chondroitin-sulfates and Cicatrix

The therapeutic management of the sequelae of deep burns always relies in principle on dermal-epidermal grafts. The latter, the price of which to pay is heavy scarring, cannot always be performed because the surface of skin available may not be sufficient. Research pathways have turned towards the creation of skin substitutes to minimise the scarring and improve the cosmetic quality of the grafts. We review the technical characteristics of collagen matrixes (Intégra(®) - Matriderm(®)) and their method of use.

Topics: Burns; Chondroitin Sulfates; Cicatrix; Collagen; Elastin; Humans; Skin, Artificial; Treatment Outcome; Wound Healing

It is well established that axonal regeneration in the adult CNS is largely unsuccessful. Numerous axon-inhibitory molecules are now known to be present in the injured CNS, and various strategies for overcoming these obstacles and enhancing CNS regeneration have been experimentally developed. Recently, the use of chondroitinase-ABC to treat models of CNS injury in vivo has proven to be highly beneficial towards regenerating axons, by degrading the axon-inhibitory chondroitin sulphate glycosaminoglycan chains found on many proteoglycans in the astroglial scar. This enzyme has now been shown to restore synaptic plasticity in the visual cortex of adult rats by disrupting perineuronal nets, which contain high levels of chondroitin sulphate proteoglycans (CS-PGs) and are expressed postnatally around groups of certain neurons in the normal CNS. The findings suggest exciting prospects for enhancing growth and plasticity in the adult CNS; however, some protective roles of CS-PGs in the CNS have also been demonstrated. Clearly many questions concerning the mechanisms regulating expression of extracellular matrix molecules in CNS pathology remain to be answered.

Topics: Animals; Axons; Blood-Brain Barrier; Central Nervous System; Chondroitin ABC Lyase; Chondroitin Sulfates; Cicatrix; Humans; Nerve Regeneration

The loss of skin has been one of the oldest, yet most frequent and costly problems in our health care system. To restore functional and esthetic integrity in patients with unstable or hypertrophic scars, in burn patients and after skin loss for hereditary, traumatic or oncological reasons, an armamentarium of reconstructive surgical procedures including autogenous, allogenous and xenogenous tissue transfer as well as implantation of alloplastic materials has been favored. For several decades there has been increasing interest focused on 'tissue engineering' of dermal, epidermal and full thickness skin substitutes by both biological and synthetic matrices. At our institution (Hannover Medical School), a collagen/glycosaminoglycan dermal regeneration matrix has been used for immediate dermal coverage after escharectomy in burn injuries as well as for dermal replacement in chronically unstable scars. This article gives an overview on the current state of the art in bioartificial skin as well as our personal experience with the collagen/glycosaminoglycan matrix for dermal replacement in different clinical situations.

Topics: Adolescent; Adult; Biocompatible Materials; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Dermis; Epidermis; Extracellular Matrix; Female; Follow-Up Studies; Glycosaminoglycans; Humans; Middle Aged; Silicones; Skin Diseases; Skin Transplantation; Skin, Artificial

The role of glycosaminoglycan sulfation patterns, particularly in regard to scar formation and inhibition of neuritogenesis, has been mainly studied in cell culture with a focus on chondroitin 4-sulfate. In this study, we investigated chondroitin 6-sulfate (C6S) and found that it also inhibits neurite outgrowth of mouse cerebellar granule neurons in vitro. To examine whether the inhibitory activity of C6S could be neutralized, seven previously characterized high-affinity C6S-binding peptides were tested, among which three peptides neutralized the inhibitory functions of C6S. We further investigated these peptides in a mouse model of spinal cord injury, since upregulation of C6S expression in the glial scar following injury has been associated with reduced axonal regrowth and functional recovery. We here subjected mice to severe compression injury at thoracic levels T7-T9, immediately followed by inserting gelfoam patches soaked in C6S-binding peptides or in a control peptide. Application of C6S-binding peptides led to functional recovery after injury and prevented fibrotic glial scar formation, as seen by decreased activation of astrocytes and microglia/macrophages. Decreased expression of several lecticans and deposition of fibronectin at the site of injury were also observed. Application of C6S-binding peptides led to axonal regrowth and inhibited the C6S-mediated activation of RhoA/ROCK and decrease of PI3K-Akt-mTOR signaling pathways. Taken together, these results indicate that treatment with C6S-binding peptides improves functional recovery in a mouse model of spinal cord injury.

