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Stefan Beckert - One of the best experts on this subject based on the ideXlab platform.
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Wound Fluid in Diabetic Foot Ulceration: More Than Just an Undefined Soup?
The international journal of lower extremity wounds, 2013Co-Authors: Markus W. Löffler, Heiko Schuster, Sarah Bühler, Stefan BeckertAbstract: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.
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superficial Wound swabbing a novel method of sampling and processing Wound Fluid for subsequent immunoassay analysis in diabetic foot ulcerations
Diabetes Care, 2012Co-Authors: Michael Schmohl, Stefan Beckert, Alfred Königsrainer, Thomas O. Joos, Nicole Schneiderhanmarra, Markus W. LöfflerAbstract: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 mediators. RESEARCH DESIGN AND METHODS Both nylon-flocked swabs and film dressings were used to collect Wound Fluid from foot ulcers of diabetic patients. In randomly selected patients, levels of Wound Fluid inflammatory mediators and matrix metalloproteases were determined using multiplexed bead-based sandwich immunoassays with respect to both sampling methods. Wound Fluid spike-in experiments were performed to evaluate the impact of different sample processing protocols on subsequent immunoassay analysis. RESULTS Using the swabbing technique, a median amount of 40 µL (2–120 µL) Wound exudate was collected, which allowed the measurement of several multiplex panels. Comparing both sampling methods, a similar qualitative protein recovery was observed with a trend to analyte enrichment by swabbing. Sample processing using swabs did not affect analyte recovery, with the exception of interleukin (IL)-8, thymus and activation-regulated chemokine, IL-17A, interferon-γ–induced protein 10, and IL-4. CONCLUSIONS Quality of Wound Fluid collected by superficial swabbing is not inferior to the current standard technique. Combined with subsequent bead-based sandwich immunoassay analysis, this new method offers a noninvasive technique, suitable for daily clinical routines, for assessment of inflammatory activity in diabetic foot ulcers.
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A novel method of sampling and processing Wound Fluid for subsequent immunoassay analysis in diabetic foot ulcerations
2012Co-Authors: Michael Schmohl, Nicole Schneiderhan-marra, Stefan Beckert, Alfred Königsrainer, Thomas O. Joos, Markus W. LöfflerAbstract:OBJECTIVEdIndiabeticfootulcers,Wound Fluidinflammatorymediatorshavepreviouslybeen proposed as surrogate markers for nonhealing. However, currently available Wound Fluid sampling techniquesarenotsuitableforclinicalpracticeduetolowlevelsofexudateandahighlogisticaleffort. 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 mediators. RESEARCH DESIGN AND METHODSdBoth nylon-flocked swabs and film dressings wereusedtocollectWound Fluidfromfootulcersofdiabeticpatients.Inrandomlyselectedpatients, levels of Wound Fluid inflammatory mediators and matrix metalloproteases were determined using multiplexed bead-based sandwich immunoassays with respect to both sampling methods. Wound Fluid spike-in experiments were performed to evaluate the impact of different sample processing protocols on subsequent immunoassay analysis. RESULTSdUsing the swabbing technique, a median amount of 40 m L( 2–120 mL) Wound exudatewascollected,whichallowedthemeasurementofseveralmultiplexpanels.Comparingboth sampling methods, a similar qualitative protein recovery was observed with a trend to analyte enrichment by swabbing. Sample processing using swabs did not affect analyte recovery, with the exception of interleukin (IL)-8, thymus and activation-regulated chemokine, IL-17A, interferong–induced protein 10, and IL-4. CONCLUSIONSdThequalityof Wound Fluid collectedby superficialswabbing isnotinferior to the current standard technique. Combined with subsequent bead-based sandwich immunoassayanalysis,thisnewmethodoffersanoninvasivetechnique,suitablefordailyclinicalroutines,for assessment of inflammatory activity in diabetic foot ulcers. Diabetes Care 35:2113–2120, 2012
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Wound Fluid Diagnostics in Diabetic Foot Ulcers
Global Perspective on Diabetic Foot Ulcerations, 2011Co-Authors: Markus W. Löffler, Michael Schmohl, Nicole Schneiderhan-marra, Stefan BeckertAbstract:Wound Fluid seems -at least theoreticallyeasily accessible and might open a new window to the local Wound microenvironment that cannot be evaluated by the analysis of serum or plasma markers. Recently, this strategy has been supported by a first time Wound Fluid proteome analysis comparing acute and chronic Wounds (Eming et al. 2010). Interestingly, there seem to be essential differences with respect to Wound Fluid protein composition when comparing acute and chronic Wounds. The Wound Fluid proteome of healing tissue is characterised by proteins involved in tissue growth and protection from inflammatory activity, whereas non-healing Wounds are characterised by a chronic inflammatory environment primarily consisting of leukocyte proteases and inflammatory mediators (Eming et al. 2010). This is particularly striking since the non-healing state in diabetic foot ulcers has previously been linked to persistent inflammatory activity (Acosta et al. 2008). Thus, the Wound Fluid of chronic Wounds seems to be characterised by an altered Wound micro-milieu and may, therefore, provide deeper insights into the causes of delayed Wound healing.
