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Vaporidou N, Peroni F, Restelli A, Jalil MN, Dye JF. Artificial Skin Therapies; Strategy for Product Development. Adv Wound Care (New Rochelle) 2023; 12:574-600. [PMID: 36680749 DOI: 10.1089/wound.2022.0050] [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] [Indexed: 01/22/2023] Open
Abstract
Significance: Tissue-engineered artificial skin for clinical reconstruction can be regarded as an established practice. Bi-layered skin equivalents are available as established allogenic or autologous therapy, and various acellular skin replacements can support tissue repair. Moreover, there is considerable commonality between the skin and other soft tissue reconstruction products. This article presents an attempt to create a comprehensive global landscape review of advanced replacement materials and associated strategies for skin and soft tissue reconstruction. Recent Advances: There has been rapid growth in the number of commercial and pre-commercial products over the past decade. In this survey, 263 base products for advanced skin therapy have been identified, across 8 therapeutic categories, giving over 350 products in total. The largest market is in the United States, followed by the E.U. zone. However, despite these advances, and the investment of resources in each product development, there are key issues concerning the clinical efficacy, cost-benefit of products, and clinical impact. Each therapeutic strategy has relative merits and limitations. Critical Issues: A critical consideration in developing and evaluating products is the therapeutic modality, associated regulatory processes, and the potential for clinical adoption geographically, determined by regulatory territory, intellectual property, and commercial distribution factors. The survey identifies an opportunity for developments that improve basic efficacy or cost-benefit. Future Directions: The economic pressures on health care systems, compounded by the demands of our increasingly ageing population, and the imperative to distribute effective health care, create an urgent global need for effective and affordable products.
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Affiliation(s)
- Nephelie Vaporidou
- Division of Surgery and Interdisciplinary Sciences, University College London, London, United Kingdom
- Oxartis Ltd., Oxford, United Kingdom
| | | | | | - M Nauman Jalil
- Oxartis Ltd., Oxford, United Kingdom
- MADE Cymru, University of Wales Trinity Saint David, Swansea, Wales, United Kingdom
| | - Julian F Dye
- Oxartis Ltd., Oxford, United Kingdom
- Research Strategy and Development, University College London, London, United Kingdom
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2
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Xia W, Lin C, Tu Z, Li Y, Shen G. Preparation of laser microporous porcine acellular dermal matrix and observation of wound transplantation. Cell Tissue Bank 2023; 24:191-202. [PMID: 35804250 PMCID: PMC10006019 DOI: 10.1007/s10561-022-10023-7] [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: 09/06/2021] [Accepted: 06/20/2022] [Indexed: 11/02/2022]
Abstract
To prepare a new type of porcine acellular dermis matrix (PADM) with the new laser microporous technique and verify its safety and feasibility. A novel porcine acellular dermis matrix (ADM) was prepared by using sequential combined decellularization of trypsin, neutral protease and SDS solution method and fully rinsed with ultrasonic wave. Specific laser microporous technology was used to prepare the laser micropore porcine acellular dermal matrix (LPADM). SD rats were chose as the animal models and autologous skin was transplanted by one-step method to observe and detect the graft activity, immunogenicity and vascularization degree of the novel PADM. A porcelain white, shiny, soft and elastic dermal matrix was prepared in this study, the results showed low DNA residue and low cytotoxicity. HE staining and SEM observation revealed that the PADM had neither residual cells nor cell fragments, while the collagen bundles were intact and orderly arranged. All the SD rats survived. No infection or skin allergy was found after surgery. None of the animals lost weight. Histological examination showed that the LPADM was fully vascularized with little tissue destruction in the experiment group. Immunohistochemical staining for CD31 showed ideal vascularization in the experiment group, and immunohistochemical staining for TNF-α showed there were no statistical significance of inflammatory reaction in both groups. This study demonstrated that the novel PADM prepared by sequential combined decellularization of trypsin, neutral protease and SDS solution method and new laser microporous technique was effective and safe in animal transplantation.
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Affiliation(s)
- Weidong Xia
- The Burn Plastic Surgery, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215006, China
| | - Cai Lin
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Zhuolong Tu
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Yuan Li
- Department of Burn, The First Affiliated Hospital of Wenzhou Medical University, Nan Bai Xiang, Wenzhou, 325000, Zhejiang, China
| | - Guoliang Shen
- The Burn Plastic Surgery, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, 215006, China.
