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Lv X, Zhao N, Long S, Wang G, Ran X, Gao J, Wang J, Wang T. 3D skin bioprinting as promising therapeutic strategy for radiation-associated skin injuries. Wound Repair Regen 2024; 32:217-228. [PMID: 38602068 DOI: 10.1111/wrr.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/16/2024] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
Both cutaneous radiation injury and radiation combined injury (RCI) could have serious skin traumas, which are collectively referred to as radiation-associated skin injuries in this paper. These two types of skin injuries require special managements of wounds, and the therapeutic effects still need to be further improved. Cutaneous radiation injuries are common in both radiotherapy patients and victims of radioactive source accidents, which could lead to skin necrosis and ulcers in serious conditions. At present, there are still many challenges in management of cutaneous radiation injuries including early diagnosis, lesion assessment, and treatment prognosis. Radiation combined injuries are special and important issues in severe nuclear accidents, which often accompanied by serious skin traumas. Mass victims of RCI would be the focus of public health concern. Three-dimensional (3D) bioprinting, as a versatile and favourable technique, offers effective approaches to fabricate biomimetic architectures with bioactivity, which provides potentials for resolve the challenges in treating radiation-associated skin injuries. Combining with the cutting-edge advances in 3D skin bioprinting, the authors analyse the damage characteristics of skin wounds in both cutaneous radiation injury and RCI and look forward to the potential value of 3D skin bioprinting for the treatments of radiation-associated skin injuries.
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Affiliation(s)
- Xiaofan Lv
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Na Zhao
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
- Institute of Materia Medica and Department of Pharmaceutics, College of Pharmacy, Army Medical University (Third Military Medical University), Chongqing, China
| | - Shuang Long
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Guojian Wang
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xinze Ran
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jining Gao
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Junping Wang
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Tao Wang
- State Key Laboratory of Trauma and Chemical Poisoning, Institute of Combined Injury, School of Preventive Military Medicine, Army Medical University (Third Military Medical University), Chongqing, China
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Schlottmann F, Strauß S, Ziesing S, Reineke C, Ipaktchi R, Weyand B, Krezdorn N, Vogt PM, Bucan V. Organization of Hannover Skin Bank: Sterile culture and procurement protocols for viable cryopreserved allogeneic skin grafts of living donors. Int Wound J 2024; 21:e14374. [PMID: 37675770 PMCID: PMC10784195 DOI: 10.1111/iwj.14374] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
Preserved allogeneic donor skin still represents one of the gold standard therapies in temporary wound coverage in severely burned patients or chronic wounds. Allogeneic skin grafts are currently commercially available as cryo- or glycerol-preserved allografts through skin tissue banks all over the world. Most of the skin tissue banks rely on human cadaveric skin donations. Due to the chronic shortage of human allogeneic transplants, such as skin, and increasing costs in the procurement of allografts from other skin tissue banks, Hannover Medical School has been building up its own skin tissue bank based on allogeneic skin grafts from living donors who underwent surgical treatment (i.e., body-contouring procedures, such as abdominioplasties). This article presents procedures and protocols for the procurement and processing of allogeneic skin grafts according to national legislation and European regulations and guidelines. Beside protocols, initial microbiological data regarding the sterility of the harvested grafts are presented. The results currently form the basis for further investigations as well as clinical applications. In summary, a microbiological testing and acceptance procedure is presented that ensures adequate patient safety and skin viability.
