This paper aimed to develop two types of support materials with a mesoporous structure of mobile crystalline matter (known in the literature as MCM, namely MCM-41 and MCM-48) and to load them with gallic acid. Soft templating methodology was chosen for the preparation of the mesoporous structures—the cylindrical micelles with certain structural characteristics being formed due to the hydrophilic and hydrophobic intermolecular forces which occur between the molecules of the surfactants (cetyltrimethylammonium bromide—CTAB) when a minimal micellar ionic concentration is reached. These mesoporous supports were loaded with gallic acid using three different types of MCM—gallic acid ratios (1:0.41; 1:0.82 and 1:1.21)—and their characterizations by FTIR, SEM, XRD, BET and drug release were performed. It is worth mentioning that the loading was carried out using a vacuum-assisted methodology: the mesoporous materials are firstly kept under vacuum at ~0.1 barr for 30 min followed by the addition of the polyphenol solutions. The concentration of the solutions was adapted such that the final volume covered the wet mesoporous support and—in this case—upon reaching normal atmospheric pressure, the solution was pushed inside the pores, and thus the polyphenols were mainly loaded inside the pores. Based on the S_BET data, it can be seen that the specific surface area decreased considerably with the increasing ratio of gallic acid; the specific surface area decreased 3.07 and 4.25 times for MCM-41 and MCM-48, respectively. The sample with the highest polyphenol content was further evaluated from a biological point of view, alone or in association with amoxicillin administration. As expected, the MCM-41 and MCM-48 were not protective against infections—but, due to the loading of the gallic acid, a potentiated inhibition was recorded for the tested gram-negative bacterial strains. Moreover, it is important to mention that these systems can be efficient solutions for the recovery of the gut microbiota after exposure to antibiotics, for instance.

Background: To assess the clinical effects of diabetic peripheral neuropathy (DPN) in patients with chronic limb-threatening ischemia (CLTI) treated by primary infrapopliteal angioplasty for neuro-ischemic Rutherford 5, foot wounds. Materials and methods: Over a 10-year period (2009–2019), a series of 304 diabetic ischemic limbs adding or not evincible neuropathic affectation were treated by primary infrapopliteal angioplasty and their files were retrospectively reviewed. Mean length of treated arterial lesions was 6.1 cm (range 1–22 cm). Inferior limb vibration perception threshold diagnostic was performed for comparing and scoring detectable DPN in all studied diabetic patients (classed from 0 to 10 points). There were 19% limbs with normal (0–1 points) perception (group 1), 55% others with “mild” and “moderate” (2–6 points) neuropathic impairment (group 2), and 26% limbs showing “severe” (7–10 points) DPN (group 3). Results: Primary infrapopliteal angioplasty succeeded in 89% cases in group 1, in 82% in group 2, and in 68% of limbs in group 3. This latest group assembled the heaviest neuropathic affectation and arterial calcifications and proved the lowest clinical benefit at 36 months: 35% (95% confidence interval [CI]=22% to 48%) of primary patency, 36% (95% CI=22% to 50%) wound healing, and 54% (95% CI=39% to 69%) limb preservation rates. A comparison between groups 1 vs 3 and 2 vs 3 of primary patency (p=0.014 and p=0.043), tissue healing (p=0.049 and p=0.01), and limb salvage (p=0.006 and p=0.023) proved significant, yet without statistical weight for group 1 vs 2 (p>0.05). Overall survival was not significantly affected between groups (p=0.34). Conclusion: The presence of severe DPN may jeopardize the results of infrapopliteal angioplasty in terms of patency, tissue cicatrization, and limb preservation, yet without significance on survival of these patients. When present, DPN requires appropriate stratification as specific indicator in CLTI treatment.

Background/Objectives: The angiosome concept is widely used to guide infrapopliteal revascularization in patients with chronic limb-threatening ischemia (CLTI). However, clinical outcomes are not always fully explained by anatomical target-artery alignment alone. The present study aimed to revisit a previously published angiosome-based cohort through a wound-oriented conceptual perspective and to explore whether perfusion heterogeneity may help contextualize variability in clinical outcomes. Methods: This retrospective secondary analysis included 51 patients with CLTI who underwent infrapopliteal endovascular revascularization. Patients were originally classified as direct, indirect, or mixed revascularization according to angiosome-based criteria. The present study represents an exploratory conceptual reinterpretation of the original dataset. No new variables were introduced, and the woundosome concept was not operationalized as a measurable patient-level variable. Statistical analyses were exploratory and descriptive in nature. Results: High rates of wound healing and limb salvage were observed across all revascularization patterns at 12 months. Within the limitations of this small exploratory cohort, no consistent detectable differences in clinical outcomes were observed across anatomical revascularization patterns. Stratification according to the number of affected angiosomes did not reveal clear outcome differences. The findings suggest that factors beyond anatomical target-artery alignment may contribute to wound healing variability in CLTI. Conclusions: The present study does not establish a validated wound-oriented perfusion model but highlights the limitations of relying exclusively on anatomical angiosome classification when interpreting clinical outcomes in CLTI. In this context, the woundosome may serve as a descriptive and hypothesis-generating conceptual framework for discussing perfusion heterogeneity and wound-level perfusion complexity. Prospective studies integrating objective perfusion assessment and standardized wound evaluation are required.

Materiale Plastice - a peer-reviewed scientific journal,specialised in the field of chemistry, polymers, elastomers and plastics research

Background/Objectives: Chronic limb-threatening ischemia (CLTI) is the most advanced stage of peripheral arterial disease and is associated with high rates of major amputation and mortality. The angiosome concept has become an important tool for planning targeted revascularization. However, its clinical value may be limited in patients with complex arterial disease, impaired collateral circulation, and microvascular dysfunction. This review explores the relationship between angiosome-guided revascularization and the emerging woundosome concept, which focuses on functional wound perfusion. Methods: A narrative review with a structured literature search was performed using PubMed/MEDLINE, Scopus, and Web of Science. Studies evaluating angiosome-guided revascularization, direct versus indirect revascularization, collateral circulation, pedal arch integrity, and perfusion-related outcomes in CLTI and diabetic foot disease were included. Results: Most observational studies and meta-analyses suggest that direct angiosome-targeted revascularization may improve wound healing and limb salvage in selected patients. However, clinical outcomes are also influenced by collateral circulation, anatomical variability, infra-malleolar perfusion, pedal arch integrity, and microvascular function. The woundosome concept expands the traditional angiosome model by emphasizing effective perfusion of the wound bed through direct arterial inflow, collateral pathways, and functional perfusion assessment. Conclusions: Combining the angiosome and woundosome concepts may provide a more practical and individualized approach to revascularization planning in CLTI by integrating anatomical vascular mapping with functional wound perfusion assessment.