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3
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Zulkiflee I, Masri S, Zawani M, Salleh A, Amirrah IN, Wee MFMR, Yusop SM, Fauzi MB. Silicon-Based Scaffold for Wound Healing Skin Regeneration Applications: A Concise Review. Polymers (Basel) 2022; 14:polym14194219. [PMID: 36236170 PMCID: PMC9571903 DOI: 10.3390/polym14194219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Silicon has made its breakthrough in various industries, including clinical and biomedical applications. Silicon-based biomaterials that were fabricated into various types of scaffolds may attract interest due to their highly favorable properties covering their excellent biocompatibility, high surface area, mechanical strength, and selectivity depending on their application including film, hydrogel, nanoparticles, and so on. Silicon-based materials have also shown exciting results involving cell culture, cell growth, as well as tissue engineering. In this article, a simple review compromising the evaluation of silicon's unique properties has been discussed and followed by the application of the silicone-based product in future perspectives in biomedical fields. The review goals are to widen and inspire broader interest in silicone-based materials in wound healing research.
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Affiliation(s)
- Izzat Zulkiflee
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Syafira Masri
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Mazlan Zawani
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Atiqah Salleh
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Ibrahim Nor Amirrah
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | | | - Salma Mohamad Yusop
- Department of Food Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Mh Busra Fauzi
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaakob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
- Correspondence:
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4
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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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5
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Xue M, Zhao R, March L, Jackson C. Dermal Fibroblast Heterogeneity and Its Contribution to the Skin Repair and Regeneration. Adv Wound Care (New Rochelle) 2022; 11:87-107. [PMID: 33607934 DOI: 10.1089/wound.2020.1287] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Significance: Dermal fibroblasts are the major cell type in the skin's dermal layer. These cells originate from distinct locations of the embryo and reside in unique niches in the dermis. Different dermal fibroblasts exhibit distinct roles in skin development, homeostasis, and wound healing. Therefore, these cells are becoming attractive candidates for cell-based therapies in wound healing. Recent Advances: Human skin dermis comprises multiple fibroblast subtypes, including papillary, reticular, and hair follicle-associated fibroblasts, and myofibroblasts after wounding. Recent studies reveal that these cells play distinct roles in wound healing and contribute to diverse healing outcomes, including nonhealing chronic wound or excessive scar formation, such as hypertrophic scars (HTS) and keloids, with papillary fibroblasts having antiscarring and reticular fibroblast scar-forming properties. Critical Issues: The identities and functions of dermal fibroblast subpopulations in many respects remain unknown. In this review, we summarize the current understanding of dermal fibroblast heterogeneity, including their defined cell markers and dermal niches, dynamic changes, and contributions to skin wound healing, with the emphasis on scarless healing, healing with excessive scars (HTS and keloids), chronic wounds, and the potential application of this heterogeneity for developing cell-based therapies that allow wounds to heal faster with less scarring. Future Directions: Heterogeneous dermal fibroblast populations and their functions are poorly characterized. Refining and advancing our understanding of dermal fibroblast heterogeneity and their participation in skin homeostasis and wound healing may create potential therapeutic applications for nonhealing chronic wounds or wounds that heal with excessive scarring.
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Affiliation(s)
- Meilang Xue
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Ruilong Zhao
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Lyn March
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Christopher Jackson
- Sutton Arthritis Research Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney at Royal North Shore Hospital, St Leonards, New South Wales, Australia
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6
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Ribeiro N, Sousa A, Cunha-Reis C, Oliveira AL, Granja PL, Monteiro FJ, Sousa SR. New prospects in skin regeneration and repair using nanophased hydroxyapatite embedded in collagen nanofibers. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2021; 33:102353. [PMID: 33421622 DOI: 10.1016/j.nano.2020.102353] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
This study reflects an exploitation of a composite matrix produced by electrospinning of collagen and electrospraying of nanophased hydroxyapatite (nanoHA), for skin regeneration applications. The main goal was to evaluate the effect of nanoHA, as source of localized calcium delivery, on human dermal fibroblasts, keratinocytes, and human mesenchymal stem cells (hMSCs) growth, proliferation, differentiation, and extracellular matrix production. This study revealed that calcium ions provided by nanoHA significantly enhanced cellular growth and proliferation rates and prevented adhesion of pathogenic bacteria strains typically found in human skin flora. Moreover, hMSCs were able to differentiate in both osteogenic and adipogenic lineages. Rat subcutaneous implantation of the membranes also revealed that no adverse reaction occurred. Therefore, the mechanically fit composite membrane presents a great potential to be used either as cell transplantation scaffold for skin wound regeneration or as wound dressing material in plastic surgery, burns treatment or skin diseases.
