Journal of

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Skin injury caused by burns, surgery and other traumas may result in unpleasant psychological experiences and be reflected in behaviors. Extracellular matrix (ECM) is the largest component of natural skin which is gel-like and is produced by skin cells. ECM synthesis is a key factor for filling up skin wounds such as burns, leishmaniasis, chicken pox, acne, etc. ECM is composed of a variety of polysaccharides, water, and collagen proteins. Considering its weight, natural skin strength and its expandability are like steel, while it has high elasticity and compaction capacities. These characteristics are due to dual effects of main ECM molecules, which are secreted by fibroblasts and epidermal cells: 1) structural fiber proteins like: elastin, fibronectin and laminin which give strength and flexibility to ECM, and 2) proteoglycans such as dermatan sulfate and hyaluronic acid which are consisted of few glycosaminoglycan chains that branch out from a linear protein core. Proteoglycans are large and hydrated molecules which are resistant to external forces and protect underneath cells. In general, understanding the skin structure and wound healing phases can help us to design useful experiments and to conduct proper researches in this area.

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Background and Aim: Synthesis of extracellular matrix (ECM) is a key factor in wound healing. The predominant component of ECM is hyaluronic acid (HA). Recent studies have shown that adipose derived stem cell-conditioned medium (ADSC-CM) can increase the expression and synthesis of collagen I, III and fibronectin which are the components of ECM. The purpose of this study was to investigate the effects of ADSC-CM on the expression of HA synthase and degrading genes in human dermal fibroblasts (HDF).

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Introduction: Foot ulcers which can result in physical and psychological casualties are commonly observed in diabetes mellitus. On time diagnosis and appropriate management can prevent undesirable events. We report a patient with diabetic ulcer and myiasis.

Case Report: A 70 year old man came to our wound clinic with bilateral plantar ulcers. Many larvae were seen in gangrenous tissue of the ulcer.

Conclusion: Prompt care and considering all factors effective in wound progression leads to prevention of disabilities in diabetic patients.

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ackground and Aim: Different treatments have been tried for healing burn wounds each of which has had its own effects and complications. Therefore, researchers have attempted to develop methods for more rapid wound healing with fewer complications and greater patient satisfaction. This study investigated the effect of topical application of vitamin C solution on granulation tissue formation resulting from burn wounds.

Methods: Thirty patients hospitalized in the Burns Ward were divided into the control and intervention groups. The intervention group received topical application of vitamin C solution together with silver sulfadiazine ointment whereas only silver sulfadiazine ointment was used for the control group. Wound healing was observed and given scores on days 1, 3, 7 and 14 using the Bates-Jensen Wound Assessment Tool. The collected data was analyzed using SPSS 16.

Results: The results of repeated measures ANOVA showed that there were statistically significant between the two groups with respect to the mean scores for granulation tissue formation (P=0.004). Moreover, topical application of vitamin C significantly improved granulation tissue formation. As for intragroup effects also, the duration of the treatment had statistically significant effects on the mean score given for granulation tissue formation; i.e., there were significant differences between the mean scores given for days 1, 3, 7 and 17 (P=0.000; F=264.430).

Conclusion: This study showed that vitamin C has accelerating effect on wound healing.

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Hypertrophic scars and keloids are fibrosis abnormalities associated with the accumulation of collagen and extra cellular matrix components. These scars are caused by abnormal wound healing, which may occur after skin injuries caused by surgery, trauma, burns, etc. and may have a large impact on the patients’ quality of life. Hypertrophic scars and colloids in addition to aesthetic problems can cause functional disruption due to tissue contraction and itching. Large numbers of research are currently being performed in the area of scar prevention or treatment, but since the physiopathological mechanisms of scar formation have not been fully elucidated, the current strategies are still unsatisfactory. In this review, we discuss the recent biological advances in scar formation and current and future strategies for the prevention and treatment of hypertrophic and keloid scars.

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Wounds are any type of tissue dehiscence which can occur on skin, mucosae or connective tissue. After the wound has created, inflammatory process, the immune system changes as well as the skin repair cascade will be activated. To provide a product that can direct the above processes in a desirable repair mechanism will be useful. Studies have shown that aloe vera products, with effects such as increased collagen production, antioxidant and water retaining properties, are good options.
Aloe vera grows mainly in arid regions and this fact can be welcomed in many parts of the world. The use of medicinal herbs also reduces the cost for the health systems. Aloe vera is a plant that does not require much cost for plant and harvest. Besides, the compatibility of aloe vera products with a variety of formulations encourages formulators to use it in the pharmaceutical and cosmetic industries.
In this review, the use of aloe vera in wound management and some skin diseases will be discussed.

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Background and Aim: The purpose of this study is to investigate the histopathology and immunohistochemistry of the effect of 5% Plantago labceolata. extract on open wound healing in rat skin.
 

