Increased life expectancy and the growing number of lifestyle diseases, such as diabetes, have had a great impact on hard-to-heal chronic wounds such as diabetic ulcers.
Several advanced wound dressings are available for the treatment of these nonhealing wounds. However, the time required for healing, and achieving cosmetically acceptable healing without scar formation and so on, are still a challenge for wound-healing technologists. Transfer genes encoding wound healing growth factors can control local events in the microenvironment, such as cell proliferation, cell migration and the formation of ECM. Stem cell therapy along with gene therapy in synergy with tissue engineering can, to a certain extent, mimic natural wound healing. This could be a new and exciting approach in the treatment of chronic nonhealing wounds and beneficial to millions of patients.
References
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3D Three-dimensional ADP Adenosine diphosphate AgNP Silver nanoparticle(s) ATP Adenosine triphosphate bFGF Basic fibroblast growth factor CMC Carboxymethyl cellulose CMCh Carboxymethyl chitosan
CLSM Confocal laser scanning microscopy DA Degree of acetylation
DAPI 4',6-Diamidino-2-phenylindole DBC Dibutyryl chitin
DE Dermal equivalent
DFU Diabetic foot ulcer(s) ECM Extracellular matrix EGF Epidermal growth factors
EGFP Enhanced green fluorescent protein EPA Elevated protease activity
FasIII Fasciclin III
A bbreviations
FDA US Food and Drug Administration FGF Fibroblast growth factor
GAG Glycosaminoglycan(s)
GF Growth factor(s)
HA Hyaluronic acid
IGF Insulin-like growth factor(s)
IL Interleukin
KGF Keratinocyte growth factor MMP Matrix metalloproteinase(s)
MRSA Methicillin-resistant Staphylococcus aureus MSC Mesenchymal stem cell(s)
MVTR Moisture vapour transmission rate
NO Nitric oxide
NOCC N,O-carboxymethyl chitosan PAR Protease activated receptor PDGF Platelet-derived growth factor(s) PEG Polyethylene glycol
PGI2 Prostacyclin
PHMB Polyhexamethylene biguanide PMN Polymorphonuclear neutrophil(s) ppm Parts per million
RGD Arginyl-glycyl-aspartic acid
rhEGF Recombinant human epidermal growth factor
ROS Reactive oxygen species
SE Skin equivalent
SEM Standard error of the mean
TF Tissue factor
TGF-α Transforming growth factor-α TGF-β Transforming growth factor-β
TIMP Tissue inhibitors of metalloproteinase(s) TNF Tumour necrosis factor
TNF-α Tumour necrosis factor-α
tPA Tissue-type plasminogen activator uPA Urokinase-type plasminogen activator
UV Ultraviolet
VEGF Vascular endothelial growth factor VLU Venous leg ulcer(s)
vWF von Willebrand factor WSC Water-soluble chitin
β-chitin-based dressing, 117 β-haemolytic Streptococcus, 113 3D
hydrogels, 150
skin surface pattern, 145 7-dehydrocholesterol, 32
A
Abnormal wound healing, 45 Abnormalities, 45
Abrasions, 2, 5, 35, 50, 53-55, 85, 117, 140, 145 Absorbable gelatin sponges, 94
Absorbent fibres, 50
Absorption, 22, 43, 51, 73, 84, 86-88, 106, 108, 112-113, 126 Acellular, 10-11
dressing, 141 matrix, 21 tissue scaffold, 22 Acetylation, 118, 119 Acrylonitrile vapour, 121 Acticoat
antimicrobial barrier silver dressing, 20 flex, 113
Actin cytoskeletal reorganisation, 70 Actisorb®, 87
Activated
charcoal dressings, 87 polyacrylate dressings, 5 Acute
incisional, 157 wound fluids, 70
wounds, 1, 5, 35, 53-54, 61, 64, 73, 87
I ndex