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Wound Fluid lactate concentration a helpful marker for diagnosing soft tissue infection in diabetic foot ulcers preliminary findings
Diabetic Medicine, 2011Co-Authors: Markus W. Löffler, Sarah Bühler, Derek Zieker, Jürgen Weinreich, Stefan Löb, Ingmar Königsrainer, Stephan Symons, Alfred Königsrainer, Hinnak Northoff, Stefan BeckertAbstract:Diabet. Med. 28, 175–178 (2011) Abstract Aims To investigate the impact of Wound Fluid lactate concentration on diagnosing soft-tissue infection in diabetic foot ulcers. Methods Lactate concentration in Wound Fluid obtained from diabetic foot ulcers was determined using a lactate analyser and compared with clinical examination findings. Results Overall median Wound Fluid lactate concentration was 21.03 mm (5.58–80.40 mm). Wound lactate levels were significantly higher in infected compared with non-infected diabetic foot ulcers (P = 0.001). Non-infected diabetic foot ulcers that healed within 6 months of treatment showed a significantly lower Wound Fluid lactate concentration at baseline as opposed to those that did not heal (P = 0.007). Conclusions Non-healing diabetic foot ulcers are characterized by high Wound Fluid lactate levels. Assessment of Wound Fluid lactate concentration might be helpful for confirming the suspicion of soft tissue infection, particularly when clinical signs are atypical.
Michael Stacey - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Wound Fluid biomarkers to determine healing in adults with venous leg ulcers a prospective study
Wound Repair and Regeneration, 2019Co-Authors: Michael Stacey, Steven A. Phillips, Forough Farrokhyar, Jillian M. SwaineAbstract:Clinical practice guidelines recommend using repeated Wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their Wound measured and Wound Fluid collected at weekly time points for 13 weeks. Wound Fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the Wound Fluid at each weekly time point. Healing status was determined by examining the change in Wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing Wounds (p < 0.1) and were included in a multivariate logistic regression model. Granulocyte macrophage-colony stimulating factor (p < 0.001) and matrix metalloprotease-13 (p = 0.004) were the best predictors of Wound healing. Receiver operating characteristic curves indicated 92% accuracy (95% CI: 85%,100%) for granulocyte macrophage-colony stimulating factor, and 78% accuracy (95% CI: 65%,90%) for matrix metalloprotease-13 in discriminating between healing and nonhealing Wounds. This study found that two biomarkers from Wound Fluid can predict healing status in chronic venous leg ulcers. These findings may lead to the ability to determine the future trajectory of a Wound and the ability to modify treatment accordingly.