Methods: After extracting the plant extract using the mixed method, 40 healthy male rats with an average weight of 200-250 grams were selected and randomly divided into two main groups of 20. Group 1 is the treatment group and group 2 the control group each of the main groups being divided into 4 subgroups (days 3, 7, 14,21) were divided. For the histopathological and immunohistochemical investigation of the healing process, the wounds of the mice of the subgroups in both the main groups were removed in full thickness and with a diameter of 15 mm and examined for histological studies. After sectioning, with the qualitative staining method of hematoxylin eosin and Masson's trichrome,using antibodies against transforming growth factor beta and vascular endothelial growth factor of the study groups, and the obtained information was converted into quantitative information. and was subjected to statistical analysis.
 

Results: Finding this study has shown that about 95% of women had felt at least one problem in their hands. During COVID-19 pandemic, hand washing with disinfectants were repeated more and more, furthers skin of the hands will be two times more damaged as compared to normal conditions, so the need to increase hand health training as part of general health, especially in older adults' women in advance.
 

Conclusion: The results show that it is possible to use the polar extract of Plantago Lanceolata L. plant 5% for wound healing.

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Treatment of chronic conditions like diabetic foot ulcer (DFU) is challenging due to increased susceptibility for infection and delayed wound healing. Complexity of existing therapy, adverse effects and microbial resistance emphasizes the need of an alternative approach for the management of DFU. The increasing body of evidence associated with probiotic application in diverse disease states merits its use in wound healing and infection too. Different probiotic strains have shown their efficacy in various infections like gut infections, oral infections and urogenital infections. Experimental studies have demonstrated probiotics’ ability for gastric ulcer healing. Underlying mechanism of the above therapeutic effects of probiotics involves modulation of local and systemic immunity. The hypothesis is based on the concept that mechanism of anti-infective and ulcer healing action of probiotics will be similar in peripheral wounds and ulcers as on any other part of the body. This paper focuses on the hypothesis that topical formulation of probiotics may be effective for the treatment of diabetic foot ulcers.

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The skin, as the outer layer, protects the body against external factors. Wounds can negatively affect its performance. Wound healing includes three stages of inflammation, proliferation, and regeneration, which begin immediately after injury. Also, some factors such as infection, obesity and diabetes can disrupt the natural healing process that leads to chronic wounds. Various surgical and non-surgical treatments have been used to manage chronic wounds, including hyperbaric oxygen therapy, ultrasound therapy, laser therapy, and skin grafting. These treatments have advantages and disadvantages. Recently, stem cells have been used as a surgical treatment for chronic wound healing. Stem cells are highly proliferative cells that can maintain their ability to divide and regenerate for a long time. Among the different types of stem cells, MSCs have many advantages such as ease of harvest, availability, and multilineage differentiation capacity for cell therapy. In addition, they showed some properties that could be useful in the clinical application of ASCs, including angiogenesis, immune system modulation, and improved tissue regeneration. This study was conducted by collecting data from reliable scientific sources from April 1401 to January 1402 at the Research Institute of Neurosciences, Brain and Spinal Cord Injury Research Center of Tehran University of Medical Sciences. Several studies have shown that ASCs can be a suitable candidate for wound healing due to their special characteristics. The purpose of this review is to discuss the use of ASCs in wound repair and healing as a new strategy in the treatment of skin problems.

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Worldwide, 16,000 deaths occur daily due to wound injuries, leading to increased concern in low- and middle-income countries. Today, with the increasing demand of consumers to use natural biological compounds instead of using harmful and carcinogenic chemical compounds, algae were introduced to the market as an effective clinical skin alternative. In fact, ease of cultivation and low nutritional requirements make algal polysaccharides an attractive alternative for advanced wound dressings. Micro and macroalgae are a new source of biological saccharide polymers for wound healing. The hydrophilic nature of these polymers due to their capacity to trap water molecules in their structure makes hydrogels that have a high ability to absorb and release liquid. In this review article, by studying the latest articles, some algae polysaccharides that are widely used as wound healing dressings such as alginates, fucoidans, carrageenans, laminarin, agar-agar and olvan are discussed. These compounds are not only used as functional biomaterials for controlled drug delivery, but also for cell stabilization and preparation of scaffolds for tissue engineering.

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Bacteria are natural sources of metabolites that exhibit diverse bioactive properties, including wound healing, antioxidative, antibacterial, antifungal, anti-inflammatory, antidiabetic, and anticancer activities. Two important groups of bacteria with wound healing potential are polysaccharides and peptides. In addition to cellulose, bacteria produce various polysaccharides (such as exopolysaccharides) with wound healing potential. The most common bacterial peptides used in wound healing studies are bacteriocins and lipopeptides. The aim of this article is to review recent literature on the potential of wound healing in vitro and in vivo by polysaccharides and peptides derived from bacteria (Actinobacteria, Bacteroides, Cyanobacteria, Firmicutes, and Proteobacteria). For this reason, a search was conducted in scientific research databases such as Web of Science, Google Scholar, Wiley, Elsevier, Taylor and Francis, BMC Springer and MDPI with the keywords polysaccharide, peptide, bacteriocins, lipopeptides, streptomyces, bacteria, lactic acid bacteria, cyanobacteria and wound healing. The overall results showed that polysaccharides and peptides and peptides derived from bacteria show wound healing power both in vitro and in vivo. In living models, including animals and humans, these metabolites have a positive effect on wound healing by inhibiting pathogens, antioxidant activity, modulating the inflammatory response, moisturizing the wound environment, promoting the proliferation and migration of fibroblasts and keratinocytes, increasing collagen synthesis, remodeling, epithelialization and angiogenesis. Therefore, peptides and polysaccharides derived from bacteria play a significant role in wound healing.