a b c d a b c d a b c d
a b c d a b c d a b c d a α β χ δ
❁
Adenoidectomy, 110
Adenosine triphosphate (ATP), 45 Adhesive gel-forming wafers, 6, 51 Adhesives, 19
Adipocytes, 29-30
Adenosine diphosphate (ADP), 39 Adrenocortical hypersecretions, 156 Adult wound healing, 44
Advanced
bioactive dressings, 57 dressings, 100, 155
wound-healing dressings, 22 Advanced wound-care
dressings, 16-17, 19, 22, 51, 100 products, 17
industry, 16 Aeruginosa, 113-114 Aetiology, 53
Agarose, 141
Age, 3, 36, 46, 61, 155 Ageing, 6, 16-17, 66 Agglutination, 99, 119 Alchite, 111
Alcohol consumption, 46 Aldehydes, 118
Algiderm, 112
Algidex AgTM (DeRoyal), 113
Alginate-and chitosan-based dressings, 43
Alginate, 3-4, 7-8, 15-16, 19, 21-22, 43, 50, 52, 82-84, 86, 99, 103-115, 120-121, 123, 125
dressings, 16, 86, 99, 108, 112, 125 fibre packing, 108
gel, 126
hydrocolloid dressings, 21 wound dressings, 6, 84, 113 -based dressings, 103 -containing dressings, 110 Alginic
acid, 6, 51, 86, 104 material, 103, 108
Algivon® dressings, 89, 115 Algosteril®, 8, 109-110 Alkylation, 118-119 Alldress®, 87 Allergy, 94
Allevyn advanced foam wound dressings, 20 Allogeneic, 135-138, 141, 144-155
Allograft, 8, 135 Allografting, 143 Almond oil, 92 Amino acid, 61, 75 Amorphous gels, 49 Amphiregulin, 62 Anchoring fibrils, 32
Angiogenesis, 5, 11, 38-39, 41, 45-46, 62, 64, 66-68, 70, 72-76, 82, 148, 157 Animal
grease, 1, 49 model, 38, 121
Antibacterial, 5, 21, 84, 86, 88-89, 111, 117-118, 122, 125-126, 140 Antibiotics, 56, 67, 76, 88, 99
agents, 99 Anticancer, 115 Anticoagulants, 98-99 Antidiabetic, 115
Anti-inflammatory, 5, 121, 140
Antimicrobial, 5, 10, 20-21, 50, 52, 88-90, 99, 112-113, 115, 117, 120 agent, 5, 50, 88
dressings, 5, 52, 88 honey dressings, 89 Antiseptic, 2, 89-90
technique, 2 wax, 92
ApinateTM dressings, 89, 115 Apligraf®, 9-10, 57, 138, 140 Apoptosis, 41, 68
Appendectomy, 53 Aprotinin, 92
Aquaflo™ hydrogel wound dressings, 21 Arginine, 75
Arginyl-glycyl-aspartic acid (RGD), 123
Arterial, 3, 15, 35, 53, 55, 64, 91, 95, 99 Arteriopathy, 67
Artificial skin, 24
skin replacement therapies, 16 skin substitutes, 22, 100 Artiss, 92
Ascophyllum nodosum, 104 Ascorbic acid, 75
Askina calgitrol, 113 Aspirin, 99
Atopic dermatitis, 5, 33 Atrophic scars, 155 Autografts, 135, 139, 142
Autologous, 9, 23, 57, 135-136, 138, 143-145, 147, 150, 155 Autologous keratinocyte cells, 57
Autolytic debridement, 53, 85-86, 88 Avulsion, 35, 54
Azide moieties, 115 Azotobacter, 104
B
Bacterial colonisation, 52, 90, 113 Bacteriostatic
foam, 5
foam dressings, 5 Bandages, 49, 51, 97, 117 Band-aid®, 19, 51, 87, 155 Basal lamina, 31
Basement membrane (BM), 65 Basic fibroblast, 3, 39, 141
Basic fibroblast growth factor (BFGF), 65, 68-69 Becaplermin, 74
Beeswax, 92 Benzyl alcohol, 144 Beriplast®, 92 Beschitin®, 8, 121
Bilayered human dermal substitutes, 18 Bioabsorbable polyglactin scaffold, 141 Bioactive
cell-based dressings, 155 compounds, 4, 50, 82 dressings, 4, 50, 82 products, 4, 7, 49, 81 Bioadhesiveness, 99
Biobrane®, 8, 10, 20, 57, 137, 139 Biocol®, 92
Biocompatibility, 81, 95, 115-116, 146 Biodegradable, 103, 106, 108, 118, 145 Bioengineered skin, 2, 135
Biofilms, 67 Biological
therapies, 16
tissue replacements, 3 Biologics, 16, 50 Biomaterials, 2 Biomedicine, 3, 104 Bioocclusive dressing, 108
Biopolymer, 58, 103, 104, 106, 125, 145, 146 Biopsy, 141
Bioseed®-S, 147