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Affiliation(s)
- Nilza Ribeiro
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto de Engenharia Biomédica, Porto, Portugal; FEUP-DEMM, Faculdade de Engenharia, da Universidade do Porto, Porto, Portugal
| | - Aureliana Sousa
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto de Engenharia Biomédica, Porto, Portugal
| | - Cassilda Cunha-Reis
- Universidade Católica Portuguesa, CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Ana Leite Oliveira
- Universidade Católica Portuguesa, CBQF-Centro de Biotecnologia e Química Fina-Laboratório Associado, Escola Superior de Biotecnologia, Porto, Portugal
| | - Pedro L Granja
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto de Engenharia Biomédica, Porto, Portugal
| | - Fernando J Monteiro
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto de Engenharia Biomédica, Porto, Portugal; FEUP-DEMM, Faculdade de Engenharia, da Universidade do Porto, Porto, Portugal
| | - Susana R Sousa
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; INEB-Instituto de Engenharia Biomédica, Porto, Portugal; ISEP-Instituto Superior de Engenharia do Porto, Politécnico do Porto, Porto, Portugal.
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7
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Helling AL, Viswanathan P, Cheliotis KS, Mobasseri SA, Yang Y, El Haj AJ, Watt FM. Dynamic Culture Substrates That Mimic the Topography of the Epidermal-Dermal Junction. Tissue Eng Part A 2018; 25:214-223. [PMID: 30280972 PMCID: PMC6388717 DOI: 10.1089/ten.tea.2018.0125] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPACT STATEMENT In human skin the junction between the epidermis and dermis undulates. Epidermal stem cells pattern according to their position relative to those undulations. Here we describe a rig in which epidermal cells are cultured on a collagen-coated poly(d,l-lactide-co-glycolide) (PLGA) membrane. When a vacuum is applied the membrane is induced to undulate. Stem cells cluster in response to the vacuum, whereas differentiating cells do not. Rho kinase inhibition results in loss of clustering, suggesting a role for Rho family members in the process. This dynamic platform is a new tool for investigating changes in the skin with age and disease.
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Affiliation(s)
- Ayelen L Helling
- 1 Center for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, London, United Kingdom
| | - Priyalakshmi Viswanathan
- 1 Center for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, London, United Kingdom
| | - Katerina S Cheliotis
- 1 Center for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, London, United Kingdom
| | - Seyedeh Atefeh Mobasseri
- 1 Center for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, London, United Kingdom
| | - Ying Yang
- 2 Institute for Science and Technology in Medicine, Keele University, Stoke-on-Trent, United Kingdom
| | - Alicia J El Haj
- 2 Institute for Science and Technology in Medicine, Keele University, Stoke-on-Trent, United Kingdom
| | - Fiona M Watt
- 1 Center for Stem Cells and Regenerative Medicine, King's College London, Guy's Hospital, London, United Kingdom
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8
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Xue M, Zhao R, Lin H, Jackson C. Delivery systems of current biologicals for the treatment of chronic cutaneous wounds and severe burns. Adv Drug Deliv Rev 2018; 129:219-241. [PMID: 29567398 DOI: 10.1016/j.addr.2018.03.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/08/2018] [Accepted: 03/13/2018] [Indexed: 12/15/2022]
Abstract
While wound therapy remains a clinical challenge in current medical practice, much effort has focused on developing biological therapeutic approaches. This paper presents a comprehensive review of delivery systems for current biologicals for the treatment of chronic wounds and severe burns. The biologicals discussed here include proteins such as growth factors and gene modifying molecules, which may be delivered to wounds free, encapsulated, or released from living systems (cells, skin grafts or skin equivalents) or biomaterials. Advances in biomaterial science and technologies have enabled the synthesis of delivery systems such as scaffolds, hydrogels and nanoparticles, designed to not only allow spatially and temporally controlled release of biologicals, but to also emulate the natural extracellular matrix microenvironment. These technologies represent an attractive field for regenerative wound therapy, by offering more personalised and effective treatments.
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9
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Gacto-Sanchez P. Surgical treatment and management of the severely burn patient: Review and update. Med Intensiva 2017; 41:356-364. [PMID: 28456441 DOI: 10.1016/j.medin.2017.02.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 02/08/2017] [Accepted: 02/18/2017] [Indexed: 01/20/2023]
Abstract
Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients.
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Affiliation(s)
- P Gacto-Sanchez
- Plastic Surgeon, Plastic and Reconstructive Department, Burns Unit, Virgen del Rocio University Hospital, Sevilla, Spain.
