Global Medicinal Plants and Phyto-Derived Compounds in Wound Healing
Namrita Lall in Medicinal Plants for Cosmetics, Health and Diseases, 2022
However, MASD requires more than moisture damage in order to occur. Severe skin ulceration may be attributable to multiple factors, such as chemical irritants within the moisture source, changes in pH, mechanical factors such as friction and pathogenic wound-associated bacteria (Gray and Weir, 2007; Gray et al., 2011). Ulceration may result from chronic wound hypoxia and impaired micronutrient delivery caused by MASD, thus decreasing the process of angiogenesis which ultimately delays the wound healing process. Severe ulceration in wounds may be prevented with the use of wound dressings to limit moisture exposure. However, chronic skin ulcers may be susceptible to excessive inflammation and prolonged wound healing, which may ultimately hinder patient health and mobility (Gray and Weir, 2007).
Skin image analysis granulation tissue for healing assessment of chronic ulcers
Ahmad Fadzil Mohamad Hani, Dileep Kumar in Optical Imaging for Biomedical and Clinical Applications, 2017
The healing process of chronic ulcers is not predictable and the chronic ulcers keep on evolving slowly over time. Healing may prolong usually due to underlying aetiologies, such as venous insufficiency, arterial perfusion, prolonged pressure and diabetes that cause inflammation and accumulation of debris and foreign materials and impair the natural course of healing. Hence, an accurate and thorough assessment of the ulcer is important to provide baseline information on the ulcer severity status and to determine the appropriate course of treatment [6,7]. Misdiagnosis of ulcer's condition can cause improper clinical decisions and lead to long periods of treatment, which reflect on the effectiveness of ulcer care and management in terms of time and cost of treatment. There are several ulcer assessment parameters that need to be thoroughly analysed by clinicians such as the physical appearance of the ulcer, the condition of the surrounding skin, the odour and pain associated with the ulcer as well the amount and characteristics of the exudates on the ulcer surface. The patients’ medical history of previous ulcers and their corresponding treatments are also needed to acquire a full analysis of the ulcer condition.
Evaluation of Anti-ulcer Potential of Sphenodesme involucrata var. paniculata (C.B. Clarke) Munir Leaves on Various Gastric Aggressive Factors
Parimelazhagan Thangaraj in Phytomedicine, 2020
Mainly, ulcer treatments are followed in two ways: prophylactic and therapeutic types. The prophylactic treatment mainly depends on strengthening the mucosal defensive factors, such as stimulating the somatostatin and prostaglandin synthesis and inhibiting the secretion of gastrin, to provide gastroprotection through protecting the mucus layer and reducing acid secretion. Apart from this, the cytoprotection of the stomach is achieved by reducing the oxidative damage through increasing the catalase activity and suppressing the peroxidation of lipids, and also the anti-inflammatory effect and the involvement of the NO-synthase pathway played gastroprotective roles, whereas, the therapeutic way of treatment involves the usage of anti-secretory or ulcer-healing drugs. Anti-secretory drugs put forth inhibitory effects on the histaminergic and cholinergic effects on the proton pump mechanism, and the ulcer healing is satisfied through the mucosal enhancement by the anti-ulcer agents (Singh et al. 2018).
Protective effect of the solvent extracts of Portulacca oleracea against acidified ethanol induced gastric ulcer in rabbits
Published in Drug and Chemical Toxicology, 2022
Muhammad Shah Zeb Jan, Waqar Ahmad, Atif Kamil, Mir Azam Khan, Maqsood Ur Rehman, Irfan ullah, Muhammad Saeed Jan
Ulcer is an injury or sore in the mucous membrane or outer surface skin of the body. Ulcer in the lining of the stomach or duodenum is a disease of digestive system that affect many people around the world (Sánchez-Mendoza et al.2011). It has been documented that fourteen million people throughout the world are suffering from gastric ulcer with a mortality rate of four million. Gastric ulcer occur as a result of imbalance between aggressive (alcohol, pepsin and acid secretion, poor diet, oxidative stress, NSAIDs and Helicobacter pylori) and protective factors (mucosal blood flow, mucus secretion, bicarbonate secretion and increased levels of antioxidants etc.) in the stomach (Zakaria et al.2016b). Gastric mucosa is damaged when aggressive factors “overcome” mucosal defensive mechanisms (Laine et al.2008).
Leucocyte- and platelet-rich fibrin (L-PRF) as a regenerative medicine strategy for the treatment of refractory leg ulcers: a prospective cohort study
Published in Platelets, 2018
Nelson R. Pinto, Matias Ubilla, Yelka Zamora, Verónica Del Rio, David M. Dohan Ehrenfest, Marc Quirynen
Despite the relative diversity of their etiology, these skin ulcers share similar biological patterns: deep impaired healing mechanisms, pathological and disruptive inflammatory equilibrium, dysfunctional local vascularization, tissue necrosis, and infection. The standard treatment for the above-mentioned chronic ulcers may include debridement of necrotic tissues, revascularization surgery, infection control, mechanical offloading, management of blood glucose, foot care education, mechanical compression, or limb elevation [12]. Full wound closure, after standard VLU care, can take months or even years in some patients, and in up to half of the patients wound closure even fails [13,14]. For DFUs, similar wound closure rates have been reported (from 24.2% to 30.9% at 12 and 20 weeks, respectively)[15]. For PU, there is no good evidence to support the use of any particular wound-cleansing solution or technique, and wound closure remains extremely difficult [8]. If such treatment fails, “advanced wound care” is recommended. In the last decade, a large array of advanced therapies has been proposed, but their efficacy, comparative effectiveness, and eventual harms are not well established. Unfortunately, most of these advanced therapies are expensive, and not necessarily clearly superior as compared to standard optimal wound care [3,8,12,16].
Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches
Published in Expert Review of Anti-infective Therapy, 2018
Javier Aragón-Sánchez, Benjamin A Lipsky
Clinicians should follow a logical sequence for diagnosing DFO that, as for most infections, should begin with the clinical evaluation. The clinician should seek risk factors for developing DFO, such as soft tissue wounds that are long-standing, overlying a bony prominence, extending to bone or joint, recurrent or multiple [3]. Osteomyelitis should be suspected when an ulcer with adequate blood supply does not heal after 6 weeks of appropriate wound care and pressure offloading [15]. This is especially true when the ulcer is deep, or large. Inflammatory signs in the skin surrounding the ulcer may be attenuated due to wound chronicity, peripheral arterial disease, or neuropathy. Purulent secretions or synovial liquid may drain spontaneously or when palpating over the inflamed area. One useful clinical sign of DFO is a red, swollen, warm digit—often called a ‘sausage toe’[16]. When the clinician suspects DFO, she/he should look for and document the point of entry of the infection [17].