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Putri IL, Sindhu FC, Aisyah IF, Pramanasari R, Wungu CDK. Comparison of combination skin substitutes and skin grafts versus skin grafts only for treating wounds measured by Vancouver Scar Scale: A comprehensive meta-analysis. SAGE Open Med 2024; 12:20503121241266342. [PMID: 39139266 PMCID: PMC11320670 DOI: 10.1177/20503121241266342] [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: 04/25/2024] [Accepted: 06/18/2024] [Indexed: 08/15/2024] Open
Abstract
Background Skin is the largest organ in the body and has multiple significant functions. A malformation or injury that compromises its integrity can lead to major issues or even mortality. Wound healing is a vital physiological process of the human skin which facilitates the repair of any damage and the preservation of homeostasis. Possible complications or infections that are fatal may ensue if the patient does not recover within the specified time. Therefore, it is essential to develop biomaterials which facilitate tissue regeneration and exhibit robust biological properties. We conducted a meta-analysis of randomized controlled trials to compare combinations of skin replacements and skin grafts to skin grafts alone for wound treatment, as measured by the Vancouver Scar Scale. Methods This meta-analysis utilized various databases, including as PubMed, ProQuest, Web of Science, Science Direct, Scopus, EBSCOhost, and ClinicalTrials.gov, to conduct a comprehensive search for randomized controlled trials that compared the effectiveness of combined skin substitutes and skin grafts to skin grafts alone in the treatment of wounds. The results primarily consisted of scar features assessed using the Vancouver Scar Scale. Results Meta-analysis was conducted on a sample of 216 participants from 7 randomized controlled trials. The trials were conducted from 2002 to 2015. The study demonstrated that the use of skin substitutes resulted in a statistically significant improvement in Vancouver Scar Scales ratings compared to skin grafts alone. The mean change was 1.38 (95% CI: 0.13-2.63; p = 0.03). Conclusion This meta-analysis indicates that the use of skin replacements provides substantial advantages and effectively aids in the closure of wounds. There is no inherent superiority among different skin substitutes. Instead, their suitability for specific patient wound circumstances is the determining factor. A comprehensive and advantageous skin substitute of significant magnitude is needed, rather than relying solely on grafts.
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Affiliation(s)
- Indri Lakhsmi Putri
- Faculty of Medicine, Department of Plastic Reconstructive and Aesthetic Surgery, Airlangga University, Surabaya, Indonesia
- Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, East Java, Indonesia
| | - Florencia Christina Sindhu
- Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, East Java, Indonesia
| | - Imaniar Fitri Aisyah
- Department of Mechanical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Rachmaniar Pramanasari
- Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, East Java, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Faculty of Medicine, Department of Physiology and Medical Biochemistry, Airlangga University, Surabaya, Jawa Timur, Indonesia
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Zhang Y, Chen F, Wu W, Xu Z, Li R, Ke T. The clinical effects of artificial dermis in the treatment of skin and soft tissue defects accompanied by bone or tendon exposure. Injury 2024; 55:111755. [PMID: 39098255 DOI: 10.1016/j.injury.2024.111755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 07/07/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE The clinical effects of artificial dermis in treating skin and soft tissue defects accompanied by bone or tendon exposure were assessed. APPROACH A retrospective analysis was conducted on the clinical data of 45 cases of skin and soft tissue defects accompanied by bone or tendon exposure admitted to the trauma surgery department of Fujian Provincial Hospital between February 2018 and August 2020. They were divided into the artificial dermis and control groups. The wound was assessed using the Vancouver Scar Scale (mVSS), and the postoperative visual analogue scale (VAS) scores were recorded at 3, 6, 9, and 12 months after surgery. At the 12-month after surgery, skin sensation recovery was evaluated using the criteria of the British Medical Research Council (BMRC). RESULTS The cases included 26 males and 19 females, aged 50 to 85 years. All patients were followed up for an average of 13.8 months (range: 12-18 months). Compared with controls, the wound healing time of the observation group was longer (35.8 ± 10.6 vs. 28.5 ± 4.8, P = 0.007), without significant differences for the number of operations and length of hospitalization. The mVSS scores were not different between groups (Pgroup = 0.294), but the scores decreased with time (Ptime < 0.001), and the group×time interaction was significant (Pinteraction < 0.001). Similarly, the VAS scores were not different between groups (Pgroup = 0.667), but the scores decreased with time (Ptime < 0.001); the group×time interaction was not significant (Pinteraction = 0.274). At the 12-month mark following the operation, in the artificial dermis group, the MCRR score was S3+ in 23 patients, while it ranged from S0 to S3 in two patients; in the control group, S3+ was observed in 17 patients, and S0-S3 in three (P = 0.815). CONCLUSION Artificial dermis treatment is considered a safe and effective alternative therapy for patients with skin and soft tissue defects accompanied by bone or tendon exposure who cannot tolerate or are unwilling to undergo autologous skin flap transplantation. It offers the advantages of minimal donor site trauma, simplicity in operation, and favorable postoperative functional recovery.
