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Wound Fluid in Diabetic Foot Ulceration: More Than Just an Undefined Soup?

Published on Jun 1, 2013in The International Journal of Lower Extremity Wounds 1.28
· DOI :10.1177/1534734613489989
Markus Loeffler77
Estimated H-index: 77
(University of Tübingen),
Heiko Schuster13
Estimated H-index: 13
(University of Tübingen)
+ 1 AuthorsStefan Beckert17
Estimated H-index: 17
(University of Tübingen)
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Abstract
Valid and reproducible sampling techniques as well as processing protocols are required for the assessment of biomarkers and mediators contained in wound exudate. Moreover, the ideal technique should be easy to use even in daily clinical routine. This is challenging since wound fluid represents an inhomogeneous mixture of different exogenous and endogenous sources. Analyzing wound fluid, however, may facilitate clinical decision making. Many techniques for obtaining wound fluid have been described. There is very little validation data, and the array of different techniques appears confusing. Structuring and new standards are needed to avoid wound fluid sampling yielding an “undefined soup.” A lot of wound fluid parameters have been analyzed, although none of them have made its way into clinical practice. Nevertheless, basic principles of wound healing have been established from wound fluid analysis. With adequate techniques suitable for daily practice, basic research might foster our clinical understanding of wound healing with implications for new therapies. So far, research has mainly concentrated on analyzing available sample material with respect to either a wide variety of analytes or comparing acute with chronic wound exudate. Clinical endpoints such as healing or wound infection as well as longitudinal data may indeed be more valuable for clinical practice, enabling the discovery of meaningful biomarkers using a suitable technique.
  • References (138)
  • Citations (8)
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References138
Newest
Published on Nov 1, 2012in Diabetes Care 15.27
Michael Schmohl4
Estimated H-index: 4
(University of Tübingen),
Stefan Beckert17
Estimated H-index: 17
(University of Tübingen)
+ 3 AuthorsMarkus Loeffler77
Estimated H-index: 77
(University of Tübingen)
OBJECTIVE In diabetic foot ulcers, wound fluid inflammatory mediators have previously been proposed as surrogate markers for nonhealing. However, currently available wound fluid sampling techniques are not suitable for clinical practice due to low levels of exudate and a high logistical effort. The aim of this investigation was to assess 1 ) the technique of superficial wound swabbing for harvesting wound fluid; and 2 ) the quality of the collected fluid for immunoassay analysis of inflammatory ...
Dirk Wildeboer11
Estimated H-index: 11
(Middlesex University),
Katja E. Hill23
Estimated H-index: 23
(Cardiff University)
+ 7 AuthorsRobert G. Price16
Estimated H-index: 16
('KCL': King's College London)
Chronic non-healing wounds are a major health problem with resident bacteria strongly implicated in their impaired healing. A rapid-screen to provide detailed knowledge of wound bacterial populations would therefore be of value and help prevent unnecessary and indiscriminate use of antibiotics—a process associated with promoting antibiotic resistance. We analysed chronic wound fluid samples, which had been assessed for microbial content, using 20 different fluorescent labelled peptide substrates...
Published on Sep 1, 2012in Wound Repair and Regeneration 2.85
Gerrit Grieb14
Estimated H-index: 14
(RWTH Aachen University),
David Simons11
Estimated H-index: 11
(DKFZ: German Cancer Research Center)
+ 4 AuthorsNorbert Pallua45
Estimated H-index: 45
(RWTH Aachen University)
Macrophage migration inhibitory factor (MIF), a structurally and functionally unique pleiotropic mediator in inflammation and immune processes, was identified decades ago. There is now strong evidence that MIF promotes revascularization and is involved in wound healing processes. However, its exact role in wound healing is still a matter of debate. A cohort of 33 patients was recruited, including 14 patients with acute and 19 patients with chronic wounds. Both serum and wound fluid samples were ...
Published on Jul 1, 2012in Diabetes Research and Clinical Practice 3.24
Julia K. Mader19
Estimated H-index: 19
(Medical University of Graz),
Franz Feichtner7
Estimated H-index: 7
(Joanneum Research)
+ 5 AuthorsMartin Ellmerer25
Estimated H-index: 25
(Medical University of Graz)
Abstract Continuous subcutaneous glucose monitoring has been tested in type 1 diabetes (T1D). Since in critically ill patients vascular access is granted vascular microdialysis may be preferential. To test this hypothesis comparative accuracy data for microdialysis applied for peripheral venous and subcutaneous glucose monitoring was obtained in experiments in T1D patients. Twelve T1D patients were investigated for up to 30 h. Extracorporeal vascular (MDv) and subcutaneous microdialysis (MDs) wa...