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10
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Boone M, Draye JP, Verween G, Pirnay JP, Verbeken G, De Vos D, Rose T, Jennes S, Jemec GBE, Del Marmol V. Real-time three-dimensional imaging of epidermal splitting and removal by high-definition optical coherence tomography. Exp Dermatol 2016; 23:725-30. [PMID: 25047067 DOI: 10.1111/exd.12516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2014] [Indexed: 01/06/2023]
Abstract
While real-time 3-D evaluation of human skin constructs is needed, only 2-D non-invasive imaging techniques are available. The aim of this paper is to evaluate the potential of high-definition optical coherence tomography (HD-OCT) for real-time 3-D assessment of the epidermal splitting and decellularization. Human skin samples were incubated with four different agents: Dispase II, NaCl 1 M, sodium dodecyl sulphate (SDS) and Triton X-100. Epidermal splitting, dermo-epidermal junction, acellularity and 3-D architecture of dermal matrices were evaluated by High-definition optical coherence tomography before and after incubation. Real-time 3-D HD-OCT assessment was compared with 2-D en face assessment by reflectance confocal microscopy (RCM). (Immuno) histopathology was used as control. HD-OCT imaging allowed real-time 3-D visualization of the impact of selected agents on epidermal splitting, dermo-epidermal junction, dermal architecture, vascular spaces and cellularity. RCM has a better resolution (1 μm) than HD-OCT (3 μm), permitting differentiation of different collagen fibres, but HD-OCT imaging has deeper penetration (570 μm) than RCM imaging (200 μm). Dispase II and NaCl treatments were found to be equally efficient in the removal of the epidermis from human split-thickness skin allografts. However, a different epidermal splitting level at the dermo-epidermal junction could be observed and confirmed by immunolabelling of collagen type IV and type VII. Epidermal splitting occurred at the level of the lamina densa with dispase II and above the lamina densa (in the lamina lucida) with NaCl. The 3-D architecture of dermal papillae and dermis was more affected by Dispase II on HD-OCT which corresponded with histopathologic (orcein staining) fragmentation of elastic fibres. With SDS treatment, the epidermal removal was incomplete as remnants of the epidermal basal cell layer remained attached to the basement membrane on the dermis. With Triton X-100 treatment, the epidermis was not removed. In conclusion, HD-OCT imaging permits real-time 3-D visualization of the impact of selected agents on human skin allografts.
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Affiliation(s)
- Marc Boone
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
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Chua AWC, Khoo YC, Tan BK, Tan KC, Foo CL, Chong SJ. Skin tissue engineering advances in severe burns: review and therapeutic applications. BURNS & TRAUMA 2016; 4:3. [PMID: 27574673 PMCID: PMC4963933 DOI: 10.1186/s41038-016-0027-y] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/11/2016] [Indexed: 01/13/2023]
Abstract
Current advances in basic stem cell research and tissue engineering augur well for the development of improved cultured skin tissue substitutes: a class of products that is still fraught with limitations for clinical use. Although the ability to grow autologous keratinocytes in-vitro from a small skin biopsy into sheets of stratified epithelium (within 3 to 4 weeks) helped alleviate the problem of insufficient donor site for extensive burn, many burn units still have to grapple with insufficient skin allografts which are used as intermediate wound coverage after burn excision. Alternatives offered by tissue-engineered skin dermal replacements to meet emergency demand have been used fairly successfully. Despite the availability of these commercial products, they all suffer from the same problems of extremely high cost, sub-normal skin microstructure and inconsistent engraftment, especially in full thickness burns. Clinical practice for severe burn treatment has since evolved to incorporate these tissue-engineered skin substitutes, usually as an adjunct to speed up epithelization for wound closure and/or to improve quality of life by improving the functional and cosmetic results long-term. This review seeks to bring the reader through the beginnings of skin tissue engineering, the utilization of some of the key products developed for the treatment of severe burns and the hope of harnessing stem cells to improve on current practice.
