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Krymchenko R, Coşar Kutluoğlu G, van Hout N, Manikowski D, Doberenz C, van Kuppevelt TH, Daamen WF. Elastogenesis in Focus: Navigating Elastic Fibers Synthesis for Advanced Dermal Biomaterial Formulation. Adv Healthc Mater 2024:e2400484. [PMID: 38989717 DOI: 10.1002/adhm.202400484] [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: 02/07/2024] [Revised: 05/31/2024] [Indexed: 07/12/2024]
Abstract
Elastin, a fibrous extracellular matrix (ECM) protein, is the main component of elastic fibers that are involved in tissues' elasticity and resilience, enabling them to undergo reversible extensibility and to endure repetitive mechanical stress. After wounding, it is challenging to regenerate elastic fibers and biomaterials developed thus far have struggled to induce its biosynthesis. This review provides a comprehensive summary of elastic fibers synthesis at the cellular level and its implications for biomaterial formulation, with a particular focus on dermal substitutes. The review delves into the intricate process of elastogenesis by cells and investigates potential triggers for elastogenesis encompassing elastin-related compounds, ECM components, and other molecules for their potential role in inducing elastin formation. Understanding of the elastogenic processes is essential for developing biomaterials that trigger not only the synthesis of the elastin protein, but also the formation of a functional and branched elastic fiber network.
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Affiliation(s)
- Roman Krymchenko
- Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud university medical center, PO Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Gizem Coşar Kutluoğlu
- Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud university medical center, PO Box 9101, Nijmegen, 6500 HB, The Netherlands
- MedSkin Solutions Dr. Suwelack AG, 48727, Billerbeck, Germany
| | - Noor van Hout
- Department of Dermatology, Radboud university medical center, Nijmegen, 6525 GA, The Netherlands
| | | | | | - Toin H van Kuppevelt
- Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud university medical center, PO Box 9101, Nijmegen, 6500 HB, The Netherlands
| | - Willeke F Daamen
- Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud university medical center, PO Box 9101, Nijmegen, 6500 HB, The Netherlands
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2
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Tedeschi A, Salutini E, Cosentino C, Poggi CD, Becherini R, Fusilli D, Anichini R. The Use of Dermal Substitute in the Treatment of Burns as a Complication of Type 2 Diabetes Mellitus and Diabetic Foot Syndrome. INT J LOW EXTR WOUND 2024:15347346241262061. [PMID: 38887078 DOI: 10.1177/15347346241262061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Diabetic Foot Syndrome is a complex and challenging clinical condition associated with high risk of mortality and lower limb amputation. The distal lesions represent the epiphenomenon of this syndrome and request a multidisciplinary care and an appropriate therapeutic path to ensure their healing. This case report describes the management of burns in a patient with type 2 diabetes mellitus, end stage renal disease and Diabetic Foot Syndrome. The lesions were treated with autologous epidermal skin graft until healing. Products that stimulate or replace extracellular matrix, which has a central role in wound healing, can be consider in the treatment of burns and offer a simpler and less disabling reconstructive possibility for the patient.
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Affiliation(s)
- Anna Tedeschi
- Diabetic Unit and Diabetic Foot Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
| | - Elisabetta Salutini
- Diabetic Unit and Diabetic Foot Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
| | - Claudia Cosentino
- Diabetic Unit and Diabetic Foot Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
| | - Chiara Delli Poggi
- Diabetic Unit and Diabetic Foot Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
| | | | - Daniela Fusilli
- Orthopedic Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
| | - Roberto Anichini
- Diabetic Unit and Diabetic Foot Unit, San Jacopo Hospital Pistoia, Pistoia, Italy
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3
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Eisler DW, Held PDM, Rahmanian-Schwarz PDA, Baur DJO, Daigeler PDA, Denzinger DM. The Goettingen minipig as an experimental model in wound-healing studies. JPRAS Open 2024; 40:336-345. [PMID: 38746039 PMCID: PMC11091460 DOI: 10.1016/j.jpra.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/30/2024] [Indexed: 05/16/2024] Open
Abstract
Background Deep dermal wounds in extensive burns and chronic wound-healing disorders represent a significant medical problem and require a high level of therapy to reduce the risk of infection and other long-term consequences, such as amputation. A better understanding of the wound-healing processes is essential, and animal models are indispensable to fundamental research. Objective This study aimed to provide a transparent protocol and prove the effectiveness of an in vivo porcine model using Goettingen minipigs for wound-healing studies. Material and methods Thirteen female Goettingen minipigs were kept in species-appropriate housing and were treated according to the German law for the protection of animals. The study was performed with permission from the local ethical review committee of animal welfare. The experimental procedure for studying dermal regeneration in 102 full-thickness wounds through clinical observation and histological analysis, focusing on neodermal formation, is described in detail. Results The Goettingen minipig model proved to be suitable in wound-healing studies. The dermal regeneration was evident and viewable without wound contamination or any rejection reaction. The histological evaluations were also reliable and clearly presented the optimized wound healing of deep dermal wounds using the different therapeutic approaches. Conclusion Given the great clinical need for alternative or complementary therapies, we considered the Goettingen minipig trial a reliable, ethically justifiable, effective, and reproducible in vivo model for wound-healing studies.
