• Journal of Trauma and Injury
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• v.20 no.1
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• pp.1-5
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• 2007

Purpose: Grafting with autograft skin remains the most effective method for treating skin defects. When insufficient donor sites are present or patients are afraid of the operation, a skin graft is impossible. Cultured allogenic keratinocytes speed wound healing by providing cover and by producing growth factors and extracellular matrix protein. We report an application of cultured allogenic keratinocytes ($Kaloderm^{(R)}$, Tegoscience, Seoul, Korea) in the treatment of an acute partial thickness skin defect. Methods: From March 2005 to January 2006, 20 patients with a partial thickness skin defect were treated with cultured allogenic keratinocytes. The wound was covered with a sheet of cultured allogenic keratinocytes and ointment with $Bactigras^{(R)}$ gauze. The wound was inspected every two or three days. We regarded completion of epithelialization as wound healing. Results: The mean period between time of injury and time of $Kaloderm^{(R)}$ application was 7.5 days. The time taken from application of $Kaloderm^{(R)}$ to complete closure of the wounds was 7.2 days. Conclusion: In view of the favorable outcome, cultured allogenic keratinocytes are safe and effective biologic dressing materials for use in the treatment of open wounds.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.14-21
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• 2014

Background: There are several options for replacement of the dermal layer in fullthickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools. Methods: We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements. Results: The average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group. Conclusion: The new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).

• Biomedical Science Letters
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• v.17 no.1
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• pp.47-53
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• 2011

This study is aimed to investigate the skin thickness, plasma components, serum IgE level and antioxidant enzymes activities by mixtures of Cnidium officinale, Saururus chinensis, Houttuynia cordata and Glycyrrhiza uralensis on the allergic contact dermatitis of rat induced by 1-chloro-2,4-dinitrochlorobenzene (DNCB). Mixtures reduced the thickness of the skin and removed the dead skin cells compared to the skin of rats treated with DNCB alone. Also, these mixtures down-regulated the contents of lipid and IgE, and reduced the activities of superoxide dismutase and catalase. These results indicate that the mixtures significantly recovered the contact dermatitis induced by DNCB. In conclusion, it is thought that the mixtures could be useful for the allergic contact dermatitis.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.357-362
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• 2005

The aim of this study is to elucidate the effect of keratinase on epidermis of rat skin. Twenty-five male Sprague-Dolly rats were used. The hair on the back were removed and $2{\times}2cm$ area was marked. The rats were divided five groups; 1) Control group(Co), 2) Cleansing gel group(Cl), 3) Cleansing gel+keratinase group, 4) Exfoliant gel group(Ex), and 5) Exfoliant gel+ keratinase group(Ex+K). The solutions were applied to the back area twice a day for five days. On fifth day, the skins were harvested, fixed and prepared for histologic sections. The thickness of keratin layer, living epidermis, dermis, and cell layer number of living epidermis were measured. In the group containing keratinase(Cl+K, Ex+K), the thickness of keratin layer and living layer were thinner than other groups. However, there were no significant differences of the cell layer number of living epidermis and thickness of the dermis among the five groups. We think the keratinase may have the effect thinning the keratin layer as well as the thickness of living epidermis, without effecting the living cell and dermal component. The keratinase containing soap may be of benefit to remove the excess keratin layers in human.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.304-309
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• 2022

Background Laminin 5, which is found in the basement membrane of dermal-epidermal junction (DEJ), is a major adhesive component and associated with proliferating and migrating keratinocytes. In this study, we hypothesized that the topical application of the skin care products containing the novel peptides might restore the DEJ structure by deriving deposition of laminin 5 and promoting the keratinocyte migration. Here, we evaluated the restoration of DEJ by measuring the skin thickness. Methods Single-center retrospective analysis was performed on a total of 13 patients who underwent skin care using Baume L.C.E. (France, Laboratories d' Anjou) between January and March 2021. All patients applied the skin care agent for 2 weeks only on their left hand dorsum. Before the initiation of the application and after 2 weeks, both their hands were evaluated on photography and ultrasound. And the patients were asked to rate their satisfaction with the questionnaire after 2 weeks. Results There was no obvious improvement in photographic assessment and questionnaire. The post-pre difference of skin thickness in ultrasound images was, in left hand, 0.1 ± 0.37 in distal point and 0.1 ± 0.35 in proximal point; and, in right hand, 0 ± 0.17 in distal point and 0 ± 0.15 in proximal point, respectively. The pre-post difference was statistically significant in proximal point (p = 0.035). Conclusion Topical application of novel peptide derivative comprising laminin 5 demonstrated cutaneous changes including skin thickness, as assessed by ultrasound. Further studies using other modalities including dermal density measurement, three-dimensional photography, optical coherence tomography, or skin biopsy would be helpful to determine the skin-improving effects.