Biosynthetic dressings, 5 Black wound, 55 Blisters, 88 Blood
clot, 38, 91 clotting, 95 coagulation, 37
loss, 37, 90, 91, 92, 94
vessels, 1, 25, 28-30, 33, 36-38, 41, 66, 76, 120, 124, 148 Bone
tissue engineering, 123 wax, 91, 94
-marrow-derived stem cells, 157 Bovine, 9, 57, 135, 138, 141, 148, 150 Branan ferulate, 22
Bronchial epithelial cells, 70 Brown
adipose tissue, 30 algae, 104-105
seaweed, 104 Buccal mucosa, 110
Burn, 2, 5, 9-11, 16, 19, 20, 35, 51, 53, 57, 59, 62, 66, 76, 84-85, 87, 89-90, 99, 103, 108, 115, 117, 126, 135-146, 155-156
dressings, 50
injuries, 8, 15, 35, 54, 57-58, 125, 138, 148-149
wounds, 2, 9, 12, 16, 57-58, 62, 66, 84, 103, 110, 121-122, 135-136, 156
C
Cadaver skin, 135 Cadesorb, 20
Cadexomer iodide, 5, 52, 90 dressings, 5
matrix, 90
Calcium alginate, 16, 50, 86, 89, 103, 108, 110-113, 115 dressings, 16, 103, 108
wound dressings, 110 Calcium chloride, 92, 94 Calcium sodium alginate, 108 Candida albicans, 113
Carbon fibres, 22 Carbonised fibre, 87
Carboxymethyl cellulose (CMC), 6, 50, 51, 112 Carboxymethyl chitosan (CMCh), 120, 122, 126, Carboxymethylation, 119-120
Cardinal signs of inflammation, 1 Catabolic enzymes, 27
Cavity wounds, 84, 86, 108, 112 Cell
elongation, 70 metabolism, 45, 145
migration, 37, 64, 68-69, 72, 120, 123, 141, 158 proliferation, 110, 158
therapies, 16 Cell-based
bioengineered skin, 12
skin substitutes, 9, 12, 57, 122 treatment, 3
Cell-seeded chitosan sponges, 58 Cell-to-cell
communication, 23, 27
connections, 27 interaction, 157 Cellular
senescence, 3
wound-care therapies, 23
Cellulose, 4, 7-8, 50, 62, 92, 94, 96, 104, 108, 110, 112, 118 dressings, 108
Celox™, 96-98 Charaka samhita, 1 Chelation, 118 Chemoattractants, 38 Chemokine, 46, 73 Chemotaxis, 38, 45 ChiGel, 117
Chitin, 3, 8, 22, 96, 99, 103, 115-121, 124-125, 128-129 Chitipack®P, 96, 117
ChitoClearTM, 117 Chitoderm®, 140 ChitoFlex®, 96-97, 117
Chitooligosaccharides (COS), 115 Chitopack®C, 117
Chitopoly, 117
Chitosan, 3-4, 8, 22, 50, 58, 82, 84, 86, 91-92, 95-97, 99, 103, 107, 111, 115- 126, 128, 140, 150
scaffold, 122-123 -glycerol phosphate, 115 -heparin complex, 121 -saccharide derivatives, 119 Chitosan-based
agents, 92
bioactive wound-dressing, 58 dressing, 94
haemostatic agents, 96, 99 haemostatic dressings, 99 wound dressing, 117 Chito-seal®, 117 Chlorhexidine, 84 Cholecystectomy, 53 Chondral repair, 123 Chondrocytes, 70, 72
Chondroitin sulfate, 39, 138 Chronic
nonhealing wounds, 2-3, 138, 157, 158 ulcer wounds, 41, 76
ulcers, 2, 76, 124
wound, 1, 3, 5-6, 12, 15-21, 35-38, 42, 49, 52-53, 55, 58-59, 61-64, 66-68, 70, 73-76, 81-82, 84, 87, 99, 110, 125-126, 136-137, 140, 144, 155-158
wound healing, 3, 16
Cica-care self-adhesive silicone gel sheets, 20 Clean-contaminated wounds, 53
Clean wounds, 53 Clopidogrel, 99 Clo-sur® pad, 117
Clot formation, 93, 97, 99, 117, 140 CO2, 88, 141
Coagulation, 36, 41, 65 Coagulum, 95, 119
Cochrane database, 89, 100-101 Cocultured fibroblast, 9, 57, 122 Coexisting illnesses, 18
Collagen, 3-5, 8, 15-16, 19-22, 28, 30, 31, 36-37, 39, 41-46, 49-50, 52, 57-58, 64, 66, 68-70, 72-73, 75, 82, 91, 94-95, 96, 99, 116, 120-123, 135, 137-142, 145, 148, 150, 155, 157
-based scaffolds, 16
-based wound dressings, 75 dressings, 5, 99
III, 43
synthesised, 39
Collagenase-3, 21, 38, 70, 72 Colon
mucosal cells, 70 myofibroblasts, 70 Colorimetry, 145 Composite dressings, 87 Compressibility, 67 Compression
