Purpose: Skin grafting is used for the transfer of cutaneous tissue from one site of the body to another. To improve graft survival, close contact between the graft and the wound bed is essential for vessels to grow across the gap. Here, we introduce an easy and efficient dressing method to improve graft survival. Materials and Methods: A retrospective chart review was performed to identify patients who underwent split thickness skin graft and negative pressure wound therapy (NPWT) or conventional treatment between January 2007 and April 2015. Overall, 25 consecutive patients were included in the NPWT group and 49 were included in the conventional dressing group to compare the outcome of the procedure. The data were obtained from medical records, including age, sex, cause of the skin defect, size of graft, time for healing, wound preparation time, and complications. Results: Of the NPWT group, the average wound size was $147.04{\pm}146.74cm^2$ (range, $9{\sim}900cm^2$). With the exception of one patient, all wounds healed without the need for further procedure. The average duration of time required for the NPWT group, which was defined as removal of stitches (or staples) and no need for additional active dressing, was $6.4{\pm}1.97days$ (range, 5~15 days). The average time for the conventional dressing group was $10.78{\pm}2.38days$ (range, 5~15 days). Conclusion: NPWT can be used to cover regions in which wound healing does not occur fully or when neither tie-over nor compressive dressings are applicable. This treatment also reduced wound healing time and allowed earlier patient mobilization and hospital discharge.
This study was carried out to investigate the effects of the wound contraction of chitosan, aloe vera, fucidin natrium, and premycin ointment on defected wound from full-thickness skin defects(1 cm $\times$ 1 cm). Twelve dogs were designed in 5 different positions on the dorsal thoracolumbar. We examined the effects of wound contraction every four other day 16 for days. Percentage of wound contraction based on epitherial overall area of defected wound which calculated by image analyzer and computer. Four to 8 days after wound contraction in wound defected dogs, the epithelial overall rate were the most high presented by 48.1 % in the chitosan group and were the lowest by 26.8% in the premycin group. In 16 days, chitosan group were the most heigh presented by 94.4% and premycin group were the lowest by 76.5% compare to saline group of 85.9%. Thus, we conclude that the chitosan is a possible role for improvement of wound contraction by wound defected dogs.
This study was designed to prepare an animal model for partial thickness bum wound which can be employed for testing topical therapy. We first evaluated whether rabbit ear and mouse back skin wound model could differentiate the wound healing process in terms of degree of re epithelialization, required days for complete wound closure, presence of scarring. $2^{nd}$ degree wet bum were prepared on mouse back skin and rabbit ear by applying 5 mL hot water($85{\pm}0.1^{\circ}C$) for 7 see followed by 5 mL ice-cold 0.5% acrynol solution for cooling and disinfecting the inflicted area. After removing the dead epidermis layer at 24 hr, tested dressings were applied for specified time and wound progression was investigated. In mouse model, wound contraction was the primary wound closing mechanism, which is quite different from human wound healing process. In rabbit ear model, epidermal regeneration was the major wound healing process rather than wound contraction and the difference in wound healing property among tested dressings could be clearly demonstrated. A rabbit ear model could differentiate the wound progression among open, occluded and epidermal growth factor(EGF) treated wound. Four sites of circular wound(diameter: 1 cm) on the anterior part of rabbit ear could be employed for the comparative wound healing study. For obtaining reproducible bum wound, degree of bum depth and bum sites should be carefully controlled in addition, employing rabbits of same strain and weight. The result suggests that rabbit ear could be employed as a reliable and human-resembled wound model.