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Affiliation(s)
- Dr. Wiebke Eisler
- Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Prof. Dr. Manuel Held
- Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Prof. Dr. Afshin Rahmanian-Schwarz
- Department of Plastic, Hand, Reconstructive and Aesthetic Surgery, Hand surgery, Traunstein Hospital, Ludwig-Maximilians-Universität Munich, Germany
| | - Dr. Jan-Ole Baur
- Department of Dermatology, University hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuernberg, Germany
| | - Prof. Dr. Adrien Daigeler
- Department of Hand, Plastic, Reconstructive, and Burn Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen, Germany
| | - Dr. Markus Denzinger
- Department of Pediatric Surgery, Klinik St. Hedwig, University Medical Center Regensburg, Regensburg, Germany
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Minniti A, Caroprese M, Zarantonello M, De Santis D, Caliendo G, Gelpi F. High-Density Dermal Matrix for Soft Tissue Augmentation Using a Matrix Tissue Graph Technique-A Comprehensive Multicenter Analysis of 20 Implants: A 1-Year Follow-Up Retrospective Study. J Clin Med 2024; 13:2954. [PMID: 38792495 PMCID: PMC11122547 DOI: 10.3390/jcm13102954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/01/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
Background: In this multicenter case series analysis, the authors present successful instances of 20 single-screw-retained and implant-supported prosthetic rehabilitation samples. Methods: A high-density heterologous dermal matrix (Derma® Osteobiol by Tecnoss, Torino, Italy) was employed with a specific technique named the matrix tissue graft (MTG) in all these cases characterized by an inadequate initial supra-crestal tissue height (thin if 1 mm or medium if 2 mm) to enhance the peri-implant soft tissues both vertically and horizontally. Results: The implants were deemed successful in all cases, yielding a success proportion of 100% (one-sided 97.5% confidence interval = 83.2-100%). The buccal and lingual gains were, respectively, 2.2 ± 0.38 mm (range 1.7-3.22 mm) and 0.83 ± 0.33 mm (range 0.1-1.5 mm). These measurements were calculated as the maximum distance between two superimposed .stl file models (derived from two different IOS devices) scanned before implant placement and 1 year after dermal matrix healing. Conclusions: An outstanding vertical and horizontal gain was obtained using this heterologous derma matrix placed above the bone crest and surrounding the dental implants.
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Affiliation(s)
| | - Marino Caroprese
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Morris Zarantonello
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
| | - Daniele De Santis
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
| | - Gialfonso Caliendo
- Department of Diagnostics & Public Health, Specialization School in Health Statistics and Biometry, University of Verona, 37129 Verona, Italy;
| | - Federico Gelpi
- Head and Neck Department, Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, 37129 Verona, Italy; (M.Z.); (D.D.S.)
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Sharifi E, Yousefiasl S, Laderian N, Rabiee N, Makvandi P, Pourmotabed S, Ashrafizadeh M, Familsattarian F, Fang W. Cell-loaded genipin cross-linked collagen/gelatin skin substitute adorned with zinc-doped bioactive glass-ceramic for cutaneous wound regeneration. Int J Biol Macromol 2023; 251:125898. [PMID: 37479201 DOI: 10.1016/j.ijbiomac.2023.125898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
An optimal tissue-engineered dermal substitute should possess biocompatibility and cell adhesion conduction to facilitate fibroblast and keratinocyte infiltration and proliferation, as well as angiogenesis potential to escalate wound healing. Zinc was doped to bioactive glass-ceramic (Zn-BGC) to promote biocompatibility and angiogenesis properties. Zn-BGC was then incorporated into a collagen (Col) and gelatin (Gel) porous scaffold. The bioactive porous bionanocomposite exhibited biocompatibility along with improved cell attachment and proliferation. Scaffolds including Col-Gel/Zn-BGC with or without mouse embryonic fibroblasts were applied on full-thickness skin wounds on the BALB/c mice to assess their wound healing potential in vivo. The results indicated that the biodegradation rate of the Col-Gel/Zn-BGC nanocomposites was comparable to the rate of skin tissue regeneration in vivo. Macroscopic wound healing results showed that Col-Gel/Zn-BGC loaded with mouse embryonic fibroblast possesses the smallest wound size, indicating the fastest healing process. Histopathological evaluations displayed that the optimal wound regeneration was observed in Col-Gel/Zn-BGC nanocomposites loaded with mouse embryonic fibroblasts indicated by epithelialization and angiogenesis; besides the number of fibroblasts and hair follicles was increased. The bioactive nanocomposite scaffold of Col-Gel containing Zn-BGC nanoparticles loaded with mouse embryonic fibroblasts can be employed as a desirable skin substitute to ameliorate cutaneous wound regeneration.
