Skin Grafts - Indications, Applns and Current Research

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Wu said that many foundations focused on specific disorders have shown a strong interest in new technologies like his to treat rare diseases like PKU — a genetic disorder that results in the decreased metabolism of a specific amino acid, phenylalanine.

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If untreated, it often leads to intellectual disability and seizures, among other problems. I think we are moving pretty efficiently. We expect clinical trials starting in the next year, and the first indication will be a skin disease because that is the most natural target. Wu sees the treatments he is developing as simple, noninvasive, affordable ways to attack a multitude of problems. That means diabetics would no longer have to prick their skin with a needle to test the glucose levels in their blood after every meal throughout the day.

Working with the Polsky Center, Wu filed a patent application on this technology in and is working with a partner to bring it to market. Other interesting potential applications include treatment of obesity and the use of skin grafts to reverse the effects of aging. Modified skin grafts can function as a gene therapy vehicle that Wu has proven can normalize body weight and blood glucose levels in diet-induced obese and diabetic mice.

Wu and his collaborators have already published widely on their efforts. He sees a bright future for his research, with the potential for various treatments that are simple and much more cost-effective than what is currently available. UChicago Medicine offers primary and specialty care at over 40 locations throughout Illinois and Indiana. UChicago Medicine and Ingalls Memorial offer a broad range of challenging clinical and non-clinical career opportunities doing work that really matters.

Close MyChart MyChart is not for medical emergencies. If you have a medical emergency, call If you need help with MyChart, call us at Background: Skin grafts are a common method of closing skin defects. The aim of this study was to audit our current skin graft practice. Methods: Data were collected prospectively on all skin grafts performed by the general surgical department between 1st December and 1st December The overall graft complication rate was Infection occurred in 13 of 17 graft failures. Conclusion: Skin grafts were performed successfully in the majority of patients.

Graft complication and failure rates compare well with the world literature. The use of prophylactic antibiotics was the only predictor of successful graft take. Volume 79 , Issue 5. The full text of this article hosted at iucr. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.

If the address matches an existing account you will receive an email with instructions to retrieve your username. Nigel J. Preservation of skin appendages, absence of inflammation, and normal amounts of fibrocytes were also observed. It is well known that as fiber density increases, picrosirius color changes; and as wound healing progresses, collagen fiber density increases. Grafts also demonstrated a distinct CD45 immunohistochemical profile on day 7.

Thin grafts also appeared to be hypervascular compared with thick grafts, as shown by dense pericyte staining around blood vessels on day Mast cell staining revealed that thin grafts also have more mast cells yellow arrowheads, Figs. Objective measurement of graft and scar thickness was performed histologically Fig. Autologous partial-thickness skin is the standard in skin replacement therapy. Although it has many advantages, we are far from an ideal therapy. When used to resurface an area where mobility or aesthetics is important, coverage with a thin partial-thickness autograft often results in a thick, nonpliable scar.

In the quest for better skin replacement, it is important that a quantifiable and relevant preclinical model exists with which to evaluate and guide development of skin substitutes and that the model accurately reflects treatment and healing responses of human wounds. In this study, we describe a porcine model of full-thickness wounds, where a gradation of skin qualities was created experimentally using variable thickness autografts.

Multiple methods to quantify skin quality were correlated with morphological, histochemical, and immunohistochemical characteristics. The significance of this study lies in the characterization of a novel preclinical model that mirrors problematic clinical scenarios: durable coverage of full-thickness skin defects using skin grafts or skin substitutes. This model may be used to determine the value of emerging skin substitutes compared with the current standard of care Fig.

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Equally important, this study establishes correlations between subjective and objective measures of skin quality, using OSAS to subjectively assess the quality of skin. The total OSAS demonstrated differences among the various graft thicknesses.

RBCP - The Epidermal-adipose Graft and its Applications

Because the pigs were essentially white, we omitted pigmentation scoring. Although OSAS is cumbersome and requires education and calibration of observers, it facilitates comparison with published reports. However, an equivalent objective scoring system is preferred. Indeed, this model permits objective validation of our subjective assessments. Although critics may argue that quality cannot be quantified, erythema, pigmentation, thickness, relief, and mobility are all quantifiable traits and taken together may represent a better objective scar scale for future preclinical and clinical studies.

Few reports have correlated histological and immunohistological characteristics of final skin quality with corresponding subjective and objective characteristics. Others have noted its correlation with scar thickness and contraction. Collagen undergoes rapid maturation in fibrosis: fiber birefringence intensity increases, and polarization color changes as fiber density increases.

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By comparison, collagen in thick grafts is more organized and less dense, resembling normal skin, suggesting that thin grafts develop a thick disorganized scar by excessive synthesis of collagen, decreased matrix degradation, or both. We noted increased numbers of mast cells in thin grafts, correlating with the worst scar. Mast cells stimulate type I collagen synthesis in fibroblasts in vitro, 20 and excessive accumulation and deposition of type I collagen is associated with dermal fibrosis.

Inflammatory activation after severe burn injury is well documented, and burn is an independent predictor of scarring. Indeed, we have shown that thin skin grafts, which result in greater contraction, elicit a strong cellular inflammatory infiltration at the graft-host junction. Infiltration of inflammatory cells in the early wound has been strongly linked to fibrogenesis and hypertrophic scarring. Using skin grafts of various thicknesses, we have established a model that may serve to evaluate products and methods of skin substitution. We have found objective measurements of erythema, pigmentation, and contraction to be highly quantitative and reliable, although subjective measurements are still necessary at this time for relief and mobility.

These findings could facilitate the development of skin substitutes to achieve higher quality skin and wound closure while minimizing donor-site morbidity.

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Your Email:. Colleague's Email:. Separate multiple e-mails with a ;. Send a copy to your email. Some error has occurred while processing your request. Please try after some time. Article as PDF 1. Received for publication June 12, ; accepted May 28, Back to Top Article Outline. Nitzschke SL, et al. Wound healing trajectories in burn patients and their impact on mortality. J Burn Care Res. Padgett EC. Indications for determination of the thickness of split skin grafts.

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Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
Skin Grafts - Indications, Applns and Current Research Skin Grafts - Indications, Applns and Current Research
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