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Baetz N, Labroo P, Ifediba M, Miller D, Stauffer K, Sieverts M, Nicodemus-Johnson J, Chan E, Robinson I, Miess J, Roth S, Irvin J, Laun J, Mundinger G, Granick MS, Milner S, Garrett C, Li WW, Swanson EW, Smith DJ, Sopko NA. Evaluation in a porcine wound model and long-term clinical assessment of an autologous heterogeneous skin construct used to close full-thickness wounds. Tissue Cell 2023; 83:102126. [PMID: 37295271 DOI: 10.1016/j.tice.2023.102126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
Acute and chronic wounds involving deeper layers of the skin are often not adequately healed by dressings alone and require therapies such as skin grafting, skin substitutes, or growth factors. Here we report the development of an autologous heterogeneous skin construct (AHSC) that aids wound closure. AHSC is manufactured from a piece of healthy full-thickness skin. The manufacturing process creates multicellular segments, which contain endogenous skin cell populations present within hair follicles. These segments are physically optimized for engraftment within the wound bed. The ability of AHSC to facilitate closure of full thickness wounds of the skin was evaluated in a swine model and clinically in 4 patients with wounds of different etiologies. Transcriptional analysis demonstrated high concordance of gene expression between AHSC and native tissues for extracellular matrix and stem cell gene expression panels. Swine wounds demonstrated complete wound epithelialization and mature stable skin by 4 months, with hair follicle development in AHSC-treated wounds evident by 15 weeks. Biomechanical, histomorphological, and compositional analysis of the resultant swine and human skin wound biopsies demonstrated the presence of epidermal and dermal architecture with follicular and glandular structures that are similar to native skin. These data suggest that treatment with AHSC can facilitate wound closure.
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Affiliation(s)
- Nicholas Baetz
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Pratima Labroo
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Marytheresa Ifediba
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Devin Miller
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Kendall Stauffer
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Michael Sieverts
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | | | - Eric Chan
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Ian Robinson
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - James Miess
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Stephanie Roth
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Jenny Irvin
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Jake Laun
- Department of Plastic Surgery, University of South Florida, Tampa, FL, USA
| | - Gerhard Mundinger
- Department of Surgery, Louisiana State University School of Medicine, New Orleans, LA, USA
| | - Mark S Granick
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Stephen Milner
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - Caroline Garrett
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | | | - Edward W Swanson
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA
| | - David J Smith
- Department of Plastic Surgery, University of South Florida, Tampa, FL, USA
| | - Nikolai A Sopko
- Department of Research and Development, PolarityTE MD, Inc., Salt Lake City, UT, USA.
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Van Nuffel M, Meulyzer C, Gheysen B, Böhrer A, Anthonissen M, Van den Kerckhove E, Degreef I. Palmar skin elasticity measured by the Cutometer MPA 580 is decreased in mild Dupuytren's disease compared to healthy controls. HAND THERAPY 2022; 27:14-21. [PMID: 37904791 PMCID: PMC10584061 DOI: 10.1177/17589983211061616] [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: 07/24/2021] [Accepted: 11/04/2021] [Indexed: 11/01/2023]
Abstract
Introduction Involvement of the palmar skin is often seen in patients with Dupuytren's disease (DD) with severe finger contractures. However, skin elasticity may be already decreased earlier in the disease. The Cutometer MPA 580 could provide an objective skin measurement tool to assess this decrease in elasticity. Linking objective skin measurements to functional outcome measures could lead to better prediction of disease progression. We set up a study to investigate if the Cutometer was able to detect differences in skin elasticity between patients with mild Dupuytren's disease and healthy controls. Methods A cross-sectional analytical study was performed. Three assessors measured skin elasticity (palmar hand) on two sites using the Cutometer on 30 patients with mild DD and 30 healthy controls. Student's t-test was used to evaluate differences in skin elasticity and a linear model to evaluate interactions between the groups and sites. Results Significant differences in skin elasticity were found between DD patients and controls, as well as differences based on the location examined. Discussion Similar to other skin conditions, the Cutometer MPA 580 was able to demonstrate a significant lower elasticity in the palmar skin in DD patients compared to healthy controls. A decrease in skin elasticity in different locations of the hand correlated with areas that often pose problems in the treatment of more severe DD. The Cutometer could potentially be a tool to identify these areas earlier in the disease.