Kim, Bum-Hoi;Lee, Hae-Woong;Sohn, Nak-Won;Park, Dong-Il1
Journal of Society of Preventive Korean Medicine
/
v.14
no.1
/
pp.97-110
/
2010
The wound healing process can be categorized as follows : inflammation, fibroplasia, neovascularization, collagen deposition, epithelialization, and wound contraction. During the healing process, various growth factors are secreted to accelerate wound healing. Previous studies have demonstrated that endogenous growth factors, such as vascular endothelial growth factor(VEGF) are the important regulatory polypeptides for coordinating the healing process. They are released from macrophages, fibroblasts, and keratinocytes at the site of injury and participate in the regulation of reepithelization, granulation tissue formation, collagen synthesis and neovascularization. Onchung-Um has been used clinically to treat various skin diseases. In addition, Onchung-Um has been also used for congestive inflammations. In the present study, we evaluated the effects of Onchung-Um on wound healing process and wound size reduction in rats. Full-thickness skin wounds ($15mm\;{\times}\;15mm$) were created on the back of rats. Rats were then divided into 2 groups : The Onchung-Um treated group that was orally administered with a dose of 193.9mg/100g of Onchung-Um extract per day for 15 days and Control group without Onchung-Um administration. Moreover, the histological changes and VEGF immunoexpressions of two groups were estimated. In results, wound closures were significantly accelerated by oral administration of Onchung-Um extract. Furthermore, in Onchung-Um treated group, there were significant increases in fibroblast migration, epithelialization compared with the Control group. VEGF expressions were also increased in Onchung-Um treated group. This study has therefore demonstrated the Onchung-Um can significantly improve the quality of wound healing and scar formation and the oral administration of Onchung-Um extract may increase early tissue angiogenesis in the incisional wound of an experimental animal model.
The objective of this study was to investigate the effects of implanted chitosan applied to surgically created wound in Japanese Macaque monkeys. 4 healthy Japanese Macaque monkeys were used. A 4 cm straight skin incision was made and undermined skin ($4{\times}4cm$) over on the 2 monkeys both sides of the dorsal midline, and a 4 cm circular skin incision was made on 2 monkeys both sides of the dorsal midline. One wound (left side) was implanted 1 mg (straight incision) and daily 0.2 mg (circular incision) of cotton type chitosan and the other wounds were treated with normal saline (3 ml) in monkeys. Each straight wound was closed with two interrupted sutures of 2-0 sutures. The monkey's circular skin incision is opened. At 14 days after initial wounding, each wound was taken for histological observations in monkeys. The inflammatory cells in the chitosan group are observed less than the control group, the collagen and the fibrin in the chitosan are observed more than the control group in monkeys. So the wound healing is moderately enhanced for chitosan treatment. The fibroblasts and the capillaries increased for chitosan treatment. The treatment of chitosan in wound is to promote healing.
The purpose of the present study was to investigate the effect of bovine amniotic membrane grafts on healing of full-thickness skin wound in dogs. Two $3cm{\times}3cm$ area-matched full-thickness skin wounds were induced bilaterally on the dorsolateral aspect of the trunk of 15 dogs. Chlorhexidine-treated amnion, dried amnion, silver sulfadiazine and 0.9% sterile saline solution were applied on the wound area and examined grossly and histopathologically. Begining 14 days after wounding, amnion applied group had appreciably less amount of inflammatory exudate and hemorrhage than sulfadiazine and saline treated groups. From 14 days after wounding, the degree of wound contraction in amnion groups, especially in the dried amnion group was greater than that of the sulfadiazine and saline treated groups. The percentages of wounds completely healed on 28 days after wounding in saline treated group, chlorhexidine-treated amnion group, dried amnion group and sulfadiazine treated group were 33%, 50%, 83% and 50%, respectively. Microscopically neovascularization and fibrosis were first noticed on 5 days after wounding in the dried amnion group and sulfadiazine treated group, on 7 days in the chlorhexidine-treated amnion group and on 14 days in the saline treated group. Epithelialization in the dried amnion and sulfadiazine treated groups was first noticed on 9 days after wounding, which was faster than that in the other groups. The present study suggests that bovine amniotic membrane, especially dried bovine amnion is effective on healing of full-thickness skin wound in dogs through both wound contraction and epithelialization.
