The Experts below are selected from a list of 1419 Experts worldwide ranked by ideXlab platform
Jinwoo Lee - One of the best experts on this subject based on the ideXlab platform.
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Development of stabilized dual growth factor-loaded hyaluronate Collagen Dressing matrix.
Journal of tissue engineering, 2021Co-Authors: Jihyun Kim, Kwang Hwan Park, Seung Hwan Han, Kyoung-mi Lee, Dong Suk Yoon, Ik Kyu Park, Hang-cheol Shin, Jinwoo LeeAbstract:Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healing processes. Here, we report dual growth factor-loaded hyaluronate Collagen Dressing (Dual-HCD) matrix, using different ratios of the concentration of stabilized growth factors-stabilized-EGF (S-EGF) and stabilized-bFGF (S-bFGF). At first, the optimal concentration ratio of S-EGF to S-bFGF in the Dual-HCD matrix is determined to be 1:2 in type I diabetic mice. This Dual-HCD matrix does not cause cytotoxicity and can be used in vivo. The wound-healing effect of this matrix is confirmed in type II diabetic mice. Dual HCD enhances angiogenesis which promotes wound healing and thus, it shows a significantly greater synergistic effect than the HCD matrix loaded with a single growth factor. Overall, we conclude that the Dual-HCD matrix represents an effective therapeutic agent for impaired diabetic wound healing.
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development of stabilized dual growth factor loaded hyaluronate Collagen Dressing matrix
Journal of Tissue Engineering, 2021Co-Authors: Jihyun Kim, Kwang Hwan Park, Seung Hwan Han, Kyoung-mi Lee, Dong Suk Yoon, Ik Kyu Park, Hang-cheol Shin, Jinwoo LeeAbstract:Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healin...
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Collagen Dressing in the treatment of diabetic foot ulcer: A prospective, randomized, placebo-controlled, single-center study.
Diabetes research and clinical practice, 2019Co-Authors: Kwang Hwan Park, Jae Bum Kwon, Jae Han Park, Ju Cheol Shin, Seung Hwan Han, Jinwoo LeeAbstract:Abstract Aims Because Collagen is fundamental to wound healing and skin formation, Collagen-containing Dressing materials might be beneficial in treating diabetic foot ulcers (DFU), but supporting evidence is needed. Here, we examined the effectiveness and safety of Collagen Dressing material in DFU treatment. Methods This prospective, randomized, placebo-controlled, single-center study included patients with type 1 or 2 diabetes and palpable foot pulse who had Wagner grade 1 or 2 ulcers ≥1.0 cm2 with no signs of healing for ≥6 weeks. Patients were treated with foam Dressing alone (control group) or with a porcine type I Collagen Dressing material (Collagen group). Complete ulcer healing rate was the primary endpoint, and healing velocity and time to 50% size reduction were secondary endpoints. Results Thirty patients were included (Collagen group: 17, control group: 13). There were no significant differences in demographic factors or baseline DFU characteristics. Compared to the control group, the Collagen group presented a higher rate of complete healing [82.4% vs. 38.5%, P = .022], faster healing velocity (P Conclusions Wound management using Collagen materials in DFUs showed faster and complete healing rate.
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Collagen Dressing in the Treatment of Diabetic Foot Ulcer: A Prospective, Randomized, Placebo- Controlled, Single-Center Study
Foot & Ankle Orthopaedics, 2016Co-Authors: Yoo Jung Park, Kwang Hwan Park, Seung Hwan Han, Jinwoo Lee, Yeokgu Hwang, Jae Wan Suh, Dong-woo Shim, Woo Jin ChoiAbstract:Category:DiabetesIntroduction/Purpose:Ulcer healing in the diabetic patients is challenging due to a prolonged inflammatory response, extracellular matrix degradation irregularities, and increased ...