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Affiliation(s)
- Frederik Schlottmann
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
| | - Sarah Strauß
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
| | - Stefan Ziesing
- Department of MicrobiologyHannover Medical SchoolHannoverGermany
| | | | - Ramin Ipaktchi
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
- Department of Plastic and Hand Surgery, InselspitalUniversity Hospital BernBernSwitzerland
| | - Birgit Weyand
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
| | - Nicco Krezdorn
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
| | - Peter Maria Vogt
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
| | - Vesna Bucan
- Department of Plastic, Aesthetic, Hand and Reconstructive SurgeryHannover Medical SchoolHannoverGermany
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Bonilla Moncada J, Ríos CA, Castro CM, Leal AL, Arturo JA, Diaz K, Duarte C, Puerto G, Moreno N, Velasco A, Moreno J. Infections in patients with adverse reactions to the use of unknown modeling substances for soft tissue enhancement in Cali, Colombia. PLoS One 2023; 18:e0277958. [PMID: 36757960 PMCID: PMC9910686 DOI: 10.1371/journal.pone.0277958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/07/2022] [Indexed: 02/10/2023] Open
Abstract
The infiltration of foreign materials not approved for medical purposes or of modeling substances used in soft tissue to modify the anatomical appearance for aesthetic purposes represents a serious health problem. These procedures lead to the development of delayed complications, including infections. The objective of this study was to characterize infections in patients with adverse reactions to the use of modeling substances in Cali, Colombia. A cross-sectional and descriptive study was used to determine the frequency of bacterial and fungal infections associated with complications from and adverse reactions to the use of modeling substances in 113 patients. We identified microorganisms in 22 patients and a frequency of 68.1% monomicrobial infections and 31.8% polymicrobial infections. The microorganisms identified in our study included Bacillus cereus, Mycobacterium fortuitum, and Pseudomonas stutzeri, among other microorganisms. The presence of adverse effects derived from the use of illegal modeling substances has been demonstrated; among these effects, infections occur with high frequency and place the health of the patient at risk and increase problems in health care.
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Affiliation(s)
- Jennifer Bonilla Moncada
- Department of Microbiology, National Health Institute, Bogotá, Colombia
- Biotechnology Institute, National University of Colombia, Bogotá, Colombia
| | | | | | - Aura Lucia Leal
- Department of Microbiology, National Health Institute, Bogotá, Colombia
| | | | | | - Carolina Duarte
- Department of Microbiology, National Health Institute, Bogotá, Colombia
| | - Gloria Puerto
- Department of Microbiology, National Health Institute, Bogotá, Colombia
- Department of Mycobacteria, National Health Institute, Bogotá, Colombia
| | | | - Amelia Velasco
- Department of Mycobacteria, National Health Institute, Bogotá, Colombia
| | - Jaime Moreno
- Department of Microbiology, National Health Institute, Bogotá, Colombia
- * E-mail:
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do Canto Canabarro M, Meneghetti KL, Geimba MP, Corção G. Biofilm formation and antibiotic susceptibility of Staphylococcus and Bacillus species isolated from human allogeneic skin. Braz J Microbiol 2021; 53:153-160. [PMID: 34735709 DOI: 10.1007/s42770-021-00642-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022] Open
Abstract
Human skin banks around the world face a serious problem with the high number of allogeneic skins that are discarded and cannot be used for grafting due to persistent bacterial contamination even after antibiotic treatment. The biofilm formation capacity of these microorganisms may contribute to the antibiotic tolerance; however, this is not yet widely discussed in the literature. Thisstudy analyzed bacterial strains isolated from allogeneic human skin samples,which were obtained from a hospital skin bank that had already been discardeddue to microbial contamination. Biofilm formation and susceptibility topenicillin, tetracycline, and gentamicin were evaluated by crystal violetbiomass quantification and determination of the minimum inhibitoryconcentration (MIC), minimum biofilm inhibitory concentration (MBIC), andminimum biofilm eradication concentration (MBEC) by the broth microdilutionmethod with resazurin dye. A total of 216 bacterial strains were evaluated, and204 (94.45%) of them were classified as biofilm formers with varying degrees ofadhesion. MBICs were at least 512 times higher than MICs, and MBECs were atleast 512 times higher than MBICs. Thus, the presence of biofilm in allogeneicskin likely contributes to the inefficiency of the applied treatments as antibiotictolerance is known to be much higher when bacteria are in the biofilmconformation. Thus, antibiotic treatment protocols in skin banks shouldconsider biofilm formation and should include compounds with antibiofilmaction.
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Affiliation(s)
- Micaela do Canto Canabarro
- Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Sarmento Leite 500, Porto Alegre, 90050-170, Brazil
| | - Karine Lena Meneghetti
- Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Sarmento Leite 500, Porto Alegre, 90050-170, Brazil
| | - Mercedes Passos Geimba
- Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Sarmento Leite 500, Porto Alegre, 90050-170, Brazil
| | - Gertrudes Corção
- Department of Microbiology, Immunology and Parasitology, Institute of Basic Health Sciences, Universidade Federal Do Rio Grande Do Sul, Sarmento Leite 500, Porto Alegre, 90050-170, Brazil.
