction sequelae or completely recovering cardiac function thus far. In this regard, cardiac tissue engineering is presented as a valid alternative to current therapies, combining the use of supportive matrices or scaffolds with therapeutic cells. However, the choice of both the scaffold and the cell lineage has not been fully elucidated yet. Thus, our working hypothesis proposes that the use of scaffolds derived from decellularized myocardium and pericardium, subsequently repopulated with cardiac adipose tissue-derived progenitor cells (cardiac ATDPCs), as a therapy for myocardial infarction, promotes cardiac regeneration and improves cardiac function. To carry out this hypothesis, we set out the following objectives: 1. Characterization of the immunomodulatory properties of the cardiac ATDPCs; 2. Generation of decellularized scaffolds from myocardial and pericardial tissue; 3. Recellularization of the acellular cardiac scaffolds with cardiac ATDPCs, generating myocardial (or EMG-ATDPC) and pericardial (or EPG-ATDPC) bioengineered constructs, respectively; and analysis of the cellular behavior of these cardiac ATDPCs seeded over the scaffolds; and 4. Evaluation of the effects exerted by the implantation of both EMG-ATDPC and EPG-ATDPC in a porcine model of acute myocardial infarction. According to the outcomes derived from the present study, the following conclusions were stated: 1. Cardiac ATDPCs do not induce activation of T-lymphocytes and, in addition, reduce their proliferative activity when these T-lymphocytes have been previously stimulated. Moreover, the cardiac ATDPCs also limit the secretion of proinflammatory cytokines released by the T-lymphocytes, indicating a low immunogenicity of our target cardiac ATDPCs. 2. The complete characterization of the myocardial and pericardial decellularized scaffolds shows a total absence of nuclei and cell debris, confirms the preservation of mechanical and structural properties of the matrix, and identifies the major matrix proteins typical of heart tissue, all together perfectly recreating the physiological cardiac microenvironment. 3. The decellularized cardiac scaffolds support recolonization with cardiac ATDPCs, retaining them alive and maintaining their vasculogenic potential. Cell density and migration, as well as preservation of cardiomyogenic potential by cardiac ATDPCs, are dependent on the type of cardiac scaffold used. And 4. The engraftment of EMG-ATDPC and EPG-ATDPC constructs promotes an enhancement in ventricular function, decreases infarct size, limits ventricular fibrosis progression, and induces neovascularization and neoinnervation, both in the infarct zone and the scaffold itself. In conclusion, the EMG-ATDPC and EPG-ATDPC constructs are useful tools for the treatment of myocardial infarction, demonstrating their cardioregenerative potential in porcine model, and being viable for their translation into clinical use.
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Nóbrega, Fernando José de Oliveira [UNESP]. "Estudo histológico da ação do laser e da terapia fotodinâmica no processo de reparação de feridas cutâneas em ratos tratados com corticóide." Universidade Estadual Paulista (UNESP), 2005. http://hdl.handle.net/11449/96162.
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nobrega_fjo_me_araca.pdf: 1565763 bytes, checksum: 329aeaf5bcd90629d9755c4db87d2dcb (MD5)Universidade Estadual Paulista (UNESP)
O processo de reparo de feridas em indivíduos imunossuprimidos pelo uso de medicação corticóide representa um problema para a área da saúde. Diversos tipos de tratamento têm sido propostos para se obter uma melhor qualidade no processo de reparo, dentre esses destaca-se o uso do laser em baixa intensidade e, mais recentemente, a terapia fotodinâmica (PDT), representada pela associação do laser com drogas fotossensibilizadoras, como o Azul de Toluidina O (TBO). O propósito deste trabalho foi avaliar, histologicamente, a ação do laser em baixa intensidade e da PDT no processso de reparo em feridas cutâneas em ratos tratados com corticóide. Foram utilizados 90 ratos, nos quais foi criada, com o auxílio de um punch, uma ferida de 8 mm de diâmetro na porção média da região dorsal. Os animais foram divididos em 5 grupos: grupo 1 (n=18): os animais não receberam nenhum tipo de tratamento, tanto local quanto sistêmico; grupo 2 (n=18): os animais receberam corticóide sistêmico e nenhum tratamento local; grupo 3 (n=18): os animais receberam sistemicamente o mesmo tratamento do grupo 2, sendo as feridas tratadas com laser de baixa intensidade; grupo 4 (n=18): os animais receberam o mesmo tratamento sistêmico do grupo 2, sendo as feridas tratadas com irrigação de TBO; e grupo 5 (n=18): os animais receberam o mesmo tratamento do grupo 4, sendo as feridas tratadas imediatamente após a sua execução, com laser em baixa intensidade. Os animais, em número de 06 (seis) para cada grupo, foram sacrificados nos períodos de 3, 7 e 14 dias após a execução dos procedimentos terapêuticos. As peças foram processadas para análise histológica e coradas pela técnica da hematoxilina e eosina (H&E) e Tricômico de Masson. Os resultados mostraram que o grupo 2 promoveu um retardo na reparação tecidual em todos os períodos experimentais...
