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Bernardelli de Mattos I, Tuca AC, Kukla F, Lemarchand T, Markovic D, Kamolz LP, Funk M. A Highly Standardized Pre-Clinical Porcine Wound Healing Model Powered by Semi-Automated Histological Analysis. Biomedicines 2024; 12:1697. [PMID: 39200162 PMCID: PMC11351733 DOI: 10.3390/biomedicines12081697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/10/2024] [Accepted: 07/25/2024] [Indexed: 09/02/2024] Open
Abstract
The wound-healing process is a physiological response that begins after a disruption to the integrity of tissues present in the skin. To understand the intricacies involved in this process, many groups have tried to develop different in vitro models; however, the lack of a systemic response has, until this day, been the major barrier to the establishment of these models as the main study platform. Therefore, in vivo models are still the most common system for studying healing responses following different treatments, especially porcine models, which share several morphological similarities to the human skin. In this work, we developed a porcine excisional wound model and used semi-automated software as a strategy to generate quantitative morphometric results of healing responses by specific tissues and compartments. Our aim was to extract the most information from the model while producing reliable, reproducible, and standardized results. In order to achieve this, we established a 7-day treatment using a bacterial cellulose dressing as our standard for all the analyzed wounds. The thickness of the residual dermis under the wound (DUtW) bed was shown to influence the healing outcome, especially for the regeneration of epidermal tissue, including the wound closure rate. The analysis of the DUtW throughout the entire dorsal region of the animals opened up the possibility of establishing a map that will facilitate the experimental design of future works, increasing their standardization and reproducibility and ultimately reducing the number of animals needed. Thus, the developed model, together with the automated morphometric analysis approach used, offers the possibility to generate robust quantitative results with a rapid turnaround time while allowing the study of multiple extra morphometric parameters, creating a more holistic analysis.
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Affiliation(s)
- Ives Bernardelli de Mattos
- Department of Tissue Engineering & Regenerative Medicine (TERM), University Hospital Würzburg, 97080 Würzburg, Germany;
- EVOMEDIS GmbH, 8036 Graz, Austria;
| | - Alexandru C. Tuca
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria;
| | - Fabian Kukla
- TPL Path Labs GmbH, A Stagebio Company, 79111 Freiburg, Germany; (F.K.); (T.L.)
| | - Thomas Lemarchand
- TPL Path Labs GmbH, A Stagebio Company, 79111 Freiburg, Germany; (F.K.); (T.L.)
| | - Danijel Markovic
- Department of Biomedical Research, Medical University of Graz, 8036 Graz, Austria;
| | - Lars P. Kamolz
- Department of Surgery, Division of Plastic, Aesthetic and Reconstructive Surgery, Medical University of Graz, 8036 Graz, Austria;
- Joanneum Research Forschungsgesellschaft mbH, COREMED, 8036 Graz, Austria
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Tuca AC, Bernardelli de Mattos I, Funk M, Markovic D, Winter R, Lemarchand T, Kniepeiss D, Spendel S, Hartmann B, Ottoman C, Kamolz LP. A Standardized Porcine Model for Partial-Thickness Wound Healing Studies: Design, Characterization, Model Validation, and Histological Insights. Int J Mol Sci 2024; 25:7658. [PMID: 39062901 PMCID: PMC11276889 DOI: 10.3390/ijms25147658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Wound healing is a complex process that is still not fully understood despite extensive research. To address this, we aimed to design and characterize a standardized porcine model for the evaluation of wound healing, dressings, cell therapies, and pharmaceutical agents. Using a standardized approach, we examined the wound healing process in 1.2 mm-deep dermatome wounds at defined positions in 11 female pigs. Unlike previous studies that have only described/analyzed selected punch biopsies, we performed and described histological analyses along the complete wound length using quantitative morphometric methods. All animals remained fully healthy following surgery and showed no signs of infection. Our histopathological evaluation using a predetermined grading score and quantitative manual morphometry demonstrated the impact of different tissue sampling methods, sampling sites, and residual dermis thickness on wound healing. Our study presents a reproducible model for wound healing evaluation and demonstrates the usefulness of porcine models for assessing dermal and epidermal wound healing. The use of histological analyses over the complete wound length provides advantages over previous studies, leading to the possibility of a deeper understanding of the wound healing process. This model could potentially facilitate future research on novel wound dressings and local wound healing therapies.