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Affiliation(s)
- Esmaeel Sharifi
- Cellular and Molecular Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Science, 8815713471 Shahrekord, Iran; Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Satar Yousefiasl
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran.
| | - Nilofar Laderian
- School of Medicine, Shahrekord University of Medical Science, 8815713471 Shahrekord, Iran
| | - Navid Rabiee
- School of Engineering, Macquarie University, Sydney, New South Wales 2109, Australia
| | - Pooyan Makvandi
- School of Engineering, Institute for Bioengineering, The University of Edinburgh, Edinburgh EH9 3JL, UK
| | - Samiramis Pourmotabed
- Department of Emergency Medicine, School of Medicine, Hamadan University of Medical Sciences, 6517838736 Hamadan, Iran
| | - Milad Ashrafizadeh
- Department of General Surgery and Integrated Chinese and Western Medicine, Institute of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Carson International Cancer Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen, Guangdong 518060, China; Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Fatemeh Familsattarian
- Department of Materials Engineering, Bu-Ali Sina University, P.O.B: 65178-38695, Hamedan, Iran
| | - Wei Fang
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
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Dickson K, Lee KC, Abdulsalam A, Amirize E, Kankam HKN, ter Horst B, Gardiner F, Bamford A, Hejmadi RK, Moiemen N. A Histological and Clinical Study of MatriDerm® Use in Burn Reconstruction. J Burn Care Res 2023; 44:1100-1109. [PMID: 36945134 PMCID: PMC10483478 DOI: 10.1093/jbcr/irad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 03/23/2023]
Abstract
Dermal substitutes are well established in the reconstructive ladder. MatriDerm® (Dr. Otto Suwelack Skin & Health Care AG, Billerbeck, Germany) is a single-layer dermal substitute composed of a bovine collagen (type I, III, and V) and elastin hydrolysate, that allows for immediate split-thickness skin grafting (SSG). The aim of this study was to histologically characterize the integration of MatriDerm® when used during burns surgery reconstruction. Eight subjects with nine burn scars and one acute burn wound underwent reconstruction with MatriDerm® and an immediate SSG. MatriDerm® integration and skin graft take were assessed with serial biopsies performed at weeks 1, 2, 3, and 4 and months 2, 3, 6, 9, and 12. Biopsies were assessed with standard special stains and immunohistochemistry, and representative slides were imaged with a transmission electron microscope. Patient satisfaction and clinical scar outcome were assessed with the Vancouver Scar Scale and a patient questionnaire. Histological analysis showed similar stages of wound healing as shown in other dermal templates but on a different timescale. There is early evidence of vascularization and an inflammatory infiltrate in the first 2 weeks. MatriDerm® is resorbed earlier than other dermal substitutes, with evidence of resorption at week 3, to be completely replaced by a neodermis at 2 months. The use of MatriDerm® in reconstruction with immediate skin grafting is supported histologically with early evidence of vascularization to support an epidermal autograft. Future histological studies may help further characterize the ideal dermal substitute.
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Affiliation(s)
- Kathryn Dickson
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Kwang Chear Lee
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Institute of Inflammation and Aging, University of Birmingham, Birmingham B15 2TT, UK
| | - Abdulrazak Abdulsalam
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Ezekwe Amirize
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Hadyn K N Kankam
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Institute of Inflammation and Aging, University of Birmingham, Birmingham B15 2TT, UK
| | - Britt ter Horst
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Fay Gardiner
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Amy Bamford
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Rahul K Hejmadi
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Naiem Moiemen
- University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Scar Free Foundation Centre for Conflict Wound Research, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
- Institute of Inflammation and Aging, University of Birmingham, Birmingham B15 2TT, UK
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Salzano G, Maffìa F, Vaira LA, Committeri U, Copelli C, Maglitto F, Manfuso A, Abbate V, Bonavolontà P, Scarpa A, Califano L, Dell'Aversana Orabona G. Locoregional Flaps for the Reconstruction of Midface Skin Defects: A Collection of Key Surgical Techniques. J Clin Med 2023; 12:jcm12113700. [PMID: 37297895 DOI: 10.3390/jcm12113700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The reconstruction of midface skin defects represents a challenge for the head and neck surgeon due to the midface's significant role in defining important facial traits. Due to the high complexity of the midface region, there is no possibility to use one definitive flap for all purposes. For moderate defects, the most common reconstructive techniques are represented by regional flaps. These flaps can be defined as donor tissue with a pedunculated axial blood supply not necessarily adjacent to the defect. The aim of this study is to highlight the more common surgical techniques adopted for midface reconstruction, providing a focus on each technique with its description and indications. METHODS A literature review was conducted using PubMed, an international database. The target of the research was to collect at least 10 different surgical techniques. RESULTS Twelve different techniques were selected and cataloged. The flaps included were the bilobed flap, rhomboid flap, facial-artery-based flaps (nasolabial flap, island composite nasal flap, retroangular flap), cervicofacial flap, paramedian forehead flap, frontal hairline island flap, keystone flap, Karapandzic flap, Abbè flap, and Mustardè flap. CONCLUSIONS The study of the facial subunits, the location and size of the defect, the choice of the appropriate flap, and respect for the vascular pedicles are the key elements for optimal outcomes.