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Development of Stabilized Growth Factor-Loaded Hyaluronate– Collagen Dressing (HCD) matrix for impaired wound healing
Biomaterials Research, 2016Co-Authors: Seong Mi Choi, Kyoung-mi Lee, Ik Kyu Park, Hang-cheol Shin, Hyun Aae Ryu, Hyun Jung Kim, Wan Jin Cho, Woo Jin Choi, Jinwoo LeeAbstract:Background Diabetes mellitus is a disease lack of insulin, which has severely delayed and impaired wound healing capacity. In the previous studies, various types of scaffolds and growth factors were used in impaired wound healing. However, there were several limitations to use them such as short half-life of growth factors in vivo and inadequate experimental conditions of wound-Dressing material. Thus, our study aimed to determine the biocompatibility and stability of the matrix containing structurally stabilized epidermal growth factor (S-EGF) and basic fibroblast growth factor (S-bFGF). Results and Discussion We stabilized EGF and bFGF that are structurally more stable than existing EGF and bFGF. We developed biocompatible matrix using S-EGF, S-bFGF, and hyaluronate– Collagen Dressing (HCD) matrix. The developed matrix, S-EGF and S-bFGF loaded on HCD matrix, had no cytotoxicity, in vitro . Also, these matrixes had longer releasing period that result in enhancement of half-life. Finally, when these matrixes were applied on the wound of diabetic mice, there were no inflammatory responses, in vivo . Thus, our results demonstrate that these matrixes are biologically safe and biocompatible as wound-Dressing material. Conclusions Our stabilized EGF and bFGF was more stable than existing EGF and bFGF and the HCD matrix had the capacity to efficiently deliver growth factors. Thus, the S-EGF and S-bFGF loaded on HCD matrix had improved stability. Therefore, these matrixes may be suitable for impaired wound healing, resulting in application of clinical treatment.
David J Torgerson - One of the best experts on this subject based on the ideXlab platform.
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systematic reviews of wound care management 2 Dressings and topical agents used in the healing of chronic wounds
Health Technology Assessment, 1999Co-Authors: M. Bradley, Nicky Cullum, Mark Petticrew, Trevor A Sheldon, E A Nelson, David J TorgersonAbstract:Background. Wound Dressings are designed to keep the wound clean and free from contamination and also to promote wound healing, particularly in chronic wounds where there may be significant tissue loss. Objectives. This review evaluates the evidence for effectiveness and cost-effectiveness of Dressings and topical preparations in pressure sores, leg ulcers and surgical wounds healing by secondary intention. Methods. Nineteen electronic databases, including MEDLINE, EMBASE, CINAHL and the Cochrane Wounds Group's specialised trials register and wound care journals were searched until October 1997. Organisations, manufacturers, researchers and healthcare professionals concerned with wound care were contacted for additional trials. The reference sections of obtained studies were also searched for further trials. Inclusion criteria: Randomised controlled trials (RCTs), published or unpublished, which assessed the effectiveness of a Dressing or topical agent in the treatment of pressure sores, leg ulcers, sinuses and surgical wounds healing by secondary intention were included in the review. Where a particular Dressing was not evaluated by an RCT, prospective controlled trials were included. Studies were only included if they reported either the proportion of wounds healed within a time period or the percentage or absolute change in wound area. Data extraction and synthesis: Trial data were extracted by one researcher and checked by a second. The results from each study were calculated as odds ratios and/or effect sizes and where appropriate, similar studies have been pooled in a meta-analysis. Results. Surgical wounds healing by secondary intention: Only five studies met the inclusion criteria. All the studies were of poor quality and had small sample size. One study found a statistical benefit for wet-to-dry Dressings compared with topical applications of aloe vera. However, neither of these products is commonly used in the UK. Pressure sores: Twenty-eight trials evaluated 31 comparisons of treatments for the healing of pressure sores. The majority of trials were of poor quality. A single report suggested that the topical application of insulin was of significant benefit for wound healing when compared with standard nursing care. A meta-analysis of five reports comparing a hydrocolloid Dressing with a traditional treatment suggested that treatment with the hydrocolloid resulted in a statistically significant improvement in the rate of pressure sore healing. Leg ulcers: Sixty studies were included that had