bandages, 20 dressings, 91
Confocal laser scanning microscopy (CLSM), 113 Connective tissue regeneration, 66
Contact dermatitis, 33
Contact lens cleaning solutions, 90 Contamination, 5, 9, 50, 53, 59, 108, 148 Contraction, 39, 68, 70, 72, 90
Contusions, 35, 54 Corneal epithelial cells, 70 Corneocyte cells, 25 Corneometry, 145
Cotton, 4, 50-52, 84, 110, 117 gauze, 84, 100
Coumadin, 98
Coverderm® (DeRoyal), 87 Coversite™, 87
Crosseal™, 92
Crosslinking, 36, 42, 64, 75, 86, 118, 145 Crush wounds, 35, 55
Cryoskin®, 144 Cullen’s circle, 73
Cultured skin substitutes, 8 Curasorb, 21, 109, 112
calcium alginate, 21
Curity™ AMD antimicrobial gauze sponge, 90 Cutaneous wound healing, 36-37, 66, 156, 157
wounds, 42 Cuts, 35, 55
Cyanoethyl chitosan, 121 Cyclooxygenase, 64 Cysteine, 27, 75
Cytokine, 11, 12, 16, 23, 33, 38, 43-45, 61, 63, 66-68, 73, 76, 90, 99-100, 120, 141, 145, 150, 155
release, 23
Cytotoxic, 84, 88, 108
D
Deacetylated chitosan, 96 Dead tissue, 6
Deep
burns treatment, 145, 146, 148 cavity wounds, 87
wounds, 1, 35, 50, 55
Deep partial-thickness burns, 156
skin loss, 54 Degradable, 84, 103
Degree of acetylation (DA), 119, 121 Degree of deacetylation, 119
Degree of electrostatic repulsion, 119 Dehydration, 32, 97
Delayed t-cell infiltration, 46
Delayed wound healing, 38, 46, 155 Dendritic cells, 156
Denervation, 67 Dental repair, 123
Deoxyribonucleic acid, 75, 156 Dermagraft®, 9-10, 57, 137, 141, 142 Dermal equivalent (DE), 145
Dermal fibroblasts, 3, 31, 137 Dermal microfibrils, 31
Dermal substitute therapy, 148
Dermis, 1-2, 9-10, 21, 25, 27-31, 36, 51, 53, 54-55, 57, 137-138, 142, 148, 157 Dermo-epidermal junction, 28, 31
Desiccation, 5, 50, 61, 82 D-glucosaminic acid, 115
Diabetes, 3, 6, 16-19, 35, 36, 64, 73, 158
Diabetic foot ulcers (DFU), 6, 9-10, 15, 21, 57, 62, 64, 67, 70, 73, 76, 135-137, 139, 140, 142, 157
Diabetic
foot wounds, 74 nonhealing ulcers, 75 skin ulcers, 108, 157
ulcers, 6, 11-12, 16, 35, 45, 52-53, 55, 58, 61, 73, 75, 113, 125-126, 135, 137, 156, 158
Dibutyryl chitin (DBC), 120-121 Dilation, 29
D-mannuronic acid, 104-105 Donor graft sites, 89, 115
Donor sites, 2, 10, 11, 20, 53, 103, 108, 110, 113, 117, 120, 136, 137, 138, 139, 145
Dressings, 1- 3, 5, 6, 12, 15-17, 22, 42, 49-52, 76, 81-82, 85-86, 90-91, 96, 99- 100, 103-104, 109-110, 112-113, 117, 121, 125-126, 149, 158
Drug delivery, 3 Drug-device, 155
Drug-releasing dressing formulation, 15 Drug-resistant organisms, 67
Dry dressings, 19, 23
Dry fibrin sealant dressings, 38 Dry fibrin sealant dressings, 94 Dry wounds, 2, 42, 84, 86 Durafiber, 20
Dystrophic epidermolysis bullosa, 141
E
Ebers papyrus, 1, 49 Eccrine sweat glands, 29 Effects of ageing, 3 Egg-box model, 107 Elastases, 38, 67 Elasticity, 67 Elastin, 28-29, 137 Elastometry, 145
Electromagnetic therapy devices, 19 Electrospinning, 122-123
Elevated protease activity (EPA), 73 Endoscopic subfascial ligation, 18 Endothelial
cell migration, 76
cells, 37-38, 64, 66, 70, 72, 75, 123, 148, 156 Endovascular arterial repair techniques, 18 Epicel®, 9, 10, 57, 136, 142, 143
Epidermal, 3, 9, 19, 21-22, 27-29, 31-32, 38, 43, 57, 68, 71, 82, 99, 108, 121, 123, 135, 138, 141-143, 148-150, 157
cells, 42, 71 dentritic cells, 32
Epidermal growth factors (EGF), 61-63, 76
Epidermis, 1, 2, 9, 25, 27-29, 31, 33, 40, 53, 55, 57, 70-71, 120, 124, 139, 143- 144, 145, 148, 157