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Affiliation(s)
- Giovanni Salzano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Francesco Maffìa
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
| | - Umberto Committeri
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Chiara Copelli
- Maxillofacial Surgery Operative Unit, Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70120 Bari, Italy
| | - Fabio Maglitto
- Maxillofacial Surgery Operative Unit, Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70120 Bari, Italy
| | - Alfonso Manfuso
- Maxillofacial Surgery Operative Unit, Department of Interdisciplinary Medicine, Aldo Moro University of Bari, 70120 Bari, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, 84081 Salerno, Italy
| | - Luigi Califano
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy
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Wallner B, Öhlbauer M, von Rüden C. Long-term results of split-thickness skin grafting with and without additional dermal matrix in severe traumatic soft tissue defects of the lower limb. Eur J Trauma Emerg Surg 2023; 49:551-557. [PMID: 36094568 DOI: 10.1007/s00068-022-02107-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Aim of this study was to compare the use of split-thickness skin graft (STSG) with and without additional MatriDerm® application in a predominantly one-step procedure for the treatment of severe traumatic soft tissue defects of the lower limb. METHODS This retrospective study included patients treated in a European level I trauma center between June 2013 and July 2018 in terms of a severe traumatic soft tissue defect of the lower extremity using STSG alone or in combination with the acellular dermal substitute MatriDerm®. The healing of the soft tissue defect was measured by assessment of the take rate. Outcome quality of the scar tissue was assessed using the Vancouver Scar Scale. RESULTS A total of 147 cases were included in this study. The overall healing rate (number of patients with take rate ≥ 75%) was 88/147 (60%) and did not demonstrate significant differences between the treatment groups (p = 0.15). Despite the difference in wound complexity between the treatment groups, there was no difference regarding the scar tissue quality 12 months postoperatively. In about 25% of all cases, a post-operative event was mentioned that had to be revised surgically. CONCLUSION Surgical treatment with STSG and additional MatriDerm® application can be recommended as satisfactory alternative for dermis replacement in patients with severe skin defects, independent of age. The additional MatriDerm® use allows for bridging of exposed ligaments, tendons, vessels or bones without relevant differences in cosmetical outcome.
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Affiliation(s)
- Britta Wallner
- Department of Plastic, Aesthetic and Reconstructive Microsurgery, Center for Severe Burn Injuries, BG Unfallklinik Murnau, Murnau, Germany
| | - Markus Öhlbauer
- Department of Plastic, Aesthetic and Reconstructive Microsurgery, Center for Severe Burn Injuries, BG Unfallklinik Murnau, Murnau, Germany
| | - Christian von Rüden
- Department of Trauma Surgery, BG Unfallklinik Murnau, Professor Küntscher Str. 8, 82418, Murnau, Germany. .,Institute for Biomechanics, Paracelsus Medical University, Salzburg, Austria.
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Dell’Aversana Orabona G, Maffia F, Audino G, Abbate V, Germano C, Bonavolontà P, Romano A, Villari R, Mormile M, Califano L. The Use of Matriderm® for Scalp Full-Thickness Defects Reconstruction: A Case Series. J Clin Med 2022; 11:jcm11206041. [PMID: 36294362 PMCID: PMC9605533 DOI: 10.3390/jcm11206041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The scalp region represent a common area affected by benignant and malignant skin tumor, and it represents a surgical challenge when it is needed to be reconstructed. The aim of this study is to present our experience with full-thickness scalp skin defects, reconstructed using Matriderm® dermal substitute and split-thickness skin graft (STSG). Methods: A retrospective analysis of patients treated for scalp region reconstruction was conducted with 16 patients. All patients underwent the same procedure: scalp full-thickness tumor excision with simultaneous reconstruction with Matriderm® and the application of a split-thickness skin graft in the same surgical time. During follow-ups, the surgical outcome was evaluated by accurate clinical examination of the wound, adopting the Vancouver Scar Scale (VSS). Results: The outcomes obtained were satisfying: wound healing at the end of the procedures was optimal, grafted skin resulted similar to surrounding tissue, and pigmentation and vascularity showed a decrease in the period between 6 months and 1 follow-up. Conclusions: The use of Matriderm® and split-thickness skin grafting for scalp full-thickness defects reconstruction resulted in an optimal, stable, and safe procedure, suitable for elderly patients.
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Affiliation(s)
- Giovanni Dell’Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Francesco Maffia
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Giovanni Audino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
- Correspondence:
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Cristiana Germano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Paola Bonavolontà
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
| | - Riccardo Villari
- Infectious Diseases Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Mauro Mormile
- Pneumology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Via Pansini 5, 80100 Naples, Italy
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In Vivo Comparison of Synthetic Macroporous Filamentous and Sponge-like Skin Substitute Matrices Reveals Morphometric Features of the Foreign Body Reaction According to 3D Biomaterial Designs. Cells 2022; 11:cells11182834. [PMID: 36139409 PMCID: PMC9496825 DOI: 10.3390/cells11182834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Synthetic macroporous biomaterials are widely used in the field of skin tissue engineering to mimic membrane functions of the native dermis. Biomaterial designs can be subclassified with respect to their shape in fibrous designs, namely fibers, meshes or fleeces, respectively, and porous designs, such as sponges and foams. However, synthetic matrices often have limitations regarding unfavorable foreign body responses (FBRs). Severe FBRs can result in unfavorable disintegration and rejection of an implant, whereas mild FBRs can lead to an acceptable integration of a biomaterial. In this context, comparative in vivo studies of different three-dimensional (3D) matrix designs are rare. Especially, the differences regarding FBRs between synthetically derived filamentous fleeces and sponge-like constructs are unknown. In the present study, the FBRs on two 3D matrix designs were explored after 25 days of subcutaneous implantation in a porcine model. Cellular reactions were quantified histopathologically to investigate in which way the FBR is influenced by the biomaterial architecture. Our results show that FBR metrics (polymorph-nucleated cells and fibrotic reactions) were significantly affected according to the matrix designs. Our findings contribute to a better understanding of the 3D matrix tissue interactions and can be useful for future developments of synthetically derived skin substitute biomaterials.