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Affiliation(s)
- Alexandru-Cristian Tuca
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (A.-C.T.); (R.W.); (S.S.); (L.-P.K.)
| | - Ives Bernardelli de Mattos
- Department of Tissue Engineering & Regenerative Medicine (TERM), University Hospital Würzburg, 97070 Würzburg, Germany
- EVOMEDIS GmbH, 8036 Graz, Austria;
| | | | - Danijel Markovic
- Core Facility Experimental Biomodels, Medical University of Graz, 8010 Graz, Austria;
| | - Raimund Winter
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (A.-C.T.); (R.W.); (S.S.); (L.-P.K.)
| | | | - Daniela Kniepeiss
- Division of General, Visceral, and Transplant Surgery, Department of Surgery, Medical University of Graz, 8010 Graz, Austria;
| | - Stephan Spendel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (A.-C.T.); (R.W.); (S.S.); (L.-P.K.)
| | - Bernd Hartmann
- BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany; (B.H.); (C.O.)
| | - Christian Ottoman
- BG Klinikum Unfallkrankenhaus Berlin, 12683 Berlin, Germany; (B.H.); (C.O.)
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (A.-C.T.); (R.W.); (S.S.); (L.-P.K.)
- Joanneum Research Forschungsgesellschaft mbH, COREMED, 8010 Graz, Austria
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Hosseini M, Shafiee A. Engineering Bioactive Scaffolds for Skin Regeneration. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2101384. [PMID: 34313003 DOI: 10.1002/smll.202101384] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/24/2021] [Indexed: 06/13/2023]
Abstract
Large skin wounds pose a major clinical challenge. Scarcity of donor site and postsurgical scarring contribute to the incomplete or partial loss of function and aesthetic concerns in skin wound patients. Currently, a wide variety of skin grafts are being applied in clinical settings. Scaffolds are used to overcome the issues related to the misaligned architecture of the repaired skin tissues. The current review summarizes the contribution of biomaterials to wound healing and skin regeneration and addresses the existing limitations in skin grafting. Then, the clinically approved biologic and synthetic skin substitutes are extensively reviewed. Next, the techniques for modification of skin grafts aiming for enhanced tissue regeneration are outlined, and a summary of different growth factor delivery systems using biomaterials is presented. Considering the significant progress in biomaterial science and manufacturing technologies, the idea of biomaterial-based skin grafts with the ability for scarless wound healing and reconstructing full skin organ is more achievable than ever.
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Affiliation(s)
- Motaharesadat Hosseini
- Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Kelvin Grove, Brisbane, QLD, 4059, Australia
| | - Abbas Shafiee
- Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, 4029, Australia
- Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, QLD, 4029, Australia
- UQ Diamantina Institute, Translational Research Institute, The University of Queensland, Brisbane, QLD, 4102, Australia
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Longobardi P, Hartwig V, Santarella L, Hoxha K, Campos J, Laurino M, Salvo P, Trivella MG, Coceani F, Rocco M, L'Abbate A. Potential markers of healing from near infrared spectroscopy imaging of venous leg ulcer. A randomized controlled clinical trial comparing conventional with hyperbaric oxygen treatment. Wound Repair Regen 2020; 28:856-866. [DOI: 10.1111/wrr.12853] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/19/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Flavio Coceani
- Istituto Scienze della Vita, Scuola Superiore Sant'Anna Pisa Italy
| | - Monica Rocco
- Dipartimento di Scienze Medico‐Chirurgiche e di Medicina Traslazionale Università degli Studi di Roma “La Sapienza” Roma Italy
| | - Antonio L'Abbate
- Istituto di Fisiologia Clinica‐CNR Pisa Italy
- Istituto Scienze della Vita, Scuola Superiore Sant'Anna Pisa Italy
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Lagus H, Klaas M, Juteau S, Elomaa O, Kere J, Vuola J, Jaks V, Kankuri E. Discovery of increased epidermal DNAH10 expression after regeneration of dermis in a randomized with-in person trial - reflections on psoriatic inflammation. Sci Rep 2019; 9:19136. [PMID: 31836722 PMCID: PMC6910998 DOI: 10.1038/s41598-019-53874-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
Because molecular memories of past inflammatory events can persist in epidermal cells, we evaluated the long-term epidermal protein expression landscapes after dermal regeneration and in psoriatic inflammation. We first characterized the effects of two dermal regeneration strategies on transplants of indicator split-thickness skin grafts (STSGs) in ten adult patients with deep burns covering more than 20% of their body surface area. After fascial excision, three adjacent areas within the wound were randomized to receive a permanent dermal matrix, a temporary granulation-tissue-inducing dressing or no dermal component as control. Control areas were covered with STSG immediately, and treated areas after two-weeks of dermis formation. Epidermis-dermis-targeted proteomics of one-year-follow-up samples were performed for protein expression profiling. Epidermal expression of axonemal dynein heavy chain 10 (DNAH10) was increased 20-fold in samples having had regenerating dermis vs control. Given the dermal inflammatory component found in our dermal regeneration samples as well as in early psoriatic lesions, we hypothesized that DNAH10 protein expression also would be affected in psoriatic skin samples. We discovered increased DNAH10 expression in inflammatory lesions when compared to unaffected skin. Our results associate DNAH10 expression with cell proliferation and inflammation as well as with the epidermal memory resulting from the previous regenerative signals of dermis. This study (ISRCTN14499986) was funded by the Finnish Ministry of Defense and by government subsidies for medical research.