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Affiliation(s)
- Yongfa Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350004, Fujian Province, PR China; Department of Emergency & Trauma Surgery, Fujian Provincial Hospital, National Regional Trauma Medical Center, No.134 East Street, Gulou District, Fuzhou 350001, Fuiian Province, PR China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou 350001, Fujian, PR China
| | - Fuyang Chen
- Trauma Center/Emergency Surgery Department, First Affiliated Hospital of Fujian Medical University, Fuzhou City, Fujian Province, 350004, PR China
| | - Weiqiang Wu
- Department of Orthopaedics, Fuzhou Second General Hospital, The Third Clinical Medical College, Fujian Medical University, Fuzhou 350007, PR China; Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma, Fuzhou Trauma Medical Center, Fuzhou 350007, PR China
| | - Zhixian Xu
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350004, Fujian Province, PR China; Department of Emergency & Trauma Surgery, Fujian Provincial Hospital, National Regional Trauma Medical Center, No.134 East Street, Gulou District, Fuzhou 350001, Fuiian Province, PR China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou 350001, Fujian, PR China
| | - Renbin Li
- Department of Orthopaedics, Fuzhou Second General Hospital, The Third Clinical Medical College, Fujian Medical University, Fuzhou 350007, PR China; Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma, Fuzhou Trauma Medical Center, Fuzhou 350007, PR China
| | - Tie Ke
- Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350004, Fujian Province, PR China; Department of Emergency & Trauma Surgery, Fujian Provincial Hospital, National Regional Trauma Medical Center, No.134 East Street, Gulou District, Fuzhou 350001, Fuiian Province, PR China; Fujian Provincial Key Laboratory of Emergency Medicine, Fujian Provincial Institute of Emergency Medicine, Fujian Emergency Medical Center, Fuzhou 350001, Fujian, PR China.
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Wang J, Huang Z, Cueva Jumbo JC, Sha K. Long-term follow-up of one-stage artificial dermis reconstruction surgery for fingertip defects with exposed phalanx. HAND SURGERY & REHABILITATION 2022; 41:353-361. [DOI: 10.1016/j.hansur.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/28/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022]
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Abdelhakim M, Lin X, Ogawa R. The Japanese Experience with Basic Fibroblast Growth Factor in Cutaneous Wound Management and Scar Prevention: A Systematic Review of Clinical and Biological Aspects. Dermatol Ther (Heidelb) 2020; 10:569-587. [PMID: 32506250 PMCID: PMC7367968 DOI: 10.1007/s13555-020-00407-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Basic fibroblast growth factor (bFGF) plays several key roles in wound healing. Over the last 2 decades, clinical and basic research on bFGF has been actively conducted in Japan with reports on its potent efficacy in accelerating the healing of chronic ulcers and burn wounds by stimulating key cellular players in the skin. However, its efficacy remains unrecognized internationally. Thus, this study reviews current knowledge about the therapeutic value of bFGF in wound management and scar prevention accumulated in Japan over the last 2 decades. METHODS We review the Japanese literature that demonstrates the anti-scarring effects of bFGF and exhaustively assess how these effects are exerted. Using the search terms "bFGF OR growth factors AND wound healing in Japan" and "bFGF AND scar prevention in Japan," we conducted a search of the PubMed database for publications on the role of bFGF in wound and scar management in Japan. All eligible papers published between 1988 and December 2019 were retrieved and reviewed. RESULTS Our search yielded 208 articles; 82 were related to the application of bFGF for dermal wound healing in Japan. Of these, 27 fulfilled all inclusion criteria; 11 were laboratory studies, 7 were case reports, 4 were clinical studies, and 5 were randomized controlled trials. CONCLUSION Further research, with recognition of the therapeutic value of bFGF in wound and scar management and its clinical applications, is needed to provide additional clinical advantages while improving wound healing and reducing the risk of post-surgical scar formation.
