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JACQUI FLETCHER OBE Clinical Editor, Wounds UK on behalf of the 4 Nations Stop the Pressure Team.

With thanks to:

The Society of Tissue Viability NWCSP, Pink Marketing, Tissue Viability colleagues from England, Northern Ireland, Scotland and Wales, Wounds UK, Journal of Wound Care, The Journal of Tissue Viability and our commercial colleagues

Zhiyong Wang1†, Hailin Xu1†, Hao Yang1†, Yi Zhang3 , Xiaoyan Wang1 , Peng Wang1 , Zhongye Xu1 ,Dongming Lv1 , Yanchao Rong1 , Yunxian Dong4 , Bing Tang1 , Zhicheng Hu1*, Wuguo Deng2* and Jiayuan Zhu1*

Abstract

Background The composite transplantation of a split-thickness skin graft (STSG) combined with an acellular dermal matrix (ADM) is a promising repair method for full-thickness skin defects. Due to delayed vascularization of the ADM, no currently available engineered skin tissue is able to permanently cover full-thickness skin defects via a single-stage procedure. Epidermal stem cells (EpSCs) have been found to promote angiogenesis in the wound bed. Whether EpSCs can induce early angiogenesis of dermal substitutes and promote the survival of single-stage tissue-engineered skin transplantation needs to be further studied.

Methods In vitro, rat vascular endothelial cells (RVECs) were treated with the supernatant of EpSCs cultured in ADM and stimulated for 48 h. RVECs were analysed by RNA sequencing and tube formation assays. For the in vivo experiment, 75 rats were randomly divided into five groups: ADM, ADM+EpSCs (AE), STSG, ADM+STSG (AS), and ADM+STSG+EpSCs (ASE) groups. The quality of wound healing was estimated by general observation and H&E and Masson staining. The blood perfusion volume was evaluated using the LDPI system, and the expression of vascular markers was determined by immunohistochemistry (IHC).

Results The active substances secreted by EpSCs cultured in ADM promoted angiogenesis, as shown by tube formation experiments and RNA-seq. EpSCs promoted epithelialization of the ADM and vascularization of the ADM implant. The ASE group showed significantly increased skin graft survival, reduced skin contraction, and an improved cosmetic appearance compared with the AS group and the STSG control group.

† Zhiyong Wang, Hailin Xu and Hao Yang contributed equally to this work

*Correspondence:

Zhicheng Hu 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

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Jiayuan Zhu 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 Full list of author information is available at the end of the article

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Conclusions In summary, our findings suggest that EpSCs promote the formation of new blood vessels in dermal substitutes and support one-step transplantation of tissue-engineered skin, and thereby provide new ideas for clinical

Keywords Epidermal stem cells, Acellular dermal matrix, Tissue-engineered skin, Vascularization, Angiogenesis

Community nurses play a vital role in the healthcare system, touching the lives of individuals across their lifespan. With a variety of job titles and opportunities for specialisation, these dedicated professionals continue to make a profound impact on patient care. This article will focus on district nurses and the challenges they face. It will also explore the impact non-healing wounds can have on patients and how implementing a comprehensive treatment pathway can effectively address the challenges encountered by community nurses in their day-to-day practice.

KEY WORDS

Community nurses;

Non-healing wounds;

Patient care;

Real world challenges

JEANETTE MILNE

Associate Director of Nursing Delivery; Northumbria Healthcare NHS Foundation Trust

This article and the best practice statement were sponsored by Smith+Nephew. The views presented in this document are the work of the author and do not necessarily reflect the views of Smith+Nephew.

Aligned with the importance of weight management for people with type 2 diabetes, the American Diabetes Association (ADA) 83rd Scientific Sessions this year showcased new and existing drug treatments for obesity, some of which also provide significant glucose-lowering in people with type 2 diabetes. In the late-breaking Weight Loss Innovations session on 25 June, Dr Robert Gabbay, Chief Scientific and Medical Officer for the ADA, described “an explosion of promising new research and innovations in recent years”, and stated that the studies presented at this year’s annual meeting “are game changers in the way we customise treatment for individuals with obesity and those with type 2 diabetes”. In this report from the Sessions, Pam Brown highlights the latest developments in pharmacotherapy for weight loss and glucose lowering.

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