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Assessment of Two Commonly used Dermal Regeneration Templates in a Swine Model without Skin Grafting. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12063205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the medical care of partial and full-thickness wounds, autologous skin grafting is still the gold standard of dermal replacement. In contrast to spontaneous reepithelializing of superficial wounds, deep dermal wounds often lead to disturbing scarring, with cosmetically or functionally unsatisfactory results. However, modern wound dressings offer promising approaches to surface reconstruction. Against the background of our future aim to develop an innovative skin substitute, we investigated the behavior of two established dermal substitutes, a crosslinked and a non-crosslinked collagen biomatrix. The products were applied topically on a total of 18 full-thickness skin defects paravertebrally on the back of female Göttingen Minipigs—six control wounds remained untreated. The evaluation was carried out planimetrically (wound closure time) and histologically (neoepidermal cell number and epidermis thickness). Both treatment groups demonstrated significantly faster reepithelialization than the controls. The histologic examination verified the highest epidermal thickness in the crosslinked biomatrix-treated wounds, whereas the non-crosslinked biomatrix-treated wounds showed a higher cell density. Our data presented a positive influence on epidermal regeneration with the chosen dermis substitutes even without additional skin transplantation and, thus, without additional donor site morbidity. Therefore, it can be stated that the single biomatrix application might be used in a clinical routine with small wounds, which needs to be investigated further in a clinical setting to determine the size and depths of a suitable wound bed. Nevertheless, currently available products cannot solely achieve wound healing that is equal to or superior to autologous tissue. Thus, the overarching aim still is the development of an innovative skin substitute to manage surface reconstruction without additional skin grafting.
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The Topical Effect of rhGDF-5 Embedded in a Collagen–Gelatin Scaffold for Accelerated Wound Healing. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The application of exogenous growth factors such as the recombinant human growth and differentiation factor 5 (rhGDF-5) represents a major research topic with great potential for the treatment of complex wounds. In a randomized, controlled minipig study, the topical effect of rhGDF-5 on full-thickness skin defects was evaluated. A total of 60 deep dermal wounds were either treated with rhGDF-5 embedded in an innovative collagen scaffold or another commonly used collagen matrix or left untreated. Wound healing was analyzed by planimetric analysis to determine wound closure over time. After 21 days, the areas of the initial wounds were excised, and the newly formed tissue was examined histologically. In comparison to untreated wounds, all examined matrices accelerated dermal wound healing. The largest acceleration of wound healing was seen with the high-dose rhGDF-5-treated wounds, which, compared to the untreated wounds, accelerated wound healing by 2.58 days, improved the neoepidermal thickness by 32.40 µm, and increased the epidermal cell density by 44.88 cells. The innovative collagen scaffold delivered rhGDF-5 adequately, served as a template to guide proliferating and restructuring cells, and accelerated wound healing. Thus, this composite product offers a novel tool for developing effective wound dressings in regenerative medicine.
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Fulchignoni C, Rocchi L, Cauteruccio M, Merendi G. Matriderm dermal substitute in the treatment of post traumatic hand's fingertip tissue loss. J Cosmet Dermatol 2021; 21:750-757. [PMID: 33786967 DOI: 10.1111/jocd.14115] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Treatment of fingers tissue loss is particularly challenging as it often necessitates advanced reconstructive techniques such as flaps or grafts, with esthetic and functional results that are not always as good as hoped for, with long healing times. Recently, along with tissue engineering development, numerous types of dermal substitute have been commercialized, with promising possibilities of treatment in finger tissue loss. In the author's unit, Matriderm® is the most commonly used dermal substitute. As described by the manufacturer, this scaffold is designed to be covered with a split-thickness skin graft. In using a two-step procedure, the authors realized that in most cases of fingertips injuries, at three weeks follow-up, the wound appeared in an advanced state of healing, which permitted to avoid grafting. MATERIAL AND METHODS Between October 2017 and October 2018, 27 fingers have been included in this study. Patients have been divided in two groups: those treated with Matriderm® alone (15 fingers) and those who had a skin graft three weeks after the first surgery (12 fingers). At the 6-month follow-up, authors evaluated the esthetic results with the Vancouver Scar Scale (VSS), the functional results with Quick Disability of the Arm, Shoulder and Hand (qDASH) score, and sensibility by the mean of two-point discrimination test (2-PD). RESULTS All outcomes were overlapping in patients treated with or without skin graft: mean VSS was 2.3, mean qDASH was 13.3, and mean 2-PD was 7.7 mm. CONCLUSIONS The results obtained allow to consider Matriderm® , used also without skin graft coverage, as a valid solution for treatment of fingertip tissue loss.