The process of wounds repair in immunosuppressed individuals for the use of corticoid therapy represents a problem for the area of health. Several treatment types have been proposed to obtain a better quality in the repair process. Among those, the use of low level laser may be emphasized and, more recently, the photodynamic therapy (PDT), represented by the association of that laser with photosensibilized drugs like toluidine blue O (TBO). The aim of this study was to evaluate, histologically, the action of the laser and of PDT in the repair process in cutaneous wounds in rats treated with corticoid. Ninety rats were used, in which was created, with the aid of a punch of 8 mm diameter, a wound in the medium portion of the dorsal region. The animals were divided in 5 groups: group 1 (n=18): the animals didn't receive any treatment type, local or systemic; group 2 (n=18): the animals received systemic corticoid and any local treatment; group 3 (n=18): the animals received systemically the same treatment of the group 2, being the wounds treated with low level laser; group 4 (n=18): the animals received the same systemic treatment of groups 2, being the wounds treated with irrigation of TBO; and group 5 (n=18): the animals received the same treatment of the group 4, being the wounds immediately treated after their execution with laser. The animals, in number of 06 (six) for each group, were sacrificed in the periods of 3, 7 and 14 days after the execution of the therapeutic procedures. The pieces were processed for histologic analysis and colored for the technique of hematoxylin-eosin (H&E) and Masson trichrome stains. The results showed that the group 2 promoted a retard in the tissue repair in all the experimental periods; the group 3 presented a more accelerated repair process than the group 4, as well as the group 5 was presented... (Complete abstract click electronic access below)
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Bossini, Paulo Sérgio. "Laser de baixa intensidade (670nm) na viabilidade do retalho cutâneo randômico em ratos." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/82/82131/tde-07082007-110337/.
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Os retalhos cutâneos são amplamente utilizados na cirurgia plástica, principalmente na reparadora. Após o procedimento operatório, uma das principais complicações é a isquemia, podendo ocasionar a necrose do retalho. Vários recursos têm sido estudados com o intuito de aumentar a viabilidade desses retalhos. Dentre esses recursos, o laser de baixa intensidade é uma alternativa de tratamento, uma vez que pode promover um aumento da microcirculação e da neoformação vascular. Entretanto, existem discrepâncias na literatura em relação aos parâmetros empregados no uso do laser de baixa intensidade, principalmente das fluências utilizadas nos tratamentos. Este estudo teve como objetivo verificar o efeito de diferentes fluências do laser de 670nm, na viabilidade do retalho cutâneo randômico em ratos. Foram utilizados 100 ratos, da linhagem Wistar, distribuídos em 5 grupos de 20 animais cada. O retalho cutâneo randômico de base cranial foi realizado com dimensões de 10 X 4 cm e uma barreira plástica foi interposta entre o mesmo e o leito doador. O grupo 1 (controle) foi submetido à simulação de tratamento com o aparelho desligado. O grupo 2 foi submetido à radiação laser com fluência de 3 J/\'CM POT.2\'. Os grupos 3, 4 e 5 foram irradiados com fluências de 6 J/\'CM POT.2\', 12 J/\'CM POT.2\' e 24 J/\'CM POT.2\', respectivamente. Todos os grupos experimentais receberam a radiação laser imediatamente após o procedimento operatório e nos 4 dias subseqüentes, utilizando-se a técnica pontual em contato em 24 pontos distribuídos sobre e ao redor do retalho. No sétimo dia pós-operatório, as porcentagens da área de necrose dos retalhos foram avaliadas pelo método do gabarito de papel e também foi coletada uma amostra do retalho de 10 animais de cada grupo, escolhidos aleatoriamente, para a realização da contagem dos vasos sangüíneos. O grupo 1 apresentou média de área de necrose de 49,92%; o grupo 2 - 41,84%; o grupo 3 - 36,51%; o grupo 4 - 29,45% e o grupo 5 - 20,37%. Na contagem dos vasos, o grupo 1 obteve média de 65,2; o grupo 2 - 92,6; o grupo 3 - 105,5; o grupo 4 - 128,7 e o grupo 5 - 171,0. Na análise estatística, realizou-se a ANOVA, seguida do teste de comparações múltiplas de Tukey. Os resultados mostraram que todos os grupos experimentais apresentaram valores estatisticamente significativos comparados ao grupo controle, sendo que o grupo 5 apresentou a menor área de necrose e o maior número de vasos quando