evaluated Dressings or topical agents in arterial and venous ulcers. Both mononuclear cultured cells in culture medium and topical ketanserin significantly increased healing rates compared with a control preparation in one trial of arterial leg ulcers. Collagen sponges appeared to be effective in two trials of leg ulcers but there were insufficient data to determine the significance of these results. Nine trials compared hydrocolloids with traditional Dressings for venous ulcers but meta-analysis demonstrated no significant difference in the proportion of ulcers healed over the trial period. Two trials compared semi-permeable films with traditional Dressings; one found a larger reduction in wound area under the film Dressing but the other found no significant difference in healing rates. Two trials compared foam Dressings and traditional or control therapies; one favoured the foam Dressing but the other found no difference between treatments. Woven zinc oxide paste bandage was more effective than either an alginate Dressing or a zinc oxide-impregnated stockinette in one trial. In two trials comparing different hydrocolloids, no significant difference in healing rates was found. Comparisons of hydrocolloids with foam Dressings found no difference in effectiveness. In trials of topical agents, allopurinol and dimethyl sulfoxide improved healing in one trial compared with inert powder. Of two trials comparing hyaluronic acid with control, one found a difference in daily healing rate and the other found no difference in proportion of ulcers healed over the trial period. Four trials compared biological Dressings with traditional therapies. None found statistically significant differences in results. Two trials compared Dressings with topical preparations. There was no difference in the proportion of ulcers healed between patients treated with cryopreserved cultured allografts or a hydrocolloid, though the former-treated ulcers had a higher rate of epithelialisation. A Collagen Dressing was more effective than treatment with daily antiseptic. A comparison of buffered acidifying ointment and ointment reported there was no difference in the proportion of ulcers healed, but there was a higher rate of epithelialisation with the buffered ointment group. In another, trial there were higher healing rates when two amino acid solutions were compared with two groups treated in saline soaks. Publication bias: A funnel plot of all trials showed no evidence of publication bias. However, publication bias was indicated in a comparison of traditional and hydrocolloid Dressings. Cost-effectiveness analysis: Nine trials provided data on costs of Dressing materials and nursing visits. Six evaluated cost- effectiveness in pressure sore treatments and three papers reported cost- effectiveness data in leg ulcer trials. Conclusions. Implication for practice: There is little evidence to indicate which Dressings or topical agents are the most effective in the treatment of chronic wounds. However, there is evidence that hydrocolloid Dressings are better than wet-to-dry Dressings for the treatment of pressure sores. In the treatment of venous ulcers, low adherent Dressings are as effective as hydrocolloid Dressings beneath compression bandaging. Recommendations for research: Research methodology could be significantly improved and commissioning groups may wish to consider the following aspects for future research. The number of patients in a trial should be based on an a priori sample size calculation. A truly objective outcome measure should be used or wound healing should be expressed as both percentage and absolute change in area. For each patient a single reference wound should be selected. Experimental groups should be comparable at baseline. Head-to-head comparisons of contemporary Dressings are required and should use agents that are recommended for wounds of a similar nature. A complete and thorough description of concurrent treatments, including secondary Dressings, should be given in trial reports. Assessment of outcomes should ideally be blind to treatment, or completely objective. Survival rate analysis should be adopted for all studies that assess wound healing. Studies to determine the biological mechanisms involved in wound healing are needed. Future trials should include cost-effectiveness and quality of life assessments, as well as objective measures of Dressing performance. Economic evaluations should be incorporated within trials that are sufficiently large to detect appropriate economic and clinical outcomes. To prevent publication bias and ensure the inclusion of unpublished trials in systematic reviews, those involved in primary research should make their data available to those undertaking systematic reviews.
Robert S Kirsner - One of the best experts on this subject based on the ideXlab platform.