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Evaluation of Wound Fluid biomarkers to determine healing in adults with venous leg ulcers: A prospective study.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 2019Co-Authors: Michael Stacey, Steven A. Phillips, Forough Farrokhyar, Jillian M. SwaineAbstract:Clinical practice guidelines recommend using repeated Wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their Wound measured and Wound Fluid collected at weekly time points for 13 weeks. Wound Fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the Wound Fluid at each weekly time point. Healing status was determined by examining the change in Wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing Wounds (p
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Cytoskeletal protein Flightless (Flii) is elevated in chronic and acute human Wounds and Wound Fluid: neutralizing its activity in chronic but not acute Wound Fluid improves cellular proliferation
European journal of dermatology : EJD, 2012Co-Authors: Nadira Ruzehaji, Michael Stacey, Randall H. Grose, Doreen Krumbiegel, Heddy Zola, Pallave Dasari, Hilary J. Wallace, Robert Fitridge, Allison J. CowinAbstract:Chronic non-healing Wounds form a medical need which will expand as the population ages and the obesity epidemic grows. Whilst the complex mechanisms underlying Wound repair are not fully understood, remodelling of the actin cytoskeleton plays a critical role. Elevated expression of the actin cytoskeletal protein Flightless I (Flii) is known to impair Wound outcomes. To determine if Flii is involved in the impaired healing observed in chronic Wounds, its expression in non-healing human Wounds from patients with venous leg ulcers was determined and compared to its expression in acute Wounds and unWounded skin. Increased expression of Flii was observed in both chronic and acute Wounds with Wound Fluid and plasma also containing secreted Flii protein. Inflammation is a key aspect of Wound repair and fluorescence-activated cell sorting (FACS) analysis revealed Flii was located in neutrophils within the blood and that it co-localised with CD16+ neutrophils in chronic Wounds. The function of secreted Flii was investigated as both chronic Wound Fluid and Flii have previously been shown to inhibit fibroblast proliferation. To determine if the inhibitory effect of Wound Fluid was due in part to the presence of Flii, Wound Fluids were depleted of Flii using Flii-specific neutralizing antibodies (FnAb). Flii depleted chronic Wound Fluid no longer inhibited fibroblast proliferation, suggesting that Flii may contribute to the inhibitory effect of chronic Wound Fluid on fibroblast function. Application of FnAbs to chronic Wounds may therefore be a novel approach used to improve the local environment of non-healing Wounds and potentially improve healing outcomes.
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Induction of MMP-1, MMP-3 and TIMP-1 in normal dermal fibroblasts by chronic venous leg ulcer Wound Fluid*.
International wound journal, 2008Co-Authors: Kavitha Subramaniam, Michael Stacey, Cheryl M. Pech, Hilary J. WallaceAbstract:In the Wound bed of chronic venous leg ulcers, an imbalance of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs) may cause excessive proteolysis and impair Wound granulation. Soluble mediators in the Wound environment may be responsible for this imbalance. The in vitro effect of Wound Fluid from venous leg ulcers on dermal fibroblast production of MMP-1, MMP-3 and TIMP-1 was compared with the effect of acute Wound Fluid from two different sources: Fluid from post-mastectomy axillary drains and Fluid from skin graft donor sites. Significantly higher MMP-1 and MMP-3 levels were induced by chronic venous leg ulcer Wound Fluid compared with both types of acute Wound Fluid (P < 0.005). Chronic venous ulcer Wound Fluid reduced TIMP-1 protein levels significantly more than acute graft Fluid (P < 0.05). Venous ulcer Wound Fluid significantly increased MMP-1 and MMP-3 production in dermal fibroblasts and reduced TIMP-1 production, confirming that mediators in the leg ulcer microenvironment can potentially induce excessive proteolysis in the ulcer dermis by altering the balance between MMPs and TIMPs. Inflammatory mediators including interleukin-1beta and tumour necrosis factor-alpha can induce these MMPs. Further work is required to confirm the factors responsible for the induction of a high MMP and low TIMP profile in fibroblasts by venous ulcer Wound Fluid.
