Dataset Information

The impact of bacterial binding dressings following colorectal surgery on surgical wound complications in an adult population.

ABSTRACT: Interventions: Trial participants will be allocated to either the intervention or control group. There is currently only one DACC dressing (Leukomed Sorbact) available in the wound care dressing. The intervention group will receive the DACC containing dressings following surgery (Leukokmed Sorbact). The DACC dressing is a cover dressing applied over the incision site The control group will receive a dressing that does not contain DACC and has the same dressing properties without the interventional dressing characteristics. Participants allocated to the control group will receive a non DACC dressing. The wear time for both groups will be 14 days, unless otherwise clinical indicated for a dressing change and assessment by the lead PI. Dressing application and wear time is to be conducted according to the manufacturer specifications. Dressings will be applied as per standard of post operative care. Dressings will be visually checked daily by the study lead wound care clinician. Primary outcome(s): The primary outcome will be determined by clinical assessment and diagnosis as well as patient reported outcome. Post discharge surveillance using telemedicine and a phone call at 3o days will be conducted on all trial participants. The primary outcome measurement is defined as the occurrence of surgical site infection as per Centres of Disease Control definition and coding ICD-11 T81.49. [Day 30 postoperative ];The primary outcome measurement is defined as the occurrence of surgical wound dehiscence as defined by World Union of Wound Healing Societies definition and coding ICD 11: T81.3. Post discharge surveillance will be conducted using telemedicine and a phone call at 30 days after surgery. [Day 30 postoperative. ] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

DISEASE(S): Infection-studies Of Infection And Infectious Agents,Skin-other Skin Conditions,Cancer-bowel-small Bowel (duodenum And Ileum),Colorectal Surgery,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Wound Healing

PROVIDER: 22999 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Immunogenic cell death (ICD) in cancer represents a functionally unique therapeutic response that can induce tumor-targeting immune responses. ICD is characterized by the exposure and release of numerous damage-associated molecular patterns (DAMPs), which confer adjuvanticity to dying cancer cells. The spatiotemporally defined emission of DAMPs during ICD has been well described; whereas the epigenetic mechanisms that regulate ICD hallmarks have not yet been deeply elucidated. Here, we aimed to examine the involvement of miRNAs and their putative targets taking advantage from well-established in vitro models of ICD. To this end, B cell lymphoma (Mino) and breast cancer (MDA-MB-231) cell lines were exposed to two different ICD inducers: the combination of retinoic acid (RA) and interferon-alpha (IFN-a) and doxorubicin, and to non ICD inducers like gamma irradiation. Then, miRNA and mRNA profiles were studied by next generation sequencing. Co-expression analysis identified 16 miRNAs differentially modulated in cells subjected to ICD. Integrated miRNA-mRNA functional analysis revealed candidate miRNAs, mRNAs, and modulated pathways associated with Immune System Process (GO Term). In this sense, ICD induced a distinctive transcriptional signature hallmarked by regulation of antigen presentation, a crucial step for a proper immune system antitumor response activation. Interestingly, the major histocompatibility complex class I (MHC-I) pathway was upregulated whereas class II (MHC-II) was downregulated. Analysis of MHC-II associated transcripts and HLA-DR surface expression validated the inhibition of this pathway by ICD on lymphoma cells. miR-4284 and miR-212-3p were the strongest miRNAs upregulated by ICD associated with this event. It is well known that MHC-II expression on tumor cells facilitates the recruitment of CD4+ T cells. However, the interaction between tumor MHC-II and the inhibitory co-receptor LAG-3 on tumor-associated lymphocytes could provide an immunosuppressive signal that directly represses effector cytotoxic activity. In this context, MHC-II downregulation by ICD could enhance antitumor immunity. Overall, we found that the miRNA profile was significantly altered during ICD. Several miRNAs are predicted to be involved in the regulation of Class I and II MHC pathway, whose implication in ICD was demonstrated herein for the first time, which could eventually modulate tumor recognition and attack by the immune system.

Project description:(ACUP Abstract) Evaluating the effect of negative pressure therapy on wound healing. The current study will physically and systematically characterize the wound site through the healing process, and provide valuable new information on how bacteria interacts with Granufoam, Surgicel, Owen's Rayon, Fibrin Glue, and the wound site during the healing process, and may lead to the development of new materials and dressings to be used for wound healing applications. (Manuscript Abstract) Wound therapies are capable of modulating the complex molecular signaling profile of tissue regeneration. However traditional, bulk tissue analysis results in nonspecific expressional profiles and diluted signaling that lacks temporal-spatial information. In this study, an acute incisional porcine wound model was developed in the context of negative pressure wound therapy (NPWT). Dressing materials were inserted into wounds with or without NPWT exposure and evaluated over 8-hours. Upon wound explantation, tissue was stratified and dissected into the epidermis, dermis, or subcutaneous layer, or left undissected as a bulk sample and all groups processed for RNAseq. RNAseq of stratified layers provided spatial localization of expressional changes within defined tissue regions, including angiogenesis, inflammation, and matrix remodeling. Different expressional profiles were observed between individual tissue layers relative to each other within a single wound group and between each individual layer relative to bulk analysis. Tissue stratification identified unique differentially expressed genes within specific layers of tissue that were hidden during bulk analysis, as well as amplification of weak signals and/or inversion of signaling between two layers of the same wound, suggesting that two layers of skin can cancel out signaling within bulk analytical approaches. The unique wound stratification and spatial RNAseq approach in this study provides a new methodology to observe expressional patterns more precisely within tissue that may have otherwise not been detectable. Together these experimental data offer novel insight into early expressional patterns and genomic profiles, within and between tissue layers, in wound healing pathways that could potentially help guide clinical decisions and improve wound outcomes.

Dataset Information

The impact of bacterial binding dressings following colorectal surgery on surgical wound complications in an adult population.

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