Le´o-Paul Tricou,1–3 Marie-Lynn Al-Hawat,1 Katia Cherifi,1 Gabriela Manrique,1 Benjamin R. Freedman,4,* and Simon Matoori1,*
1Faculte´ de Pharmacie, Universite´ de Montre´al, Montre´al, Canada.
2ISPB Faculte´ de Pharmacie, Universite´ Claude Bernard Lyon 1, Lyon, France.
3Chemical Engineering Department, Polytechnique Montreal, Montre´al, Canada.
4Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston,
Massachusetts, USA.
Significance: Chronic diabetic wounds on the lower extremities (diabetic foot ulcers, DFU) are one of the most prevalent and life-threatening complications of diabetes, responsible for significant loss of quality of life and cost to the health care system. Available pharmacologic treatments fail to achieve com plete healing in many patients. Recent studies and investigational treatments have highlighted the potential of modulating wound pH in DFU.
Recent Advances: Data from in vitro, preclinical, and clinical studies highlight the role of pH in the pathophysiology of DFU, and topical administration of pH-lowering agents have shown promise as a therapeutic strategy for diabetic wounds. In this critical review, we describe the role of pH in DFU patho-physiology and present selected low-molecular-weight and hydrogel-based pH-modulating systems for wound healing and infection control in diabetic.
Critical Issues: The molecular mechanisms leading to pH alterations in diabetic wounds are complex and may differ between in vitro models, animal models of diabetes, and the human pathophysiology. Wound pH-lowering bandages for DFU therapy must be tested in established animal models of diabetic wound healing and patients with diabetes to establish a comprehensive benefit-risk profile.
Future Directions: As our understanding of the role of pH in the pathophysiology of diabetic wounds is deepening, new treatments for this therapeutic target are being developed and will be tested in preclinical and clinical studies. These therapeutic systems will establish a target product profile for pH-lowering treatments such as an optimal pH profile for each wound healing stage. Thus, controlling wound bed pH could become a powerful tool to accelerate chronic diabetic wound healing.
Keywords: pH management, diabetic wound healing, diabetes, pH-lowering strategies, pH modulation, acidic wound dressings
H.Guan1,M.Nuth1, S.R. Weiss2, A. Fausto2, Y. Liu3, H. Koo3, M.S. Wolff4 , and R.P. Ricciardi1,5
Abstract
The COVID-19 pandemic has escalated the risk of SARS-CoV-2 transmission in the dental practice, especially as droplet-aerosol particles are generated by high-speed instruments. This has heightened awareness of other orally transmitted viruses, including influenza and herpes simplex virus 1 (HSV1), which are capable of threatening life and impairing health. While current disinfection procedures commonly use surface wipe-downs to reduce viral transmission, they are not fully effective. Consequently, this provides the opportunity for a spectrum of emitted viruses to reside airborne for hours and upon surfaces for days. The objective of this study was to develop an experimental platform to identify a safe and effective virucide with the ability to rapidly destroy oral viruses transported within droplets and aerosols. Our test method employed mixing viruses and virucides in a fine-mist bottle atomizer to mimic the generation of oral droplet-aerosols. The results revealed that human betacoronavirus OC43 (related to SARS-CoV-2), human influenza virus (H1N1), and HSV1 from atomizer-produced droplet-aerosols were each fully destroyed by only 100 ppm of hypochlorous acid (HOCl) within 30 s, which was the shortest time point of exposure to the virucide. Importantly, 100 ppm HOCl introduced into the oral cavity is known to be safe for humans. In conclusion, this frontline approach establishes the potential of using 100 ppm HOCl in waterlines to continuously irrigate the oral cavity during dental procedures to expeditiously destroy harmful viruses transmitted within aerosols and droplets to protect practitioners, staff, and other patients.
Keywords: virucide, saliva, infection, high-speed instruments, waterlines, prevention
擅长大面积深度烧伤的早期救治、各种烧烫伤创面的综合处理、烧伤后瘢痕增生挛缩畸形的修复。长期致力于急性皮肤缺损、慢性皮肤溃疡（褥疮、糖尿病足等）的外科治疗。
擅长领域：介入微创诊疗血管性疾病等，如下肢动脉硬化闭塞症、糖尿病足、血管畸形、静脉曲张、动静脉血栓形成、静脉狭窄闭塞等。
东莞康华医院国际造口治疗师，采用全球倡导的伤口湿性愈合疗法和造口专科护理新技术，在糖尿病溃疡足、下肢动/静脉溃疡、骨髓炎、外科术后感染/脂肪液化、肿瘤伤口、放射性皮炎、痛风破溃感染、压力性损伤（压疮）、液体外渗、造口并发症、失禁、瘘管等方面提供专业化的诊治、咨询及健康教育。
从事骨科临床工作和外科学教学工作30年。擅长骨关节疾病、四肢骨折和手外伤的保守治疗、手术治疗（关节置换手术、四肢骨折内固定手术、创伤修复手术）；各类创面的修复：包括糖尿病足、难治性痛风破溃感染伤口、创伤术后伤口不愈合。
长期从事影像诊断和介入放射学诊疗工作，擅长肿瘤和血管病的介入治疗。
佛山市禅城区中心医院慢性伤口造口专科主任。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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