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  • 1
    Electronic Resource
    Electronic Resource
    007
Rebalancing Wound Biochemistry Improves Healing: A Clinical Study Examining Effect of Promogran (2004)
    Oxford, UK; Malden, USA : Blackwell Science Ltd/Inc.
    Wound repair and regeneration 12 (2004), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Normal wound healing is a carefully controlled balance of new tissue formation and destructive processes necessary to remove damaged tissue. Within this complex environment there are many points of regulation, which control the biological processes necessary to achieve wound repair. An alteration in any of these processes can result in an imbalance of the biochemical components, which ultimately results in delayed wound closure and the formation of a chronic wound. Therefore, we propose that an effective therapeutic approach would modify this hostile environment and redress this imbalance.In this study we have evaluated the effect of PROMOGRAN in vivo, in patients with venous leg ulcers. Wound fluid samples were collected and analyzed from a number of patients prior to and during treatment with PROMOGRAN.Our results have shown that wounds, which respond to PROMOGRAN treatment, have also shown a decrease in protease activity in the corresponding wound fluid samples. Whilst it is impossible to determine whether this reduction in protease levels is responsible for healing or merely symptomatic of other changes occurring within the wound, we have shown that a decrease in proteolytic activity is concomitant with healing.This study provides clinical evidence that PROMOGRAN can rebalance the chronic wound environment in situ and thereby promotes wound repair.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2004.0abstracth.x
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  • 2
    Electronic Resource
    Electronic Resource
    076
A Clinical Study Investigating the Temporal Changes in Proteolytic Activity in Wounds Treated with Promogran* (2005)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The pathophysiology of wound repair is a delicately balanced, dynamic process involving both stimulatory and degradative factors to remove damaged tissue and synthesize new tissue. An imbalance of any of these factors may result in the formation of a chronic wound. Previous studies have indicated that the chronic wound environment is detrimental to cell and cytokine function, leading to delayed healing. The presence of a hostile chronic wound environment has been supported by many studies reporting elevated proteolytic activity in these wounds. However, it has not been determined if this elevation is due to an excess of a particular protease or a reduction in inhibitor levels.In this study we investigated the effect of PROMOGRANTM, a protease "modulating matrix, on wound healing in patients with venous leg ulcers and examined the effect on the wound environment. Wound fluid samples were collected from a number of patients throughout the course of treatment and both protease and inhibitor levels were analyzed.Our results indicate that wounds which respond to PROMOGRANTM also exhibited an overall decrease in human neutrophil-derived elastase and MMP activity. An increase in the ratio of alpha-1-antitrypsin to human neutrophil-derived elastase was also observed suggesting a greater degree of regulation post therapy, and a return to a more acute-like wound environment. Wounds that did not respond to this treatment demonstrated a greatly reduced ratio, signifying a persistent excess of proteolytic activity and a continued delay in healing.It is unclear whether the observed biochemical changes in the wound environment are responsible for healing or merely symptomatic of the disease state. We have, however, shown that an overall reduction in proteolytic activity is concomitant with healing. This suggests that therapies that redress the balance of inhibitor to protease may be beneficial in treatment of chronic wounds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2005.130215bx.x
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  • 3
    Electronic Resource
    Electronic Resource
    166
The Role of Serine Proteases and their Inhibitors in Chronic Wounds (2005)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The role of proteases in chronic wounds has been the subject of many investigations in recent years. These studies have reported biochemical differences between chronic and acute wound fluids and have shown that elevated levels of proteases, in particular the matrix metalloproteinases are abundant in chronic wounds. While this has led to the hypothesis that the chronic wound environment is hostile and not conducive to wound repair, it is still unknown whether this is due to a direct or indirect defect in protease regulation or their inhibitors.We hypothesize that an excess of proteases, specifically the serine proteases present in chronic wounds, are primarily responsible for this hostile wound environment. These proteases degrade endogenous growth factors, reducing their efficacy and delaying healing.In this study, fluid and tissue from chronic and acute wounds were collected over a 24-hour period. Using ELISA, samples were assessed for protease activity (specifically elastase and typsin-like enzymes), their inhibitors and growth factors.Our results show that serine proteases, predominantly elastase, were significantly elevated in the chronic wound fluids. The serpins designed to control these proteases were not up-regulated when compared to the acute controls, resulting in excessive proteolytic activity. An increase in serine protease production without an increase in their serpins is thought to result in a reduction in growth factors, an effect, which was also observed in the chronic wound samples.This work indicates that there is an imbalance in the ratio of inhibitor to enzyme, due to an up regulation of protease production in chronic wounds. We also conclude that misregulation of serine proteases may be responsible for the observed excessive degradation of the extracellular matrix and growth factors in these chronic wounds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2005.130216br.x
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    073
Effect of Advanced Wound Therapies on Fibroblast Proliferation in Acute Wound Fluid (2005)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Wound repair and regeneration 13 (2005), S. 0 
    Details
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Wound repair is described as a delicately balanced and well-orchestrated progression of events, which ultimately results in healing in the majority of acute cases. However, time taken to complete healing can vary greatly between patients and any alteration in this physiological process could delay healing further. Thus, a wound treatment, which facilitates healing independent of wound type and in patients where healing is compromised or impeded, would be extremely advantageous.Previous studies suggest a beneficial role for biomaterials such as collagen/ORC in modifying the chronic wound environment; however, their effect on the acute wound environment is unknown. While it is generally accepted that acute wounds heal at an optimum rate due to a positive wound environment, we wanted to determine if current advanced wound healing treatments could augment or impact this healing rate.In this study we evaluated the effect of advanced wound therapies in the presence of acute wound fluid on human dermal fibroblast proliferation. We hypothesize that an enhanced effect on fibroblast proliferation in the presence of acute wound fluid may be indicative of a beneficial effect in the treatment of acute wounds.Results demonstrate that of the wound treatments tested only collagen/ORC containing therapies exhibited a positive effect on fibroblast proliferation in the presence of acute wound fluid. We conclude, therefore, that collagen/ORC biomaterials, already shown to be beneficial in the treatment of chronic wounds, may also be a valuable therapy in the treatment of acute wounds.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1067-1927.2005.130215bu.x
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    Paper (German National Licenses)
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