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Abstract
Allograft skin has been widely used for wound management in burn centers. Functional as biologic dressing, it can not only provide ideal temporary wound coverage in extensive burns when autograft is not immediately available but also prepare the wound bed for definitive autografting. In this article, the up-to-date clinical application of allograft in burn care was reviewed, including coverage of extensive burn wounds, combined use with meshed autograft, template for delayed application of cultured epidermal autografts, and the use of human acellular dermal matrix. Although it has potential disadvantages of rejection and disease transmission, allograft skin remains a workhorse in treatment of severe burn wounds.
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Coagulase-negative staphylococci in outpatient routines: the implications of switching from CLSI to BrCAST/EUCAST guidelines. Braz J Microbiol 2020; 51:1071-1078. [PMID: 32328965 DOI: 10.1007/s42770-020-00278-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/16/2020] [Indexed: 12/20/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) are frequently isolated in clinical specimens and are important reservoirs of resistance genes. In 2019, the Brazilian government set the BrCAST/EUCAST (Brazilian Committee on Antimicrobial Susceptibility Testing) guidelines as the national standard, resulting in changes in the interpretation of CoNS susceptibility tests. From outpatients, disk-diffusion susceptibility of 65 CoNS cultures were evaluated and compared using classification criteria from both CLSI and BrCAST/EUCAST. The isolates were identified using matrix assisted laser desorption ionization-time of flight (MALDI-TOF), and the presence of the mecA gene was determined. The most prevalent species were Staphylococcus saprophyticus (32.3%), S. haemolyticus (18.5%), and S. epidermidis (9.2%). Almost perfect agreement was seen between the guidelines, except concerning oxacillin and gentamicin, and the prevalence of multidrug resistant isolates increased with the use of BrCAST/EUCAST. Of all, 15 (23.1%) isolates, mainly S. epidermidis and S. haemolyticus, were positive for the mecA gene, and only three were detected when using CLSI or BrCAST/EUCAST disk-diffusion screening. This, using either guideline, could reveal the difficulty of determining oxacillin resistance. Using warning zones or molecular methods might well be indicated for CoNS. In conclusion, adoption of the BrCAST/EUCAST guidelines will result in certain artificial changes in epidemiological susceptibility profiles, and clinicians and institutions should be aware of the possible implications.
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Hu X, Chang L, Wang Z, Liu G, Hu Z, Li N. Age- and Sex-Linked Bacterial Community Variation and Function Prediction from Insoles of Healthy Chinese Population. Indian J Microbiol 2020; 60:222-229. [PMID: 32255855 DOI: 10.1007/s12088-020-00855-w] [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: 09/18/2019] [Accepted: 01/04/2020] [Indexed: 10/25/2022] Open
Abstract
Sweat secretion keeps feet and insoles humid and rich in nutrients, which are the conditions needed to maintain abundant microbial growth. Analyzing the diversity and function of microorganisms in the insole is of great significance in the development of functional insoles and prediction of human foot hygiene condition. In this study, pure culture method, MiSeq high-throughput sequencing technology, and PICRUSt gene function prediction were used to analyze the diversity and function of the bacterial community from insoles of healthy population of different sexes and age groups. Staphylococcus, Micrococcus, and Brevibacterium are present in all insole samples, and there is no significant difference between sexes of the same age group. However, a significant difference in insole microbial population was obtained among age groups. For community function, all six samples expressed similarity in the preliminary metabolism, but in samples from the elderly, many specific catabolic genes were associated with human disease and drug resistance. This study provides a reference for the development of multi-function insoles and other sanitary products for disease prediction in a healthy population.
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Affiliation(s)
- Xiaojing Hu
- 1Henan Engineering Laboratory for Bioconversion Technology of Functional Microbial, College of Life Sciences, Henan Normal University, Xinxiang, 453002 Henan China
| | - Licao Chang
- 1Henan Engineering Laboratory for Bioconversion Technology of Functional Microbial, College of Life Sciences, Henan Normal University, Xinxiang, 453002 Henan China
| | - Zhenyu Wang
- 1Henan Engineering Laboratory for Bioconversion Technology of Functional Microbial, College of Life Sciences, Henan Normal University, Xinxiang, 453002 Henan China
| | - Guosheng Liu
- 1Henan Engineering Laboratory for Bioconversion Technology of Functional Microbial, College of Life Sciences, Henan Normal University, Xinxiang, 453002 Henan China
| | - Zongjie Hu
- Henan Bangni Bioengineering Co. Ltd, Xinxiang, 453000 Henan China
| | - Ning Li
- Henan Bangni Bioengineering Co. Ltd, Xinxiang, 453000 Henan China
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