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Affiliation(s)
- Alvin Wen Choong Chua
- Singapore General Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, 20 College Road, Academia Level 4, Singapore, 169845 Singapore ; Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore ; Transplant Tissue Centre, c/o Skin Bank Unit, Singapore General Hospital, Block 4 Level 3 Room A7, Outram Road, Singapore, 169608 Singapore
| | - Yik Cheong Khoo
- Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore ; Transplant Tissue Centre, c/o Skin Bank Unit, Singapore General Hospital, Block 4 Level 3 Room A7, Outram Road, Singapore, 169608 Singapore
| | - Bien Keem Tan
- Singapore General Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, 20 College Road, Academia Level 4, Singapore, 169845 Singapore ; Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore ; Transplant Tissue Centre, c/o Skin Bank Unit, Singapore General Hospital, Block 4 Level 3 Room A7, Outram Road, Singapore, 169608 Singapore
| | - Kok Chai Tan
- Singapore General Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, 20 College Road, Academia Level 4, Singapore, 169845 Singapore ; Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore
| | - Chee Liam Foo
- Singapore General Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, 20 College Road, Academia Level 4, Singapore, 169845 Singapore ; Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore
| | - Si Jack Chong
- Singapore General Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, 20 College Road, Academia Level 4, Singapore, 169845 Singapore ; Singapore General Hospital, Skin Bank Unit, Block 4 Level 3 Room 15, Outram Road, Singapore, 169608 Singapore ; Transplant Tissue Centre, c/o Skin Bank Unit, Singapore General Hospital, Block 4 Level 3 Room A7, Outram Road, Singapore, 169608 Singapore
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12
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Boone MALM, Draye JP, Verween G, Aiti A, Pirnay JP, Verbeken G, De Vos D, Rose T, Jennes S, Jemec GBE, del Marmol V. Recellularizing of human acellular dermal matrices imaged by high-definition optical coherence tomography. Exp Dermatol 2015; 24:349-54. [DOI: 10.1111/exd.12662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 01/28/2023]
Affiliation(s)
- Marc A. L. M. Boone
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
| | - Jean Pierre Draye
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gunther Verween
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Annalisa Aiti
- Regional Skin Bank; Emilia Romagna and Cell Factory; Burn Center; Bufalini Hospital; Cesena Italy
| | - Jean-Paul Pirnay
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gilbert Verbeken
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Daniel De Vos
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Thomas Rose
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Serge Jennes
- Human Cell and Tissue Banks; Laboratory for Molecular and Cellular Technology; Burn Wound Centre; Queen Astrid Military Hospital; Brussels Belgium
| | - Gregor B. E. Jemec
- Department of Dermatology; Roskilde Hospital; Health Sciences Faculty; University of Copenhagen; Roskilde Denmark
| | - Veronique del Marmol
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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13
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Gugerell A, Neumann A, Kober J, Tammaro L, Hoch E, Schnabelrauch M, Kamolz L, Kasper C, Keck M. Adipose-derived stem cells cultivated on electrospun l-lactide/glycolide copolymer fleece and gelatin hydrogels under flow conditions – aiming physiological reality in hypodermis tissue engineering. Burns 2015; 41:163-71. [DOI: 10.1016/j.burns.2014.06.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/03/2014] [Accepted: 06/09/2014] [Indexed: 11/30/2022]
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14
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Gardien KLM, Middelkoop E, Ulrich MMW. Progress towards cell-based burn wound treatments. Regen Med 2015; 9:201-18. [PMID: 24750061 DOI: 10.2217/rme.13.97] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cell therapy as part of the concept of regenerative medicine represents an upcoming platform technology. Although cultured epidermal cells have been used in burn treatment for decades, new developments have renewed the interest in this type of treatment. Whereas early results were hampered by long culture times in order to produce confluent sheets of keratinocytes, undifferentiated proliferating cells can nowadays be applied on burns with different application techniques. The application of cells on carriers has improved early as well as long-term results in experimental settings. The results of several commercially available epidermal substitutes for burn wound treatment are reviewed in this article. These data clearly demonstrate a lack of randomized comparative trials and application of measurable outcome parameters. Experimental research in culture systems and animal models has demonstrated new developments and proof of concepts of further improvements in epidermal coverage. These include combinations of epidermal cells and mesenchymal stem cells, and the guidance of both material and cell interactions towards regeneration of skin appendages as well as vascular and nerve structures.
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Affiliation(s)
- Kim L M Gardien
- Department of Plastic Reconstructive & Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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15
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Shahrokhi S, Arno A, Jeschke MG. The use of dermal substitutes in burn surgery: acute phase. Wound Repair Regen 2014; 22:14-22. [PMID: 24393152 DOI: 10.1111/wrr.12119] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/12/2013] [Indexed: 11/30/2022]
Abstract
Major burns represent a challenge in autologous skin coverage and may lead to severe functional and cosmetic sequelae. Dermal substitutes are increasingly becoming an essential part of burn care during the acute phase of treatment. In the long term dermal substitutes improve functional and cosmetic results and thus enhance quality of life. In the chronic wound setting, dermal substitutes are used to reconstruct and improve burn scars and defects. Despite the potential of dermal substitutes, further research is required to strengthen scientific evidence regarding their effects and also to develop new technologies and products. Furthermore, dermal substitutes have a pivotal role in future research strategies as they have the potential to provide adequate scaffold for stem cells, tissue engineering, and regenerative medicine with conceivable application of obtaining long-lasting and scarless artificial skin. This review discusses the status quo of dermal substitutes and novel strategies in the use of dermal substitutes with a focus on burn care.
