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伤口敷料对慢性伤口组织内机械转导的影响。

Impact of Wound Dressing on Mechanotransduction within Tissues of Chronic Wounds.

作者信息

McElvain Kelly, Klister Joshua, Ebben Alessandra, Gopalakrishnan Sandeep, Dabagh Mahsa

机构信息

Department of Biomedical Engineering, College of Engineering & Applied Science, University of Wisconsin-Milwaukee, 3200 N Cramer St., P.O. Box 784, Milwaukee, WI 53201, USA.

College of Nursing, University of Wisconsin-Milwaukee, 1921 E Hartford Ave., P.O. Box 412, Milwaukee, WI 53211, USA.

出版信息

Biomedicines. 2022 Nov 30;10(12):3080. doi: 10.3390/biomedicines10123080.

Abstract

Chronic wounds are significant public health problems impacting the health-related quality of individuals' lives (due to disability, decreased productivity, and loss of independence) and an immense economic burden to healthcare systems around the world. In this study, our main objective is to investigate how mechanotransduction can impact the healing process in chronic wounds. We have developed new three-dimensional models of wound tissue to study the distribution of forces within these tissues exerted by wound dressings with different characteristics. The roles of mechanical forces on wound healing have gained significant clinical attention; the application of mechanical forces is expected to influence the physiology of tissue surrounding a wound. We aim to investigate whether the force transmission within wound tissue is impacted by the dressing characteristics and whether this impact may differ with wound tissue's properties. Our results show that wound dressings with lower stiffnesses promote force transmission within a wound tissue. This impact is even more significant on stiffer wound tissues. Furthermore, we show that size of wound dressing alters forces that transmit within the wound tissue where dressings with 9 cm length show higher stresses. The wound tissue stiffening has been associated with healing of a wound. Our results demonstrate that wounds with stiffer tissue experience higher stresses. Taken all together, our findings suggest that low stiffness of wound dressing and its size may be introduced as a criterion to explain parameters predisposing a chronic wound to heal. This study's findings on the role of dressings and tissue characteristics demonstrate that precision dressings are required for wound management and understanding how a dressing impacts mechanotransduction in wound tissue will lead to design of novel dressings promoting healing in chronic wounds.

摘要

慢性伤口是严重的公共卫生问题,影响着个人与健康相关的生活质量(由于残疾、生产力下降和失去独立性),也是全球医疗系统的巨大经济负担。在本研究中,我们的主要目标是研究机械转导如何影响慢性伤口的愈合过程。我们开发了新的伤口组织三维模型,以研究具有不同特性的伤口敷料在这些组织内施加的力的分布。机械力对伤口愈合的作用已引起临床的广泛关注;预计机械力的施加会影响伤口周围组织的生理机能。我们旨在研究伤口组织内的力传递是否受敷料特性的影响,以及这种影响是否会因伤口组织的特性而有所不同。我们的结果表明,刚度较低的伤口敷料能促进伤口组织内的力传递。这种影响在较硬的伤口组织上更为显著。此外,我们表明伤口敷料的尺寸会改变在伤口组织内传递的力,其中长度为9厘米的敷料显示出更高的应力。伤口组织变硬与伤口愈合有关。我们的结果表明,组织较硬的伤口承受的应力更高。综上所述,我们的研究结果表明,伤口敷料的低刚度及其尺寸可作为解释慢性伤口愈合易感性参数的一个标准。本研究关于敷料和组织特性作用的发现表明,伤口处理需要精准敷料,了解敷料如何影响伤口组织中的机械转导将有助于设计促进慢性伤口愈合的新型敷料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2169/9775138/826c4193e926/biomedicines-10-03080-g001a.jpg

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