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D'Arpa P, Leung KP. Pharmaceutical Prophylaxis of Scarring with Emphasis on Burns: A Review of Preclinical and Clinical Studies. Adv Wound Care (New Rochelle) 2022; 11:428-442. [PMID: 33625898 PMCID: PMC9142134 DOI: 10.1089/wound.2020.1236] [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: 01/29/2023] Open
Abstract
Significance: The worldwide estimate of burns requiring medical attention each year is 11 million. Each year in the United States, ∼486,000 burn injuries receive medical attention, including 40,000 hospitalizations. Scars resulting from burns can be disfiguring and impair functions. The development of prophylactic drugs for cutaneous scarring could improve the outcomes for burns, traumatic lacerations (>6 million/year treated in U.S. emergency rooms), and surgical incisions (∼250 million/year worldwide). Antiscar pharmaceuticals have been estimated to have a market of $12 billion. Recent Advances: Many small molecules, cells, proteins/polypeptides, and nucleic acids have mitigated scarring in animal studies and clinical trials, but none have received Food and Drug Administration (FDA) approval yet. Critical Issues: The development of antiscar pharmaceuticals involves the identification of the proper dose, frequency of application, and window of administration postwounding for the indicated wound. Risks of infection and impaired healing must be considered. Scar outcome needs to be evaluated after scars have matured. Future Directions: Once treatments have demonstrated safety and efficacy in rodent and/or rabbit and porcine wound models, human testing can begin, such as on artificially created wounds on healthy subjects and on bilateral-surgical wounds, comparing treatments versus vehicle controls on intrapatient-matched wounds, before testing on separate cohorts of patients. Given the progress made in the past 20 years, FDA-approved drugs for improving scar outcomes may be expected.
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Affiliation(s)
- Peter D'Arpa
- The Geneva Foundation, Tacoma, Washington, USA.,Correspondence: 15104 DuFief Dr, North Potomac, MD 20878, USA.
| | - Kai P. Leung
- Division of Combat Wound Repair, US Army Institute of Surgical Research, Fort Sam Houston, Texas, USA.,Correspondence: Division of Combat Wound Repair, U.S. Army Institute of Surgical Research, 3650 Chambers Pass, Building 3611, Fort Sam Houston, TX 78234-6315, USA.
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Ramalingam R, Dhand C, Mayandi V, Leung CM, Ezhilarasu H, Karuppannan SK, Prasannan P, Ong ST, Sunderasan N, Kaliappan I, Kamruddin M, Barathi VA, Verma NK, Ramakrishna S, Lakshminarayanan R, Arunachalam KD. Core-Shell Structured Antimicrobial Nanofiber Dressings Containing Herbal Extract and Antibiotics Combination for the Prevention of Biofilms and Promotion of Cutaneous Wound Healing. ACS APPLIED MATERIALS & INTERFACES 2021; 13:24356-24369. [PMID: 34024104 DOI: 10.1021/acsami.0c20642] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Burn wounds are susceptible to microbial invasion from both resident and exogenous bacteria, which becomes a critical public health issue and causes substantial economic burden. There is a perceived demand to produce new antimicrobial wound dressings that hinder bacterial colonization while accelerating the healing process and hence would provide an improved standard of care for patients. Since ancient times, herbal extracts from medicinally important plants have extensively been used for treating burn injuries. This work reports the utility of electrospun nanofibers containing plant extracts and antibiotics combination as a multifunctional scaffold for treating second-degree burns. First, we determined the various components of plant extracts from Gymnema sylvestre by two different processing methods and their synergism with minocycline antibiotics. Then, we prepared core-shell nanofibrous dressings with poly-ε-caprolactone/gelatin laden with minocycline hydrochloride as a shell and gelatin infused with G. sylvestre extracts (ultrasound-assisted extracts and cold macerated extracts) as the core using coaxial electrospinning. The electrospun nanofibers displayed a smooth, continuous, and bead-free morphology with adequate wettability. The presence of extract components in the core-shell nanofibers resulted in enhanced mechanical properties when compared to pristine mats. The core-shell structures resulted in sustained release of the bioactive components when compared to nanofiber blends. Core-shell nanofiber mats containing plant extracts and antibiotic combinations displayed potent antimicrobial and antibiofilm properties while promoting the spread and proliferation of skin cells when compared to pristine mats. In a porcine model of cutaneous second-degree burns, we showed that wounds treated with the antimicrobial dressing improved re-epithelialization and collagen organization in comparison to untreated wounds.
