Role of Mechanotransduction on Decision Making for Treatment of Chronic Wounds

Abstract

Abstract Chronic wounds create tremendous clinical, social, and economic burdens that generate frustration within hospitals and outpatient clinics, impair the health-related quality of life of chronic wound patients, and enormously drain healthcare resources. Common wound care and treatment techniques involve the usage of wound dressings. However, although there have been decades of advancements in the wound care field, resulting in the introduction of new, novel wound dressings, there remains a significant number of chronic wounds that fail to fully heal or are recurrent. Few studies consider how the specific mechanical properties of wound dressings influence complex mechanical responses within wound tissue. Mechanotransduction is a biological process that has been shown to influence wound tissue response, signaling cellular processes that alter regeneration and wound repair. The objective of this study is to take an initial step to determine and interpret the extents to which biophysical wound dressing properties impact mechanotransduction within a wound tissue. Current experimental techniques make it challenging to investigate many of the complexities of the wound healing process. Thus, the purpose of this study is to begin with computational models and theoretical descriptions that propose predictions and explanations of the role of various mechanical wound dressing characteristics on mechanotransduction in wound tissues. Three-dimensional models of wound tissue and wound dressings have been developed to analyze how von Mises stresses are distributed within the tissue models. The results of this study support that the shape, thickness, length, and stiffness of wound dressings impact the stress transmitted to the wound tissue. Our results show that shorter (7 cm in length) ellipsoid dressings lead to highest stresses within the wound tissue where dressing’s thickness and stiffness don’t show a significant impact. However, in ticker ellipsoid dressings (11 cm in length), higher stresses are observed when dressing is softer and thinner. When using a rectangular dressing, shorter, softer, thinner ones lead to high stress transmission to a wound tissue. The findings suggest that standards regarding biophysical wound dressing parameters, including stiffness, shape, thickness, and size, may be introduced to improve decision making for treatment of chronic wounds. These parameters may be brought to use to elucidate factors predisposing a chronic wound to heal. With an enhanced understanding of dressing properties and how they affect stress response within patient-specific wound tissues, more informed decision making for the treatment and care of chronic wounds can be made with the application of novel, precision dressings.