Thickness Skin Defects Research Articles

The biological and therapeutic assessment of a P(3HB-co-4HB)-bioactive glass-graphene composite biomaterial for tissue regeneration.

An ideal wound dressing should create a healing environment that relieves pain, protects against infections, maintains moisture, removes debris, and speeds up wound closure and repair. However, conventional options like gauze often fall short in fulfilling these requirements, especially for chronic or nonhealing wounds. Hence there is a critical need for inventive formulations that offer efficient, cost-effective, and eco-friendly alternatives. This study focuses on assessing the innovative formulation based on a microbial-derived copolymer known as poly(3-hydroxybutyrate-co-4-hydroxybutyrate), P(3HB-co-4HB) bioactive glass and graphene particles, and exploring their biological response in vitro and in vivo-to find the best combination that promotes cell adhesion and enhances wound healing. The formulation optimized at concentration of bioactive glass (1 w/w%) and graphene (0.01 w/w%) showed accelerated degradation and enhanced blood vessel formation. Meanwhile biocompatibility was evaluated using murine osteoblasts, human dermal fibroblasts, and standard cell culture assays, demonstrating no adverse effects after 7 days of culture and well-regulated inflammatory kinetics. Whole thickness skin defect using mice indicated the feasibility of the biocomposites for a faster wound closure and reduced inflammation. Overall, this biocomposite appears promising as an ideal wound dressing material and positively influencing wound healing rates.

Silver Nanoparticles Preparation and their Effect on Full-thickness Skin Wound Healing in Rabbit Model

With the increased prevalence of antibiotic-resistant bacteria infections, there is a pressed need for innovative antimicrobial agent. Metal nanoparticle, especially those made of noble metals such as silver, show excellent properties such as signaling the regeneration of collagen, low toxicity in vivo, bacteriostatic and bactericidal activities, and inhibiting the targeting of bacteria in wound. Therefore, this study aims to prepare silver nanoparticles then investigate its antimicrobial effect in wound healing in animal model. Silver nanoparticles were successfully prepared by chemical reduction of silver nitrate, then characterized by UV-Visible absorption spectroscopy. The in-vivo study was done by application of colloidal solution of silver nanoparticles on excisional full- thickness skin defect on the dorsum of New Zeeland rabbit as an animal model. The results indicated significant reduction of the sepsis in two infected cases after the 1st week followed by complete recovery after the 2nd dose of (SNPs drops). While the other cases showed wound closure without any sepsis which demonstrated the high efficiency of silver nanoparticles as antimicrobial agent when compared with the control group which showed persistent signs of sepsis in the all cases. The histological investigation in the control group proved that the quality of the healing process was very poor. The lengths of the newly formed epithelium, collagen deposition, and the granulation thickness are considered the positive signs of the wound healing process which obviously observed with the animal treated with SNPs.it could be concluded that silver nanoparticles can be used as an effective antimicrobial agent as promising step instead of using systemic the antibiotics.

Prospective Randomized Comparison of Scar Appearances between Cograft of Acellular Dermal Matrix with Autologous Split-Thickness Skin and Autologous Split-Thickness Skin Graft Alone for Full-Thickness Skin Defects of the Extremities.

Sir: We read with interest the recent article by Yi and Kim (Plast Reconstr Surg. 2015;135:609e–616e). The authors compared the effect of simultaneous application of acellular dermal matrix with autologous split-thickness skin graft and that of split-thickness skin graft alone on traumatic full-thickness skin defects on the extremities, and concluded that the cograft of acellular dermal matrix with split-thickness skin graft produced better outcomes than split-thickness skin graft alone in terms of scar appearance, without increasing complications. The combination of acellular dermal matrix with epidermal coverage, usually an autologous split- thickness skin graft, has increasingly replaced the full-thickness skin graft to reconstruct full-thickness skin defects. However, the timing of split-thickness skin grafting remains controversial. For a split-thickness skin graft to attach promptly after transplantation, a well-vascularized wound bed is required. The thickness of a skin graft that can easily become vascularized is approximately 0.7 to 1.0 mm. Therefore, most acellular dermal matrices thicker than 1.0 mm are covered by a split-thickness skin graft 3 to 4 weeks later to allow sufficient vascularization and to avoid graft necrosis or loss.1 However, this two-step approach is lengthy, gives no guarantee of success, and is an additional stress factor for the patient. More recent approaches include use of thinner dermal layers, with the aim of transplanting acellular dermal matrix simultaneously with split-thickness skin graft.2 Several of the authors’ procedures might contribute to the success of their single-step technique: (1) the wound bed was completely débrided and prepared with well-vascularized granulation tissue before grafting, (2) negative-pressure therapy was applied throughout to stimulate angiogenesis and prevent complications, and (3) the application of meshed acellular dermal matrix and thin split-thickness skin graft improved the take rate and allowed better blood supply to the cograft. However, we still have great interest in the thickness of the acellular dermal matrix in this article. Does the meshed morphology of acellular dermal matrix compensate for the thickness of it? In addition, the split-thickness skin graft combined with acellular dermal matrix was meshed and expanded, whereas the split-thickness skin graft applied alone was neither meshed nor expanded and was 0.1 mm thicker than the cografted one. The difference interests and confuses us. Beyond this, the pigmentation merits specific attention. Melanocytes and fibroblasts are believed to contribute to the repigmentation process.3 Because acellular dermal matrix does not contain cellular components, it is acceptable in this article that the pigmentation subscore was not improved in the cograft group. In our experience, noncultured autologous cell suspensions, such as ReCell (Avita Medical, Northridge, Calif.), could commendably improve skin color, as it contains viable melanocytes and fibroblasts apart from abundant keratinocytes.4 As these authors move forward, it could be tentatively used to aid the cograft of acellular dermal matrix and split-thickness skin graft or even cografted directly with acellular dermal matrix to heal full- thickness skin defects. We agree with the authors that the one-step graft of acellular dermal matrix and split-thickness skin graft is more than welcome and encourage them and others to investigate this approach so that this very important technique can be more completely understood and taken advantage of. DISCLOSURE The authors have no financial interest to declare in relation to the content of this communication. Panxi Yu, M.D.Zuoliang Qi, M.D., Ph.D.Plastic Surgery HospitalChinese Academy of Medical Sciences and Peking UnionMedical CollegeBeijing, People’s Republic of China

Studied on a novel human keratinocyte membrane delivery system in vitro

The culture of keratinocytes on flexible membranes has been proposed as a means to simplify, accelerate and improve the efficiency with which proliferating cells are delivered to full thickness or non-healing skin defects. The purpose of this article was to study the ability of chitosan-gelatin manbranes to facilitate the growth of human keratinocytes. The membranes with different chitosan contents were studied. The surface properties of chitosan-gelatin membranes were investigate by SEM, and water contact angle test. The mechanical property of the membranes was tested. Data implied that gelatin could make the membranes more flexible and hydrophilic than chitosan membranes, which may regulate the seeded cells behavior. Loading human keratinocytes on chitosan-gelatin membranes, cells attachment, spread, and growth were investigated by light microscopy, SEM, and MTT test. The results suggested that the adhesion and proliferation of keratinocytes seeded on chitosan-gelatin membranes were same as on tissue culture plate, in which gelatin could modify the interaction between keratinocytes and chitosan membranes. Therefore, chitosan-gelatin membrane is a good candidate for keratinocytes delivery system.