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Collection of Wound Exudate From Human Digit Tip Amputations Does Not Impair Regenerative Healing: A Randomized Trial.
Published on Oct 1, 2015in Medicine 2.03
· DOI :10.1097/MD.0000000000001764
Tobias Kisch4
Estimated H-index: 4
,
Julia Maria Klemens1
Estimated H-index: 1
+ 7 AuthorsMatthias Brandenburger2
Estimated H-index: 2
Abstract
The regrowth of amputated digit tips represents a unique regenerative healing in mammals with subcutaneous volume regrowth, restoration of dactylogram, and suppression of scar formation. Although factor analysis in amphibians and even in mice is easy to obtain, safety of harvesting biomaterial from human digit tip amputations for analysis has not yet been described. The aim of this study was to evaluate if recovering wound exudate does hamper clinical outcome or influence microbiologic or inflammation status. A predefined cohort of 18 patients with fresh digit tip amputations was randomly assigned to receive standard therapy (debridement, occlusive dressing) with (n = 9) or without (n = 9) collection of the whole wound exudate in every dressing change. Primary endpoint (lengthening) and secondary endpoints (regeneration of dactylogram, nail bed and bone healing, time to complete wound closure, scar formation, 2-point discrimination, microbiologic analysis, inflammatory factors interleukin (IL)-1α, tumor necrosis factor-α, IL-4, and IL-6) were determined by an independent, blinded observer. Patients’ characteristics showed no significant differences between the groups. All patients completed the study to the end of 3 months follow-up. Exudate collection did not influence primary and secondary endpoints. Furthermore, positive microbiologic findings as well as pus- and necrosis-like appearance neither impaired tissue restoration nor influenced inflammatory factor release. Here, the authors developed an easy and safe protocol for harvesting wound exudate from human digit tip amputations. For the first time, it was shown that harvesting does not impair regenerative healing. Using this method, further studies can be conducted to analyze regeneration associated factors in the human digit tip. DRKS.de Identifier: DRKS00006882 (UTN: U1111-1166-5723).
  • References (39)
  • Cited By (2)
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References39
Published on Jan 1, 1991in Diabetes Care 13.40
Arshag D. Mooradian50
Estimated H-index: 50
,
Richard L. Reed25
Estimated H-index: 25
+ 1 AuthorsPhilip Scuderi21
Estimated H-index: 21
25 Citations
Published on Jan 1, 2013in Methods of Molecular Biology
Jennifer Simkin10
Estimated H-index: 10
(Tulane University),
Manjong Han12
Estimated H-index: 12
(Tulane University)
+ 2 AuthorsKen Muneoka23
Estimated H-index: 23
(Tulane University)
23 Citations Source Cite
Published on Dec 1, 2014in Tissue Engineering Part A
Kristen M. Lynch3
Estimated H-index: 3
,
Tabassum Ahsan9
Estimated H-index: 9
The capacity to regenerate complex tissue structures after amputation in humans is limited to the digit tip. In a comparable mouse digit model, which includes both distal regeneration-competent and proximal regeneration-incompetent regions, successful regeneration involves precise orchestration of complex microenvironmental cues, including paracrine signaling via heterogeneous cell–cell interactions. Initial cellular processes, such as proliferation and migration, are critical in the formation o...
8 Citations Source Cite
Published on May 1, 2011in Wound Repair and Regeneration 2.95
Øystein Grimstad5
Estimated H-index: 5
(Norwegian University of Science and Technology),
Øystein Sandanger9
Estimated H-index: 9
(Norwegian University of Science and Technology)
+ 4 AuthorsTerje Espevik65
Estimated H-index: 65
(Norwegian University of Science and Technology)
Acute wounds contain many biological active molecules, including several cytokines and growth factors. However, the cellular sources of each molecule, as well as the stimuli inducing them, are poorly characterized. We quantified the levels of 27 cytokines, chemokines, and growth factors in acute wound fluid in a luminex-based assay. The acute wound fluid contained particularly high levels of IL-6 and IL-8, as well as elevated levels of MCP-1, IL-1RA, PDGF, IP-10, IFN-γ, and TNF-α. Surprisingly, ...