Epithelial cells, 29, 40, 42, 68, 70, 123 wound, 1
Epithelialization, 2, 5, 20, 39, 42-43, 52, 55, 62-63, 66, 68, 72, 82, 85, 89, 103, 115, 120, 122
Epithelializing wounds, 86, 108 Erythrocytes, 95-96
Eschar, 42, 54, 85 covered wounds, 86 Escherichia coli, 113 Esterification, 118, 144 Etherification, 118 Evarrest®, 92 Evisel®, 92
Excisional wounds, 157 Exocytosis, 26
Extracellular matrix (ECM), 3, 21, 36-37, 39, 43-45, 61, 64, 66, 67-68, 70, 72, 73, 82, 123, 137, 139, 141, 145, 147, 150, 156, 157-158
proteins, 123
Extracellular proteins, 23, 137
Exudates, 3-6, 21, 42-43, 49-52, 70, 73, 81, 86-90, 100, 112, 115, 125, 139 Exudation, 49-50, 52
F
Faecal fistulae, 87 Fatty acids, 25, 87
FDA, 4, 9-10, 50, 57, 64, 74, 76, 89, 92- 94, 96, 97, 117, 140, 142, 148 FGF-1, 62
FGF-2, 62-63 FGF-7, 62 Fibrillin, 28 Fibrils, 31
Fibrin, 19, 36, 37, 41, 64, 90-91, 93, 121, 136-137, 139, 145, 147 clot, 92
cuffs, 124 deposition, 41 sealants, 92
-based haemostats, 92 Fibrinolysis, 92
Fibroblast, 2, 5, 8-9, 29, 36-39, 41-42, 45, 57, 58, 61-62, 64-67, 69-70, 72-73, 75, 82, 95, 99, 108, 110, 116, 119-124, 135, 137-142, 145, 147-148, 155-157 cells, 9, 58, 99, 122, 141
Fibroblast growth factor (FGF), 62 Fibronectin, 39, 41, 68-69, 72, 123 Fibrous
products, 6, 51 sheet dressings, 108 Filaggrin, 121
Film dressings, 16 Film-type dressings, 84 First plasters, 89 First-degree burns, 55 Flat sheets, 112 Floseal®, 93
Foam dressings, 16, 21, 84, 87 Foetal
inflammatory responses, 43 skin, 43
wound healing, 43-44, 156 wounds, 43, 156
Foot ulcers, 10-11, 57, 64, 84, 138, 146 Foreign bodies, 3, 53, 82
Framycetin sulfate, 84 Free sterols, 27
Friction, 5, 26, 35, 50, 54, 61
Full-thickness, 2, 53-55, 139, 141, 143-144 burns, 156
dermal loss, 54 skin, 54 skin loss, 54 tissue loss, 54
wounds, 2, 5, 53, 55, 58, 85-86, 144-145 Fungating lesions, 87
Fungi, 113
G
Gangrene, 54
Gauze, 2, 4, 6, 21, 49-52, 82, 84-85, 90, 96, 98-99, 103, 108, 110 dressings, 84
-based products, 6, 52 Gel porosity, 107
Gelable polysaccharides, 6, 51 Gelatin, 72, 92-94, 106, 123
matrices, 91 Gelatinase A, 70
Gelatinase B, 70, 72 Gelatinases, 67, 69-70 Gelation, 107, 123 Gel-fibre dressing, 20 Gelfoam, 93
Gel-forming agents, 84, 86 Gel-like clot, 98
Gelling, 106 Gene
therapy, 3, 156-158 transfer, 157 -modified skin, 156 Globulin, 95
Glucosamine, 75
Glucosamine-containing polymers, 91 Glucosaminoglycans, 123
Glutaraldehyde crosslinked collagen, 122 Glycoprotein, 72
Glycosaminoglycans (GAG), 19, 44, 95, 119-120, 142, 148 matrix, 19
Glycosphingolipids, 26-27 Glycosylated species, 70 Gold standard, 81, 148 Graft copolymerisation, 118
Grafting, 2, 10-11, 118, 135, 141, 147-148 Graftjacket®, 10, 21
RTM, 21 Xpress, 21 Granular
Cells, 26 wounds, 86
Granulating wounds, 50, 53
Granulation, 5, 39, 41-42, 55, 57, 61-62, 84-85, 89, 103, 108, 115, 120, 124 tissue, 39, 63, 124
Granulocyte colony stimulating factor, 74 Granuloma, 94
G-rich alginate, 125
Growth factors, 3, 9, 12, 16, 22-23, 36, 38-39, 41-46, 50, 58, 61, 62-70, 73-76, 82, 99-100, 121-124, 141, 155-158
Guluronic acid, 86, 105, 107, 113, 126
H
HA derivative, 144, 150 HaCat keratinocytes, 121 Haemagglutination, 95 Haematopoiesis, 66 Haemoglobin, 75
Haemostasis, 37-39, 41, 46, 61, 69, 86, 90-92, 94, 96, 99-100, 110, 117, 119, 147
