scholarly journals Treatment of Leg Chronic Wounds with Dermal Substitutes and Thin Skin Grafts

Skin Grafts ◽  
10.5772/51852 ◽  
2013 ◽  
Author(s):  
Silvestro Canonico ◽  
Ferdinando Campitiello ◽  
Angela Della ◽  
Vincenzo Padovano ◽  
Gianluca Pellino
Keyword(s):  
Chronic Wounds ◽  
Skin Grafts ◽  
Dermal Substitutes ◽  
Thin Skin

The Crucial Role of Vascularization and Lymphangiogenesis in Skin Reconstruction

2018 ◽  
Vol 59 (3-4) ◽  
pp. 242-254 ◽  
Author(s):  
Florian S.  Frueh ◽  
Nadia Sanchez-Macedo ◽  
Maurizio Calcagni ◽  
Pietro Giovanoli ◽  
Nicole Lindenblatt
Keyword(s):  
Clinical Practice ◽  
Skin Grafting ◽  
Lymphatic Drainage ◽  
Skin Grafts ◽  
Skin Substitutes ◽  
Microvascular Network ◽  
Skin Defects ◽  
Dermal Substitutes ◽  
Skin Reconstruction

Background: The treatment of extensive skin defects and bradytrophic wounds remains a challenge in clinical practice. Despite emerging tissue engineering approaches, skin grafts and dermal substitutes are still the routine procedure for the majority of skin defects. Here, we review the role of vascularization and lymphangiogenesis for skin grafting and dermal substitutes from the clinician’s perspective. Summary: Graft revascularization is a dynamic combination of inosculation, angiogenesis, and vasculogenesis. The majority of a graft’s microvasculature regresses and is replaced by ingrowing microvessels from the wound bed, finally resulting in a chimeric microvascular network. After inosculation within 48–72 h, the graft is re-oxygenated. In contrast to skin grafts, the vascularization of dermal substitutes is slow and dependent on the ingrowth of vessel-forming angiogenic cells. Preclinical angiogenic strategies with adipose tissue-derived isolates are appealing for the treatment of difficult wounds and may markedly accelerate skin reconstruction in the future. However, their translation from bench to bedside is still restricted by major regulatory restrictions. Finally, the lymphatic system contributes to edema reduction and the removal of local wound debris. Therapeutic lymphangiogenesis is an emerging field of research in skin reconstruction. Key Messages: For the successful engraftment of skin grafts and dermal substitutes, the rapid formation of a microvascular network is of pivotal importance. Hence, to understand the biological processes behind revascularization of skin substitutes and to implement this knowledge into clinical practice is a prerequisite when treating skin defects. Furthermore, a functional lymphatic drainage crucially contributes to the engraftment of skin substitutes.

scholarly journals Use of epidermal skin grafts in chronic wounds: a case series

2017 ◽  
Vol 14 (6) ◽  
pp. 1213-1218 ◽  
Author(s):  
Peter AM Everts ◽  
Marco Warbout ◽  
Diana de Veth ◽  
Merel Cirkel ◽  
Nicole E Spruijt ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Case Series ◽  
Skin Grafts

Acellular Dermal Matrix Combined with Autologous Skin Grafts for Closure of Chronic Wounds after Reconstruction of Skull Defects with Titanium Mesh

2016 ◽  
Vol 77 (04) ◽  
pp. 297-299 ◽  
Author(s):  
Cai Lin ◽  
Xinling Wang ◽  
Xiangwei Lin ◽  
Sunyue He ◽  
Yunfeng Liu ◽  
...  
Keyword(s):  
Chronic Wounds ◽  
Acellular Dermal Matrix ◽  
Skin Grafts ◽  
Titanium Mesh ◽  
Dermal Matrix ◽  
Skull Defects ◽  
Acellular Dermal

643 The Use of Topical Exogenous Nutrient Supplementation to Improve Graft Take on an Avascular Wound Bed

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S167-S168
Author(s):  
Laura Cooper ◽  
Phillip Kemp Bohan ◽  
Anders H Carlsson ◽  
Rodney K Chan ◽  
Tyler Everett
Keyword(s):  
Graft Survival ◽  
Skin Graft ◽  
Skin Grafting ◽  
Dermal Substitute ◽  
Skin Grafts ◽  
Pressure Therapy ◽  
Nutrient Supplementation ◽  
Successful Model ◽  
Dermal Substitutes ◽  
Graft Take

