A wound that forms a straight line heals less quickly than a wound with a zigzag pattern. Researchers provide a possible explanation for this in a new study.
You may not have noticed it, but wound care practitioners have known it for a while: Wounds that form waves, or a zigzag pattern, generally heal faster than a straight injury. Scientists from Nanyang Technological University in Singapore suggest that this is because cells bridge with each other more quickly in undulating wounds.
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Building cell bridges
To arrive at this conclusion, the researchers made cuts in a hydrogel. These synthetic wounds varied in width (from 30 to 100 microns) and degree of zigzagging. The hydrogel, a material largely made up of water, was studded with cells from the kidneys of dogs. It would be a type epithelial cells which can also be found in the skin.
The scientists then spent 64 hours studying the path the cells took and the speed at which they connected the edges of the wounds. This bridge building is also known as re-epithelialization, and it is the way wounds heal naturally.
Rotating movements
In a straight cut, the cells moved in a straight line, parallel to the edges of the wound. In a synthetic wound with a zigzag pattern, they made circular – “vortex-like” – movements, pharmacologist Xu Hongmei describes in the new study. “In this way, the cells near one edge of the cut came into contact more quickly with the cells near the opposite edge. Together they formed a bridge more quickly.” Five times faster than in a straight wound to be exact.
Armand Rondas, specialist in geriatric medicine and complex wound treatment, points out that this is laboratory research, and we do not know whether epithelial cells also behave this way in real wounds. In the words of Rondas: “This is still very far from the situation and re-epithelialization of wounds in humans.” Wound biologist Harm Jaap Smit agrees. He also wonders whether cells other than canine kidney cells also display this behaviour.
Less tension
The researchers from Singapore hope that their study will eventually lead to ways to make better incisions during surgery. After all, the chance of infections is smaller if wounds heal faster. There is another advantage of a zigzag wound, says Smit. “This wound absorbs tension much better and can distribute the tension better,” says the wound biologist.
Smit only wonders whether you can make a zigzag wound small enough. “And I don’t think the disadvantage of a longer incision (more chance of bacteria in the wound) outweighs the advantage of less tension in the tissue.” In short: there is still a long way to go before this study finds its way to the operating table.
Beeld: Gary John Norman/Getty Images
2023-05-17 11:02:20
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