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Affiliation(s)
- Raghavendra Ramalingam
- Center for Environmental Nuclear Research, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu 603203, India
- Department of Physics and Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu 603203, India
- Center for Nanofibers and Nanotechnology, Department of Mechanical Engineering, Faculty of Engineering, 2 Engineering Drive 3, National University of Singapore, 117576, Singapore
| | - Chetna Dhand
- Ocular Infections & Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856, Singapore
- Industrial Waste Utilization, Nano and Biomaterials, CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh 462026, India
| | - Venkatesh Mayandi
- Ocular Infections & Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856, Singapore
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Drive, Singapore 637551, Singapore
| | - Chak Ming Leung
- Department of Biomedical Engineering, National University of Singapore, 117581, Singapore
- NUS Graduate School for Integrative Sciences & Engineering, National University of Singapore, 117456, Singapore
| | - Hariharan Ezhilarasu
- Center for Nanofibers and Nanotechnology, Department of Mechanical Engineering, Faculty of Engineering, 2 Engineering Drive 3, National University of Singapore, 117576, Singapore
| | - Sathish Kumar Karuppannan
- Center for Environmental Nuclear Research, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu 603203, India
| | - Praseetha Prasannan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Seow Theng Ong
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Nandhini Sunderasan
- Interdiscipilinary Institute of Indian System of Medicine, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu (Dt), Tamil Nadu 603203, India
| | - Ilango Kaliappan
- Department of Pharmaceutical Chemistry, SRM College of Pharmacy, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu (Dt), Tamil Nadu 603203, India
| | - Mohammed Kamruddin
- Materials Physics Division, Material Science Group, Indira Gandhi Centre for Atomic Research, Kalpakkam, Tamilnadu 603102, India
| | - Veluchamy Amutha Barathi
- Ocular Infections & Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block, Level 7, 119228, Singapore
| | - Navin Kumar Verma
- Ocular Infections & Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
- Skin Research Institute of Singapore, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Seeram Ramakrishna
- Center for Nanofibers and Nanotechnology, Department of Mechanical Engineering, Faculty of Engineering, 2 Engineering Drive 3, National University of Singapore, 117576, Singapore
| | - Rajamani Lakshminarayanan
- Ocular Infections & Anti-Infectives Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower, 169856, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, 169857, Singapore
- Department of Pharmacy, National University of Singapore, 18 Science Drive, 117543, Singapore
| | - Kantha Deivi Arunachalam
- Center for Environmental Nuclear Research, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu 603203, India
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Li Y, Zhang Z, Xu K, Du S, Gu X, Cao R, Cui S. Minocycline alleviates peripheral nerve adhesion by promoting regulatory macrophage polarization via the TAK1 and its downstream pathway. Life Sci 2021; 276:119422. [PMID: 33781833 DOI: 10.1016/j.lfs.2021.119422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/15/2021] [Accepted: 03/20/2021] [Indexed: 12/20/2022]
Abstract
AIMS Inflammation plays a key role in peripheral nerve adhesion and often leads to severe pain and nerve dysfunction. Minocycline was reported to have potent anti-inflammatory effects and might be a promising drug to prevent or attenuate peripheral nerve adhesion. The present study aimed to clarify whether minocycline contributes to nerve adhesion protection and its underlying mechanism. MATERIALS AND METHODS Rats with sciatic nerve adhesion induced by glutaraldehyde glue (GG) were intraperitoneally injected with minocycline or saline every 12 h for 7 consecutive days. After that, the adhesion score, Ashcroft score, demyelination, macrophage polarization and inflammatory factors in peripheral nerve adhesion tissues or tissues in sham group were determined with histological staining, western blot and real time-PCR. Murine macrophage RAW264.7 cells were stimulated by LPS alone or together with minocycline at different concentrations and time duration to study the mechanism of minocycline in alleviating nerve adhesion. KEY FINDINGS We found that minocycline treatment reduced the adhesion score, Ashcroft score, the growth of scar tissue, demyelination, and macrophage recruitment. Moreover, minocycline significantly and dose-dependently promoted regulatory macrophage polarization but decreased pro-inflammatory macrophage polarization. Furthermore, mechanism studies showed that TAK1 and its downstream pathway p38/JNK/ERK1/2/p65 were inhibited by minocycline, which led to lower IL-1β and TNFα expression, but increased IL-10 expression. SIGNIFICANCE Altogether, these results suggest that minocycline is highly effective against peripheral nerve adhesion through anti-fibrosis, anti-inflammation, and myelination protection, making it a highly promising candidate for treating adhesion-related disorders.