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Affiliation(s)
- Shahriar Shahrokhi
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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16
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Three-dimensional biomaterial degradation — Material choice, design and extrinsic factor considerations. Biotechnol Adv 2014; 32:984-99. [DOI: 10.1016/j.biotechadv.2014.04.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 04/18/2014] [Accepted: 04/30/2014] [Indexed: 11/20/2022]
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17
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Liu L, Liu X, Deng H, Wu Z, Zhang J, Cen B, Xu Q, Ji A. Something between the amazing functions and various morphologies of self-assembling peptides materials in the medical field. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2014; 25:1331-45. [DOI: 10.1080/09205063.2014.943536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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18
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The in vitro characterization of a gelatin scaffold, prepared by cryogelation and assessed in vivo as a dermal replacement in wound repair. Acta Biomater 2014; 10:3156-66. [PMID: 24704695 DOI: 10.1016/j.actbio.2014.03.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 03/14/2014] [Accepted: 03/25/2014] [Indexed: 02/04/2023]
Abstract
A sheet gelatin scaffold with attached silicone pseudoepidermal layer for wound repair purposes was produced by a cryogelation technique. The resulting scaffold possessed an interconnected macroporous structure with a pore size distribution of 131 ± 17 μm at one surface decreasing to 30 ± 8 μm at the attached silicone surface. The dynamic storage modulus (G') and mechanical stability were comparable to the clinical gold standard dermal regeneration template, Integra®. The scaffolds were seeded in vitro with human primary dermal fibroblasts. The gelatin based material was not only non-cytotoxic, but over a 28 day culture period also demonstrated advantages in cell migration, proliferation and distribution within the matrix when compared with Integra®. When seeded with human keratinocytes, the neoepidermal layer that formed over the cryogel scaffold appeared to be more advanced and mature when compared with that formed over Integra®. The in vivo application of the gelatin scaffold in a porcine wound healing model showed that the material supports wound healing by allowing host cellular infiltration, biointegration and remodelling. The results of our in vitro and in vivo studies suggest that the gelatin based scaffold produced by a cryogelation technique is a promising material for dermal substitution, wound healing and other potential biomedical applications.
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19
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Nailbed reconstruction using dermal regeneration template. J Plast Reconstr Aesthet Surg 2014; 67:e303-5. [PMID: 24934098 DOI: 10.1016/j.bjps.2014.05.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/23/2014] [Accepted: 05/25/2014] [Indexed: 11/21/2022]
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20
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Braghirolli DI, Steffens D, Pranke P. Electrospinning for regenerative medicine: a review of the main topics. Drug Discov Today 2014; 19:743-53. [DOI: 10.1016/j.drudis.2014.03.024] [Citation(s) in RCA: 157] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 03/06/2014] [Accepted: 03/27/2014] [Indexed: 12/20/2022]
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21
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Bonvallet PP, Culpepper BK, Bain JL, Schultz MJ, Thomas SJ, Bellis SL. Microporous dermal-like electrospun scaffolds promote accelerated skin regeneration. Tissue Eng Part A 2014; 20:2434-45. [PMID: 24568584 DOI: 10.1089/ten.tea.2013.0645] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The goal of this study was to synthesize skin substitutes that blend native extracellular matrix (ECM) molecules with synthetic polymers which have favorable mechanical properties. To this end, scaffolds were electrospun from collagen I (col) and poly(ɛ-caprolactone) (PCL), and then pores were introduced mechanically to promote fibroblast infiltration, and subsequent filling of the pores with ECM. A 70:30 col/PCL ratio was determined to provide optimal support for dermal fibroblast growth, and a pore diameter, 160 μm, was identified that enabled fibroblasts to infiltrate and fill pores with native matrix molecules, including fibronectin and collagen I. Mechanical testing of 70:30 col/PCL scaffolds with 160 μm pores revealed a tensile strength of 1.4 MPa, and the scaffolds also exhibited a low rate of contraction (<19%). Upon implantation, scaffolds should support epidermal regeneration; we, therefore, evaluated keratinocyte growth on fibroblast-embedded scaffolds with matrix-filled pores. Keratinocytes formed a stratified layer on the surface of fibroblast-remodeled scaffolds, and staining for cytokeratin 10 revealed terminally differentiated keratinocytes at the apical surface. When implanted, 70:30 col/PCL scaffolds degraded within 3-4 weeks, an optimal time frame for degradation in vivo. Finally, 70:30 col/PCL scaffolds with or without 160 μm pores were implanted into full-thickness critical-sized skin defects. Relative to nonporous scaffolds or sham wounds, scaffolds with 160 μm pores induced accelerated wound closure, and stimulated regeneration of healthy dermal tissue, evidenced by a more normal-appearing matrix architecture, blood vessel in-growth, and hair follicle development. Collectively, these results suggest that microporous electrospun scaffolds are effective substrates for skin regeneration.
