Effective wound bed preparation using maggot debridement therapy for patients with critical limb ischaemia

Objective: Patients with critical limb ischaemia (CLI) lack sufficient blood flow in to the limb, which leads to difficulties in the normal wound healing process. Therefore, maggot debridement therapy (MDT) has not generally been recommended for CLI patients. We evaluated the effectiveness of wound bed preparation by MDT in CLI patients who had undergone mid-foot amputation. Methods: Patients who underwent mid-foot amputation after angioplasty between April 2014 and October 2016 were retrospectively investigated by classifying them into an MDT group or a conventional treatment group. The primary outcome was defined as achievement of wound healing. Secondary outcomes were the proportions of amputation-free survival (AFS) and successful ambulatory improvement. Propensity scores were used to evaluate treatment outcomes based on five factors: ankle-brachial index, skin perfusion pressure of the foot, nutritional status, experience with dialysis and age. Results: A total of 39 patients (39 legs) were included, seven within the MDT group and 32 in the conventional treatment group. Clinical backgrounds of the two groups showed no significant differences except for higher albumin levels for the MDT group (3.5±0.4g/dl; p=0.014). The wound healing proportion was significantly higher in the MDT group (86%) than in the control group (38%) (p=0.035). At 6 months after amputation, no significant differences were found between the two groups for AFS (71% versus 47%; p=0.41) or ambulatory capability (43% versus 28%; p=0.65). This result was also similar to the propensity score adjustment analysis. Conclusions: The efficacy of MDT with favourable wound bed preparation was shown in our CLI patients based on effective debridement and granulation formation by maggots, avoiding the loss of their heels. Wound-healing rates after MDT were higher for patients than for those receiving conventional treatment. MDT is considered a valid adjuvant treatment strategy for patients with CLI after revascularisation treatment is conducted. More favourable wound bed preparation and successful graft take were achieved in the MDT group, suggesting the effectiveness of MDT for wound healing in CLI patients. </jats:sec

Marine-origin Polysaccharides for tissue engineering and regenrative medicine. Chitosan and Fucoidan as illustrative examples

Marine polysaccharides are receiving wide attention not only from scientists but also from engineering and medical staff, given the several properties being reported for this class of biopolymers and based on the reputation gain by the terrestrial representatives. The marine environment is a source yet to be untapped, with several approaches being disclosed to promote the sustainable exploitation of marine biological resources. Conjugating the interesting properties with the sustainability of their use, the potential on the application of marine polysaccharides is, indeed, huge. In this chapter, the main properties and biological activities of marine polysaccharides will be explored, particularly the ones more relevant for application in a biomedical context, with a particular focus in two illustrative examples: chitosan and fucoidan. Both resemble chemical characteristics of glycosaminoglycans found in the human extracellular matrix, from which arises a particular interest regarding tissue engineering and regeneration.ComplexiTE (ERC‐2012‐ADG 20120216‐321266), funded by the European Research Council under the European Union’s Seventh Framework Programme for Research and Development, R&D&I Structured Project (NORTE‐01‐0145‐FEDER‐000021), supported by the ERDF under Programa Operacional Regional do Norte (NORTE2020) and CVMar+I (0302_CVMAR_I_1_P), co‐funded by ERDF under INTERREG España‐Portugal. The authors would also like to acknowledge the scholarships of LLR (SFRH/BD/112139), funded by Portuguese Foundation for Science and Technology, and of CO (Norte‐08‐5369‐000037), financed by ERDF through NORTE202

Does Blood of Healthy Subjects Contain Bacterial Ribosomal DNA?

Real-time PCR methods with primers and a probe targeting conserved regions of the bacterial 16S ribosomal DNA (rDNA) revealed a larger amount of rDNA in blood specimens from healthy individuals than in matched reagent controls. However, the origins and identities of these blood-associated bacterial rDNA sequences remain obscure