Topics: Animals; Axons; Cells, Cultured; Chondroitin Sulfate Proteoglycans; Chondroitin Sulfates; Cicatrix; Disease Models, Animal; Gliosis; Glycogen Synthase Kinase 3 beta; Locomotion; Macrophages; Mice, Inbred C57BL; Microglia; Neuronal Outgrowth; Neurons; Peptides; Phosphatidylinositol 3-Kinases; Proto-Oncogene Proteins c-akt; Recovery of Function; Remyelination; rho-Associated Kinases; rhoA GTP-Binding Protein; Spinal Cord Injuries; TOR Serine-Threonine Kinases

The advent of dermal regeneration templates has fostered major advances in the treatment of acute burns and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2 mm-thick bovine collagen templates (Matriderm® and Integra®), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No intra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.

Topics: Adolescent; Adult; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Elastin; Female; Guided Tissue Regeneration; Humans; Longitudinal Studies; Male; Middle Aged; Negative-Pressure Wound Therapy; Plastic Surgery Procedures; Postoperative Complications; Skin; Skin Transplantation; Transplantation, Autologous; Young Adult

Few studies have been conducted to explore the utility of the Integra. We retrospectively reviewed all patients treated by IDRT combined with STSG from May 2015 to October 2018. The inclusion criterion was traumatic or post-infectious soft tissue defects (STDs) of the dorsal hand, fingers, and thumb, not suitable for direct wound closure and requiring local, pedicle, or free flap reconstruction. After debridement, a two-stage procedure was applied, namely IDRT followed by STSG. Indications, functional outcomes, aesthetic results, complications, patient satisfaction, and the STSG take rate were evaluated over a 36-month follow-up using standardised instruments.. The 36-month follow-up demonstrated that IDRT is a safe and reliable technique that can be considered a viable alternative to flap reconstruction for the management of traumatic STDs in selected patients. The aesthetic outcomes are acceptable, functional recovery of the fingers is excellent, patient satisfaction is very high and the rate of complications is very low.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Chondroitin Sulfates; Cicatrix; Collagen; Debridement; Esthetics; Female; Finger Injuries; Fingers; Hand; Hand Injuries; Humans; Male; Middle Aged; Patient Satisfaction; Physical Appearance, Body; Plastic Surgery Procedures; Retrospective Studies; Skin Transplantation; Soft Tissue Injuries; Thumb; Treatment Outcome; Wound Infection; Young Adult

Chondroitin sulfate proteoglycans produced in glial scar tissue are a major inhibitory factor for axonal regeneration after central nervous system injury in mammals. The inhibition is largely due to chondroitin sulfates, whose effects differ according to the sulfation pattern. In contrast to mammals, fish nerves spontaneously regenerate beyond the scar tissue after spinal cord injury, although the mechanisms that allow for axons to pass through the scar are unclear. Here, we used immunohistochemistry to examine the expression of two chondroitin sulfates with different sulfation variants at the lesion site in goldfish spinal cord. The intact spinal cord was immunoreactive for both chondroitin sulfate-A (CS-A) and chondroitin sulfate-C (CS-C), and CS-A immunoreactivity overlapped extensively with glial processes positive for glial fibrillary acidic protein. At 1week after inducing the spinal lesion, CS-A immunoreactivity was observed in the cell bodies and extracellular matrix, as well as in glial processes surrounding the lesion center. At 2weeks after the spinal lesion, regenerating axons entering the lesion center overtook the CS-A abundant area. In contrast, at 1week after lesion induction, CS-C immunoreactivity was significantly decreased, and at 2weeks after lesion induction, CS-C immunoreactivity was observed along the regenerating axons entering the lesion center. The present findings suggest that after spinal cord injury in goldfish, chondroitin sulfate proteoglycans are deposited in the extracellular matrix at the lesion site but do not form an impenetrable barrier to the growth of regenerating axons.

