• Archives of Craniofacial Surgery
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• v.20 no.2
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• pp.94-100
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• 2019

Background: Skin defects of head and neck need reconstruction using various local flaps. In some cases, surgeons should consider skin graft for large skin defect. It is important to heal skin graft and donor sites. The authors investigated wound healing mechanisms at the donor sites with split-thick-ness skin graft (STSG). In this study, the authors compared two types of immediate regraft including sheets and islands for the donor site after facial skin graft using remnant skin. Methods: The author reviewed 10 patients who underwent STSG, from March 2015 to May 2017, for skin defects in the craniofacial area. The donor site was immediately covered with the two types using remnant skin after harvesting skin onto the recipient site. Depending on the size of the remnant skin, we conducted regraft with the single sheet (n= 5) and island types (n= 5). Results: On postoperative day 1 and 3 months, the scar formation was evaluated using the Patient and Observer Scar Assessment Scale (POSAS) and Vancouver Scar Scale (VSS). Total POSAS and VSS scores for the island type were lower than in single sheet group after 3 months postoperatively. There was significant difference in specific categories of POSAS and VSS. Conclusion: This study showed a reduction in scar formation following immediate regrafting of the remnant skin at the donor site after STSG surgery. Particularly, the island type is useful for clinical application to facilitate healing of donor sites with STSG.

• Journal of Korean Medicine Rehabilitation
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• v.26 no.2
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• pp.29-50
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• 2016

Objectives There is few Korean medicinal studies about post-operation wound healing despite much effort for minimizing wound or post-op scar. The aim of this study is to evaluate the wound healing effect of Gyejibokryeong-hwan (Guizhifuling-wan, GBH) after skin suture. Methods < In vitro > We observed anti-oxidative and anti-inflammatory effect by using lipopolysaccharide (LPS)-treated RAW 264.7 cells. For anti-oxidation, we mesured the total amount of polyphenol, flavonoid, DPPH scavenging ability, ABTS scavenging ability and the value of ROS production, and for anti-inflammation, we mesured the amount of NO and pro-inflammatory cytokines ($TNF-{\alpha}$, $IL-1{\beta}$, IL-6). < In vivo > Thirty SD rats were divided into five equal groups (n=6, one normal, two controls and two experimentals). All groups except normal group were made a scar (around $1{\times}4cm^2$) in the back by the depth of the fascia and then sutured by a thread and needle. Normal group rats received no treatment at all. Control group rats were fed distilled water, and positive control group rats were percutaneously applied terramycin once in 2 days. GBH 200 group rats were orally medicated GBH 200 mg/kg, and GBH 400 group rats were orally medicated GBH 400 mg/kg per day for two weeks. We analyzed the blood samples (WBC, neutrophil, lymphocyte, monocyte, eosinophil), and the serums (TIMP-1, MMP-2, MMP-2. $PGE_2$, $TGF-{\beta}$, VEGF), and examined the wounded skin tissue histopathologically. Results < in vitro > 1. DPPH and ABTS scavenging activity was increased concentration-dependantly, and ROS production was significantly increased in GBH treated cells ($100{\mu}g/ml$). Therefore in this study, Gyejibokryeong-hwan appears to have the anti-oxidative. 2. NO production was significantly reduced in GBH treated cells ($100{\mu}g/ml$), and $IL-1{\beta}$ production was significantly reduced in GBH treated cells ($1{\mu}g/ml$). But, $TNF-{\alpha}$ and IL-6 did not show uneffective action. Therefore in this study, Gyejibokryeong-hwan did not show any significant effect on anti-inflammatory process. < in vivo > 1. Monocyte and neutrophil was significantly increased in GBH (200, 400) groups. WBC, lymphocyte and eosinophil did not show significant change. 2. TIMP-1, MMP-2, VEGF were significantly increased in GBH 400 group, $PGE_2$ was significantly reduced in GBH 400 group. $TGF-{\beta}$ was significantly increased in GBH (200, 400) groups, and MMP-9 was increased concentration-dependantly in GBH groups, but there was no significance. 3. In histopathological examinations, collagen was significantly increased and keratin was significantly decreased in GBH (200, 400) groups. Conclusions According to in vitro experiment, GBH appears to have the anti-oxidative effect and in vivo experiment, GBH stimulate the wound healing process hematologically and histopathologically. In conclusion, the results suggest that GBH promotes wound healing after skin suture.