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Affiliation(s)
- Paul P Bonvallet
- 1 Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham , Birmingham, Alabama
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22
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Pereira RF, Barrias CC, Granja PL, Bartolo PJ. Advanced biofabrication strategies for skin regeneration and repair. Nanomedicine (Lond) 2013; 8:603-21. [DOI: 10.2217/nnm.13.50] [Citation(s) in RCA: 207] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Skin is the largest organ of human body, acting as a barrier with protective, immunologic and sensorial functions. Its permanent exposure to the external environment can result in different kinds of damage with loss of variable volumes of extracellular matrix. For the treatment of skin lesions, several strategies are currently available, such as the application of autografts, allografts, wound dressings and tissue-engineered substitutes. Although proven clinically effective, these strategies are still characterized by key limitations such as patient morbidity, inadequate vascularization, low adherence to the wound bed, the inability to reproduce skin appendages and high manufacturing costs. Advanced strategies based on both bottom-up and top-down approaches offer an effective, permanent and viable alternative to solve the abovementioned drawbacks by combining biomaterials, cells, growth factors and advanced biomanufacturing techniques. This review details recent advances in skin regeneration and repair strategies, and describes their major advantages and limitations. Future prospects for skin regeneration are also outlined.
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Affiliation(s)
- Rúben F Pereira
- Centre for Rapid & Sustainable Product Development, Polytechnic Institute of Leiria, Portugal
- Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
| | - Cristina C Barrias
- Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Pedro L Granja
- Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal
- Faculdade de Engenharia da Universidade do Porto, Departamento de Engenharia Metalúrgica & Materiais, Porto, Portugal
| | - Paulo J Bartolo
- Centre for Rapid & Sustainable Product Development, Polytechnic Institute of Leiria, Portugal.
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Kalin M, Kuru S, Kismet K, Barlas AM, Akgun YA, Astarci HM, Ustun H, Ertas E. The Effectiveness of Porcine Dermal Collagen (Permacol(®)) on Wound Healing in the Rat Model. Indian J Surg 2013; 77:407-11. [PMID: 26730035 DOI: 10.1007/s12262-013-0854-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 01/16/2013] [Indexed: 10/27/2022] Open
Abstract
Porcine acellular dermal collagen (PDC), which is a biological material derived from processing porcine dermis, has already been used for urologic, gynecologic, plastic, and general surgery procedures up to now. The aim of this study is to investigate the effectiveness of PDC on wound healing as a dermal substitute in the rat model. Twenty Wistar albino rats were divided into two groups. Standard full-thickness skin defects were created on the back of the rats. In the control group (Group 1), the dressings moisturized with saline were changed daily. In the study group (Group 2), porcine dermal collagen was implanted onto each wound and fixed with 4-0 polypropylene sutures. Contraction percentages of wound areas were calculated on the third, seventh, tenth, and fourteenth days by using the planimetric program. On fourteenth day, the wound areas were excised for histopathological examination, inflammatory scoring, and evaluation of collagen deposition. The study group was superior to the control group in terms of inflammatory scoring, type I/type III collagen ratio, and wound contraction rates. Porcine dermal collagen may be used effectively and safely on full-thickness wounds as a current dermal substitute.