Topics: Animals; Axons; Chondroitin Sulfates; Cicatrix; Fish Proteins; Glial Fibrillary Acidic Protein; Goldfish; Immunohistochemistry; Neuroglia; Spinal Cord; Spinal Cord Injuries; Spinal Cord Regeneration

Although tendon-exposed or bone-exposed wounds can be resurfaced with flaps, such surgeries may not be feasible in patients with poor general or local conditions. Biosynthetic artificial skin is an alternative for critical wound coverage. We designed a new artificial skin bilayer to close difficult wounds permanently.. This study compares incorporation and wound contraction between silicone acellular porcine dermis (SAPD) and the Integra graft (Integra Life Sciences Corp., Billerica, Mass) in a rat model.. The SAPD was manufactured according to our previously described standard procedures. Integra grafts were obtained commercially. We included 24 male adult Sprague-Dawley rats and divided them into 2 groups. After creating a 3 × 4-cm full-thickness wound on the back, we transplanted the same-sized SAPD and Integra grafts onto the rat wounds. Autologous full-thickness skin (FTS) was grafted onto the acellular porcine dermal matrix (APDM) of the SAPD and the Integra dermal matrix (IDM) 2 weeks later. We measured the wound size and contraction rate of recipient wounds, studied the incorporation of FTS on the dermal matrix, and did pathological examination. Generalized estimating equations were used to assess the data from repeated wound and scar contraction measurements using SAS v9.2.. The sizes of wounds of both groups decreased over time. No difference in wound contraction was observed between the SAPD and Integra groups at weeks 2, 4, or 6 after grafting. However, the contraction rates in both groups increased significantly. The pathological examination showed that the FTS was well incorporated in the APDM and IDM. The recipient wounds showed new vessels and cell infiltration in the new matrix, but no severe inflammation. Skin appendages were regenerating in the FTS. There was no rejection sign.. Both SAPD and Integra are double-layered artificial skin products. Our results demonstrate that APDM and IDM are good templates and show excellent incorporation with autologous FTS graft. The results also demonstrated gradual wound contraction over time, but the contraction rate was not different between SAPD and Integra 6 weeks after grafting in a rat model.

Topics: Acellular Dermis; Animals; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Disease Models, Animal; Male; Rats; Rats, Sprague-Dawley; Skin Transplantation; Swine; Transplantation, Autologous; Wound Closure Techniques; Wound Healing

Upon skin injuries, dermal fibroblasts actively produce transforming growth factor-β (TGF-β), which leads to the formation of α-smooth muscle actin (αSMA)-positive granulation tissues. The hyperplasia or incomplete regression of these tissues subsequently causes scar formation in the skin, where sulfated glycosaminoglycans (GAGs), side chains of unique proteoglycans, are supposed to play important roles.. The aim of this study is to clarify the effects of sulfated GAGs on dermal cell behaviors triggered by the TGF-β signaling, along with its possible regulators basic fibroblast growth factor (bFGF) and cell surface epimorphin. bFGF and epimorphin might regulate the TGF-β-induced αSMA expression, they could exert such effects only in specific cellular contexts, given that they lack conventional signal sequences for extracellular localization.. Human scar-derived dermal fibroblasts (HSFs) were treated with TGF-β alone, TGF-β plus bFGF, and TGF-β plus cell surface expression of epimorphin. The effects of GAGs on the expression of αSMA and the cellular morphology were then investigated.. A highly sulfated chondroitin sulfate (CS-E) or its substitute (heparinoid) had marked inhibitory effects on TGF-β-mediated changes in HSF behaviors. We found that heparinoid can directly associate with TGF-β, bFGF and epimorphin. We also found that bFGF downregulated αSMA, which was attenuated by heparinoid, whereas epimorphin augmented αSMA expression, which was further amplified by heparinoid.. TGF-β, bFGF and epimorphin in the extracellular microenvironment cooperatively affect HSF behaviors under the control of a highly sulfated chondroitin sulfate. These results provide important evidence towards understanding the regulation of TGF-β-induced HSF behaviors.

Topics: Actins; Animals; Cell Membrane; Chlorocebus aethiops; Chondroitin Sulfates; Cicatrix; COS Cells; Fibroblast Growth Factor 2; Fibroblasts; Glycosaminoglycans; Heparinoids; Humans; Proteoglycans; Recombinant Proteins; Signal Transduction; Swine; Syntaxin 1; Transforming Growth Factor beta