Haemostatic, 22, 37, 84, 86, 91-99, 103, 108, 110, 115-117, 119-121, 140 agents, 37, 91, 92
dressing, 103, 110, 117, 122 intervention, 91
plug, 95
wound dressing, 111, 117 Haemostats, 19, 94, 95 Hair follicles, 28, 29, 156 Hand surgery, 141
Hard-to-heal wounds, 23, 61 H-bonding, 118
Healing time, 2, 3, 15, 62, 139, 141 Heavily exudating wounds, 6, 84, 86, 87 HemCon®, 8, 38, 94, 96-98, 117, 122
chitosan bandage, 38, 94 Hemogrip™, 96, 99 Heparansulfate, 39
Heparin, 38, 62, 98, 99, 121, 140 Heparin-binding EGF, 62
Heparinised blood, 95 Hepatocytes, 123 Herbs, 1, 49, 92
Hippocrates, 1, 91, 112 Histidine, 26
Histiocytosis X, 33 Homeostasis, 30, 45, 72 Honey, 1, 5, 7, 49, 52, 89 Honey-based dressings, 5, 52
Human immunodeficiency virus-type 1, 33 Human tissue, 9, 57, 122, 135, 155 Hyaff®, 144, 145
Hyalograft 3DTM, 137, 139, 144-146, 147 Hyalomatrix® PA, 144, 145, 146
Hyaluronic acid (HA), 22, 39, 41, 43, 75, 95, 116, 121, 123, 135 Hydrated collagen sponges, 9, 57
Hydrocolloid, 6, 15-16, 19, 21, 24, 43, 50-52, 89, 115 dressing, 6, 50, 51, 84, 86
-based dressings, 43
Hydrogel, 15-16, 19-21, 43, 50-52, 84-86, 99, 120-121, 123 dressings, 6, 16, 21, 43, 84-86, 99
wound and burn dressing, 5 wound dressings, 50
Hydrogen peroxide and superoxide (O2-), 45 Hydrophilic, 4, 5, 50, 87
gel, 108
nonresorbable materials, 50 polymers, 5, 50
wound dressing, 4, 50 Hydrophobic lipids, 25-26 Hydroxypropyl chitosan, 119 Hyperbaric oxygen therapy, 19 Hypertrophic, 45, 46, 53, 57, 64, 66
chondrocytes, 70 scars, 155 Hypertrophy, 147
Hypodermis, 9, 25, 29, 31, 57 Hypothalamus, 31
I
Iatrogenic wounds, 2, 53 Ideal wound dressing, 3, 81 IGF-1, 66, 68-69
IL-1, 63, 66, 69, 73 IL-6, 44, 63, 66, 73 Immunogenicity, 115 Impregnation, 52 In situ, 121
In vitro, 88, 94, 113, 135, 142 In vivo, 93, 123
Inadine®, 90 Inadine™, 84
Incisional, 66
Infected pressure sores, 87
Infected wounds, 57, 61, 84, 87, 88, 89, 115, 126
Infection, 1-3, 5, 15, 19, 21, 25, 27, 35, 42-43, 45, 52-56, 58-59, 61, 67, 75, 81- 82, 88-91, 94, 100, 112, 115-116, 125, 139, 143, 146, 155
Infiltrating leukocytes, 38
Inflammation, 23, 35-38, 41, 45-46, 55, 63, 66-68, 73, 108, 121, 157 cells, 36, 39, 66, 67, 73, 119, 156
Insufficiency, 3, 45
Insulin-like growth factors (IGF), 66 Intact skin, 54
Integra®, 8, 11, 19, 57, 138, 145, 148-149 artificial skin, 19
Interactive
dressings, 5, 52, 57 products, 4, 49, 52, 81-82 Interleukin (IL)-1, 39
International diabetes federation, 6, 13, 24 Interstitial collagenases, 67
Intramolecular disulfide bonds, 62 Intrasite hydrogel wound-dressing, 20 Intrasite®, 121
Invasorb, 87
Iodine, 2, 5, 20, 84, 89-90, 96, 99 Iodosorb, 8, 20, 90
cadexomer matrix, 20 dressing, 90
Ionic silver, 5, 89, 112-113, 115 Ischaemia, 3
ulcers, 61
J
Jelonet, 84
Jun N-terminal kinase, 70
K
Kaltostat®, 8, 83, 109-110 Kaoline, 94
Kaolin-impregnated gauze, 94
Keloid, 2-3, 45-46, 53, 64, 66, 120, 156
formation, 2-3, 120, 156 scars, 156
Kendall™ calcium alginate dressings, 21 Keratansulfate, 39
Keratin, 25, 27, 62 Keratinisation, 27
Keratinocyte, 2, 8-9, 25-27, 31, 57, 58, 61-63, 65-68, 70, 72-73, 99, 108, 110, 121-124, 135-136, 138-139, 141, 143, 144-148, 155, 157
cells, 2, 9, 25-26, 57-58, 73, 99, 122-124, 141, 144 GF-1, 141
growth factor-2, 99 Keratohyalin, 26
Kerlix™ AMD antimicrobial gauze, 90 Ketones, 118
KGF, 62-63
L
Laceration, 35, 55 Lactose, 115 Lamina densa, 32 Lamina lucida, 31-32 Laminaria hyperbores, 104 Laminin, 72, 123