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Affiliation(s)
- Heli Lagus
- Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mariliis Klaas
- Department of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Susanna Juteau
- Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Helsinki, Finland
| | - Outi Elomaa
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum and Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland
| | - Juha Kere
- Department of Biosciences and Nutrition, Karolinska Institutet, Solna, Sweden
| | - Jyrki Vuola
- Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Viljar Jaks
- Department of Cell Biology, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Esko Kankuri
- Faculty of Medicine, Department of Pharmacology, University of Helsinki, Helsinki, Finland.
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Le Clerc J, Tricot-Doleux S, Pellen-Mussi P, Pérard M, Jeanne S, Pérez F. Expression of factors involved in dental pulp physiopathological processes by nemotic human pulpal fibroblasts. Int Endod J 2017; 51 Suppl 2:e94-e106. [DOI: 10.1111/iej.12762] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 03/06/2017] [Indexed: 12/16/2022]
Affiliation(s)
- J. Le Clerc
- Faculté d'Odontologie; Equipe Verres et Céramiques; UMR CNRS 6226; Institut des Sciences Chimiques de Rennes, Université de Rennes 1; Rennes France
- Service d'Odontologie Conservatrice et Endodontie; Centre Hospitalier Universitaire; Rennes France
| | - S. Tricot-Doleux
- Faculté d'Odontologie; Equipe Verres et Céramiques; UMR CNRS 6226; Institut des Sciences Chimiques de Rennes, Université de Rennes 1; Rennes France
| | - P. Pellen-Mussi
- Faculté d'Odontologie; Equipe Verres et Céramiques; UMR CNRS 6226; Institut des Sciences Chimiques de Rennes, Université de Rennes 1; Rennes France
| | - M. Pérard
- Faculté d'Odontologie; Equipe Verres et Céramiques; UMR CNRS 6226; Institut des Sciences Chimiques de Rennes, Université de Rennes 1; Rennes France
- Service d'Odontologie Conservatrice et Endodontie; Centre Hospitalier Universitaire; Rennes France
| | - S. Jeanne
- Faculté d'Odontologie; Equipe Verres et Céramiques; UMR CNRS 6226; Institut des Sciences Chimiques de Rennes, Université de Rennes 1; Rennes France
- Service de Parodontologie; Centre Hospitalier Universitaire; Rennes France
| | - F. Pérez
- Service d'Odontologie Conservatrice et Endodontie; Centre Hospitalier Universitaire; Nantes France
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Been RA, Bernatchez SF, Conrad-Vlasak DM, Asmus RA, Ekholm BP, Parks PJ. In vivo methods to evaluate a new skin protectant for loss of skin integrity. Wound Repair Regen 2016; 24:851-859. [PMID: 27312780 DOI: 10.1111/wrr.12455] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/12/2016] [Indexed: 11/28/2022]
Abstract
A new skin protectant was developed for use on conditions involving partial-thickness skin loss such as severe incontinence-associated dermatitis. This new formulation is based on a cyanoacrylate chemistry designed to polymerize in situ and create a breathable film able to protect the skin surface from external irritants. This film provides an environment favorable for healing to occur beneath the film. To evaluate the characteristics of the novel chemistry, we devised a preclinical testing strategy comprising three different animal models. The data from all three models was considered collectively to create an overall assessment of effectiveness. A guinea pig model was used to evaluate the barrier efficacy of the new product in protecting intact skin from irritation. A porcine partial-thickness wound model was used to evaluate the efficacy of the product in helping control minor bleeding and exudate. A similar model was also used to assess the process of reepithelialization in the continued presence of an irritant. In the first model, untreated sites had 8.5 times more irritation than sites covered with the new product (p < 0.001). In the second model, a single application of the new product successfully attached to intact peri-wound skin and to denuded, weepy skin. It significantly reduced the amount of fluid weeping from the wounds (p ≤ 0.001) and continued to perform throughout a 96 hours experiment. In the third model, the percent of reepithelialization was significantly greater for the wounds covered with the new product than for the control wounds (p = 0.003; on average, 18.3% greater, with a 95% confidence interval of 9.2% to 27.5%). These results suggest that the new skin protectant protects intact and denuded skin from irritants and provides an environment favorable to healing, offering promise for the management of various conditions involving loss of epidermis.