Published on Jul 1, 2012in Biotechnology Progress 2.41
Stephen T. Britland9
Estimated H-index: 9
(University of Bradford),
Oliver Ross‐Smith1
Estimated H-index: 1
(University of Bradford)
+ 3 AuthorsPeter Vowden23
Estimated H-index: 23
(Bradford Royal Infirmary)
Published on May 1, 2012in Wound Repair and Regeneration 2.85
Laura E. Edsberg13
Estimated H-index: 13
(Daemen College),
Jennifer T. Wyffels8
Estimated H-index: 8
(Daemen College)
+ 1 AuthorsKristin M. Fries6
Estimated H-index: 6
(Daemen College)
Analysis of the proteomic profile of pressure ulcers over time is a critical step in the identification of biomarkers of healing or nonhealing in pressure ulcers. The wound fluid from 32 subjects with 42 pressure ulcers was evaluated over 6 weeks at 15 time points. Samples specific to both the interior and the periphery of the wound bed were collected. Antibody screening arrays, isobaric tags for relative and absolute quantitation with mass spectrometry and multiplexed microarrays were used to c...
Published on Feb 7, 2012in Analytical Chemistry 6.35
Christoph Krisp11
Estimated H-index: 11
,
Matthew J. McKay13
Estimated H-index: 13
+ 1 AuthorsMark P. Molloy34
Estimated H-index: 34
The targeted analysis of proteins in complex biological samples is best achieved using selected reaction monitoring (SRM). To maximize the sensitivity of this approach, sample fractionation or enrichment is still required, particularly to detect less abundant proteins in clinically relevant biofluids. Here, we report the development of multidimensional protein identification technology (MudPIT)-SRM, taking advantage of the robust online strong cation exchange chromatography for tryptic peptide f...
Published on Jan 1, 2012in Biological & Pharmaceutical Bulletin 1.54
Fumihiro Mizokami7
Estimated H-index: 7
,
Yusuke Murasawa3
Estimated H-index: 3
+ 1 AuthorsZenzo Isogai12
Estimated H-index: 12
Iodoform gauze is used in clinical practice for treatment of infected wounds. However, effectiveness and action mechanism of iodoform gauze for removal of necrotic tissue are unknown. We therefore employed case control and biochemical studies in order to clarify the pharmacological activity of iodoform gauze. A clinical study demonstrated that treatment with iodoform gauze removed necrotic tissue more effectively than treatment with conventional ointments. More than 60% of iodoform gauze-treated...
Published on Jan 1, 2012in Biosensors and Bioelectronics 9.52
Ilenia Ciani8
Estimated H-index: 8
(Edin.: University of Edinburgh),
Holger Schulze19
Estimated H-index: 19
+ 10 AuthorsJason Crain27
Estimated H-index: 27
A method for label-free, electrochemical impedance immunosensing for the detection and quantification of three infection biomarkers in both buffer and directly in the defined model matrix of mock wound fluid is demonstrated. Triggering Receptor-1 Expressed on Myeloid cells (TREM-1) and Matrix MetalloPeptidase 9 (MMP-9) are detected via direct assay and N-3-oxo-dodecanoyl-l-HomoSerineLactone (HSL), relevant in bacterial quorum sensing, is detected using a competition assay. Detection is performed...
Published on Oct 1, 2011in Archives of Dermatological Research 2.31
Rikke Zillmer1
Estimated H-index: 1
(UCPH: University of Copenhagen),
Hannah Trøstrup3
Estimated H-index: 3
(UCPH: University of Copenhagen)
+ 2 AuthorsMagnus S. Ågren14
Estimated H-index: 14
(UCPH: University of Copenhagen)
Wound fluid collected from chronic wounds may be used as a simple gauge of the processes taking place in the tissue. There is lack of information on the optimal conditions for wound fluid procurement. We have studied possible diurnal variations and duration of wound fluid accumulation using retentive hydrophobic foam on the levels of prototypic cytokines [interleukin (IL)-1α, IL-1β], a chemokine (IL-8) and proteinases [matrix metalloproteinase (MMP)-9] in 23 chronic venous leg ulcer patients. Bi...