• Applied Microscopy
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• v.39 no.3
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• pp.253-260
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• 2009

GM-CSF is a multipotent growth factor, which also plays an important role during the process of wound healing. rrhGM-CSF was specifically produced from rice cell culture in our laboratory (Hanson Biotech Co., Ltd, Daejeon). The rrhGMCSF contains more oligosaccharide side chains than any other types of GM-CSF. This work was taken to evaluate the influence on wound healing of rrhGM-CSF in male golden hamsters. Full thickness skin defects of 9 mm in diameter were made in the back of hamsters, and 100 ${\mu}L$ ointment containing rrhGM-CSF 50 ${\mu}g/mL$ was applied. Control groups were given ointment without rrhGM-CSF. The wound sizes were relatively reduced and skin was well regenerated in the experimental group compared with the control group. Structurally, reepithelialization and architecture of the skin following injury were well accomplished in the experimental group. And also, positive reaction of PCNA of the skin following injury was more prominent in rrhGM-CSF containing ointment treatment group. Since this type of GM-CSF has highly glycosylated side chains, the effectiveness might be retain longer and stable, regarding acceleration of wound healing in the animal model. The present study has important implications for further development of the therapeutic manipulation of wound healing using rrhGM-CSF.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.1-19
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• 2022

Objectives This study aims to evaluate the wound healing effects of oral administered hot water extracts of Korean black ginseng (KBG). Methods 40 C57BL/6 mice were divided into five groups; normal, control, vitamin E 200 mg/kg, KBG 100 mg/kg, KBG 200 mg/kg, each n=8. Skin wounds were made in the back of all mice except normal group using biopsy punches. Wounds were observed on days 7 and 14 after injury. The anti-oxidant and inflammatory protein levels were evaluated using western blotting. Skin tissue was analyzed by hematoxylin & eosin and Masson's trichrome staining method. Results KBG significantly accelerated reducing wound area. KBG significantly decreased myeloperoxidase activity. KBG significantly decreased oxidative stress factors such as NADPH oxidase-4 and p22^phox and increased antioxidant enzymes including nuclear factor erythroid 2-related factor2, kelch-like ECH-associated protein-1, heme oxygenase-1, superoxide dismutase, catalase and glutathione peroxidase-1/2. Moreover, KBG significantly decreased inflammation factors including nuclear factor-κB, phosphorylated inhibitor of κBα, cyclooxygenase-2, inducible nitric oxide synthase, tumor necrosis factor-α and interleukin (IL)-6 and increased anti-inflammation cytokine such as IL-4 and IL-10. In addition, KBG significantly increased tight junction proteins including claudin-1, claudin-3, claudin-4. In histopathologic, KBG made the epithelium thin and uniform, and accelerated the remodeling of collagen. Conclusions The results suggest that KBG has healing effects on skin wound in mice by anti-inflammatory and antioxidant activity.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.359-368
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• 2011

Purpose: Aquacel Ag$^{(R)}$ is a hydrofiber wound dressing integrated with ionic silver. Sorbact$^{(R)}$ is a hydrophobiccoated dressing that uses the hydrophobic interaction with microbes. In this study, we compared the wound healing effects and the antibacterial effects of Medifoam$^{(R)}$, Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact$^{(R)}$ dressings against MRSA-infected wounds. Methods: Eighty rats were divided into four groups: Medifoam$^{(R)}$; Betadine soaked; Aquacel Ag$^{(R)}$; and Sorbact$^{(R)}$. A $1.5{\times}1.5cm$ square full-thickness wound was made on the dorsum of each rat and infected with MRSA. Twenty-four hours thereafter, each dressing was applied to the wound and changed every other day. One, 3, 7, 11 and 15 days after the wound infection, swab culture grade, wound bed appearance score, and wound defect size change were evaluated, and 7 and 15 days after, histologic evaluation was compared between the groups. Results: The bacteria load of wounds in the Sorbact$^{(R)}$ group decreased earlier than in the other groups. The wound bed appearance score of the Sorbact$^{(R)}$ group also increased quicker, compared with the other groups. However, the size of wounds of the Aquacel Ag$^{(R)}$ group decreased more rapidly, compared with other groups. From the histologic point of view, there was no significant difference between Betadine soaked, Aquacel Ag$^{(R)}$ and Sorbact groups. Conclusion: The hydrophobic dressing using Sorbact$^{(R)}$ showed a more rapid reduction in the MRSA load and an elevation in the wound bed appearance score, but a slower decrease in wound size change due to detachment of wound bed tissue when the dressing was eliminated in the low exudate wound. The silver-containing hydrofiber dressing using Aquacel Ag$^{(R)}$ was more effective in ultimate wound size reduction, but some debris was trapped in the wound tissue and induced foreign body reaction in the high exudate wound. Thus, ongoing selection process of treatment based on the evaluation of the infectious wound state will be very important.

