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Wound Infection: Emerging Challenges in Normal and Diabetic Skin Wounds

A special issue of Molecules (ISSN 1420-3049). This special issue belongs to the section "Medicinal Chemistry".

Deadline for manuscript submissions: closed (30 April 2022) | Viewed by 24038

Special Issue Editor


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Guest Editor
Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
Interests: wound infection; wound repair; immunotherapy; bugs as drugs; antimicrobial resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Wound management is a major global challenge posing a significant burden to patients and healthcare systems. The incidence of diabetes continues to increase in the Western world, and the prevalence of acute and chronic wounds related to this condition continues to be a major focus of wound care research.  Wound healing is an incredibly complex physiological process, with numerous interdependent factors influencing critical events. More than 50% of chronic wounds exhibit signs and symptoms that are consistent with localized bacterial biofilms underlying severe infections that contribute to tissue destruction, delayed wound-healing, and other serious complications. In many diverse pathologies, such as diabetes mellitus, normal wound healing is impaired, which may lead to severe complications, ranging from ulcers to chronic skin infections. As such, advanced biomedical approaches for effective wound care aim at providing antimicrobial protection to the open wound together with promotion of fast and correct healing, so that fully functional healthy skin can be swiftly restored.

The aim of this Special Issue is to highlight recent advances in the efforts that have been made over the past several years to find interventions in wound-healing properties. This Special Issue may include original research articles and reviews working towards the development of new and effective wound care treatments for diabetic and other skin and soft tissue infections.

Dr. Kajal Gupta
Guest Editor

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Keywords

  • Acute, chronic, and complex skin wounds
  • Wound infection
  • Wound repair
  • Skin and tissue regeneration
  • Diabetic skin wound infection
  • Biofilms
  • Antibiotic resistance

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Published Papers (3 papers)

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Review

33 pages, 6095 KiB  
Review
Advances in Fibrin-Based Materials in Wound Repair: A Review
by Ilker S. Bayer
Molecules 2022, 27(14), 4504; https://doi.org/10.3390/molecules27144504 - 14 Jul 2022
Cited by 38 | Viewed by 5506
Abstract
The first bioprocess that occurs in response to wounding is the deterrence of local hemorrhage. This is accomplished by platelet aggregation and initiation of the hemostasis cascade. The resulting blood clot immediately enables the cessation of bleeding and then functions as a provisional [...] Read more.
The first bioprocess that occurs in response to wounding is the deterrence of local hemorrhage. This is accomplished by platelet aggregation and initiation of the hemostasis cascade. The resulting blood clot immediately enables the cessation of bleeding and then functions as a provisional matrix for wound healing, which begins a few days after injury. Here, fibrinogen and fibrin fibers are the key players, because they literally serve as scaffolds for tissue regeneration and promote the migration of cells, as well as the ingrowth of tissues. Fibrin is also an important modulator of healing and a host defense system against microbes that effectively maintains incoming leukocytes and acts as reservoir for growth factors. This review presents recent advances in the understanding and applications of fibrin and fibrin-fiber-incorporated biomedical materials applied to wound healing and subsequent tissue repair. It also discusses how fibrin-based materials function through several wound healing stages including physical barrier formation, the entrapment of bacteria, drug and cell delivery, and eventual degradation. Pure fibrin is not mechanically strong and stable enough to act as a singular wound repair material. To alleviate this problem, this paper will demonstrate recent advances in the modification of fibrin with next-generation materials exhibiting enhanced stability and medical efficacy, along with a detailed look at the mechanical properties of fibrin and fibrin-laden materials. Specifically, fibrin-based nanocomposites and their role in wound repair, sustained drug release, cell delivery to wound sites, skin reconstruction, and biomedical applications of drug-loaded fibrin-based materials will be demonstrated and discussed. Full article
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19 pages, 655 KiB  
Review
Gas Plasma-Augmented Wound Healing in Animal Models and Veterinary Medicine
by Sander Bekeschus, Axel Kramer and Anke Schmidt
Molecules 2021, 26(18), 5682; https://doi.org/10.3390/molecules26185682 - 19 Sep 2021
Cited by 23 | Viewed by 5011
Abstract
The loss of skin integrity is inevitable in life. Wound healing is a necessary sequence of events to reconstitute the body’s integrity against potentially harmful environmental agents and restore homeostasis. Attempts to improve cutaneous wound healing are therefore as old as humanity itself. [...] Read more.
The loss of skin integrity is inevitable in life. Wound healing is a necessary sequence of events to reconstitute the body’s integrity against potentially harmful environmental agents and restore homeostasis. Attempts to improve cutaneous wound healing are therefore as old as humanity itself. Furthermore, nowadays, targeting defective wound healing is of utmost importance in an aging society with underlying diseases such as diabetes and vascular insufficiencies being on the rise. Because chronic wounds’ etiology and specific traits differ, there is widespread polypragmasia in targeting non-healing conditions. Reactive oxygen and nitrogen species (ROS/RNS) are an overarching theme accompanying wound healing and its biological stages. ROS are signaling agents generated by phagocytes to inactivate pathogens. Although ROS/RNS’s central role in the biology of wound healing has long been appreciated, it was only until the recent decade that these agents were explicitly used to target defective wound healing using gas plasma technology. Gas plasma is a physical state of matter and is a partially ionized gas operated at body temperature which generates a plethora of ROS/RNS simultaneously in a spatiotemporally controlled manner. Animal models of wound healing have been vital in driving the development of these wound healing-promoting technologies, and this review summarizes the current knowledge and identifies open ends derived from in vivo wound models under gas plasma therapy. While gas plasma-assisted wound healing in humans has become well established in Europe, veterinary medicine is an emerging field with great potential to improve the lives of suffering animals. Full article
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12 pages, 888 KiB  
Review
Skin Wound Healing: Normal Macrophage Function and Macrophage Dysfunction in Diabetic Wounds
by Savannah M. Aitcheson, Francesca D. Frentiu, Sheree E. Hurn, Katie Edwards and Rachael Z. Murray
Molecules 2021, 26(16), 4917; https://doi.org/10.3390/molecules26164917 - 13 Aug 2021
Cited by 194 | Viewed by 12559
Abstract
Macrophages play a prominent role in wound healing. In the early stages, they promote inflammation and remove pathogens, wound debris, and cells that have apoptosed. Later in the repair process, they dampen inflammation and secrete factors that regulate the proliferation, differentiation, and migration [...] Read more.
Macrophages play a prominent role in wound healing. In the early stages, they promote inflammation and remove pathogens, wound debris, and cells that have apoptosed. Later in the repair process, they dampen inflammation and secrete factors that regulate the proliferation, differentiation, and migration of keratinocytes, fibroblasts, and endothelial cells, leading to neovascularisation and wound closure. The macrophages that coordinate this repair process are complex: they originate from different sources and have distinct phenotypes with diverse functions that act at various times in the repair process. Macrophages in individuals with diabetes are altered, displaying hyperresponsiveness to inflammatory stimulants and increased secretion of pro-inflammatory cytokines. They also have a reduced ability to phagocytose pathogens and efferocytose cells that have undergone apoptosis. This leads to a reduced capacity to remove pathogens and, as efferocytosis is a trigger for their phenotypic switch, it reduces the number of M2 reparative macrophages in the wound. This can lead to diabetic foot ulcers (DFUs) forming and contributes to their increased risk of not healing and becoming infected, and potentially, amputation. Understanding macrophage dysregulation in DFUs and how these cells might be altered, along with the associated inflammation, will ultimately allow for better therapies that might complement current treatment and increase DFU’s healing rates. Full article
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