Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Oct;21(10):487-92; quiz 493-4.
doi: 10.1097/01.ASW.0000323563.59885.1c.

Using gene transcription patterns (bar coding scans) to guide wound debridement and healing

Marjana Tomic-Canic  1 , Elizabeth A Ayello, Olivera Stojadinovic, Michael S Golinko, Harold Brem
Affiliations

Using gene transcription patterns (bar coding scans) to guide wound debridement and healing

Marjana Tomic-Canic et al. Adv Skin Wound Care. 2008 Oct.

Abstract

Purpose: To acquaint wound care practitioners with new information related to debridement of chronic wounds.

Target audience: This continuing education activity is intended for physicians and nurses with an interest in wound care.

Objectives: After reading this article and taking this test, the reader should be able to: 1. Explain the role of keratinocytes in wound healing. 2. Discuss new research findings on the physiological differences between healing and nonhealing wounds.3. Identify implications of the new research for debridement of chronic wounds.

PubMed Disclaimer

Figures

Figure 1
Figure 1. KERATINOCYTE TOPOGRAPHY IN A WOUND
A typical diabetic ulcer is shown. Arrows indicate specific wound locations: Wound bed = location C; nonhealing edge = location A; healing edge = location B.
Figure 2
Figure 2. HISTOLOGY OF WOUND EDGE
Histopathology of nonhealing edge (left) reveals thick cornified layer (stratum corneum) and thick, hyperproliferative epidermis. Section of normal skin (right) is shown for comparison.
Figure 3
Figure 3. MOLECULAR MARKERS OF CHRONIC WOUNDS
C-myc is a pathogenic marker of chronic wounds. Immunohistochemistry is showing positive staining with c-myc–specific antibody of the nuclei of the biopsy from a patient with chronic wound (top), whereas there is no c-myc staining in biopsy of normal skin (bottom).
Figure 4
Figure 4. BIOLOGICALLY BASED MARGINS OF DEBRIDEMENT
Digital photograph of a neuropathic plantar foot ulcer in a patient with diabetes. The solid black lines indicate nonhealing edge (location A, indicated by black arrows). Two outer circles (broken lines) indicate 2 possible margins of debridement, the presumed location B or healing-edge of the wound. At this edge, keratinocytes have the ability to migrate and participate in the wound healing process.
Figure 5
Figure 5. WOUND BAR CODE
Histology and gene expression profiles obtained from biopsies from a patient with venous ulcer are shown for 3 locations: nonhealing edge (location A), healing edge (location B), and normal skin. Specific gene expression pattern is detected from each of the locations, indicating that it can be used to determine the subpopulation of cells within the wound. Colors indicate the degree of regulation of specific genes.
Figure 6
Figure 6. WOUND BAR CODE LOCATION
Debridement aims at removal of cells from location A, thus exposing cells from location B exposed to wound healing stimuli.
See this image and copyright information in PMC

References

    1. Center for Medicare & Medicaid Services. Expert Advisory Panel on the Usual Care of Chronic Wounds [cited 10/28/2006] [Last accessed August 1, 2008]. Available at: http://www.cms.hhs.gov/mcd/viewmcac.asp?where=index&mid=28.
    1. Brem H, Jacobs T, Vileikyte L, et al. Wound-healing protocols for diabetic foot and pressure ulcers. Surg Technol Int. 2003;11:85–92. - PubMed
    1. Whitney J, Phillips L, Aslam R, et al. Guidelines for the treatment of pressure ulcers. Wound Repair Regen. 2006;14:663–79. - PubMed
    1. Steed DL. Clinical evaluation of recombinant human platelet-derived growth factor for the treatment of lower extremity ulcers. Plast Reconstr Surg. 2006;117(7 Suppl):143S–149S. discussion 150S–151S. - PubMed
    1. Robson MC, Cooper DM, Aslam R, et al. Guidelines for the treatment of venous ulcers. Wound Repair Regen. 2006;14:649–62. - PubMed

Publication types