• Archives of Plastic Surgery
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• 제49권2호
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• pp.258-265
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• 2022

Background Chitosan (CS) is a well-known antimicrobial dressing material. Moreover, widely used amniotic membranes contain growth factors beneficial for wound healing. Herein, we created a novel amnion-conjugated CS-alginate membrane dressing and tested its wound healing potency in a diabetic swine model. Methods The bovine amniotic powder growth factor contents were evaluated by protein assay, and the powder's wound healing effects were assessed in vitro by HaCaT cell scratch closure. In vivo, two minipigs developed streptozotocin-induced diabetes. Serial serum glucose measurements and intravenous glucose tolerance tests were performed to confirm their diabetic status. Twelve square-shaped wounds created on each pig's back were randomly divided into control (n = 4), CS (n = 4), and amnion-CS (AC; n = 4) groups and treated accordingly with different dressings. Wound healing in each group was assessed by measuring wound contraction over time, capturing wound perfusion with indocyanine green (ICG) angiography, and histologically analyzing inflammatory markers. Results Amniotic powder elution promoted HaCaT cell migration in the scratch wound model, suggesting its beneficial in vitro wound healing effects. In vivo, the CS and AC groups showed earlier wound contraction initiation and reepithelialization and earlier wound perfusion improvement by ICG angiography than the control group. Additionally, the wound size of the AC group at week 3 was significantly smaller than those in the control group. There was no significant difference in the numbers of acute and chronic inflammatory cells between the groups. Conclusion The amnion-conjugated CS-alginate membrane, as well as CS dressing alone, could be a favorable dressing option for diabetic wounds.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.417-421
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• 2012

We present a case of a near total amputation at the distal tibial level, in which the patient emphatically wanted to save the leg. The anterior and posterior tibial nerves were intact, indicating a high possibility of sensory recovery after revascularization. The patient had open fractures at the tibia and fibula, but no bone shortening was performed. The posterior tibial vessels were reconstructed with an interposition saphenous vein graft from the contralateral side and a usable anterior tibial artery graft from the undamaged ipsilateral distal portions. The skin and soft tissue defects were covered using a subatmospheric pressure system for demarcating the wound, and a latissimus dorsi myocutaneous free flap for definite coverage of the wound. At 6 months after surgery, the patient was ambulatory without requiring additional procedures. Replantation without bone shortening, with use of vessel grafts and temporary coverage of the wound with subatmospheric pressure dressings before definite coverage, can shorten recovery time.

• Archives of Reconstructive Microsurgery
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• 제25권2호
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• pp.29-36
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• 2016

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.

• 한국섬유공학회:학술대회논문집
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• 한국섬유공학회 2002년도 봄 학술발표회 논문집
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• pp.478-480
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• 2002

피부란 인체를 외부의 자극으로부터 보호하며 수분의 손실을 막아주는 기능을 수행하는 중요한 장기 중의 하나이다. 피부가 화상이나 각종 외상에 의하여 결손이 일어나게 되면 그 보호작용이 상실되어 기능의 장애를 일으키게 된다. 또한 수분손실에 따른 여러 가지 부작용과 외부로부터의 세균감염 등을 일으켜 환부의 치료를 어렵게 하거나 2차적인 기능장애 또는 손상 등과 같은 추가적인 부작용을 초래하게 된다. (중략)

• 한국섬유공학회:학술대회논문집
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• 한국섬유공학회 2001년도 가을 학술발표회 논문집
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• pp.327-329
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• 2001

피부란 인체를 외부의 자극으로부터 보호하며 수분의 손실을 막아주는 기능을 수행하는 중요한 장기 중의 하나이다. 피부가 화상이나 각종 외상에 의하여 결손이 일어나게 되면 그 보호작용이 상실되어 기능의 장애를 일으키게 된다. 또한 수분손실에 따른 여러 가지 부작용과 외부로부터의 세균감염 등을 일으켜 환부의 치료를 어렵게 하거나 2차적인 기능장애 또는 손상 등과 같은 추가적인 부작용을 초래하게 된다. (중략)

• Archives of Plastic Surgery
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• 제39권5호
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• pp.463-468
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• 2012

Background In the extremities of premature infants, the skin and subcutaneous tissue are very pliable due to immaturity and have a greater degree of skin laxity and mobility. Thus, we can expect wounds to heal rapidly by wound contraction. This study investigates wound healing of full-thickness defects in premature infant extremities. Methods The study consisted of 13 premature infants who had a total of 14 cases of full-thickness skin defects of the extremities due to extravasation after total parenteral nutrition. The wound was managed with intensive moist dressings with antibiotic and anti-inflammatory agents. After wound closure, moisturization and mild compression were performed. Results Most of the full-thickness defects in the premature infants were closed by wound contraction without granulation tissue formation on the wound bed. The defects resulted in 3 pinpoint scars, 9 linear scars, and 2 round hypertrophic scars. The wounds with less granulation tissue were healed by contraction and resulted in linear scars parallel to the relaxed skin tension line. The wounds with more granulation tissue resulted in round scars. There was mild contracture without functional abnormality in 3 cases with a defect over two thirds of the longitudinal length of the dorsum of the hand or foot. The patients' parents were satisfied with the outcomes in 12 of 14 cases. Conclusions Full-thickness skin defects in premature infants typically heal by wound contraction with minimal granulation tissue and scar formation probably due to excellent skin mobility.