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Biochemical analysis of Wound Fluid from nonhealing and healing chronic leg ulcers
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 1996Co-Authors: Naomi Trengove, Simon R. Langton, Michael StaceyAbstract:The purpose of this study was to determine the biochemical composition of Fluid taken from chronic Wounds, to compare these values with that of serum, and therefore to assess whether the Wound Fluid is representative of the extracellular environment of the Wound. Paired Wound Fluid and blood samples were collected from eight patients with chronic leg ulcers in a nonhealing and healing phase. Wound Fluid and serum samples were screened for a profile of general biochemical analyses, including electrolytes, lactate, glucose, and protein analyses. Electrolyte levels were essentially identical in Wound Fluid and serum samples. Lactate and lactate dehydrogenase levels were significantly greater and glucose and bicarbonate levels were significantly lower in Wound Fluid when compared with the paired serum samples. Albumin and total protein levels in Wound Fluid were on average half those of serum levels. In this small sample of eight patients, Wound Fluid collected from chronic leg ulcers is an exudate with the biochemical composition expected in extracellular Fluid. In addition, bicarbonate and glucose levels increase and C-reactive protein levels decrease in Wound Fluid, but remain unchanged in serum, during healing. These results suggest changes in the state of hypoxia and the inflammatory process in the healing Wound.
Markus W. Löffler - One of the best experts on this subject based on the ideXlab platform.
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Wound Fluid in Diabetic Foot Ulceration: More Than Just an Undefined Soup?
The international journal of lower extremity wounds, 2013Co-Authors: Markus W. Löffler, Heiko Schuster, Sarah Bühler, Stefan BeckertAbstract: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.
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superficial Wound swabbing a novel method of sampling and processing Wound Fluid for subsequent immunoassay analysis in diabetic foot ulcerations
Diabetes Care, 2012Co-Authors: Michael Schmohl, Stefan Beckert, Alfred Königsrainer, Thomas O. Joos, Nicole Schneiderhanmarra, Markus W. LöfflerAbstract: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 mediators. RESEARCH DESIGN AND METHODS Both nylon-flocked swabs and film dressings were used to collect Wound Fluid from foot ulcers of diabetic patients. In randomly selected patients, levels of Wound Fluid inflammatory mediators and matrix metalloproteases were determined using multiplexed bead-based sandwich immunoassays with respect to both sampling methods. Wound Fluid spike-in experiments were performed to evaluate the impact of different sample processing protocols on subsequent immunoassay analysis. RESULTS Using the swabbing technique, a median amount of 40 µL (2–120 µL) Wound exudate was collected, which allowed the measurement of several multiplex panels. Comparing both sampling methods, a similar qualitative protein recovery was observed with a trend to analyte enrichment by swabbing. Sample processing using swabs did not affect analyte recovery, with the exception of interleukin (IL)-8, thymus and activation-regulated chemokine, IL-17A, interferon-γ–induced protein 10, and IL-4. CONCLUSIONS Quality of Wound Fluid collected by superficial swabbing is not inferior to the current standard technique. Combined with subsequent bead-based sandwich immunoassay analysis, this new method offers a noninvasive technique, suitable for daily clinical routines, for assessment of inflammatory activity in diabetic foot ulcers.