comparado aos demais grupos deste estudo (p < 0,01). O teste de correlação linear de Pearson indicou alta correlação negativa entre a porcentagem de necrose e o número de vasos dos retalhos (-0,972 / p = 0,0001). O laser de baixa intensidade (670nm) aplicado com fluência de 24 J/\'CM POT.2\' foi mais eficaz no aumento da viabilidade do retalho cutâneo randômico em ratos, comparado às outras fluências utilizadas neste estudo.Skin flaps are widely used in plastic surgery, mainly in repair surgeries. After this reconstructive procedure, one of the main consequences is the decrease of blood flow in the area, which can be responsible by tissue necrosis. In this context, a lot of studies have investigated treatments able to increase the viability of the flap and the low level laser therapy (LLLT) has been chosen as an efficient treatment to reduce post-injury inflammatory processes and to stimulate the formation of new blood vessels. However, the use of a wide range of fluences by different authors and the lack of standardized experimental conditions make it difficult to compare published results. The aim of this study was to investigate the dose-response effects of 670nm laser on the viability of random skin flap in rats. One hundred Wistar male rats were used in this study. The animals were divided into 5 groups: group 1 (control group); group 2 (treated with 3 J/\'CM POT.2\'); group 3 (treated with 6 J/\'CM POT.2\'); group 4 (treated with 12 J/\'CM POT.2\') and group 5 (treated with 24 J/\'CM POT.2\'). The skin flap was made on the back of all animals studied (dimensions: 10 x 4 cm) and before the sutures were done, a plastic sheet was interposed between the flap and the donor site. Laser irradiation was performed immediately after the surgery and on days 1, 2, 3 and 4 post-surgery. The irradiation was made punctually, on 24 points on the skin surface and around it. The percentage of the necrosis area of the flap was calculated by the paper template method at the day 7 postoperative. Moreover, a sample of the skin flaps was collected from 10 rats of each group, which were chosen aleatory, to performe the count of the blood vessels. The animals of all treated groups showed statistically significant differences when compared to the control group (necrosis area: 49, 92%). The necrosis area of the treated groups were 41,82% (group 2), 36,51% (group 3), 29,45% (group 4) and 20,37% (group 5). In the count of blood vessels, group 1 showed the mean of 65,2; group 2 - 92,6; group 3 - 105,5; group 4 - 128,7 and group 5 - 171,0. The ANOVA test, followed by the Tukey test, for multiple comparasions were used. The results showed that all experimental groups showed statistically lower values for the necrosis area compared to the control and a higher number of blood vessels in the skin flap. It can be observed that the best results were found in the animals of group 5 (p < 0,01). In addition, the Pearson coefficient showed a significant negative correlation between necrosis area and the number of vessels (-0,972 / p = 0,0001). This present study has demonstrated that the 670nm laser was efficient to increase the viability of the skin flap, at all fluences used, with a tendency of reaching better results at higher dosages (24 J/\'CM POT.2\').
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Crusca, Jaqueline de Souza. "Laser de baixa intensidade no tratamento de úlceras cutâneas aplicando curativos de pericárdio porcino revestido com quitosana." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/82/82131/tde-20072012-091549/.
Full textAbstract:
As lesões na pele, quando extensas, representam um grande problema de saúde pública e elevados custos associados aos tratamentos. A laserterapia tem sido aplicada por décadas a fim de acelerar o processo de cicatrização cutânea. Já a matriz de pericárdio porcino apresenta potencial para ser utilizado como curativo biológico, porém o patch tem rápida biodegradação, por isso adicionou-se quitosana. Muitos autores observaram esses tratamentos individualmente, no entanto não há dados concisos sobre a associação dessas terapias. O objetivo desse estudo foi avaliar a resposta clínica, histológica e histomorfométrica da ação fotobiomoduladora do laser no processo de reparação de úlceras cutâneas com o auxílio do curativo de pericárdio porcino revestido com quitosana. A úlcera cutânea foi induzida cirurgicamente em 48 ratos distribuídos em 6 grupos distintos com 8 animais cada, sendo eles: Matriz (curativo de pericárdio porcino); ML (curativo de pericárdio porcino com a aplicação da laserterapia); MQ (curativo de pericárdio porcino revestido com quitosana); MQL (curativo de pericárdio porcino revestido com quitosana com a aplicação da laserterapia); Ctrl (o grupo controle que não recebeu curativo algum) e Laser (o grupo controle que recebeu somente a laserterapia). Nos grupos que receberam imediatamente após o procedimento cirúrgico a radiação laser, com as seguintes características: comprimentos de onda da luz = 660nm, irradiância = 30mW/\'CM POT.2\', e densidade de energia de 30j/\'CM POT.2\'. O registro fotográfico das úlceras foi realizado no 10º dia pós-operatório e para fornecer a área ulcerada foi utilizado o software Image J. Foi realizada uma análise histológica e histomorfométrica (contagem de fibroblastos, células inflamatórias, vasos sanguíneos e colágenos) a partir de biópsias coletadas no 10º dia pós-operatório. Os resultados obtidos foram dados através das médias dos grupos com relação a cada análise, sendo eles: área da lesão (Laser = 0,48 \'CM POT.2\', Matriz = 0,46 \'CM POT.2\', Ctrl = 0,28 \'CM POT.2\', ML = 0,23 \'CM POT.2\', MQ = 0,22 \'CM POT.2\' e MQL = 0,19 \'CM POT.2\'); formação colagênica (Laser = 54,51%, Matriz = 51,75%, Ctrl = 58,84%, ML = 68,77%, MQ = 69,50% e MQL = 71,72%); células inflamatórias (Laser = 126,31, Matriz = 132,40, Ctrl = 101,85, ML = 97,67, MQ = 95,27 e MQL = 94,15); vasos sanguíneos (Laser = 6,83, Matriz = 4,48, Ctrl = 5,37, ML = 7,46, MQ = 5,42 e MQL = 3,98) e fibroblastos (Laser = 55,83, Matriz = 71,31, Ctrl = 78,63, ML = 85,40, MQ = 105,06 e MQL = 108,58). Os dados foram analisados pela análise de variância, com post hoc de Tukey, a fim de comparar os grupos com um nível de significância de 95% (p<0,05). Com base nesses achados, observou-se que houve melhora estatisticamente significante no grupo com curativos de pericárdio porcino revestido com quitosana associado à aplicação da laserterapia (MQL) quando comparado ao controle, mostrando-se mais eficaz no processo cicatricial de úlceras.Large skin injuries represent a major public health issue, with high costs associated with the treatments. Laser therapy has been used for decades to accelerate the process of skin healing. The porcine pericardium matrix has the potential to be used as a biological dressing, but the patch has rapid biodegradation, so chitosan was added to delay this effect. Many authors have used these treatments individually; however there is no accurate data on the combination of these therapies. The aim of this study was to assess the clinical, histological and histomorphometric photobiomodulation laser action in the repair of skin ulcers associated with porcine pericardium dressing coated with chitosan. The skin ulcer was surgically induced in 48 rats, which were distributed into 6 groups with 8 animals each: Matrix (porcine pericardium dressing), ML (porcine pericardium dressing with laser therapy), MQ (porcine pericardium dressing coated with chitosan), MQL (porcine pericardium with a bandage coated with chitosan and laser therapy), Ctrl (the control group did not receive treatment) and Laser (the control group that received only laser therapy). The laser radiation groups received the treatment immediately after the surgery, with the following characteristics: light wavelength = 660nm, irradiance = 30mW/\'CM POT.2\' and of energy density 30j/\'CM POT.2\'. The photographic record of the ulcers was performed on the 10th postoperative day and to provide the ulcerated area was used the software ImageJ. We performed a histological and histomorphometric (count of fibroblasts, inflammatory cells, blood vessels and collagen) from biopsies also on the 10th postoperatively day. The results were given as means of groups from each analysis, as follows: lesion area (Laser = 0,48 \'CM POT.2\', Matriz = 0,46 \'CM POT.2\', Ctrl = 0,28 \'CM POT.2\', ML = 0,23 \'CM POT.2\', MQ = 0,22 \'CM POT.2\' e MQL = 0,19 \'CM POT.2\'), collagen formation (Laser = 54,51%, Matriz = 51,75%, Ctrl = 58,84%, ML = 68,77%, MQ = 69,50% e MQL = 71,72%), inflammatory cells (Laser = 126,31, Matriz = 132,40, Ctrl = 101,85, ML = 97,67, MQ = 95,27 e MQL = 94,15); blood vessels (Laser = 6,83, Matriz = 4,48, Ctrl = 5,37, ML = 7,46, MQ = 5,42 e MQL = 3,98) and fibroblasts (Laser = 55,83, Matriz = 71,31, Ctrl = 78,63, ML = 85,40, MQ = 105,06 e MQL = 108,58). Data were analyzed by analysis of variance with Tukey\'s post hoc to compare the groups with a significance level of 95% (p<0.05). Based on these findings, we observed that there was a statistically significant improvement in the group with porcine pericardium dressings coated with chitosan associated with the application of laser therapy (MQL) compared to control, displaying more effective in healing ulcers.