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Affiliation(s)
- Camillo Fulchignoni
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Lorenzo Rocchi
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Michele Cauteruccio
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Roma, Italia
| | - Gianfranco Merendi
- Orthopaedics & Hand Surgery Unit, Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Roma, Italia
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Araujo TAT, Almeida MC, Avanzi I, Parisi J, Simon Sales AF, Na Y, Renno A. Collagen membranes for skin wound repair: A systematic review. J Biomater Appl 2020; 36:95-112. [PMID: 33349104 DOI: 10.1177/0885328220980278] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Membranes or skin dressing are common treatments for skin wound injuries, collagen being one the most effective materials for their manufacturing. Many different sources of collagen with diverse methods of extraction and processing have been used, with evidence of positive effects on the stimulation of skin wound healing. In spite of these factors, there is still limited understanding of the interaction between collagen membranes and biological tissues, especially due to the series of different types of collagen origin. In this context, this study aimed to conduct a systematic review of the available literature examining the effect of various collagen membranes for accelerating skin wound healing in experimental animal models and clinical trials. The present review was performed from March to May of 2020 searching in two databases (PubMed and Scopus). The following Medical Subject Headings (MeSH) descriptors were used: "collagen", "dressing", "membranes", "skin" and "wound". After the eligibility assessment, 16 studies were included and analyzed. The studies demonstrated that collagen was obtained predominantly from bovine and porcine sources, by acetic acid and/or enzyme dissolution. Additionally, most of the studies demonstrated that the membranes were processed mainly by freeze-drying or lyophilization methods. All the in vivo and clinical trial studies evidenced positive outcomes in the wound healing process, thus confirming that collagen membranes are one of the most efficient treatment for skin wounds, highlighting the enormous potential of this biomaterial to be used for skin tissue engineering purposes.
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Affiliation(s)
| | - Matheus Cruz Almeida
- Department of Biosciences, Universidade Federal de Sao Paulo (UNIFESP), Santos, Brazil
| | - Ingrid Avanzi
- Department of Biosciences, Universidade Federal de Sao Paulo (UNIFESP), Santos, Brazil.,Sao Paulo State Faculty of Technology (FATEC), Santos, Brazil
| | - Julia Parisi
- Department of Biosciences, Universidade Federal de Sao Paulo (UNIFESP), Santos, Brazil
| | | | - Yu Na
- National Dental Centre, Singapore, Singapore
| | - Ana Renno
- Department of Biosciences, Universidade Federal de Sao Paulo (UNIFESP), Santos, Brazil
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15
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Evaluation of a cross-linked versus non-cross-linked collagen matrix in full-thickness skin defects. Burns 2020; 47:150-156. [PMID: 33279341 DOI: 10.1016/j.burns.2020.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 01/06/2020] [Accepted: 03/27/2020] [Indexed: 11/22/2022]
Abstract
Autologous skin transplantation is the gold standard for treatment of full-thickness skin defects such as deep burn injuries, but has the disadvantages of limited donor sites and donor site morbidities. Alternative skin replacement products, such as xenografts and allografts, are not a permanent solution. Numerous manufactured skin substitutes already show promising approaches, but have limited efficacy. Therefore, wound dressings adaptable to the physiology of wound healing are still needed. In a randomized controlled in vivo study, a newly designed biocompatible collagen nonwoven matrix was compared to the Integra® bilayer dermal substitute and untreated controls in 48 full-thickness skin defects in a swine model. The take of all templates was complete, and all the tissue-engineered products accelerated dermal wound healing compared to the untreated controls, as identified by planimetric measurements. The higher collagen dose treatments and Integra®-covered wounds developed the thickest, cell-rich neoepidermal tissue in histological examination. The innovative biocompatible collagen matrix is flexibly applicable and modifiable, and offers potential as a carrier membrane for therapeutic supplemental products such as growth factors to further develop effective wound dressings.
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16
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Chen Q, Deng X, Qiang L, Yao M, Guan L, Xie N, Zhao D, Ma J, Ma L, Wu Y, Yan X. Investigating the effects of walnut ointment on non-healing burn wounds. Burns 2020; 47:455-465. [PMID: 32736884 DOI: 10.1016/j.burns.2020.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/30/2022]
Abstract
Effective treatments for non-healing burn wounds are an unmet need for 95% of burn sufferers. Approaches currently available to treat non-healing burn wounds are not satisfactory due to undesirable side-effects or expense. The anti-oxidation and antibacterial activities of walnuts are recommended for treating chronic diseases. Walnut ointment has been developed and successfully applied to treat non-healing burn wounds in our hospital for decades. We report herein a detailed retrospective case review examining patients' response to the walnut ointment. The walnut ointment has shortened healing time of non-healing burn wounds and improved clinical outcomes. In order to investigate the mechanism of action, walnut ointment has been applied on wounds of porcine full-thickness burn wound models. Histological and immunohistochemical analysis indicated our walnut ointment supports wound healing through promoting keratinocyte proliferation and differentiation. Taken together, we recommend the walnut ointment offers an effective and economical treatment for patients presenting with non-healing burn wounds.