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Affiliation(s)
- Murat Kalin
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Serdar Kuru
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Kemal Kismet
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey ; Genel Cerrahi Klinigi, Ulucanlar, S.B. Ankara Egitim ve Arastirma Hastanesi, Ankara, Turkey
| | - Aziz Mutlu Barlas
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Yusuf Akif Akgun
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
| | | | - Huseyin Ustun
- Pathology Department, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ertugrul Ertas
- General Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey
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24
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Jayarama Reddy V, Radhakrishnan S, Ravichandran R, Mukherjee S, Balamurugan R, Sundarrajan S, Ramakrishna S. Nanofibrous structured biomimetic strategies for skin tissue regeneration. Wound Repair Regen 2012; 21:1-16. [PMID: 23126632 DOI: 10.1111/j.1524-475x.2012.00861.x] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/28/2012] [Indexed: 01/09/2023]
Abstract
Mimicking porous topography of natural extracellular matrix is advantageous for successful regeneration of damaged tissues or organs. Nanotechnology being one of the most promising and growing technology today shows an extremely huge potential in the field of tissue engineering. Nanofibrous structures that mimic the native extracellular matrix and promote the adhesion of various cells are being developed as tissue-engineered scaffolds for skin, bone, vasculature, heart, cornea, nervous system, and other tissues. A range of novel biocomposite materials has been developed to enhance the bioactive or therapeutic properties of these nanofibrous scaffolds via surface modifications, including the immobilization of functional cell-adhesive ligands and bioactive molecules such as drugs, enzymes, and cytokines. In skin tissue engineering, usage of allogeneic skin is avoided to reestablish physiological continuity and also to address the challenge of curing acute and chronic wounds, which remains as the area of exploration with various biomimetic approaches. Two-dimensional, three-dimensional scaffolds and stem cells are presently used as dermal regeneration templates for the treatment of full-thickness skin defects resulting from injuries and severe burns. The present review elaborates specifically on the fabrication of nanofibrous structured strategies for wound dressings, wound healing, and controlled release of growth factors for skin tissue regeneration.
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Affiliation(s)
- Venugopal Jayarama Reddy
- Centre for Nanofibers & Nanotechnology, Faculty of Engineering, National University of Singapore, Singapore.
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25
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Development of a vascularized skin construct using adipose-derived stem cells from debrided burned skin. Stem Cells Int 2012; 2012:841203. [PMID: 22848228 PMCID: PMC3399490 DOI: 10.1155/2012/841203] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/25/2012] [Indexed: 01/06/2023] Open
Abstract
Large body surface area burns pose significant therapeutic challenges. Clinically, the extent and depth of burn injury may mandate the use of allograft for temporary wound coverage while autografts are serially harvested from the same donor areas. The paucity of donor sites in patients with burns involving large surface areas highlights the need for better skin substitutes that can achieve early and complete coverage and retain normal skin durability with minimal donor requirements. We have isolated autologous stem cells from the adipose layer of surgically debrided burned skin (dsASCs), using a point-of-care stem cell isolation device. These cells, in a collagen—polyethylene glycol fibrin-based bilayer hydrogel, differentiate into an epithelial layer, a vascularized dermal layer, and a hypodermal layer. All-trans-retinoic acid and fenofibrate were used to differentiate dsASCs into epithelial-like cells. Immunocytochemical analysis showed a matrix- and time-dependent change in the expression of stromal, vascular, and epithelial cell markers. These results indicate that stem cells isolated from debrided skin can be used as a single autologous cell source to develop a vascularized skin construct without culture expansion or addition of exogenous growth factors. This technique may provide an alternative approach for cutaneous coverage after extensive burn injuries.
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26
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Wold KA, Damodaran VB, Suazo LA, Bowen RA, Reynolds MM. Fabrication of biodegradable polymeric nanofibers with covalently attached NO donors. ACS APPLIED MATERIALS & INTERFACES 2012; 4:3022-3030. [PMID: 22663769 DOI: 10.1021/am300383w] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Many common wound healing aids are created from biodegradable polymeric materials. Often, these materials are unable to induce complete healing in wounds because of their failure to prevent infection and promote cell growth. This study reports the development of therapeutic materials aimed at overcoming these limitations through the release of a naturally occurring antimicrobial agent from a porous, polymeric fiber scaffold. The antimicrobial character was achieved through the release of nitric oxide (NO) while the porous structure was fabricated through electrospinning polymers into nanofibers. Three variations of the polymer poly(lactic-co-glycolic-co-hydroxymethyl propionic acid) (PLGH) modified to include thiol and NO groups were investigated. Fibers of the modified polymers exhibited smooth, bead free morphologies with diameters averaging between 200 and 410 nm. These fibers were deposited in a random manner to create a highly porous fibrous scaffold. The fibers were found to release NO under physiological pH and temperature and have the capacity to release 0.026 to 0.280 mmol NO g(-1). The materials maintained their fibrous morphological structure after this exposure to aqueous conditions. The sustained morphological stability of the fiber structure coupled to their extended NO release gives these materials great potential for use in wound healing materials.
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Affiliation(s)
- Kathryn A Wold
- School of Biomedical Engineering, Colorado State University , 204 Engineering Building, Fort Collins, Colorado 80523, United States
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