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Push-pull theory: using mechanotransduction to achieve tissue perfusion and wound healing in complex cases.

Abstract：

:Wound healing has evolved from gauze therapy to the use of proteomics, gene therapy, and cellular-based therapies in the short time span of 45 years. Education for health care providers has not kept pace with the logarithmic acceleration in technology development and treatment options. A patient with a non-healing wound requires a comprehensive work-up, including a focus on six primary points of interest. These points include the status of tissue perfusion, role of bacterial contamination, pressure applied to the tissue, the immune status of the host, co-morbid medical conditions including the patient's psychosocial status, and lastly, the status of the wound itself. Even after re-establishing macrovascular flow, many wounds either fail to improve or paradoxically worsen. Potential mechanisms for these unexpected findings include reperfusion injury, no-reflow, and the presence of stunned/hibernating tissue. Using the concept of mechanotransduction, the clinician can simulate normal pulsatile blood flow and re-establish adequate microvascular perfusion. Treatment regimens may include negative pressure therapy, electrical stimulation, ultrasound therapy, and other energy-based modalities.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Ennis WJ,Meneses P,Borhani M

doi

10.1016/j.ygyno.2008.07.054

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

S81-6

issue

2 Suppl

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(08)00638-0

journal_volume

111

pub_type

杂志文章,评审

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