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A novel method of sampling and processing Wound Fluid for subsequent immunoassay analysis in diabetic foot ulcerations
2012Co-Authors: Michael Schmohl, Nicole Schneiderhan-marra, Stefan Beckert, Alfred Königsrainer, Thomas O. Joos, Markus W. LöfflerAbstract:OBJECTIVEdIndiabeticfootulcers,Wound Fluidinflammatorymediatorshavepreviouslybeen proposed as surrogate markers for nonhealing. However, currently available Wound Fluid sampling techniquesarenotsuitableforclinicalpracticeduetolowlevelsofexudateandahighlogisticaleffort. 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 mediators. RESEARCH DESIGN AND METHODSdBoth nylon-flocked swabs and film dressings wereusedtocollectWound Fluidfromfootulcersofdiabeticpatients.Inrandomlyselectedpatients, levels of Wound Fluid inflammatory mediators and matrix metalloproteases were determined using multiplexed bead-based sandwich immunoassays with respect to both sampling methods. Wound Fluid spike-in experiments were performed to evaluate the impact of different sample processing protocols on subsequent immunoassay analysis. RESULTSdUsing the swabbing technique, a median amount of 40 m L( 2–120 mL) Wound exudatewascollected,whichallowedthemeasurementofseveralmultiplexpanels.Comparingboth sampling methods, a similar qualitative protein recovery was observed with a trend to analyte enrichment by swabbing. Sample processing using swabs did not affect analyte recovery, with the exception of interleukin (IL)-8, thymus and activation-regulated chemokine, IL-17A, interferong–induced protein 10, and IL-4. CONCLUSIONSdThequalityof Wound Fluid collectedby superficialswabbing isnotinferior to the current standard technique. Combined with subsequent bead-based sandwich immunoassayanalysis,thisnewmethodoffersanoninvasivetechnique,suitablefordailyclinicalroutines,for assessment of inflammatory activity in diabetic foot ulcers. Diabetes Care 35:2113–2120, 2012
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Wound Fluid Diagnostics in Diabetic Foot Ulcers
Global Perspective on Diabetic Foot Ulcerations, 2011Co-Authors: Markus W. Löffler, Michael Schmohl, Nicole Schneiderhan-marra, Stefan BeckertAbstract:Wound Fluid seems -at least theoreticallyeasily accessible and might open a new window to the local Wound microenvironment that cannot be evaluated by the analysis of serum or plasma markers. Recently, this strategy has been supported by a first time Wound Fluid proteome analysis comparing acute and chronic Wounds (Eming et al. 2010). Interestingly, there seem to be essential differences with respect to Wound Fluid protein composition when comparing acute and chronic Wounds. The Wound Fluid proteome of healing tissue is characterised by proteins involved in tissue growth and protection from inflammatory activity, whereas non-healing Wounds are characterised by a chronic inflammatory environment primarily consisting of leukocyte proteases and inflammatory mediators (Eming et al. 2010). This is particularly striking since the non-healing state in diabetic foot ulcers has previously been linked to persistent inflammatory activity (Acosta et al. 2008). Thus, the Wound Fluid of chronic Wounds seems to be characterised by an altered Wound micro-milieu and may, therefore, provide deeper insights into the causes of delayed Wound healing.
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Wound Fluid lactate concentration a helpful marker for diagnosing soft tissue infection in diabetic foot ulcers preliminary findings
Diabetic Medicine, 2011Co-Authors: Markus W. Löffler, Sarah Bühler, Derek Zieker, Jürgen Weinreich, Stefan Löb, Ingmar Königsrainer, Stephan Symons, Alfred Königsrainer, Hinnak Northoff, Stefan BeckertAbstract:Diabet. Med. 28, 175–178 (2011) Abstract Aims To investigate the impact of Wound Fluid lactate concentration on diagnosing soft-tissue infection in diabetic foot ulcers. Methods Lactate concentration in Wound Fluid obtained from diabetic foot ulcers was determined using a lactate analyser and compared with clinical examination findings. Results Overall median Wound Fluid lactate concentration was 21.03 mm (5.58–80.40 mm). Wound lactate levels were significantly higher in infected compared with non-infected diabetic foot ulcers (P = 0.001). Non-infected diabetic foot ulcers that healed within 6 months of treatment showed a significantly lower Wound Fluid lactate concentration at baseline as opposed to those that did not heal (P = 0.007). Conclusions Non-healing diabetic foot ulcers are characterized by high Wound Fluid lactate levels. Assessment of Wound Fluid lactate concentration might be helpful for confirming the suspicion of soft tissue infection, particularly when clinical signs are atypical.
Sena Yesil - One of the best experts on this subject based on the ideXlab platform.
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Hyperglycemia is associated with lower levels of urokinase-type plasminogen activator and urokinase-type plasminogen activator receptor in Wound Fluid.