• Journal of the Korean Burn Society
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• v.23 no.1
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• pp.20-24
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• 2020

Diabetic patients have an increased risk of burn injuries on foot. Because of their diabetic neuropathy, they could contact with hot water or warming device without being aware of it. Split-thickness skin graft (STSG) is successful in treatment of various wound types; however, donor site wounds are sometimes problematic, and complications such as pain and impaired healing often occur. Although, donor site wounds in healthy young individuals can rapidly heal without complications, the wound-healing capacity of elderly patients or those with a comorbidity has been reported to be low. The dermatome is the most commonly used tool because it can harvest a large skin graft in one attempt. However, it is difficult to harvest tissues if the area is not flat. Furthermore, because the harvested skin is usually rectangular, additional skin usually remains after skin grafting. Therefore, use of razor blade and fragmented STSG on a large defect area is advantageous for harvesting a graft with a desired size, shape, and thickness. From January 2018 to July 2018, fragmented STSG was used in 9 patients who suffered from burn induced open wound on foot with diabetic neuropathy. With this approach, healing process was relatively rapid. The mean age of patients was 70 (57~86 years) and all of 9 patients had diabetes mellitus type 2. In all patients, the skin graft on the defect site healed well and did not result in complications such as hematoma or seroma.

• Archives of Plastic Surgery
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• v.46 no.2
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• pp.167-170
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• 2019

Full-thickness scalp burns secondary to hair coloring are rare; however, such defects can be large and complex reconstruction of hair-bearing tissue may be necessary. Many skin-stretching devices that use gradual traction have been applied to take advantage of the viscoelastic properties of the skin. A 21-year-old female patient was seen with a burn defect on her occipital scalp leading to exposed subcutaneous tissue after chemical application of hair coloring in a salon. The dimensions of the wound were $10cm{\times}5cm$, and a skin graft or flap would have been necessary to close the defect. Two long transfixing K-wires (1.4 mm) and paired 3-wire threads (23 gauge), which are readily available in most hospitals, were applied over a period of 12 days for trichophytic closure of the defect. The remaining scalp scars after primary trichophytic closure with this skin-stretching method were refined with hair follicle transplantation. This skin-stretching method is simple to apply and valuable for helping to close problematic areas of skin shortage that would otherwise require more complicated procedures. This case shows a relatively unknown complication of hair coloring and its treatment.

• The Journal of Korean Society for Radiation Therapy
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• v.30 no.1_2
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• pp.49-63
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• 2018

