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      Biocirugía: utilización de larvas de insectos necrófagos en la curación de heridas. La terapia larval Translated title: Biosurgery: using necrophagous larvae for healing wounds. Larval therapy

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          Abstract

          La terapia larval es una técnica que permite aplicar las larvas de algunas especies de dípteros sobre heridas crónicas o sobre focos de infección localizados, con la finalidad de restaurar el tejido afectado. La velocidad y la eficacia del tratamiento, sumadas a la casi nula pérdida de tejido sano durante el proceso de reparación tisular, han hecho de la terapia larval o biocirugía una alternativa viable para la curación de heridas asociadas con entidades como pie diabético, úlceras venosas, úlceras crónicas de la piel y quemaduras, así como de ciertos tipos de tumores benignos, abscesos y osteomielitis. Aunque la medicina moderna ha sido, en muchos casos, reticente a la aplicación de terapias de esta índole, eventos como la resistencia a los antibióticos y las alteraciones en el proceso de cicatrización en las heridas crónicas han permitido modificar la posición inicial de muchos médicos al respecto.

          Translated abstract

          Larval therapy is a technique that allows the use of larva of some diptera species on chronic wounds or localized infected focuses, in order to promote the affected tissue restoration. The treatment velocity and efficacy, with almost no healthy tissue loses during the process, have made larval therapy (sometimes called biosurgery) a viable alternative for healing wounds associated with entities as diabetic foot, venous ulcers, cutaneous chronic ulcers and burns, and some benign tumors, abscesses and osteomyelitis. Although modern medicine has been, in many cases, reticent on the application of this kind of therapies, events as antibiotic resistance and alterations in cicatrization process in chronic wounds, have modified the respective initial point of view of many doctors.

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          Most cited references54

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          Angiogenesis in wound healing.

          During wound healing, angiogenic capillary sprouts invade the fibrin/fibronectin-rich wound clot and within a few days organize into a microvascular network throughout the granulation tissue. As collagen accumulates in the granulation tissue to produce scar, the density of blood vessels diminishes. A dynamic interaction occurs among endothelial cells, angiogenic cytokines, such as FGF, VEGF, TGF-beta, angiopoietin, and mast cell tryptase, and the extracellular matrix (ECM) environment. Specific endothelial cell ECM receptors are critical for these morphogenetic changes in blood vessels during wound repair. In particular, alpha(v)beta3, the integrin receptor for fibrin and fibronectin, appears to be required for wound angiogenesis: alpha(v)beta3 is expressed on the tips of angiogenic capillary sprouts invading the wound clot, and functional inhibitors of alpha(v)beta3 transiently inhibit granulation tissue formation. Recent investigations have shown that the wound ECM can regulate angiogenesis in part by modulating integrin receptor expression. mRNA levels of alpha(v)beta3 in human dermal microvascular endothelial cells either plated on fibronectin or overlaid by fibrin gel were higher than in cells plated on collagen or overlaid by collagen gel. Wound angiogenesis also appears to be regulated by endothelial cell interaction with the specific three-dimensional ECM environment in the wound space. In an in vitro model of human sprout angiogenesis, three-dimensional fibrin gel, simulating early wound clot, but not collagen gel, simulating late granulation tissue, supported capillary sprout formation. Understanding the molecular mechanisms that regulate wound angiogenesis, particularly how ECM modulates ECM receptor and angiogenic factor requirements, may provide new approaches for treating chronic wounds.
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            Definitions and guidelines for assessment of wounds and evaluation of healing.

            Chronic wounds represent a worldwide problem. For laboratory and clinical research to adequately address this problem, a common language needs to exist. This language should include a system of wound classification, a lexicon of wound descriptors, and a description of the processes that are likely to affect wound healing and wound healing end points. The report that follows defines wound, acute wound, chronic wound, healing and forms of healing, wound assessment, wound extent, wound burden, and wound severity. The utility of these definitions is demonstrated as they relate to the healing of a skin wound, but these definitions are broadly applicable to all wounds.
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              Definitions and guidelines for assessment of wounds and evaluation of healing.

              Chronic wounds represent a worldwide problem. For laboratory and clinical research to adequately address this problem, a common language needs to exist. This language should include a system of wound classification, a lexicon of wound descriptors, and a description of the processes that are likely to affect wound healing and would healing end points. The report that follows defines wound, acute wound, chronic wound, healing and forms of healing, wound assessment, wound extent, wound burden, and wound severity. The utility of these definitions is demonstrated as they relate to the healing of a skin wound, but these definitions are broadly applicable to all wounds.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                recis
                Revista Ciencias de la Salud
                Rev. Cienc. Salud
                Editorial Universidad del Rosario (Bogotá )
                1692-7273
                June 2004
                : 2
                : 2
                : 156-164
                Affiliations
                [1 ] Universidad del Rosario Colombia
                [2 ] Universidad del Rosario Colombia
                [3 ] Universidad del Rosario Colombia
                [4 ] Universidad del Rosario Colombia
                Article
                S1692-72732004000200006
                b0722f81-32c0-45ea-887e-8226d16b4cf5

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Colombia

                Self URI (journal page): http://www.scielo.org.co/scielo.php?script=sci_serial&pid=1692-7273&lng=en
                Categories
                PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

                Public health
                Insects,surgery,therapy,history,larva,insectos,cirugía,terapia,historia
                Public health
                Insects, surgery, therapy, history, larva, insectos, cirugía, terapia, historia

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