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Affiliation(s)
- Raha A Been
- 3M Critical & Chronic Care Solutions Division, St. Paul, Minnesota
| | | | | | - Robert A Asmus
- 3M Critical & Chronic Care Solutions Division, St. Paul, Minnesota
| | - Bruce P Ekholm
- 3M Critical & Chronic Care Solutions Division, St. Paul, Minnesota
| | - Patrick J Parks
- 3M Critical & Chronic Care Solutions Division, St. Paul, Minnesota
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Negative pressure wound therapy induces early wound healing by increased and accelerated expression of vascular endothelial growth factor receptors. EUROPEAN JOURNAL OF PLASTIC SURGERY 2016; 39:247-256. [PMID: 27512293 PMCID: PMC4960285 DOI: 10.1007/s00238-016-1200-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 05/02/2016] [Indexed: 01/01/2023]
Abstract
Background Negative pressure wound therapy (NPWT) is commonly used to accelerate wound healing, especially following thoracic surgery; however, the mechanism remains elusive. Given the important role of vasculogenesis in wound healing, we evaluated whether NPWT might accelerate vasculogenesis in the wound area. Toward this end, we investigated the temporal expression of vascular endothelial growth factor receptors (VEGFRs) in an NPWT-wound healing rabbit model. Methods Rabbits were divided into an NPWT group and a non-NPWT control group, and tissue samples were collected around wounds made in the skin of each rabbit at five time points: 0, 7, 14, 21, and 28 days after wound creation. Cryopreserved samples were then immunostained and subject to image analysis to evaluate the temporal changes in VEGFR1, VEGFR2, and VEGFR3 expression in the wound-healing process. Results Results of histological analysis of the temporal changes in VEGFR expression throughout the healing process showed that compared to the control group, VEGFR2 and VEGFR3 were abundantly and rapidly expressed in the NPWT group, and were expressed earlier than VEGFR1. Conclusions NPWT promotes the expression of VEGFR2 and VEGFR3, which provides insight into the mechanism by which NPWT accelerates wound healing. Level of Evidence: Not ratable.
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Boekema B, Boekestijn B, Breederveld R. Evaluation of saline, RPMI and DMEM/F12 for storage of split-thickness skin grafts. Burns 2015; 41:848-52. [DOI: 10.1016/j.burns.2014.10.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 09/08/2014] [Accepted: 10/20/2014] [Indexed: 10/24/2022]
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Balaji S, King A, Marsh E, LeSaint M, Bhattacharya SS, Han N, Dhamija Y, Ranjan R, Le LD, Bollyky PL, Crombleholme TM, Keswani SG. The role of interleukin-10 and hyaluronan in murine fetal fibroblast function in vitro: implications for recapitulating fetal regenerative wound healing. PLoS One 2015; 10:e0124302. [PMID: 25951109 PMCID: PMC4423847 DOI: 10.1371/journal.pone.0124302] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 03/12/2015] [Indexed: 12/14/2022] Open
Abstract
Background Mid-gestation fetal cutaneous wounds heal scarlessly and this has been attributed in part to abundant hyaluronan (HA) in the extracellular matrix (ECM) and a unique fibroblast phenotype. We recently reported a novel role for interleukin 10 (IL-10) as a regulator of HA synthesis in the fetal ECM, as well as the ability of the fetal fibroblast to produce an HA-rich pericellular matrix (PCM). We hypothesized that IL-10-mediated HA synthesis was essential to the fetal fibroblast functional phenotype and, moreover, that this phenotype could be recapitulated in adult fibroblasts via supplementation with IL-10 via an HA dependent process. Methodology/Principal Findings To evaluate the differences in functional profile, we compared metabolism (MTS assay), apoptosis (caspase-3 staining), migration (scratch wound assay) and invasion (transwell assay) between C57Bl/6J murine fetal (E14.5) and adult (8 weeks) fibroblasts. We found that fetal fibroblasts have lower rates of metabolism and apoptosis, and an increased ability to migrate and invade compared to adult fibroblasts, and that these effects were dependent on IL-10 and HA synthase activity. Further, addition of IL-10 to adult fibroblasts resulted in increased fibroblast migration and invasion and recapitulated the fetal phenotype in an HA-dependent manner. Conclusions/Significance Our data demonstrates the functional differences between fetal and adult fibroblasts, and that IL-10 mediated HA synthesis is essential for the fetal fibroblasts' enhanced invasion and migration properties. Moreover, IL-10 via an HA-dependent mechanism can recapitulate this aspect of the fetal phenotype in adult fibroblasts, suggesting a novel mechanism of IL-10 in regenerative wound healing.
