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Kamolz LP, Kotzbeck P, Schintler M, Spendel S. Skin regeneration, repair, and reconstruction: present and future. Eur Surg 2022. [DOI: 10.1007/s10353-022-00757-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Summary
Background
Large skin defects caused by trauma (e.g., burns) or due to other reasons (e.g., tumor-related skin resections) require sufficient skin replacement. The constant improvement of innovative methods of skin replacement and skin expansion mean that even burn victims with more than 80% body surface burned have a realistic chance of survival. Due to these new developments, not only has survival rate increased, but also quality of life has increased tremendously over the past decades.
Methods
The aim of this review is to present an overview of current standards and future trends concerning the treatment of skin defects. The main focus is placed on the most important technologies and future trends.
Results
Autologous skin grafting was developed more than 3500 years ago. Several approaches and techniques have been discovered and established in burn care and plastic surgery since then. Great achievements were made during the 19th and 20th centuries. Many of these old and new techniques are still part of modern burn and plastic surgery. Today, autologous skin grafting is still considered to be the gold standard for many wounds, but new technologies have been developed, ranging from biological to synthetic skin replacement materials.
Conclusion
Today, old and new technologies are available which allow us new treatment concepts. All this has led to the reconstructive clockwork for reconstructive surgery of the 21st century.
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Nischwitz SP, Popp D, Shubitidze D, Luze H, Zrim R, Klemm K, Rapp M, Haller HL, Feisst M, Kamolz LP. The successful use of polylactide wound dressings for chronic lower leg wounds: A retrospective analysis. Int Wound J 2021; 19:1180-1187. [PMID: 34750983 PMCID: PMC9284639 DOI: 10.1111/iwj.13713] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 12/28/2022] Open
Abstract
Chronic wounds are a challenging medical entity for patients, medical professionals and healthcare systems. Frequently, patients present themselves to wound specialists after months or even years of unsuccessful treatment. Recent developments have resulted in a multitude of different advanced wound dressings created to treat complex, chronic wounds, one of which is the polylactide dressing Suprathel. This study aimed at investigating the healing potential of Suprathel in chronic wounds and differentiating between old and “young”, diabetic and non‐diabetic chronic wounds. A prospective, multicentric, non‐controlled intervention study was conducted, treating patients with chronic lower leg ulcers (>3 months) with Suprathel and assessing them weekly. Afterwards, a retrospective analysis was performed analysing the wound size initially, after 4 and after 8 weeks of treatment. Furthermore, a differentiation between diabetic and non‐diabetic, and chronic wounds older and younger than 12 months, was assessed. A significant reduction in wound size was observed in the study population after 8 weeks of treatment. The effect size in the diabetic wound and the old chronic wound group even reached more than one, with the other groups still showing a large effect of the intervention. This study shows that Suprathel is a valuable tool in the armamentarium of a wound specialist. Not only could we show a positive effect on chronic wounds, we could even demonstrate a significant wound size reduction in chronic wounds of old and young, as well as diabetic wounds, with the treatment of older chronic and diabetic wounds yielding an even larger effect size. Further randomised, controlled studies are necessary to show the full potential of advanced wound dressing materials in large patient cohorts.
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Affiliation(s)
- Sebastian P Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Daniel Popp
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - David Shubitidze
- Clinic for Vascular and Endovascular Surgery, AMEOS Klinikum St. Clemens, Oberhausen, Germany
| | - Hanna Luze
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
| | - Robert Zrim
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,International University of Monaco, Monaco
| | - Klaus Klemm
- Clinic for Vascular Surgery, Vascular and Endovascular Surgery, Marienhospital Stuttgart, Vinzenz von Paul Kliniken, Stuttgart, Germany
| | - Matthias Rapp
- Clinic for Orthopedics, Trauma Surgery and Sports Traumatology - Burn Center, Marienhospital Stuttgart, Stuttgart, Germany
| | | | - Manuel Feisst
- Institute of Medical Biometry, University Heidelberg, Heidelberg, Germany
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.,COREMED - Cooperative Centre for Regenerative Medicine, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
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