Sohn, Hyung Bin;Son, Dae Gu;Kim, Jun Hyung;Han, Ki Hwan;Ryoo, Nam Hee;Kwon, Sun Young
Archives of Plastic Surgery
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v.33
no.5
/
pp.606-611
/
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.
This study was conducted to examine the effects of egg shell membrane hydrolysates (ESMH) on skin whitening, wound healing, and UV-protection. ESMH was divided into three groups by molecular weight (Fraction I: above 10 kDa of ESMH, Fraction II: 3 kDa-10 kDa of ESMH, Fraction III: below 3 kDa of ESMH). As a result, all of ESMHs showed over 90% of protein contents. The wound healing experiment using HaCaT cells showed that the fraction I was slightly superior to other fractions depending on the concentration though it was not significantly different. In the experiments of inhibition of tyrosinase and L-3,4-dihydroxyphenylalanine (L-DOPA) oxidation to verify the L-DOPA whitening effect, the whole ESMH (before fractioning) showed a similar amount of inhibition effect with arbutin (control). In the inhibition of melanin formation in B16-F1 melanoma cells, the fraction I showed a high inhibitory effect. In the experiment for protecting the skin from ultraviolet rays using HaCaT cells, all the fractions showed a higher rate of cell viability than the control. In conclusion, this study confirmed that the cosmetic effects of ESMHs such as skin whitening, wound healing, and UV-protection, which were divided depending on the molecule weight. We could confirm that the possibility of ESMHs as a material for functional cosmetics.
Purpose: The purpose of this study was to investigate the effect of electrical stimulation (ES) on the wound closure rate, collagen deposition, and TGF-${\beta}$1 mRNA expression in skin wound of rat. Methods: Twenty male Sprague-Dawley rats (222~271 g) were randomly divided into ES (n=10) and control group (n=10). The ES group received a cathodal stimulation with 50 V at 100 pps for 30 minutes for 7 days, while the control group was not given electrical stimulation. The wound closure rate, collagen density and TGF-${\beta}$1 mRNA ratio were measured. Results: The mean wound closure rates in the ES and control groups were $83.79{\pm}16.35$% and $51.57{\pm}17.76$%, respectively (p<0.001). The collagen density in the ES and control groups were $46.67{\pm}10.68$% and $25.03{\pm}13.09$%, respectively (p<0.001). The TGF-${\beta}$1 mRNA ratio in the ES and control groups were $1.35{\pm}0.60$ and $0.63{\pm}0.30$, respectively at 6 hours post-wound (p<0.01) and $1.69{\pm}0.47$ and $1.32{\pm}0.28$, respectively, at 7 days post-wound (p<0.05). Conclusions: ES accelerated the wound closure rate of skin incision wounds and was accompanied by an increase in collagen deposition in the regenerating dermis. In addition, ES increased TGF-${\beta}$1 mRNA expression during wound healing process. These findings suggest that ES may activate TGF-${\beta}$1 expression, and may increase synthesis activities of fibroblasts in regenerating skin wounds in rats.
Wound healing is a complex and dynamic process, making the accurate and timely assessment of skin wounds a crucial aspect of effective wound care management, especially for chronic wounds. Unlike conventional wound dressings that simply cover the wound area once some form of medicine is administered onto the wound, recent studies have introduced versatile approaches to smart wound dressings capable of interacting with wound fluids to monitor physicochemical and pathological parameters to determine the wound healing status. Such electrochemical wound dressings can be integrated with on-demand, closed-loop drug delivery or stimulation systems and ultimately expanded into an ideal technological platform for the prevention, treatment, and management of skin wounds or illnesses. This article briefly reviews the wound healing mechanism and recent strategies for effective wound care management. Specifically, this review discusses the following aspects of smart wound dressings: sensor-integrated smart bandages to detect wound biomarkers, smart bandages developed to accelerate wound healing, and wireless, closed-loop automatic (on-demand) wound healing systems. This review concludes by providing future perspectives on effective wound care management.
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