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Impaired wound healing following significant tissue damage such as severe burns, trauma, or surgery can result in scarring and skin fibrosis. Pathological scarring leads to changes in the natural shape of the wound and, in addition to cosmetic problems, may be accompanied by pain and even limit the person's normal movement. The immune response plays a very important role in the wound healing process. Activation of immune cells and factors initiates the inflammatory process, facilitates wound cleansing, and tissue repair and regeneration. However, disruption of the immune system during the wound healing process leads to persistent inflammation and delayed healing, ultimately leading to the development of chronic wounds. The microenvironment of a chronic wound contains a large number of immune cells, including proinflammatory macrophages, and high expression of inflammatory mediators such as TNF-α and IL-1β is observed in it. Among them, macrophages, as innate immune cells, play a key role in promoting the immune response and activating adaptive immunity. These cells are also key factors in the transition from the inflammatory phase to the tissue repair phase. As a result, dysregulation of macrophage function will have consequences such as scarring. Therefore, knowledge of the exact mechanism of the inflammatory process during wound healing, the inflammatory and anti-inflammatory mediators produced, and the effect of macrophages on this process can promise the achievement of new strategies in scarless wound healing. Therefore, this article discusses the mechanism of the immune system during the inflammatory process, and the key role of macrophages in this process, as well as scar formation.
 

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Bacteria are natural sources of metabolites that exhibit diverse bioactive properties, including wound healing, antioxidative, antibacterial, antifungal, anti-inflammatory, antidiabetic, and anticancer activities. Two important groups of bacteria with wound healing potential are polysaccharides and peptides. In addition to cellulose, bacteria produce various polysaccharides (such as exopolysaccharides) with wound healing potential. The most common bacterial peptides used in wound healing studies are bacteriocins and lipopeptides. The aim of this article is to review recent literature on the potential of wound healing in vitro and in vivo by polysaccharides and peptides derived from bacteria (Actinobacteria, Bacteroides, Cyanobacteria, Firmicutes, and Proteobacteria). For this reason, a search was conducted in scientific research databases such as Web of Science, Google Scholar, Wiley, Elsevier, Taylor and Francis, BMC Springer and MDPI with the keywords polysaccharide, peptide, bacteriocins, lipopeptides, streptomyces, bacteria, lactic acid bacteria, cyanobacteria and wound healing. The overall results showed that polysaccharides and peptides and peptides derived from bacteria show wound healing power both in vitro and in vivo. In living models, including animals and humans, these metabolites have a positive effect on wound healing by inhibiting pathogens, antioxidant activity, modulating the inflammatory response, moisturizing the wound environment, promoting the proliferation and migration of fibroblasts and keratinocytes, increasing collagen synthesis, remodeling, epithelialization and angiogenesis. Therefore, peptides and polysaccharides derived from bacteria play a significant role in wound healing.
 

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Antimicrobial photodynamic inactivation is emerging as a non‑antibiotic strategy for treating infected wounds, particularly those harboring multidrug‑resistant bacteria. aPDI relies on a photosensitizer that, when illuminated with an appropriate wavelength, generates reactive oxygen species (ROS) that cause rapid, non‑specific damage to microbial membranes, proteins and nucleic acids. Effective photosensitizers combine high quantum yield to penetrate both Gram‑positive and Gram‑negative organisms, while light sources such as LEDs or lasers provide precise control of irradiance and tissue penetration. Clinical investigations have demonstrated that aPDI, alone or in combination with low‑dose antibiotics or growth factors, can reduce bacterial load in chronic wounds by up to 84 % and accelerate healing. Current challenges include limited light penetration, optimal dosing, and potential phototoxicity, emerging solutions involve nanocarrier‑delivered photosensitizers, oxygen‑releasing dressings, and ultrasound‑mediated activation to enhance efficacy and safety.

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The treatment of wounds has historically been a significant challenge in medicine, incurring substantial financial and emotional costs for both governments and patients. Consequently, researchers have continuously sought novel methods to enhance the wound healing process. In recent years, with the advancements in computer science and the emergence of Artificial Intelligence (AI), many professional fields, including medical sciences, have undergone transformations. There has been a general effort to utilize AI as an assistant or even a human replacement in certain processes. In the field of wound care, the application of AI-based tools is expected to improve the speed and accuracy of the treatment system, leading to faster wound healing and better outcomes for patients.
AI has been presented in various models, each operating on different datasets and employed in diverse research studies. Both software and hardware tools based on AI have been designed and introduced in several investigations. Their performance has been evaluated at various levels, from laboratory to clinical settings, and their efficacy has been demonstrated.
Based on the findings, it can be stated that AI can provide effective assistance to clinical and research staff in the diagnostic, therapeutic, and educational processes of wound treatment. In some cases, it may even reduce the need for direct clinical staff involvement for patients.