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comparative effectiveness of a bilayered living cellular construct and a porcine Collagen wound Dressing in the treatment of venous leg ulcers
Wound Repair and Regeneration, 2014Co-Authors: William A Marston, Michael L Sabolinski, R Nathan N B Parsons, Robert S KirsnerAbstract:Using data from a national wound-specific electronic medical record (WoundExpert, Net Health, Pittsburgh, PA), we compared the effectiveness of a bilayered living cellular construct (BLCC) and an acellular porcine small intestine submucosa Collagen Dressing (SIS) for the treatment of venous leg ulcer. Data from 1,489 patients with 1,801 refractory venous leg ulcers (as defined by failure to have >40% reduction in size in the 4 weeks prior to treatment) with surface areas between 1 and 150 cm2 in size, treated between July 2009 and July 2012 at 158 wound care facilities across the US were analyzed. Patient baseline demographics and wound characteristics were comparable between groups. Kaplan-Meier–derived estimates of wound closure for BLCC (1,451 wounds) was significantly greater (p = 0.01, log-rank test) by weeks 12 (31% vs. 26%), 24 (50% vs. 41%), and 36 (61% vs. 46%), respectively, compared with SIS (350 wounds). BLCC treatment reduced the median time to wound closure by 44%, achieving healing 19 weeks sooner (24 vs. 43 weeks, p = 0.01, log-rank test). Treatment with BLCC increased the probability of healing by 29% compared with porcine SIS Dressing (hazard ratio = 1.29 [95% confidence interval 1.06, 1.56], p = 0.01).
Michael L Sabolinski - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of Wound Closure Rates Using a Human Fibroblast-derived Dermal Substitute Versus a Fetal Bovine Collagen Dressing: A Retrospective Study.
Wound management & prevention, 2019Co-Authors: Ryan H Fitzgerald, Michael L Sabolinski, Michelle SkornickiAbstract:Diabetic foot ulcers (DFUs) are associated with an increased risk for serious and costly outcomes such as osteomyelitis, amputation, and hospitalization. PURPOSE A retrospective study was conducted to evaluate the proportion of patients healed and time to healing of DFUs treated with a human fibroblast-derived dermal substitute (HFDS) or a fetal bovine Collagen Dressing (FBCD). METHODS Data from patients with a DFU who received the first treatment in 2014 were extracted from the electronic record database of 93 wound care centers. Baseline demographics (eg, age, gender, body mass index, and number of wounds); wound location, size, and duration; and wound-specific information such as wound size and number of and interval between applications were obtained. Study criteria stipulated patients who received at least one treatment in 2014 with HFDS or FBCD on a DFU with location coded as foot, toe, heel, metatarsal head, toe web space, toe amputation site, or transmetatarsal amputation site; ulcer size ≥1 cm2 to
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evaluation of wound closure rates using a human fibroblast derived dermal substitute versus a fetal bovine Collagen Dressing a retrospective study
Wound Management & Prevention, 2019Co-Authors: Ryan H Fitzgerald, Michael L Sabolinski, Michelle SkornickiAbstract:Diabetic foot ulcers (DFUs) are associated with an increased risk for serious and costly outcomes such as osteomyelitis, amputation, and hospitalization. PURPOSE A retrospective study was conducted to evaluate the proportion of patients healed and time to healing of DFUs treated with a human fibroblast-derived dermal substitute (HFDS) or a fetal bovine Collagen Dressing (FBCD). METHODS Data from patients with a DFU who received the first treatment in 2014 were extracted from the electronic record database of 93 wound care centers. Baseline demographics (eg, age, gender, body mass index, and number of wounds); wound location, size, and duration; and wound-specific information such as wound size and number of and interval between applications were obtained. Study criteria stipulated patients who received at least one treatment in 2014 with HFDS or FBCD on a DFU with location coded as foot, toe, heel, metatarsal head, toe web space, toe amputation site, or transmetatarsal amputation site; ulcer size ≥1 cm2 to <20 cm2; and ulcer area reduction ≤50% in the 28 days before the first treatment with HFDS or FBCD were eligible for inclusion. Wounds that received an alternate skin substitute treatment up to 28 days before or concurrent with the first HFDS or FBCD treatment or if patient data that lacked baseline or follow-up wound area measurement were excluded. Deidentified data were extracted directly into data files and