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Affiliation(s)
- Maarten Van Nuffel
- Department of Medical Sciences, KU Leuven-University of Leuven; Hand Unit, Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Caroline Meulyzer
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Britt Gheysen
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Arne Böhrer
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
| | - Mieke Anthonissen
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
- Oscare, Organisation for Burns, Scar After-care and Research, Antwerp, Belgium
| | - Eric Van den Kerckhove
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven; Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, Belgium
- Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ilse Degreef
- Department of Medical Sciences, KU Leuven-University of Leuven; Hand Unit, Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
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Augustin M, Keuthage W, Lobmann R, Lützkendorf S, Groth H, Möller U, Thomassin L, Bohbot S, Dissemond J, Blome C. Clinical evaluation of UrgoStart Plus dressings in real-life conditions: results of a prospective multicentre study on 961 patients. J Wound Care 2021; 30:966-978. [PMID: 34881999 DOI: 10.12968/jowc.2021.30.12.966] [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] [Indexed: 01/22/2023]
Abstract
AIMS This study aimed to evaluate the performances of lipid colloid technology with nano-oligosaccharide factor (TLC-NOSF) dressings with polyabsorbent fibres in an unselected population of patients under real-life conditions. METHODS A large, prospective, multicentre, observational study with three polyabsorbent TLC-NOSF dressings (UrgoStart Plus Pad, UrgoStart Plus and UrgoStart Plus Border, Laboratoires Urgo, France) was conducted in Germany between January 2019 and June 2020. Main outcomes included wound healing rate, clinical assessment of wound healing progression, local tolerance and acceptance of dressings, and changes in health-related quality of life (HRQoL) of the patients, assessed with the validated Wound-QoL questionnaire. RESULTS A total of 961 patients with wounds of various aetiologies (leg ulcers (LU), diabetic foot ulcers (DFU), pressure ulcers (PU) and other types of wounds) were treated with the evaluated dressings in 105 centres for a mean duration of 62 days (standard deviation 37 days). By the last visit, a wound closure or an improvement in wound healing was reported in 92.0% of the treated wounds. The highest wound closure rates were achieved when the dressings were used as first-line treatment: 71.3% in DFUs, 52.9% in LUs, 53.6% in PUs and 61.8% in the other wounds. Improvement of the wound healing process was also associated with an 87.5% relative reduction of sloughy tissue, a decrease of the level of exudate in 68.9% of the wounds, and an improvement in the periwound skin condition in 66.4% of the patients at the final visit. The dressings were 'very well' or 'well' tolerated and 'very well' or 'well' accepted by the large majority of patients. The HRQoL questionnaires were completed both at initial and final visits by 337 patients, representative of the total cohort. Despite the relatively short duration of the wounds, the HRQoL of the patients was already impaired at baseline, with 81.6% of the patients being severely affected in at least one aspect of their HRQoL. By the final visit, significant improvements in each dimension of the patients' HRQoL were reported (p<0.001), along with a reduction of the proportion of patients in need of intervention and in the number of actions needed per patient in relation to their HRQoL. CONCLUSIONS These results are consistent with previous clinical evidence on TLC-NOSF dressings. They confirm the good healing properties and safety profile of these dressings, and that a significant improvement in patient HRQoL is achieved in non-selected patients treated in real-life practice. These data support the use of such dressings as a first-line intervention and until wound healing in the management of chronic wounds, in association with appropriate standard of care.
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Affiliation(s)
- Matthias Augustin
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | - Ralf Lobmann
- Krankenhaus Bad Cannstatt (kbc) / Klinikum, Stuttgart, Germany
| | | | - Hauke Groth
- Medical Office specialized on Diabetes Relllingen, Hamburg-Rellingen, Germany
| | | | | | - Serge Bohbot
- Medical Affairs Department, Laboratoires URGO Medical, Paris, France
| | - Joachim Dissemond
- Department of Dermatology, Venereology, and Allergology, University Hospital Essen, Essen, Germany
| | - Christine Blome
- German Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Park B, Seong G, Yeom K, Yun D, Choi M, Kim M. A retrospective study to evaluate the efficacy and safety of staged purse-string sutures for the reconstruction of surgical defects on skin using computer image analysis program. Indian J Dermatol 2021; 66:645-648. [PMID: 35283493 PMCID: PMC8906307 DOI: 10.4103/ijd.ijd_402_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Staged purse-string suturing has been recently introduced for the reconstruction of round or oval defects following tumor excision. Objective: The aim of this study was to evaluate the clinical advantage of staged purse-string suturing for the reconstruction of relatively large skin defects. Materials and Methods: Twenty-one patients who received staged purse-string sutures were included in the study. To evaluate the defects and scar sizes objectively, computer-based image analysis was used. A modified observer scar assessment scale (OSAS) was applied for evaluating the clinical efficacy. Results: The mean primary postsurgical defect size in the total 21 cases was 1446.2 ± 1187.2 mm2, and the mean final scar size was about 268.1 ± 252.3 mm2. The defect area decreased gradually as staged purse-string suturing was performed. The mean total modified OSAS was 7.96 ± 1.69. Conclusion: Staged purse-string sutures might be an alternative reconstructive method for relatively large round or oval skin defects.
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