Langerhans cells, 27, 32-33 LaserSkin®, 11, 136, 146
Leg ulcers, 10, 15, 21, 58, 86-87, 89-90, 108, 110, 115, 117, 136 Leptin, 31
Leptospermum scoparium, 89, 115 Leukocytes, 38, 75, 82
L-guluronic acid, 104 Lifestyle diseases, 158 Lint, 1, 49, 52, 100 Lipocytes, 31 Liquid nitrogen, 144 Living cells, 1, 142 Living skin, 57
Low exudation, necrotic, 49 Low immunogenic response, 148
Low molecular weight chitosan (LMWC), 115 Lymphocytes, 41, 75
Lyophilisation, 123
Lyophilised collagen sponge layer, 148
M
M426 lung fibroblasts, 62
Maceration, 42, 52, 61, 81, 84, 85, 87 Macrocystis pyrifera, 104, 105
Macrophages, 5, 29, 36-39, 41, 61, 63-64, 66, 70, 75, 110, 116, 119-120, 123, 140
Malleolar ulcers, 146 Malnutrition, 3 Malodorous, 87
Mannuronic acid (M-rich), 86, 105, 112, 126 Mannuronic acid content (G-rich), 112 Manuka honey, 89, 115
Matrilysin, 72
Matrix delivery system, 157
Matrix metalloproteinases (MMP), 3, 61, 64, 66, 67-73, 75, 76 Maturation, 37, 41-42, 120, 141
Maturing neutrophils, 70
Maxorb® Extra Ag silver alginate, 113 Medicinal plants, 1
extracts, 91
MEDIHONEY®, 89, 109
antimicrobial honey dressings, 89, 115 gel sheet, 89, 115
Meissner’s corpuscles, 28 Melanin, 27
Melanocytes, 27
Membrane type-MMP, 67 Merkel cells, 27
Mesenchymal stem cells (MSC), 157 Metallic silver, 112
Metalloproteinase, 41, 43, 75
Metalloproteinases, 39, 61, 64, 68, 157
Methicillin-resistant Staphylococcus aureus (MRSA), 5, 113 Methionine, 75
Microfibrillar collagen, 37, 92, 94 Microperforated HA membrane, 146 Microvascular endothelial cell, 108, 110
Mineral-based agent, 92 Minerals, 45, 49, 75, 91 Missile wounds, 35, 55 Mitogenic, 62, 64
MMP-1, 64, 66-68, 70-73 MMP-10, 67, 72
MMP-11 (Stromelysins), 67, 72 MMP-13 (Collagenases), 67, 70, 72 MMP-14 (Membrane type-MMP), 67, 72 MMP-2, 64, 67, 69-70, 72, 73
MMP-28 (Epilysin), 28, 67, 72 MMP-3, 64, 66, 67, 68, 72 MMP-8, 67, 70, 73
MMP-9 (Gelatinases), 64, 66, 67, 69, 70, 73 Moderate exudation wounds, 49
Modern
dressings, 6, 74
wound dressings, 2, 42-43 Moist wound care, 16
Moist wound healing, 2, 5, 42-43, 49, 53, 125 dressings, 43
environment, 2, 42, 86, 100
Moisture vapour transmission rate (MVTR), 43 Monocytes, 43, 75, 90
Morphology, 53, 106
M-Rich alginate dressings, 125 Muraminic acid, 95
Musculoskeletal tissue repair, 64 Myocardial heart wound, 123 MySkin®, 136, 144
N
N-acetylation, 119
N,O-carboxymethyl chitosan (NOCC), 115, 120, 126 N-acetyl-β-D-glucosamine, 116, 123
Nanocrystalline silver, 88 Nanosilver dressings, 113 Nanotechnology, 150 Nanotopography, 150 Natural skin, 149, 155
Natural wound healing, 125, 150, 158 microenvironment, 3
Naturally occurring materials, 49
N-carboxybutyl chitosan membranes, 120 Necrotic, 6, 53, 55, 84, 86, 100, 108
tissue, 53, 84, 100, 108 Negative pressure
devices, 19
wound therapy, 16, 20 Neoangiogenesis, 145 Neoepidermis, 146
Neonatal foreskin, 140, 141 Neovascularisation, 45, 68 Neovasculature, 39
Nerve bundles, 28 Neural cells, 123
Neuropathic ulcers, 53-54, 74 Neuropathy, 45, 61
Neutrophil
accumulation, 38 infiltration, 38, 40 influx, 38
Neutrophils, 38, 63 Nitric oxide (NO), 65
N-methacrylate-glycol-modified chitosan gel, 123 Nonadherence, 84
Nonblanchable erythema, 53 Noncollagenous proteins, 4, 50, 82 Nonhealing
diabetic ulcers, 6