transferred to a third-party data management and statistical group for analysis. The frequency of DFUs achieving wound closure (defined as area ≤0.25 cm2) by weeks 12 and 24 and median time to wound closure of wounds that healed were analyzed. Baseline characteristics were compared using 2-sample t tests for continuous variables and 2-tailed Fisher's exact tests for difference in proportions between treatments. Frequency of and median time to wound closure were determined by Cox proportional hazards analysis. The frequency of wounds closed at 12 and 24 weeks, median time to wound closure, hazard ratio with 95% confidence interval, and P value were estimated from the Cox model. Statistical significance was defined as P <.05. RESULTS Records showed 206 patients with 208 DFUs received treatment (108 HFDS, mean age 60.2 years, mean wound duration 8.8 months; 100 FBCD, mean age 65.2 years, mean wound duration 12.8 months) and were included. Mean number of treatment applications was 4.5 and 2.4 for HFDS and FBCD, respectively. After 12 and 24 weeks 44 (41%) and 69 (64%) of HFDS-treated wounds, respectively, and 21 (21%) and 43 (43%) of FBCD-treated wounds, respectively, were healed (at 12 weeks, P = .03; at 24 weeks, P = .03, log rank 2-tailed test, unadjusted). Median time to wound closure for HFDS and FBCD was 14.6 and 25 weeks, respectively (P = .03; log rank, 2-tailed test; Kaplan-Meier analysis). HFDS treatment significantly increased the probability of wound healing compared to FBCD treatment in the Cox proportional hazards analysis after adjusting for treatment terms, baseline wound area, baseline wound duration, baseline wound depth, wound location, and patient age at first treatment (HR = 1.77; 95% CI: 1.06-2.97; P = .03). CONCLUSION DFU wounds are more likely to heal when treated with HFDS than with FBCD as used by facilities in this database. Studies examining the efficacy, cost-effectiveness, and patient-centered outcomes of these treatments is warranted. .
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Comparative effectiveness of a bilayered living cellular construct and an acellular fetal bovine Collagen Dressing in the treatment of venous leg ulcers.
Journal of Comparative Effectiveness Research, 2018Co-Authors: Michael L Sabolinski, Gary GibbonsAbstract:Aim: To compare the effectiveness of bilayered living cellular construct (BLCC) and an acellular fetal bovine Collagen Dressing (FBCD) for the treatment of venous leg ulcers. Methods: Data from WoundExpert® (Net Health, PA, USA) was used to analyze 1021 refractory venous leg ulcers treated at 177 facilities. Results: Kaplan-Meier analyses showed that BLCC (893 wounds) was superior to FBCD (128 wounds), p = 0.01 for: wound closure by weeks 12 (31 vs 25%), 24 (55 vs 43%) and 36 (68 vs 53%); reduction in time to wound closure of 37%, (19 vs 30 weeks); and improvement in the probability of healing by 45%. Conclusion: BLC versus FBCD showed significant differences in both time to and frequency of healing suggesting that BLCC may provide significant cost savings compared with FBCD.
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comparative effectiveness of a bilayered living cellular construct and a porcine Collagen wound Dressing in the treatment of venous leg ulcers
Wound Repair and Regeneration, 2014Co-Authors: William A Marston, Michael L Sabolinski, R Nathan N B Parsons, Robert S KirsnerAbstract:Using data from a national wound-specific electronic medical record (WoundExpert, Net Health, Pittsburgh, PA), we compared the effectiveness of a bilayered living cellular construct (BLCC) and an acellular porcine small intestine submucosa Collagen Dressing (SIS) for the treatment of venous leg ulcer. Data from 1,489 patients with 1,801 refractory venous leg ulcers (as defined by failure to have >40% reduction in size in the 4 weeks prior to treatment) with surface areas between 1 and 150 cm2 in size, treated between July 2009 and July 2012 at 158 wound care facilities across the US were analyzed. Patient baseline demographics and wound characteristics were comparable between groups. Kaplan-Meier–derived estimates of wound closure for BLCC (1,451 wounds) was significantly greater (p = 0.01, log-rank test) by weeks 12 (31% vs. 26%), 24 (50% vs. 41%), and 36 (61% vs. 46%), respectively, compared with SIS (350 wounds). BLCC treatment reduced the median time to wound closure by 44%, achieving healing 19 weeks sooner (24 vs. 43 weeks, p = 0.01, log-rank test). Treatment with BLCC increased the probability of healing by 29% compared with porcine SIS Dressing (hazard ratio = 1.29 [95% confidence interval 1.06, 1.56], p = 0.01).