Purpose : The purpose of this study is investigating the changes of treatment plan and comparing skin dose with or without the skin flash. To investigate optimal applications of the skin flash, the changes of skin dose of each plans by various thicknesses of skin flash were measured and analyzed also. Methods and Material : Anthropomorphic phantom was scanned by CT for this study. The 2 fields hybrid IMRT and the 6 fields static IMRT were generated from the Eclipse (ver. 13.7.16, Varian, USA) RTP system. Additional plans were generated from each IMRT plans by changing skin flash thickness to 0.5 cm, 1.0 cm, 1.5 cm, 2.0 cm and 2.5 cm. MU and maximum doses were measured also. The treatment equipment was 6MV of VitalBeam (Varian Medical System, USA). Measuring device was a metal oxide semiconductor field-effect transistor(MOSFET). Measuring points of skin doses are upper (1), middle (2) and lower (3) positions from center of the left breast of the phantom. Other points of skin doses, artificially moved to medial and lateral sides by 0.5 cm, were also measured. Results : The reference value of 2F-hIMRT was 206.7 cGy at 1, 186.7 cGy at 2, and 222 cGy at 3, and reference values of 6F-sIMRT were measured at 192 cGy at 1, 213 cGy at 2, and 215 cGy at 3. In comparison with these reference values, the first measurement point in 2F-hIMRT was 261.3 cGy with a skin flash 2.0 cm and 2.5 cm, and the highest dose difference was 26.1 %diff. and 5.6 %diff, respectively. The third measurement point was 245.3 cGy and 10.5 %diff at the skin flash 2.5 cm. In the 6F-sIMRT, the highest dose difference was observed at 216.3 cGy and 12.7 %diff. when applying the skin flash 2.0 cm for the first measurement point and the dose difference was the largest at the application point of 2.0 cm, not the skin flash 2.5 cm for each measurement point. In cases of medial 0.5 cm shift points of 2F-hIMRT and 6F-sIMRT without skin flash, the measured value was -75.2 %diff. and -70.1 %diff. at 2F, At -14.8, -12.5, and -21.0 %diff. at the 1st, 2nd and 3rd measurement points, respectively. Generally, both treatment plans showed an increase in total MU, maximum dose and %diff as skin flash thickness increased, except for some results. The difference of skin dose using 0.5 cm thickness of skin flash was lowest lesser than 20 % in every conditions. Conclusion : Minimizing the thickness of skin flash by 0.5 cm is considered most ideal because it makes it possible to keep down MUs and lowering maximum doses. In addition, It was found that MUs, maximum doses and differences of skin doses did not increase infinitely as skin flash thickness increase by. If the error margin caused by PTV or other factors is lesser than 1.0 cm, It is considered that there will be many advantages in with the skin flash technique comparing without it.

• The Korea Journal of Herbology
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• v.28 no.6
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• pp.25-29
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• 2013

Objectives : The dried root of Sophora flavescens Aiton have been used to treat patient with skin diseases such as eczema in Eastern countries. S. flavescens can clear away heat and dry dampness and purge sthenic-fire from the liver and gallbladder. Recently, anti-allergic effect of S. flavescens has been reported. However, the effect on skin condition of contact dermatitis still remains unknown. Thus, the purpose of this study is to evaluate the efficacy of S. flavescens on contact dermatitis. Methods : In order to investigate the effects of S. flavescens (methanol extract of S. flavescens, MESR) on skin condition, the contact dermatitis was induced in mice skin by using 1-fluoro-2,4-dinitrofluorobenzene (DNFB). As the effective endpoints, skin thickness, skin weight, histopathological change were checked. In addition, effects on skin lesion, body weight and spleen/body weight ratio were also investigated. Results : Topical application of MESR ($500{\mu}g/day$) lowered skin thickness (P < 0.05) and skin weight (P < 0.05), respectively. MESR-treated group showed diminished spongiosis and immune cell infiltration in skin tissues compared to those of non-treated control group. The inhibition of skin lesions was also observed in MESR-treated group. In addition, MESR did not affect body weight gain and spleen/body weight ratio in contrast with those in dexamethasone-treated group. Conclusion : These data suggest that Sophorae Radix could improve skin lesion of contact dermatitis. This indicates the possibility for Sophorae Radix to be used to patients with skin diseases such as contact dermatitis.

• Archives of Plastic Surgery
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• v.33 no.5
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• pp.606-611
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• 2006

Purpose: Animal models of a chronic wound are yet to be fully developed, and animal studies on this subject has yet to take place. The purpose of this study is to create the foundation for research on chronic wound healing based on a swine model, the most similar to that of a human. Methods: Three female 2-3 month old 'yolkshires' were used. Total of eight full thickness skin defects, $6{\times}3cm$ sized, were created on the back of each pigs. Three groups were created for comparison; Group I (n=4) was left as they were after full skin thickness excision, while the excised tissues of Group II (n=3) were turned inside out and sutured so that the epidermis would come in contact with the fascia. Group III (n=3) were excised full skin thickness in depth and silicone blocks were implanted in them. Dressing was not practised so that the wounds would be vulnerable to infection. Results: In Group III, the skin contraction rate was the least among the three groups for each three weeks of observation respectively. Also during the three weeks, bacteral colonization was at the highest among the comparison. On the third week, inflammatory cells were still active, but the generations of epidermis and collagen synthesis were detected minimally. Conclusion: The Group III was relatively the most similar model of chronic wounds. and modification of the silicone blocks, could provide us with a very effective chronic skin wound model similar to human.