• KSBB Journal
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• 제23권1호
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• pp.8-17
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• 2008

There are many different approaches to healing of acute and chronic ulcer and large skin defect, such as burn. Currently available wound covers fall into two categories. Permanent covering, such as autografts, and temporary ones, such as allograft including de-epidermized cadaver skin, bioartificial skin, xenografts, and synthetic dressings. Autologous skin grafting in the form of split- or full-thickness skin is still the good standard. Following on from developments in the 1980s involving the use of cultured keratinocyte grafts in wound healing, the last decade has been great progress in the fabrication of composite bioartificial skin grafts. However, two bottleneck on producing cultured bioartificial skin, whether of the simple epithelial cell sheet type, or the more complex composite type, continue to be the generation of sufficient keratinocytes cheaply and quickly and develop biocompatible dermal scaffolds. This article covers the development, clinical application, and current research directions associated with bioartificial skin.

• 한국산림과학회지
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• 제105권4호
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• pp.505-509
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• 2016

본 연구는 현재 수목관리 현장에서 사용 중인 상처도포제의 유효성을 확인하기 위해 실시하였다. 티오파네이트메틸 도포제(상표명: 톱신페스트)는 은행나무, 느티나무, 왕벚나무에서, 라놀린은 느티나무와 왕벚나무에서, 테부코나졸 도포제(상표명: 실바코)는 왕벚나무에서 각각 무처리구 대비 유의하게 높은 상처유합률을 나타냈다. 페트롤리움젤리(상표명: 바셀린)는 은행나무, 느티나무, 왕벚나무 등 소나무를 제외한 전 수종에서, 인체 무독성 접착제(상표명: 오공본드)는 느티나무에서 각각 무처리구보다 유의하게 낮은 상처유합률을 보였다. 특히 바셀린을 처리한 느티나무와 왕벚나무 상처부위에서는 형성층이 괴사되어 상처가 확대되는 피해가 발생하였다. 소나무는 수지 유출로 인해 상처도포제 처리효과가 나타나지 않았다.

• Archives of Pharmacal Research
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• 제28권11호
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• pp.1311-1316
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• 2005

To better define the relationship between dermal regeneration and wound contraction and scar formation, the effects of epidermal growth factor (EGF) loaded in collagen sponge matrix on the fibroblast cell proliferation rate and the dermal mechanical strength were investigated. Collagen sponges with acid-soluble fraction of pig skin were prepared and incorporated with EGF at 0, 4, and 8 $\mu$g/1.7 $cm^{2}$. Dermal fibroblasts were cultured to 80$\%$ confluence using DMEM, treated with the samples submerged, and the cell viability was estimated using MTT assay. A deep, $2^{nd}$ degree- burn of diameter 1 cm was prepared on the rabbit ear and the tested dressings were applied twice during the 15-day, post burn period. The processes of re-epithelialization and dermal regeneration were investigated until the complete wound closure day and histological analysis was performed with H-E staining. EGF increased the fibroblast cell proliferation rate. The histology showed well developed, weave-like collagen bundles and fibroblasts in EGF-treated wounds while open wounds showed irregular collagen bundles and impaired fibroblast growth. The breaking strength (944.1 $\pm$ 35.6 vs. 411.5 $\pm$ 57.0 Fmax, $gmm^{-2}$) and skin resilience (11.3 $\pm$ 1.4 vs. 6.5 $\pm$ 0.6 mJ/$mm^{2}$) were significantly increased with EGF­treated wounds as compared with open wounds, suggesting that EGF enhanced the dermal matrix formation and improved the wound mechanical strength. In conclusion, EGF-improved dermal matrix formation is related with a lower wound contraction rate. The impaired dermal regeneration observed in the open wounds could contribute to the formation of wound contraction and scar tissue development. An extraneous supply of EGF in the collagen dressing on deep, $2^{nd}$ degree-burns enhanced the dermal matrix formation.

• Archives of Plastic Surgery
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• 제34권6호
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• pp.691-696
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• 2007

Purpose: The emergency of multi-drug resistant stains of bacteria represents a challenge in the field of plastic surgery. Especially, MRSA(methycillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa have strong pathogenicity as well as multi-drug resistance so that they have become a lot more problematic strains. This study has been planned to reduce the bacterial burden by applying $Acticoat^{(R)}$(Smith & Nephew Healthcare, Hull, England)dressing into the chronic wounds infected by multi-drug resistant strains and to facilitate their healing. Methods: Nanocrystalline silver dressings($Acticoat^{(R)}$) were applied to chronic wound infected by MRSA or Pseudomonas aeruginosa. Multi-drug resistant bacteria were smeared over a slide glass using sterilized cotton swabs and gram stains were performed directly before and after applying $Acticoat^{(R)}$ dressings at 1, 24, 48 and 72 hours. The gram-stained slides were observed using an optical microscope magnified 1000 times(${\times}1000$). The bacterial counts of the control group(0 hour) were compared to those of the experimental groups(1, 24, 48, and 72 hour). Paired T-test was used to assess a statistical significance. MRSA was cultured in two BAPs(blood agar plate) and two MacConkey plates with streak plate method. None were interventions on one culture plate, while on the other culture plate, $Acticoat^{(R)}$ was placed in a square shape and cultured for 72 hours at $37^{\circ}C$, then plates were examined. Pseudomonas aeruginosa was cultured in the same manner as MRSA. Results: There are the large amount of declination of bacterial counts with statistical significance after $Acticoat^{(R)}$ dressing. The bacteria grew in culture plate without specific intervention, but no bacteria grew in culture plate with applying of $Acticoat^{(R)}$ dressing. Conclusion: We believe that $Acticoat^{(R)}$ dressing could be used as an effective method of treating chronic wounds which are infected by multi-drug resistant organisms.