41 Citations Source Cite
Published on Jan 1, 1991in Diabetes Care 13.40
Arshag D. Mooradian50
Estimated H-index: 50
,
Richard L. Reed25
Estimated H-index: 25
+ 1 AuthorsPhilip Scuderi21
Estimated H-index: 21
Objective To determine whether chronic hyperglycemia causes increased levels of serum tumor necrosis factor (TNF) and interleukin 1 α (IL-1 α) and IL-1 β. Research Design and Methods Sera were obtained from 59 diabetic patients, 44 chronically ill nondiabetic patients, and 34 age-matched healthy control subjects. Mononuclear cells were isolated from a subgroup of diabetic patients and healthy control subjects. Results Except for a modest increase in the prevalence of detectable serum TNF levels ...
46 Citations Source Cite
Published on Jun 1, 1998in American Journal of Pathology 4.07
Nicholas N. Nissen2
Estimated H-index: 2
(Loyola University Chicago),
Peter J. Polverini14
Estimated H-index: 14
+ 3 AuthorsLuisa A. DiPietro41
Estimated H-index: 41
Angiogenesis is an essential component of normal wound repair, yet the primary mediators of wound angiogenesis have not been well described. The current study characterizes the contribution of vascular endothelial cell growth factor (VEGF) to the angiogenic environment of human surgical wounds. Surgical wound fluid samples (n = 70) were collected daily for up to 7 postoperative days (POD) from 14 patients undergoing mastectomy or neck dissection. VEGF levels in surgical wound fluid were lowest o...
621 Citations
Published on Apr 1, 1995in Development 5.41
A. D. Reginelli1
Estimated H-index: 1
,
Yao-Qi Wang1
Estimated H-index: 1
+ 1 AuthorsK. Muneoka1
Estimated H-index: 1
We report that during mouse fetal development transcripts of Msx1 and Msx2 become progressively restricted to cells that will form more distal digit structures; the Msx2 expression domain is always more distal than Msx1. At birth both Msx1 and Msx2 are expressed in cells of the nail bed and hair follicle. We have found that the regenerative ability of mouse digit tips is restricted to levels in which the amputation plane is within the region of Msx1, but not Msx2, expression in early fetal digit...
191 Citations
Published on Mar 1, 2013in Wound Repair and Regeneration 2.95
Takeo Minematsu12
Estimated H-index: 12
(University of Tokyo),
Gojiro Nakagami18
Estimated H-index: 18
(University of Tokyo)
+ 10 AuthorsNobuhiko Haga23
Estimated H-index: 23
(University of Tokyo)
Because wound exudate includes secreted proteins that affect wound healing, its biochemical analysis is useful for objective assessment of chronic wounds. Wound blotting allows for collection of fresh exudate by attaching a nitrocellulose membrane onto the wound surface. To determine its applicability for several analysis methods and its executability in clinical wound assessment, this study comprised an animal experiment and clinical case reports. In the animal experiment, full-thickness wounds...
14 Citations Source Cite
Markus W. Löffler8
Estimated H-index: 8
(University of Tübingen),
Heiko Schuster12
Estimated H-index: 12
(University of Tübingen)
+ 1 AuthorsStefan Beckert16
Estimated H-index: 16
(University of Tübingen)
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 describ...
8 Citations Source Cite
Published on Dec 1, 1974in Journal of Pediatric Surgery 2.13
Cynthia M. Illingworth1
Estimated H-index: 1
Summary We have developed a simple, relatively painless and very effective method of treating trapped fingers in small children. When a finger tip of a small child has been amputated, there is a remarkable capacity for the tip to regenerate if given a chance and if the injury is treated by a nonintervention technique.
218 Citations Source Cite
Cited By2
Ranieri Cancedda61
Estimated H-index: 61
,
Sveva Bollini17
Estimated H-index: 17
+ 2 AuthorsRoberta Tasso16
Estimated H-index: 16
For repair of chronic or difficult to heal tissue lesions and defects, major constraints exist to a broad application of cell therapy and tissue engineering approaches, i.e. transplantation of “ex vivo” expanded autologous stem/progenitor cells, alone or associated to carrier biomaterials. To enable a large number of patients to benefit, new strategies should be considered. One of the main goals of contemporary Regenerative Medicine is to develop new regenerative therapies, inspired from Mother ...
6 Citations Source Cite