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Affiliation(s)
- Swathi Balaji
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Alice King
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Emily Marsh
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Maria LeSaint
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Sukanta S. Bhattacharya
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Nathaniel Han
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Yashu Dhamija
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Rajeev Ranjan
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Louis D. Le
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
| | - Paul L. Bollyky
- Division of Infectious Diseases, Department of Medicine, Stanford University School of Medicine, Palo Alto, California, United States of America
| | - Timothy M. Crombleholme
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Center for Children's Surgery, Children’s Hospital Colorado and The University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Sundeep G. Keswani
- Laboratory for Regenerative Wound Healing, Division of Pediatric, General, Thoracic and Fetal Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America
- Division of Pediatric General and Thoracic Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States of America
- * E-mail:
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Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2014; 1:e84. [PMID: 25289278 PMCID: PMC4174104 DOI: 10.1097/gox.0000000000000031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 11/07/2013] [Indexed: 11/27/2022]
Abstract
Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority.
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Nuutila K, Peura M, Suomela S, Hukkanen M, Siltanen A, Harjula A, Vuola J, Kankuri E. Recombinant human collagen III gel for transplantation of autologous skin cells in porcine full-thickness wounds. J Tissue Eng Regen Med 2013; 9:1386-93. [PMID: 23362205 DOI: 10.1002/term.1691] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 10/17/2012] [Accepted: 12/20/2012] [Indexed: 01/12/2023]
Abstract
Complex skin wounds, such as chronic ulcers and deep burns, require lengthy treatments and cause extensive burdens on healthcare and the economy. Use of biomaterials and cell transplantation may improve traditional treatments and promote the healing of difficult-to-treat wounds. In this study, we investigated the use of recombinant human collagen III (rhCol-III) gel as a delivery vehicle for cultured autologous skin cells (keratinocytes only or keratinocyte-fibroblast mixtures). We examined its effect on the healing of full-thickness wounds in a porcine wound-healing model. Two Landrace pigs were used for the study. Fourteen deep dermal wounds were created on the back of each pig with an 8 mm biopsy punch. Syringes containing acellular rhCol-III gel (n = 8) or rhCol-III gel with autologous keratinocytes (n = 8) or rhCol-III gel with autologous keratinocytes and fibroblasts (n = 8) were applied into wounds. Untreated wounds were used as controls for the treatment groups (n = 4). We used rhCol-III gel to manufacture a cell-delivery syringe containing autologous skin cells. In a full-thickness wound-healing model, we observed that rhCol-III gel enhances early granulation tissue formation. Interestingly, we found cell type-dependent differences in the stability of rhCol-III in vivo. Fibroblast-containing gel was effectively removed from the wound, whereas gels without cells or with keratinocytes only remained intact. Our results demonstrate that the properties of rhCol-III gel for skin cell transplantation can be significantly altered in a cell type-dependent manner.
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Affiliation(s)
- Kristo Nuutila
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,3rd Department of Surgery, Helsinki University Central Hospital, Finland
| | - Matti Peura
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,3rd Department of Surgery, Helsinki University Central Hospital, Finland
| | - Sari Suomela
- Department of Dermatology, Helsinki University Central Hospital, Finland
| | - Mika Hukkanen
- Institute of Biomedicine, Anatomy, University of Helsinki, Finland
| | - Antti Siltanen
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,3rd Department of Surgery, Helsinki University Central Hospital, Finland
| | - Ari Harjula
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,3rd Department of Surgery, Helsinki University Central Hospital, Finland
| | - Jyrki Vuola
- Helsinki Burn Centre, Department of Plastic Surgery, Helsinki University Central Hospital, Finland
| | - Esko Kankuri
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.,3rd Department of Surgery, Helsinki University Central Hospital, Finland
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