The work described in this thesis focussed on the modes of action of maggot therapy in chronic wounds, especially related to the inflammatory phase of wound healing. For this purpose, the effect of... Show moreThe work described in this thesis focussed on the modes of action of maggot therapy in chronic wounds, especially related to the inflammatory phase of wound healing. For this purpose, the effect of maggot excretions and/or secretions on microbiological, haematological and immunological processes was investigated. The results showed that maggot excretions/secretions breakdown biofilms of both Gram-positive and Gram-negative bacteria, exposing them to the immune system, antibiotics, and ingestion and subsequent degradation by the maggots. Furthermore, proteases in maggot secretions enhance debridement by increasing the fibrinolytic activity of wound components and by degrading matrix components directly. Additionally, maggot secretions inhibit the pro-inflammatory responses of phagocytes but do not affect their ability to ingest and intracellularly kill micro-organisms. Finally, secretions induce the production of growth factors essential for angiogenesis. In conclusion, the results described in this thesis provide new insights into the modes of action of maggot therapy in chronic wounds. The success of maggot therapy may be explained by the broad spectrum of processes that are modulated by maggot secretions. Show less
Vernix caseosa (VC) is the cheesy, white cream that covers the skin of the human fetus and the newborn. VC is a protective cream, which consists of water containing dead cells that are embedded in... Show moreVernix caseosa (VC) is the cheesy, white cream that covers the skin of the human fetus and the newborn. VC is a protective cream, which consists of water containing dead cells that are embedded in lipids. This natural cream is suggested to feature multiple biological functions such as facilitating the skin formation during pregnancy and hydrating the skin of the newborn. The aim of this thesis was the rational design of synthetic creams which mimic VC__s structure and its unique properties. Synthetic creams were made of highly hydrated synthetic particles embedded in wool wax and skin lipids. These creams were shown to mimic excellently the structure and composition of natural VC, while the water content and release properties could be controlled. The developed creams showed their great potential for disrupted and underdeveloped skin concerning several aspects: the skin barrier recovery rate was drastically reduced, crust formation was prevented and thickening of the epidermis was less frequently observed. These promising results give rise to future clinical studies in order to prove the benefits of the newly developed creams to treat healthy, dry and diseased human skin. Show less