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Affiliation(s)
- Yueying Li
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China
| | - Zhan Zhang
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China
| | - Ke Xu
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China
| | - Shuang Du
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China
| | - Xiaosong Gu
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China; Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Jiangsu Clinical Medicine Center of Tissue Engineering and Nerve Injury Repair, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, PR China.
| | - Rangjuan Cao
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China.
| | - Shusen Cui
- Department of Hand Surgery, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, PR China.
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Fabrication of biocompatible antibacterial nanowafers based on HNT/PVA nanocomposites loaded with minocycline for burn wound dressing. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 110:110685. [DOI: 10.1016/j.msec.2020.110685] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 12/30/2019] [Accepted: 01/19/2020] [Indexed: 12/17/2022]
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5
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Barbieri JS, Bhate K, Hartnett KP, Fleming-Dutra KE, Margolis DJ. Trends in Oral Antibiotic Prescription in Dermatology, 2008 to 2016. JAMA Dermatol 2020; 155:290-297. [PMID: 30649187 DOI: 10.1001/jamadermatol.2018.4944] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Dermatologists prescribe more oral antibiotic courses per clinician than any other specialty, and this use puts patients at risk of antibiotic-resistant infections and antibiotic-associated adverse events. Objective To characterize the temporal trends in the diagnoses most commonly associated with oral antibiotic prescription by dermatologists, as well as the duration of this use. Design, Setting, and Participants Repeated cross-sectional analysis of antibiotic prescribing by dermatologists from January 1, 2008, to December 31, 2016. The setting was Optum Clinformatics Data Mart (Eden Prairie, Minnesota) deidentified commercial claims data. Participants were dermatology clinicians identified by their National Uniform Claim Committee taxonomy codes, and courses of oral antibiotics prescribed by these clinicians were identified by their National Drug Codes. Exposures Claims for oral antibiotic prescriptions were consolidated into courses of therapy and associated with the primary diagnosis from the most recent visit. Courses were stratified into those of extended duration (>28 days) and those of short duration (≤28 days). Main Outcomes and Measures Frequency of antibiotic prescribing and associated diagnoses. Poisson regression models were used to assess for changes in the frequency of antibiotic prescribing over time. Results Between 2008 and 2016 among 985 866 courses of oral antibiotics prescribed by 11 986 unique dermatologists, overall antibiotic prescribing among dermatologists decreased 36.6% (1.23 courses per 100 visits) from 3.36 (95% CI, 3.34-3.38) to 2.13 (95% CI, 2.12-2.14) courses per 100 visits with a dermatologist (prevalence rate ratio for annual change, 0.931; 95% CI, 0.930-0.932), with much of this decrease occurring among extended courses for acne and rosacea. Oral antibiotic use associated with surgical visits increased 69.6% (2.73 courses per 100 visits) from 3.92 (95% CI, 3.83-4.01) to 6.65 (95% CI, 6.57-6.74) courses per 100 visits associated with a surgical visit (prevalence rate ratio, 1.061; 95% CI, 1.059-1.063). Conclusions and Relevance Continuing to develop alternatives to oral antibiotics for noninfectious conditions, such as acne, can improve antibiotic stewardship and decrease complications from antibiotic use. In addition, the rising use of postoperative antibiotics after surgical visits is concerning and may put patients at unnecessary risk of adverse events. Future studies are needed to identify the value of this practice and the risk of adverse events.
