The efficacy of NPWT in promoting wound healing has been largely accepted by clinicians, yet the number of high-level clinical studies demonstrating its effectiveness is small and much more can be learned about the mechanisms of action. In the future, hopefully we will have the data to assist clinicians in selecting optimal parameters for specific wounds including interface material, waveform of suction application, and the amount of suction to be applied. Further investigation into specific interface coatings and instillation therapy are also needed. We believe that advances in mechanobiology, the science of wound healing, the understanding of biofilms, and advances in cell therapy will lead to better care for our patients.

Despite the wide applications, systematic mechanobiological investigation of 3D porous scaffolds has yet to be performed due to the lack of methodologies for decoupling the complex interplay between structural and mechanical properties. Here, we discover the regulatory effect of cryoprotectants on ice crystal growth and use this property to realize separate control of the scaffold pore size and stiffness. Fibroblasts and macrophages are sensitive to both structural and mechanical properties of the gelatin scaffolds, particularly to pore sizes. Interestingly, macrophages within smaller and softer pores exhibit pro-inflammatory phenotype, whereas anti-inflammatory phenotype is induced by larger and stiffer pores. The structure-regulated cellular mechano-responsiveness is attributed to the physical confinement caused by pores or osmotic pressure. Finally, in vivo stimulation of endogenous fibroblasts and macrophages by implanted scaffolds produce mechano-responses similar to the corresponding cells in vitro, indicating that the physical properties of scaffolds can be leveraged to modulate tissue regeneration.

Mechanotransduction is the process by which physical forces are converted into biochemical signals that are then integrated into cellular responses. It plays a crucial role in bone repair and regeneration and thus has attracted a great deal of interest from researchers in various fields. This report reviews the current clinical evidence that shows the role mechanotransduction plays in bone processes such as physical adaptation, pathological fracture healing, and therapeutic distraction osteogenesis. We also outline the progress that has been made in understanding bone mechanotransduction from both the macro‐ and microperspectives. Specifically, we describe the theories that postulate how mechanical force exhibits effects on bone repair and regeneration ( i.e ., the tensegrity and mechanosome theories). We also summarize the recent advances in our understanding of the molecular signaling pathways of mechanotransduction' which include calcium ion channels, integrins, Wnt/β‐catenin, prostaglandin, and nitric oxide. A better understanding of skeletal mechanotransduction will facilitate research into this promising field and could lead to the development of applications that improve bone structures and functions.—Huang, C., Ogawa, R. Mechanotransduction in bone repair and regeneration. FASEB J. 24, 3625–3632 (2010). www.fasebj.org