ulcers, 6, 16, 19, 62, 64, 73-75, 99, 138 wounds, 12, 57, 64, 81, 117, 157-158 Nonhuman tissue, 135, 155
Noninvasive medical devices, 51 Nonmalignant tumours, 156 Nonmetallic clay mineral, 94 Nonresorbable
gauze/sponge dressing, 4, 50 materials, 4
matrices, 5, 50
Nonwoven dressing, 22
Normal wound healing, 38, 41-42, 45, 58, 68, 73 N-sulfosuccinoyl chitosan, 121
Nylon scaffold, 144
O
O-acetylation, 118 Obesity, 6, 16-18, 46 Obstinate ulcer, 1 Occluded wounds, 2, 42
Occlusive wound dressing, 4, 50 Octenidine, 90
Oestrogen, 156
Old traumatic wounds, 53 Opsite, 7, 20, 83
Optimum moisture content, 42 level, 42
Oral epithelial cells, 70 OrCel®, 11, 138-139, 141 Osteoarthritis, 117 Osteoblasts, 70, 119 O-succinyl-chitosan, 119 Otological surgery, 148 Oxidised cellulose, 92 Oxygen transport, 75 Oxygenation, 45
Oxygen-storing droplets, 126
P
Pain management, 43 Papillary dermis, 28, 33 Paraffin, 52, 84, 103, 108
gauze, 84 Paranet™, 84 Parenchyma cells, 72
Partial-thickness, 53-54, 138, 141, 144 skin loss, 53
wounds, 2, 20, 53, 55, 88, 138 Passive products, 4, 49, 81-82
Pathogenesis, 33, 64, 73
Pathogens, 25, 49, 53, 70, 89, 115 Pathological response, 42
Pegylated chitosan sponge, 124 Perioperative cleansing products, 90 Peripheral
cells, 40 neutrophils, 70 Periwound tissue, 42
Permacol™ biologic implant, 21 Permanent wound-healing devices, 2 Petrolatum gauze, 143
PGI2: prostacyclin, 65 Phaeophyceae, 104 Phagocytes, 38, 66, 75 Phagocytic cells, 32 Phagocytosis, 38 Phospholipids, 27
Phosphorylated chitin, 122 Photocrosslinkable chitosan, 115 Photocurable CMCh, 120
Plant extract-based haemostatic agent, 92 Plasma cells, 70
Platelet plug, 37
Platelet-derived growth factor (PDGF), 3, 36-39, 41, 43, 45, 63-64, 74, 76, 99, 148, 157
Platelet-derived growth factor (PDGF)-AB, 141 Platelet-independent mechanism, 140
Platelets, 36-37, 61, 64, 90, 93-96, 117, 140 Polar lipids, 26-27
Polyacrylate, 5, 52 Polyacrylic acid, 121
Polyaminopropyl biguanide, 90 Polyelectrolyte, 121
Polyethylene fibres, 117
Polyethylene glycol (PEG), 90, 121 Polyethylene terephthalate, 22 Polyethylenimine, 107
Polyglycolic acid, 22
Polyhexamethylene biguanide (PHMB), 5, 52, 90 Polyhexanide, 90
Polyhydroxyalkanoates, 3 Polylactic acid, 3, 22, 122 Polymeric films, 4, 49, 82 Polymeric hydrogel dressing, 85 Polymorphonuclear cells, 119 Polymorphonuclear leukocytes, 38 Polymorphonuclear neutrophils, 38 Polymorphonuclearneutrophils (PMN), 36 Poly-N-acetyl-glucosamine, 94
Polypeptides, 107 Polyphenols, 106
Polysaccharide, 95, 104, 115, 118, 125, 145 PolySkin™ transparent dressings, 21
Polyurethane (PU), 4, 6-7, 43, 50, 51, 87-88, 99, 140 Polyurethane-based film dressing, 43
Polyvinyl alcohol, 140 Polyvinyl pyrolidone, 113
Porcine, 9, 20-21, 93, 135, 137-139 skin, 93
Porosity, 107, 148
Post-operative wounds, 20 Povidone iodine, 90 Pressure
bandages, 37 relief devices, 19
sores, 2, 15-16, 53, 58, 125, 156
ulcers, 10-11, 20-21, 23, 35, 53, 55, 61, 87, 99, 103, 110, 112, 137, 145 Primary intention, 57
Proliferation, 27, 36-39, 41-42, 46, 61-64, 66-69, 72, 75-76, 82, 95, 103, 108, 110, 116, 120-123, 140, 145-146, 155
Proliferative, 37, 39, 61-62, 143, 157 Prolonged inflammation, 45
Prophylaxis, 90 Prostaglandin, 37, 38
Protease, 20, 39, 45, 70, 72-73, 157
Protein, 6, 26-27, 30, 36, 38-40, 42-44, 62, 66, 75 Proteoglycans, 4, 39, 44, 50, 69, 72, 82, 119, 145 Proteolytic enzymes, 3, 38, 67, 70