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Affiliation(s)
- John S Barbieri
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Ketaki Bhate
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kathleen P Hartnett
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.,United States Public Health Service Commissioned Corps, Rockville, Maryland
| | - Katherine E Fleming-Dutra
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David J Margolis
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
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6
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Xu T, Yang R, Ma X, Chen W, Liu S, Liu X, Cai X, Xu H, Chi B. Bionic Poly(γ-Glutamic Acid) Electrospun Fibrous Scaffolds for Preventing Hypertrophic Scars. Adv Healthc Mater 2019; 8:e1900123. [PMID: 30972958 DOI: 10.1002/adhm.201900123] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 03/15/2019] [Indexed: 12/16/2022]
Abstract
Hypertrophic scarring (HS) remains a great challenge in wound dressing. Although various bionic extracellular matrix (ECM) biomaterials have been designed towards HS treatment, not all biomaterials can synergize biological functions and application functions in wound repair. Bionic scar-inhibiting scaffolds, loaded with biomolecules or drugs, become promising strategies for scarless skin regeneration. In this work, inspired by the physicochemical environment of ECM, a versatile fabrication of poly(γ-glutamic acid) based on electrospun photocrosslinkable hydrogel fibrous scaffolds incorporated with ginsenoside Rg3 (GS-Rg3) is developed for tissue repair and wound therapy. Decorated with adhesive peptide, bionic fibrous scaffolds can accelerate fibroblasts to sprout and grow, forming organized space-filling basement that gradually fills a depression before wound close up in the early stage. Additionally, by sustained release of GS-Rg3 in late stage, fibrous scaffolds promote scarless wound healing in vivo as evidenced by the promotion of cell communication and skin regeneration, as well as the subsequent decrease of angiogenesis and collagen accumulation. These ECM-inspired fibrous scaffolds, therefore, offer new perspectives on accelerated wound healing and tissue regeneration.
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Affiliation(s)
- Tingting Xu
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
| | - Rong Yang
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
| | - Xuebin Ma
- School of Chemical EngineeringNanjing University of Science and Technology Nanjing 210094 China
| | - Wei Chen
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
| | - Shuai Liu
- School of Chemical EngineeringNanjing University of Science and Technology Nanjing 210094 China
| | - Xin Liu
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
| | - Xiaojun Cai
- College of Materials Science and EngineeringNanjing Tech University Nanjing 211816 Nanjing China
| | - Hong Xu
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
- Jiangsu National Synergetic Innovation Center for Advanced Materials Nanjing Tech University Nanjing 211816 China
| | - Bo Chi
- State Key Laboratory of Materials‐Oriented Chemical EngineeringCollege of Food Science and Light IndustryNanjing Tech University Nanjing 211816 China
- Jiangsu National Synergetic Innovation Center for Advanced Materials Nanjing Tech University Nanjing 211816 China
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7
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Wang L, Yang J, Ran B, Yang X, Zheng W, Long Y, Jiang X. Small Molecular TGF-β1-Inhibitor-Loaded Electrospun Fibrous Scaffolds for Preventing Hypertrophic Scars. ACS APPLIED MATERIALS & INTERFACES 2017; 9:32545-32553. [PMID: 28875694 DOI: 10.1021/acsami.7b09796] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hypertrophic scarring (HS) is a disorder that occurs during wound healing and seriously depresses the quality of human life. Scar-inhibiting scaffolds, though bringing promise to HS prevention, face problems such as the incompatibility of the scaffold materials and the instability of bioactive molecules. Herein, we present a TGF-β1-inhibitor-doped poly(ε-caprolactone) (PCL)/gelatin (PG) coelectrospun nanofibrous scaffold (PGT) for HS prevention during wound healing. The appropriate ratio of PCL to gelatin can avoid individual defects of the two materials and achieve an optimized mechanical property and biocompatibility. The TGF-β1 inhibitor (SB-525334) is a small molecule and is highly stable during electrospinning and drug release processes. The PGT effectively inhibits fibroblast (the major cell type contributing to scar formation) proliferation in vitro and successfully prevents HS formation during the healing of full-thickness model wounds on rabbit ear. Our strategy offers an excellent solution for potential large-scale production of scaffolds for clinical HS prevention.