Journal of diabetes and its complications, 2014Co-Authors: Baris Akinci, Cem Terzi, Gokmen Omur Sevindik, Faize Yuksel, Ulku Aybuke Tunc, Sunay Tunali, Sena YesilAbstract:Abstract Aims Wounds in patients with hyperglycemia show impaired healing. Plasminogen activation is crucial in several overlapping phases of Wound healing process. In this study, we aimed i) to compare acute Wound Fluid in patients with hyperglycemia and normoglycemia, ii) to focus on the elements of plasminogen activation in the Wound Fluid, and iii) to determine if the acute Wound Fluid characteristics are associated with surgical site infections. Methods In a cohort of 54 patients, a closed suction drain was placed in the Wound above the anterior abdominal wall fascia under the skin in order to collect postoperative acute Wound Fluid samples for 3 following days after colorectal surgery. Patients were classified as normoglycemic (n = 25) or hyperglycemic (n = 29; 17 with type 2 diabetes and 12 with stress induced hyperglycemia). Surgical site infection was defined according to the Centers for Disease Control criteria. The levels of urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAr), plasminogen activator inhibitor-1 (PAI-1), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and fibroblast growth factor-1 (FGF-1) were measured in the Wound Fluid. Results Compared to normoglycemic subjects, patients with hyperglycemia had significantly lower levels of uPA and uPAr in the Wound Fluid despite similar or even higher circulating levels. There was no significant difference in IL-1β, TNF-α, PAI-1 and FGF-1 levels. In the whole study population, the Wound Fluid levels of uPA and uPAr were negatively correlated with circulating glucose levels. No difference was detected in the Wound Fluid characteristics of patients with and without surgical site infection. Conclusion Patients with hyperglycemia exhibit decreased levels of uPA and uPAr in the Wound Fluid, suggesting a local failure in plasminogen activation at the Wound site.
Jillian M. Swaine - One of the best experts on this subject based on the ideXlab platform.
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evaluation of Wound Fluid biomarkers to determine healing in adults with venous leg ulcers a prospective study
Wound Repair and Regeneration, 2019Co-Authors: Michael Stacey, Steven A. Phillips, Forough Farrokhyar, Jillian M. SwaineAbstract:Clinical practice guidelines recommend using repeated Wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their Wound measured and Wound Fluid collected at weekly time points for 13 weeks. Wound Fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the Wound Fluid at each weekly time point. Healing status was determined by examining the change in Wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing Wounds (p < 0.1) and were included in a multivariate logistic regression model. Granulocyte macrophage-colony stimulating factor (p < 0.001) and matrix metalloprotease-13 (p = 0.004) were the best predictors of Wound healing. Receiver operating characteristic curves indicated 92% accuracy (95% CI: 85%,100%) for granulocyte macrophage-colony stimulating factor, and 78% accuracy (95% CI: 65%,90%) for matrix metalloprotease-13 in discriminating between healing and nonhealing Wounds. This study found that two biomarkers from Wound Fluid can predict healing status in chronic venous leg ulcers. These findings may lead to the ability to determine the future trajectory of a Wound and the ability to modify treatment accordingly.
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Evaluation of Wound Fluid biomarkers to determine healing in adults with venous leg ulcers: A prospective study.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society, 2019Co-Authors: Michael Stacey, Steven A. Phillips, Forough Farrokhyar, Jillian M. SwaineAbstract:Clinical practice guidelines recommend using repeated Wound surface area measurements to determine if a chronic ulcer is healing. This results in delays in determining the healing status. This study aimed to evaluate whether any of a panel of biomarkers can determine the healing status of chronic venous leg ulcers. Forty-two patients with chronic venous leg ulcers had their Wound measured and Wound Fluid collected at weekly time points for 13 weeks. Wound Fluid was analyzed using multiplex enzyme-linked immunosorbent assay to determine the concentration of biomarkers in the Wound Fluid at each weekly time point. Healing status was determined by examining the change in Wound size at the previous and subsequent weeks. Predictive accuracy with 95% confidence intervals (CI) is reported. Of 42 patients, 105 evaluable weekly time points were obtained, with 32 classified as healing, 27 as nonhealing, and 46 as indeterminate. Thirteen biomarkers significantly differed between healing and nonhealing Wounds (p
