Abstract
Wounds with full-thickness skin loss are commonly managed by skin grafting. In the absence of a graft, reepithelialization is imperfect and leads to increased scar formation. Biomaterials can alter wound healing so that it produces more regenerative tissue and fewer scars. This current study use the new chitosan based biomaterial in full-thickness wound with impaired healing on rat model. Wounds were evaluated after being treated with a chitosan dermal substitute, a chitosan skin substitute, or duoderm CGF. Wounds treated with the chitosan skin substitute showed the most re-epithelialization (33.2 ± 2.8%), longest epithelial tongue (1.62 ± 0.13 mm), and shortest migratory tongue distance (7.11 ± 0.25 mm). The scar size of wounds treated with the chitosan dermal substitute (0.13 ± 0.02 cm) and chitosan skin substitute (0.16 ± 0.05 cm) were significantly decreased (P < 0.05) compared with duoderm (0.45 ± 0.11 cm). Human leukocyte antigen (HLA) expression on days 7, 14, and 21 revealed the presence of human hair follicle stem cells and fibroblasts that were incorporated into and surviving in the irradiated wound. We have proven that a chitosan dermal substitute and chitosan skin substitute are suitable for wound healing in full-thickness wounds that are impaired due to radiation.
Highlights
Wound healing is a complex biological process that involves molecular and cellular responses
The epithelial tongue (ET) in irradiated wounds treated with a chitosan skin substitute was longer (1.62 ± 0.13 mm) than those in the irradiated wounds treated with a chitosan dermal substitute (1.22 ± 0.19 mm) or duoderm (1.14±0.18 mm) (P = 0.20 and P = 1.0, resp.) In the nonirradiated wounds, the ET was longer after wounds were treated with a chitosan dermal substitute (1.23 ± 0.12 mm) compared to a chitosan skin substitute (1.19 ± 0.21 mm) or duoderm (1.11 ± 0.30 mm) (Figure 2) (P = 1.0)
The migratory tongue distance (MT) distances in irradiated wounds treated with chitosan skin substitutes were shorter (7.11 ± 0.25 mm) than irradiated wounds treated with a chitosan dermal substitute (8.16 ± 0.26 mm) or duoderm (7.25 ± 0.47 mm) (P = 1.0 and P = 0.26, resp.)
Summary
Wound healing is a complex biological process that involves molecular and cellular responses. The reconstruction of skin after injury involves different types of wound healing depending on the wound classification. Skin with a superficial loss of the epidermis gradually heals over time without intervention. In a partial-thickness wound, the epidermis primarily heals by re-epithelialization, which is the resurfacing of a wound bed by neokeratinocytes. Partialthickness wounds heal by primary intention, known as surgical wound healing. This type of healing employs sutures, staples, glue, or strips between both sides of the wound edge to close the wound bed. The major events in healing by primary intention are connective tissue deposition and reepithelialization. There is no formation of granulation tissue or wound contraction [1]
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