Kwang Hwan Park - One of the best experts on this subject based on the ideXlab platform.
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development of stabilized dual growth factor loaded hyaluronate Collagen Dressing matrix
Journal of Tissue Engineering, 2021Co-Authors: Jihyun Kim, Kwang Hwan Park, Seung Hwan Han, Kyoung-mi Lee, Dong Suk Yoon, Ik Kyu Park, Hang-cheol Shin, Jinwoo LeeAbstract:Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healin...
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Development of stabilized dual growth factor-loaded hyaluronate Collagen Dressing matrix.
Journal of tissue engineering, 2021Co-Authors: Jihyun Kim, Kwang Hwan Park, Seung Hwan Han, Kyoung-mi Lee, Dong Suk Yoon, Ik Kyu Park, Hang-cheol Shin, Jinwoo LeeAbstract:Patients with diabetes experience impaired growth factor production such as epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF), and they are reportedly involved in wound healing processes. Here, we report dual growth factor-loaded hyaluronate Collagen Dressing (Dual-HCD) matrix, using different ratios of the concentration of stabilized growth factors-stabilized-EGF (S-EGF) and stabilized-bFGF (S-bFGF). At first, the optimal concentration ratio of S-EGF to S-bFGF in the Dual-HCD matrix is determined to be 1:2 in type I diabetic mice. This Dual-HCD matrix does not cause cytotoxicity and can be used in vivo. The wound-healing effect of this matrix is confirmed in type II diabetic mice. Dual HCD enhances angiogenesis which promotes wound healing and thus, it shows a significantly greater synergistic effect than the HCD matrix loaded with a single growth factor. Overall, we conclude that the Dual-HCD matrix represents an effective therapeutic agent for impaired diabetic wound healing.
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Collagen Dressing in the treatment of diabetic foot ulcer: A prospective, randomized, placebo-controlled, single-center study.
Diabetes research and clinical practice, 2019Co-Authors: Kwang Hwan Park, Jae Bum Kwon, Jae Han Park, Ju Cheol Shin, Seung Hwan Han, Jinwoo LeeAbstract:Abstract Aims Because Collagen is fundamental to wound healing and skin formation, Collagen-containing Dressing materials might be beneficial in treating diabetic foot ulcers (DFU), but supporting evidence is needed. Here, we examined the effectiveness and safety of Collagen Dressing material in DFU treatment. Methods This prospective, randomized, placebo-controlled, single-center study included patients with type 1 or 2 diabetes and palpable foot pulse who had Wagner grade 1 or 2 ulcers ≥1.0 cm2 with no signs of healing for ≥6 weeks. Patients were treated with foam Dressing alone (control group) or with a porcine type I Collagen Dressing material (Collagen group). Complete ulcer healing rate was the primary endpoint, and healing velocity and time to 50% size reduction were secondary endpoints. Results Thirty patients were included (Collagen group: 17, control group: 13). There were no significant differences in demographic factors or baseline DFU characteristics. Compared to the control group, the Collagen group presented a higher rate of complete healing [82.4% vs. 38.5%, P = .022], faster healing velocity (P Conclusions Wound management using Collagen materials in DFUs showed faster and complete healing rate.
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Collagen Dressing in the Treatment of Diabetic Foot Ulcer: A Prospective, Randomized, Placebo- Controlled, Single-Center Study
Foot & Ankle Orthopaedics, 2016Co-Authors: Yoo Jung Park, Kwang Hwan Park, Seung Hwan Han, Jinwoo Lee, Yeokgu Hwang, Jae Wan Suh, Dong-woo Shim, Woo Jin ChoiAbstract:Category:DiabetesIntroduction/Purpose:Ulcer healing in the diabetic patients is challenging due to a prolonged inflammatory response, extracellular matrix degradation irregularities, and increased ...