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Affiliation(s)
- Qian Chen
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, Xinyang Central Hospital, Henan, China
| | - Xingwang Deng
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, The First People's Hospital of Shizuishan, Ningxia, China
| | - Lijuan Qiang
- School of Clinical Medicine, Ningxia Medical University, Ningxia, China; Department of Burns and Plastic Surgery, People's Hospital of Ningxia Hui Autonomous Region, Ningxia, China
| | - Ming Yao
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Lifeng Guan
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Nan Xie
- Clinical Medicine Research Center, National Health Commission, Beijing National Health Hospital, Beijing, China
| | - Dan Zhao
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China
| | - Jiaxiang Ma
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China
| | - Liqiong Ma
- Department of Pathology, General Hospital of Ningxia Medical University, Ningxia, China
| | - Yinsheng Wu
- Department of Burns and Plastic Surgery, General Hospital of Ningxia Medical University, Ningxia, China
| | - Xie Yan
- Tissue Organ Bank & Tissue Engineering Centre, General Hospital of Ningxia Medical University, Ningxia, China; School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
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Effects of Fibroblast Growth Factor 2 on Burn Injury and Repair Process: Analysis Using a Refined Mouse Model. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2757. [PMID: 32440425 PMCID: PMC7209900 DOI: 10.1097/gox.0000000000002757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/11/2020] [Indexed: 11/26/2022]
Abstract
Background Burn injury is one of the most debilitating traumas, which induces multiple organ dysfunctions, resulting in high levels of morbidity and mortality. Fibroblast growth factor 2 (FGF2) has been applied to burn injury, whose precise mechanisms underlying facilitating the healing have not been fully understood. Although various animal models have been developed in pigs, rabbits, rats, and mice, no mouse model that creates burns consistent in their extent and depth have not been developed. Here, we developed a mouse burn model, and investigated details of the burn process, and elucidated the mechanisms of FGF2 effects. Methods A device with an 8-mm metal probe and a temperature controller was developed, which controls the temperature of the probe. Using the device, 1 or 2 of full-thickness burn injuries were generated on the back under catagen/telogen of 6-month-old C57BL/6 male mice. After 24 hours, FGF2 or phosphate-buffered saline was injected into the injured region, and at days 3, 5, and 7, histological and immunohistochemical analysis was performed to observe the injury and repair process. Results The device constantly generated a mouse full-thickness burn injury. The repair was initiated on the bottom of the burn as well as the margin. Local treatment with FGF2 displayed higher levels of immunostaining for both CD31+ and alpha-smooth muscle actin. Conclusions The device we developed is useful to generate a mouse burn injury model. FGF2 facilitates tissue repair with an increased number of both CD31+ and αSMA+ cells.
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18
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Wen Q, Mithieux SM, Weiss AS. Elastin Biomaterials in Dermal Repair. Trends Biotechnol 2020; 38:280-291. [DOI: 10.1016/j.tibtech.2019.08.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/28/2019] [Accepted: 08/27/2019] [Indexed: 02/05/2023]
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19
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Gaspar-Pintiliescu A, Stanciuc AM, Craciunescu O. Natural composite dressings based on collagen, gelatin and plant bioactive compounds for wound healing: A review. Int J Biol Macromol 2019; 138:854-865. [PMID: 31351963 DOI: 10.1016/j.ijbiomac.2019.07.155] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 12/15/2022]
Abstract
Skin wound dressings are commonly used to stimulate and enhance skin tissue repair. Even if wounds seem easy to repair for clinicians and to replicate in an in vitro set-up for scientists, chronic wounds remain currently an open challenge in skin tissue engineering for patients with complementary diseases. The seemingly simple process of skin healing hides a heterogenous sequence of events, specific timing, and high level of organization and coordination among the involved cell types. Taken together, all these aspects make wound healing a unique process, but we are not yet able to completely repair the chronic wounds or to reproduce them in vitro with high fidelity. This review highlights the main characteristics and properties of a natural polymer, which is widely used as biomaterial, namely collagen and of its denatured form, gelatin. Available wound dressings based on collagen/gelatin and proposed variants loaded with bioactive compounds derived from plants are presented. Applications of these composite biomaterials are discussed with emphasis on skin wound healing. A perspective on current issues is given in the light of future research. The emerging technologies support the development of innovative dressings based exclusively on natural constituents, either polymeric or bioactive compounds.