Cited By8
Newest
Published on Feb 1, 2019in Journal of Proteomics 3.54
Nayara Rodrigues Vieira Cavassan1
Estimated H-index: 1
(UNESP: Sao Paulo State University),
Caio Cavassan de Camargo3
Estimated H-index: 3
(UNESP: Sao Paulo State University)
+ 5 AuthorsLucilene Delazari dos Santos16
Estimated H-index: 16
(UNESP: Sao Paulo State University)
Abstract Chronic venous ulcers affect the quality of life of patients around the world. The aims of this study were to identify the proteins expressed in chronic venous ulcer exudates, to categorize them according to their roles and to correlate them with the clinical and epidemiological aspects of the disease. The study population consisted of 37 ulcers from 28 patients, and the inflammatory exudates of these thirty-seven ulcers were subjected to tryptic digestion and mass spectrometry analysis...
Published on Apr 3, 2018in Artificial Cells Nanomedicine and Biotechnology 4.46
Natarajan Krishnan1
Estimated H-index: 1
(BDU: Bharathidasan University),
Balasubramanian Velramar1
Estimated H-index: 1
(BDU: Bharathidasan University)
+ 1 AuthorsRajesh Kannan Velu2
Estimated H-index: 2
(BDU: Bharathidasan University)
AbstractPseudomonas aeruginosa and its lipopolysaccharides play a key role in the pathogenesis of diabetic foot infection, for which, currently no effective therapeutic agents are available. Hence, newer forms of therapeutic agents are required for treating Pseudomonas aeruginosa infection. In this present study, nanocrystalline silver nanoparticles (AgNPs) were synthesized using culture filtrate of Brevibacillus brevis KN8(2) followed by an investigation of its in vivo anti-pseudomonal and anti...
Published on Oct 30, 2017in Cochrane Database of Systematic Reviews 7.75
Maggie J Westby4
Estimated H-index: 4
,
Jo C Dumville36
Estimated H-index: 36
+ 4 AuthorsRichard D Riley37
Estimated H-index: 37
(Keele University)
This is a protocol for a Cochrane Review (Prognosis). The objectives are as follows: To determine whether protease activity is an independent prognostic factor for the healing of venous leg ulcers.
Published on Jul 1, 2016in Advanced Materials 25.81
Anna McLister4
Estimated H-index: 4
(Ulster University),
Jolene McHugh2
Estimated H-index: 2
(Ulster University)
+ 1 AuthorsJames Davis30
Estimated H-index: 30
(Ulster University)
The pH of wound fluid has long been recognized as an important diagnostic for assessing wound condition, but as yet there are few technological options available to the clinician. The availability of sensors that can measure wound pH, either in the clinic or at home could significantly improve clinical outcome – particularly in the early identification of complications such as infection. New material designs and electrochemical research strategies that are being targeted at wound diagnostics are...
Published on Jan 1, 2016
James Davis30
Estimated H-index: 30
(Ulster University),
A. McLister1
Estimated H-index: 1
(Ulster University)
Diagnostics play an increasingly important role in the wound management plan for chronic wounds as they can provide valuable insights into why a wound is failing to progress. Active interventions to encourage healing will often require several different approaches and there is little doubt that the provision of detailed information on the chemical dynamics at play within the wound environment would be of tremendous benefit in facilitating more informed treatment decisions and dressing selection....
Xiaoyan Ji3
Estimated H-index: 3
(Tianjin Medical University),
Peng Jin1
Estimated H-index: 1
(Tianjin Medical University)
+ 2 AuthorsPenghua Wang4
Estimated H-index: 4
(Tianjin Medical University)
The objective was to determine multidrug-resistant organisms’ (MDROs) profile in diabetic foot ulcers (DFU), antibiotic resistance of MDROs, and to find the potential risk factors for infection with MDROs. In 157 patients with DFU admitted to Tianjin Metabolic Disease Hospital, China, from January 2011 to January 2012, microbiological specimens were taken on admission. The patients were divided into 2 groups according to the infection of MDROs. Potential risk factors for MDRO-positive specimens ...
Published on Nov 1, 2013in Journal of Wound Care 1.95
David Voegeli16
Estimated H-index: 16
,
Bashir A. Lwaleed16
Estimated H-index: 16
Despite the advances in our understanding of normal and abnormal wound healing over the past decade, a specific biomarker which can be used clinically to identify ‘hard-to-heal’ wounds still remains elusive. Tissue and exudate samples extracted from the site of the wound are traditionally analysed using histological, microbiological and biochemical laboratory techniques. The aim of this paper is to review the advantages of these techniques, their limitations and the rapid developments in the fie...
Nikolaos Papanas32
Estimated H-index: 32
(DUTH: Democritus University of Thrace),
Raj Mani10
Estimated H-index: 10
(University Hospital Southampton NHS Foundation Trust)