Abstract Introduction Skin graft survival relies on imbibition, inosculation, and revascularization from the wound bed. When a wound bed is poorly vascularized, as in the case of exposed fascia, tendon or bone, skin grafting may be delayed until the wound bed improves. We propose that topical nutrient supplementation may be able to increase take of skin grafts applied over an avascular wound bed. Methods Twenty full-thickness 5cm-diameter wounds were created on the dorsum of anesthetized swine and a dermal substitute (0.4mm, 0.8mm, 1.2mm, or 1.6mm thick) was placed on each wound. Negative pressure therapy with and without intermittent (3x per day) saline instillation was applied. Wounds were analyzed using a non-contact 3D camera at day 7 and day 14. Results Dermal substitutes of 0.8mm, 1.2mm, and 1.6mm thicknesses inhibited graft take significantly (p< 0.01, p=0.02, p< 0.01, respectively) for all wounds treated with wound vac alone. Addition of the normal saline instill showed a significant improvement in graft take (p=0.03) over wound vac alone for the wounds treated with the 0.8mm dermal substitute. Wounds covered with 1.2mm and 1.6mm dermal substitute continued to show significantly decreased graft take (p=0.03 and p=0.02, respectively). Wounds with 0.4mm dermal substitute showed similar graft take to control for both the wound vac and wound vac + instill treatments. Conclusions Dermal substitutes ≥0.8mm create a successful model of an avascular wound bed. Vac + instill treatment overcame the impedance of an avascular wound bed only for the 0.8mm dermal substitute thickness. This thickness of dermal substitute creates an ideal avascular wound bed model from which to conduct further studies incorporating topical nutrients instilled directly onto skin grafts placed onto avascular wound beds. Applicability of Research to Practice Single-stage skin grafting procedures onto avascular wound beds may become feasible with topical nutrient supplementation providing the environment to maintain graft survival until the wound bed is able to support the skin graft.

A New Method for Securing Dermal Substitutes and Skin Grafts to Difficult Portions of the Face Using a Custom 3D-Printed Facemask

2019 ◽  
Vol 40 (6) ◽  
pp. 1015-1018 ◽  
Author(s):  
Hernán A Aguilar ◽  
Horacio F Mayer
Keyword(s):  
Three Dimensional ◽  
Skin Grafts ◽  
Success Rates ◽  
Three Dimensional Printing ◽  
Burn Care ◽  
Dermal Substitutes ◽  
Thickness Skin ◽  
Facial Burns ◽  
The Face ◽  
3D Printed

Abstract Management of third-degree facial burns remains one of the most difficult challenges in burn care. Patients with deep facial burns usually require gradual escharectomy, tangential excision of the wound, and resurfacing with full-thickness skin grafts or dermal substitutes associated with split-thickness skin grafts to provide better and superior cosmetic results. Immobilization of skin grafts and dermal substitutes by reducing shearing forces and hematoma formation underneath is paramount to improve success rates. Due to the irregular shape of the face, the proper immobilization of grafts with traditional methods is often difficult, especially over concave portions of the face. Herein, we report the original use of a custom three-dimensional printing facemask for securing dermal substitutes and skin grafts to difficult sites on the face.

scholarly journals Evaluation of the Use of Single Stage Dermal Substitutes in Acute and Chronic Wounds of the Hand

2019 ◽  
Vol 43 (1) ◽  
pp. 47-53
Author(s):  
Ahmed Mitwalli ◽  
Ahmed El Badawy ◽  
Ahmed Hassan ◽  
Nada Mahmoud
Keyword(s):  
Chronic Wounds ◽  
Single Stage ◽  
Dermal Substitutes

Skin Regeneration for Children With Burn Scar Contracture Using Autologous Cultured Dermal Substitutes and Superthin Auto-Skin Grafts

2006 ◽  
Vol 57 (4) ◽  
pp. 408-414 ◽  
Author(s):  
Yasushi Fujimori ◽  
Koichi Ueda ◽  
Hiromichi Fumimoto ◽  
Kentaro Kubo ◽  
Yoshimitsu Kuroyanagi
Keyword(s):  
Skin Regeneration ◽  
Skin Grafts ◽  
Burn Scar ◽  
Scar Contracture ◽  
Dermal Substitutes
Sign in / Sign up

Export Citation Format

Share Document