مقالات پذیرفته شده در هفتمین کنگره بین المللی زیست پزشکی
Advances in Wound Healing and Skin Tissue Regeneration
Advances in Wound Healing and Skin Tissue Regeneration
negar abdolahzadeh,1,*asoo mehdizadeh,2amir amani,3samaneh mollazadeh,4
1. Department of Advanced Sciences and Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran 2. Department of Biological Sciences, Faculty of Sciences, University of Kurdistan , Sanandaj , iran. 3. Department of Advanced Sciences and Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran 4. Department of Advanced Sciences and Technologies, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
Introduction: The skin is the largest organ in the body and its main function is to protect against environmental influences through the immune response. Skin ulcers are a pathological condition caused by disease or physical/chemical damage, and they can be classified as acute or chronic wounds depending on their origin and duration of recovery. Acute wounds are caused by traumatic injuries or surgical procedures, while chronic wounds are often associated with infections, vascular disease, diabetes, and cancer. The healing process of a wound depends on its size, depth, and damage to the layers of the skin. Factors such as nutritional or immunological weakness, age, chronic stress, and other co-morbidities can also affect the recovery process. Treating chronic wounds has become a significant financial burden, with millions of patients affected in the United States alone. The annual cost of treating chronic wounds exceeds $25 billion and is expected to rise due to increasing healthcare costs, an aging population, and the growing incidence of diabetes and obesity worldwide. Projected medical costs for all wounds range from $28.1 billion to $96.8 billion, including infection management and wound repair costs.
The process of skin wound healing can be categorized into three distinct biological stages: inflammation, proliferation, repair, and regeneration. Throughout the healing process of injuries, a variety of mechanisms are involved, such as coagulation, accumulation, inflammation, synthesis and deposition of matrix, angiogenesis, fibroplasia, epithelialization, contraction, and regeneration . The normal progression of wound healing can be further divided into four phases: the coagulation phase, the inflammatory phase, the proliferative/tissue formation phase of granulation, and the regeneration phase.
Methods: To discover the latest developments in the field of wound healing and skin tissue regeneration, we conducted a thorough search using the PubMed and Google Scholar databases. We used specific keywords such as wound healing, regenerative medicine, skin, tissue engineering, cell therapy, fibroblast, platelet-rich plasma, and gene therapy. This comprehensive search covered the period from 2000 to 2023 and provided the possibility of a comprehensive review of the subject.
Results: Significant progress has been made in the field of wound management and wound healing. These advances include improvements in clinical techniques for treating wounds, such as skin grafts, skin substitutes, biological wound dressings, and topical antimicrobial agents, as well as the administration of systemic antibiotics. In addition, pharmacological approaches including corticosteroids, TGFβ modulators, and botulinum toxin A are used for wound management. Other treatment methods include surgical procedures such as fat grafting and scar modification through laser therapy.
Today, in order to repair all types of burn wounds, diabetic wounds, deep wounds and pressure wounds, extensive studies are conducted with the help of tissue engineering and regenerative medicine. Tissue engineering and Regeneration can be divided into four main categories: tissue scaffolds, growth factors, cells, and gene therapy. Fibroblasts, adipose-derived stem cells, and keratinocytes are common cells in skin wound healing. Dermal fibroblast cells play an important role in normal skin as well as wound healing after injury.
Conclusion: Cell Therapy are used in autologous and allogeneic form, by injecting into the wound, spraying and with the help of scaffold. The presence of fibroblasts is vital in the stages of wound healing and they play a key role in the deposition of extracellular matrix (ECM) components, wound contraction and regeneration of new ECM. Cells survive for a limited time, and are used as a source of growth factors and cytokines to support the function of the patient's own cells. During extensive studies, the effect of gene therapy on the healing of skin wounds has been measured.The list of genes examined in these studies is as follows: PDGF-B, SDGF-1α, VEGF-A, IL-8, TGFβ1, EGF, FGF-1 and fibromodulin.