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Affiliation(s)
- Mohamed Abdelhakim
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - Xunxun Lin
- Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Rei Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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A comparison of the wound healing process after the application of three dermal substitutes with or without basic fibroblast growth factor impregnation in diabetic mice. J Plast Reconstr Aesthet Surg 2020; 73:1547-1555. [PMID: 32487360 DOI: 10.1016/j.bjps.2020.01.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/10/2019] [Accepted: 01/05/2020] [Indexed: 01/13/2023]
Abstract
Pelnac GplusⓇ, IntegraⓇ, and TerudermisⓇ are approved artificial dermis products in Japan. Previously, we proved that Pelnac GplusⓇ was able to sustain basic fibroblast growth factor (bFGF) and accelerated wound healing by releasing impregnated bFGF. In this study, we impregnated Pelnac GplusⓇ, IntegraⓇ, and TerudermisⓇ with bFGF and compared the binding activity and wound-healing process. We applied bFGF to each material and compared the bFGF concentrations in the surrounding area after 24-h incubation. For the in vivo study, dermal substitutes were impregnated with bFGF and implanted into full-thickness wounds of BKS.Cg-+Leprdb/+Leprdb/Jcl mice. Wounds were evaluated at days 7, 14, and 21 after implantation. The in vitro study showed that bFGF is strongly bound to IntegraⓇ, followed by Pelnac GplusⓇ and TerudermisⓇ. The in vivo study showed that fibroblasts and capillaries had infiltrated into the Pelnac GplusⓇ but not the IntegraⓇ or TerudermisⓇ. Furthermore, long epithelium and wide granulation tissue were formed in the Pelnac GplusⓇ with bFGF group. The TerudermisⓇ with bFGF group had more capillaries than other groups, but only at the base of the wound. The combination of Pelnac GplusⓇ with bFGF may be a novel approach for treating full-thickness skin defects or chronic skin ulcers.
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Di Domenico M, Pinto F, Quagliuolo L, Contaldo M, Settembre G, Romano A, Coppola M, Ferati K, Bexheti-Ferati A, Sciarra A, Nicoletti GF, Ferraro GA, Boccellino M. The Role of Oxidative Stress and Hormones in Controlling Obesity. Front Endocrinol (Lausanne) 2019; 10:540. [PMID: 31456748 PMCID: PMC6701166 DOI: 10.3389/fendo.2019.00540] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/19/2019] [Indexed: 12/15/2022] Open
Abstract
The accumulation of adipose tissue in the body occurs because the energy introduced with food and drink exceeds that expense, but to understand why this imbalance is established and why it is maintained over time, it is important to consider the main causes and risk factors of excess weight. In this review, we will refer to the main factors linked to obesity, starting from oxidative stress to hormonal factors including the role of obesity in breast cancer. Among the many hypotheses formulated on the etiopathology of obesity, a key role can be attributed to the relationship between stress oxidative and intestinal microbiota. Multiple evidences tend to show that genetic, epigenetic, and lifestyle factors contribute to determine in the obese an imbalance of the redox balance correlated with the alteration of the intestinal microbial flora. Obesity acts negatively on the wound healing, in fact several studies indicate morbid obesity significantly increased the risk of a post-operative wound complication and infection. Currently, in the treatment of obesity, medical interventions are aimed not only at modifying caloric intake, but also to modulate and improve the composition of diet with the aim of rebalancing the microbiota-redox state axis.
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Affiliation(s)
- Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, United States
| | - Federica Pinto
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucio Quagliuolo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuliana Settembre
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio Romano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mario Coppola
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Kenan Ferati
- Faculty of Medicine, University of Tetovo, Tetovo, Macedonia
| | | | - Antonella Sciarra
- Department of Translational Medicad Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanni Francesco Nicoletti
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giuseppe Andrea Ferraro
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
- *Correspondence: Giuseppe Andrea Ferraro
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