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Affiliation(s)
| | | | - Oana Craciunescu
- National Institute of R&D for Biological Sciences, Bucharest, Romania
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20
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Mofazzal Jahromi MA, Sahandi Zangabad P, Moosavi Basri SM, Sahandi Zangabad K, Ghamarypour A, Aref AR, Karimi M, Hamblin MR. Nanomedicine and advanced technologies for burns: Preventing infection and facilitating wound healing. Adv Drug Deliv Rev 2018; 123:33-64. [PMID: 28782570 PMCID: PMC5742034 DOI: 10.1016/j.addr.2017.08.001] [Citation(s) in RCA: 250] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 07/20/2017] [Accepted: 08/01/2017] [Indexed: 12/11/2022]
Abstract
According to the latest report from the World Health Organization, an estimated 265,000 deaths still occur every year as a direct result of burn injuries. A widespread range of these deaths induced by burn wound happens in low- and middle-income countries, where survivors face a lifetime of morbidity. Most of the deaths occur due to infections when a high percentage of the external regions of the body area is affected. Microbial nutrient availability, skin barrier disruption, and vascular supply destruction in burn injuries as well as systemic immunosuppression are important parameters that cause burns to be susceptible to infections. Topical antimicrobials and dressings are generally employed to inhibit burn infections followed by a burn wound therapy, because systemic antibiotics have problems in reaching the infected site, coupled with increasing microbial drug resistance. Nanotechnology has provided a range of molecular designed nanostructures (NS) that can be used in both therapeutic and diagnostic applications in burns. These NSs can be divided into organic and non-organic (such as polymeric nanoparticles (NPs) and silver NPs, respectively), and many have been designed to display multifunctional activity. The present review covers the physiology of skin, burn classification, burn wound pathogenesis, animal models of burn wound infection, and various topical therapeutic approaches designed to combat infection and stimulate healing. These include biological based approaches (e.g. immune-based antimicrobial molecules, therapeutic microorganisms, antimicrobial agents, etc.), antimicrobial photo- and ultrasound-therapy, as well as nanotechnology-based wound healing approaches as a revolutionizing area. Thus, we focus on organic and non-organic NSs designed to deliver growth factors to burned skin, and scaffolds, dressings, etc. for exogenous stem cells to aid skin regeneration. Eventually, recent breakthroughs and technologies with substantial potentials in tissue regeneration and skin wound therapy (that are as the basis of burn wound therapies) are briefly taken into consideration including 3D-printing, cell-imprinted substrates, nano-architectured surfaces, and novel gene-editing tools such as CRISPR-Cas.
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Affiliation(s)
- Mirza Ali Mofazzal Jahromi
- Department of Advanced Medical Sciences & Technologies, School of Medicine, Jahrom University of Medical Sciences (JUMS), Jahrom, Iran; Research Center for Noncommunicable Diseases, School of Medicine, Jahrom University of Medical Sciences (JUMS), Jahrom, Iran
| | - Parham Sahandi Zangabad
- Research Center for Pharmaceutical Nanotechnology (RCPN), Tabriz University of Medical Science (TUOMS), Tabriz, Iran; Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Moosavi Basri
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Bioenvironmental Research Center, Sharif University of Technology, Tehran, Iran; Civil & Environmental Engineering Department, Shahid Beheshti University, Tehran, Iran
| | - Keyvan Sahandi Zangabad
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Polymer Engineering, Sahand University of Technology, PO Box 51335-1996, Tabriz, Iran; Nanomedicine Research Association (NRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ameneh Ghamarypour
- Bio-Nano-Interfaces: Convergence of Sciences (BNICS), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Biology, Science and Research Branch, Islamic Azad university, Tehran, Iran
| | - Amir R Aref
- Department of Medical Oncology, Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Mahdi Karimi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Medical Nanotechnology, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Research Center for Science and Technology in Medicine, Tehran University of Medical Sciences, Tehran, Iran; Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Dermatology, Harvard Medical School, Boston, USA; Harvard-MIT Division of Health Sciences and Technology, Cambridge, USA.
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Medical Applications of Collagen and Hyaluronan in Regenerative Medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1077:285-306. [PMID: 30357694 DOI: 10.1007/978-981-13-0947-2_15] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
In order to develop and commercialize for the regenerative medicinal products, smart biomaterials with biocompatibility must be needed. In this chapter, we introduce collagen and hyaluronic acid (HA) as extracellular matrix as well as deal with the molecular mechanism as microenvironment, mechanistic effects, and gene expression. Application of collagen and HA have been reviewed in the area of orthopedics, orthopedics, ophthalmology, dermatology and plastic surgery. Finally, the ongoing and commercial products of collagen and HA for regenerative medicine have been introduced.
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22
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Moore AL, Marshall CD, Longaker MT. Minimizing Skin Scarring through Biomaterial Design. J Funct Biomater 2017; 8:jfb8010003. [PMID: 28117733 PMCID: PMC5371876 DOI: 10.3390/jfb8010003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/03/2017] [Accepted: 01/16/2017] [Indexed: 12/14/2022] Open
Abstract
Wound healing continues to be a major burden to patients, though research in the field has expanded significantly. Due to an aging population and increasing comorbid conditions, the cost of chronic wounds is expected to increase for patients and the U.S. healthcare system alike. With this knowledge, the number of engineered products to facilitate wound healing has also increased dramatically, with some already in clinical use. In this review, the major biomaterials used to facilitate skin wound healing will be examined, with particular attention allocated to the science behind their development. Experimental therapies will also be evaluated.
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Affiliation(s)
- Alessandra L Moore
- Division of General and Gastrointestinal Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Clement D Marshall
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Michael T Longaker
- Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
- Institute of Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA 94305, USA.
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