• Archives of Pharmacal Research
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• v.21 no.5
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• pp.487-495
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• 1998

Gorwth factors such as TGF-beta, PDGF and FGF are thought to play important roles in wound healing. However, thier biological activity and signal transduction during wound repair remain poorly understood. Growth factors are often ligands for receptor tyrosine kinase and receptor serine/threonine kinases. With recent advances in signal transduction by receptor kinases, we are beginning to understand the underlying mechanism of how growth factors may regulate cutaneous wound repair. In this paper, we will describe the pharmacological effects of growth factors on wound healing, and dscuss the potential underlying signaing mechanisms. thus, we hope to provide the basis for designing more specific therapeutics for wound healing in the near future.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.452-457
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• 2014

In the field of tissue engineering and reconstruction, the development of efficient biomaterial is in high demand to achieve uncomplicated wound healing. Chronic wounds and excessive scarring are the major complications of tissue repair and, as this inadequate healing continues to increase, novel therapies and treatments for dysfunctional skin repair and reconstruction are important. This paper reviews the various aspects of the complications related to wound healing and focuses on chitosan because of its unique function in accelerating wound healing. The proliferation of keratinocytes is essential for wound closure, and adipose-derived stem cells play a significant role in wound healing. Thus, chitosan in combination with keratinocytes and adipose-derived stem cells may act as a vehicle for delivering cells, which would increase the proliferation of keratinocytes and help complete recovery from injuries.

• Archives of Plastic Surgery
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• v.47 no.6
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• pp.528-534
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• 2020

Split-thickness skin grafting (STSG) is the gold standard for coverage of acute burns and reconstructive wounds. However, the choice of the donor site for STSG varies among surgeons, and the scalp represents a relatively under-utilized donor site. Understanding the validity of potential risks will assist in optimizing wound management. A comprehensive literature search was conducted of the PubMed database to identify studies evaluating scalp skin grafting in human subjects published between January 1, 1964 and December 31, 2019. Data were collected on early and late complications at the scalp donor site. In total, 27 articles comparing scalp donor site complications were included. The selected studies included analyses of acute burn patients only (21 of 27 articles), mean total body surface area (20 of 27), age distribution (22 of 27), sex (12 of 27), ethnicity (5 of 27), tumescent technique (21 of 27), depth setting of the dermatome (24 of 27), number of harvests (20 of 27), mean days of epithelization (18 of 27), and early and late complications (27 of 27). The total rate of early complications was 3.82% (117 of 3,062 patients). The total rate of late complications was 5.19% (159 of 3,062 patients). The literature on scalp skin grafting has not yet identified an ideal surgical technique for preventing donor site complications. Although scalp skin grafting provided superior outcomes with fewer donor site complications, there continues to be a lack of standardization. The use of scalp donor sites for STSG can prevent early and late complications if proper surgical planning, procedures, and postoperative care are performed.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.733-739
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• 2011

Purpose: Cellulose is a natural substance from plants or bacteria. It is known that bacterial synthesized cellulose has an effect of wound healing. The aim of this study is to show the effect of bacterial synthesized cellulose from citrus on wound healing. Methods: Three full-thickness skin defects were made on the back of Sprague-Dawley rats. Three wounds were treated by vaseline gauze (Group V), Algisite $M^{(R)}$ (Group A) and bacterial synthesized cellulose from citrus (Group C) was used for dressing on skin defect on rats. We analyzed the gross, histological and biochemistry finding. Results: Group C showed more decrease of wound size compared to Group V (33% versus 7.2%) after 14 days. The histologic findings revealed Group C and Group A preceed the process of wound healing rather than Group V (More rapid collagen deposition and neovascularization and reduced inflammation). Also, the expressions of vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-${\beta}1$ were increased in the Group C and Group A compared with the Group V in 7 days. VEGF and TGF-${\beta}1$ expression were decreased in the Group C and Group A in 14 days, however Group V was not decreased at 14 day because of delayed wound healing process. Conclusion: Bacterial synthesized cellulose from citrus affects wound healing by reducing the inflammatory stage. And stimulates wound contracture by the deposition of extracellular matrix, thus preventing the formation of chronic wounds.

• Journal of Pharmaceutical Investigation
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• v.32 no.2
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• pp.113-117
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• 2002

Cyto-toxic effect of silver sulfadiazine (Ag-SD) on keratinocytes and its implication on wound healing process were investigated in $2^{nd}$ degree bum hairless mouse model. As a dermal model, HaCat (immortalized keratinocytes) monolayer culture in DMEM with 10% FBS was used. Cyto-toxicity of Ag-SD was estimated by measuring the cell viability using neutral red assay after adding the drug. The $2^{nd}$ degree bum was prepared on hairless mouse back skin (1 cm diameter) and dressings with Ag-SD were applied for 96 hr. The process of re-epithelialization and the presence of inflammatory cells were investigated and histology with Hematoxylin-Eosin staining was performed. Ag-SD displayed highly cyto-toxic effect on cultured HaCat cells in a concentration dependent manner $(1-100\;{\mu}g/mL)$. Topical application of Ag-SD (2%) could control the infection: no inflammatory cells were observed in histology. However the cyto-toxic effect of Ag-SD on skin cells induced the impairment in epidermal regeneration.