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Affiliation(s)
- Le Wang
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University , Qingdao 266071, China
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
| | - Junchuan Yang
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
| | - Bei Ran
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
| | - Xinglong Yang
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
- University of Chinese Academy of Sciences , Beijing, 100049, China
| | - Wenfu Zheng
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
| | - Yunze Long
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University , Qingdao 266071, China
| | - Xingyu Jiang
- CAS Center of Excellence for Nanoscience, Beijing Engineering Research Center for BioNanotechnology, CAS Key Lab for Biological Effects of Nanomaterials and Nanosafety, National Center for NanoScience and Technology , Beijing, 100190, China
- University of Chinese Academy of Sciences , Beijing, 100049, China
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Topical Minocycline Effectively Decontaminates and Reduces Inflammation in Infected Porcine Wounds. Plast Reconstr Surg 2016; 138:856e-868e. [DOI: 10.1097/prs.0000000000002633] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Todd PS, Gordon SC, Rovner RL, Tung R. Eruptive Penile Syringomas in an Adolescent: Novel Approach with Serial Microexcisions and Suture-Adhesive Repair. Pediatr Dermatol 2016; 33:e57-60. [PMID: 26764082 DOI: 10.1111/pde.12745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Penile syringomas are benign adnexal tumors that are usually asymptomatic but can be cosmetically distressing. Because of the delicate nature of skin in this region, treatment is difficult, and there are few case reports of procedural destruction of these tumors. We report a case of successful surgical excision using Castroviejo ophthalmic scissors followed by primary closure with fast-absorbing plain gut suture and a cyanoacrylate adhesive application. This procedure was well tolerated and had an impressive cosmetic outcome.
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Affiliation(s)
- Patricia S Todd
- Division of Dermatology, Loyola University Medical Center, Maywood, Illinois
| | - Samantha C Gordon
- Division of Dermatology, Loyola University Medical Center, Maywood, Illinois
| | - Rebecca L Rovner
- Division of Dermatology, Loyola University Medical Center, Maywood, Illinois
| | - Rebecca Tung
- Division of Dermatology, Loyola University Medical Center, Maywood, Illinois
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Abstract
Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.
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Affiliation(s)
- Shilpa Garg
- Department of Dermatology, Army College of Medical Sciences, Base Hospital, Delhi Cantt, New Delhi, India
| | - Naveen Dahiya
- Department of Plastic Surgery, Deen Dayal Upadhyay Hospital, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Abstract
BACKGROUND With the investigation and potential introduction of several novel scar-reducing therapies to the market within the next several years, it is germane to review both the pathophysiology of scarring and the safety and efficacy of currently available and emerging therapeutic agents. METHODS An extensive review of the English-language literature was conducted using the MEDLINE database. RESULTS A comprehensive review of the pathophysiology of scarring and scar management, including both emerging and currently available therapies, was completed. Current clinical studies are limited by small sample sizes, lack of well-designed controls, and lack of standardized scar outcome measurement parameters. CONCLUSIONS A prominent challenge in the study of scar management is the paucity of well-designed, large, randomized, controlled studies examining existing scar-reducing techniques. The greatest improvement in scar-reducing protocols likely entails a polytherapeutic strategy for management. Further investigation into the role of inflammation in scarring is paramount to the development of improved scar-reducing agents. There is a need for large controlled trials using a polytherapeutic strategy that combines existing and novel agents to provide a standardized evidence-based evaluation of efficacy.
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Scar Treatments: Preclinical and Clinical Studies. J Am Coll Surg 2008; 206:719-30. [PMID: 18387479 DOI: 10.1016/j.jamcollsurg.2007.11.022] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 11/07/2007] [Accepted: 11/28/2007] [Indexed: 01/18/2023]
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14
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Inhibitory Effect of Minocycline on Hypertrophic Scarring. Plast Reconstr Surg 2008; 121:1070. [DOI: 10.1097/01.prs.0000299648.09028.8d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Keloid and hypertrophic scar: Neurogenic inflammation hypotheses. Med Hypotheses 2008; 71:32-8. [DOI: 10.1016/j.mehy.2008.01.032] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Revised: 01/04/2008] [Accepted: 01/08/2008] [Indexed: 11/24/2022]
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