Long-term function following severe burns to the hand may be poor secondary to scar adhesions to the underlying tendons, webspaces, and joints. In this pilot study, we report the feasibility of applying a pasty dermal matrix combined with percutaneous cannula teno- and adhesiolysis.. In this 6 month follow-up pilot study, we included eight hands in five patients with hand burns undergoing minimal-invasive, percutaneous cannula adhesiolysis and injection of INTEGRA™ Flowable Wound Matrix for a pilot study of this new concept. The flowable collagen-glycosaminoglycan wound matrix (FCGWM) was applied with a buttoned 2mm cannula to induce formation of a neo-gliding plane. Post treatment follow-up was performed to assess active range of motion (AROM), grip strength, Disabilities of the Arm, Shoulder and Hand (DASH) score, Vancouver Scar Scale (VSS) and quality of life Short-Form (SF)-36 questionnaire.. No complications were detected associated with the treatment of FCGWM injection. The mean improvement (AROM) at 6 months was 30.6° for digits 2-5. The improvement in the DASH score was a mean of 9 points out of 100. The VSS improved by a mean of 2 points out of 14.. The study demonstrates the feasibility and safety of percutaneous FCGWM for dermal augmentation after burn. Results from this pilot study show improvements in AROM for digits 2-5, functional scores from the patient's perspective (DASH) and scar quality (VSS). The flowable form of established INTEGRA™ wound matrix offers the advantage of minimal-invasive injection after scar release in the post-burned hand with a reduction in the risk of postsurgical re-scarring.

Topics: Adult; Burns; Catheterization; Catheters; Chondroitin Sulfates; Cicatrix; Collagen; Feasibility Studies; Female; Hand Injuries; Hand Joints; Hand Strength; Humans; Male; Middle Aged; Minimally Invasive Surgical Procedures; Pilot Projects; Plastic Surgery Procedures; Range of Motion, Articular; Tissue Adhesions; Treatment Outcome

Spinal cord injury (SCI) is characterized by a high rate of disability and imposes a heavy burden on society and patients. SCI can activate glial cells and lead to swelling, hyperplasty, and reactive gliosis, which can severely reduce the space for nerve growth. Glial cells can secrete a large amount of extracellular inhibitory components, thus altering the microenvironment of axon growth. Both these factors seriously impede nerve regeneration. In the present study, we investigate whether curcumin (cur), a phytochemical compound with potent anti-inflammatory effect, plays a role in the repair of SCI.. We established a rat model of SCI and treated the animals with different concentrations of cur. Using behavioral assessment, immunohistochemistry, real-time polymerase chain reaction, Western blotting, and enzyme-linked immunosorbent assay, we detected the intracellular and extracellular components of glial scar and related cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, nuclear factor (NF)-κb, transforming growth factor (TGF)-β1, TGF-β2, and sex determining region Y-box (SOX)-9.. We found that cur inhibited the expression of proinflammatory cytokines, such as TNF-α, IL-1β, and NF-κb; reduced the expression of the intracellular components glial fibrillary acidic protein through anti-inflammation; and suppressed the reactive gliosis. Also, cur inhibited the generation of TGF-β1, TGF-β2, and SOX-9; decreased the deposition of chondroitin sulfate proteoglycan by inhibiting the transforming growth factors and transcription factor; and improved the microenvironment for nerve growth. Through the joint inhibition of the intracellular and extracellular components of glial scar, cur significantly reduced glial scar volume and improved the Basso, Beattie, and Bresnahan locomotor rating and axon growth.. Our data support a role for curcumin in promoting neural function recovery after SCI by the joint inhibition of the intracellular and extracellular components of glial scar, providing an important strategy for treating SCI.

Topics: Animals; Antineoplastic Agents; Chondroitin Sulfates; Cicatrix; Curcumin; Cytokines; Extracellular Matrix; Female; Glial Fibrillary Acidic Protein; Gliosis; Locomotion; Phytotherapy; Plant Extracts; Random Allocation; Rats, Sprague-Dawley; Spinal Cord Injuries; Transcription Factors

The prevalence of acellular dermal matrices in reconstructive surgery has increased through the last decade with satisfying outcomes. Long-term follow-up and effectiveness studies could enable appropriate use of these devices and challenge the current gold-standard treatments. This paper presents functional and cosmetic long-term outcomes on the Integra(®) Dermal Regeneration Template (IDRT) for treating traumatic soft-tissue defects of the foot and ankle.. All adult patients who underwent severe traumatic foot and ankle reconstruction with Integra(®) since 2004 were retrospectively included. Results were evaluated using standardized outcome instruments.. Twenty-one reconstructions were evaluated 4.5 ± 2.5 years after foot and ankle injury. Major complications inducing a second application included 1 hematoma and 1 infection. Seven patients (35%) had good or excellent Foot and Ankle Ability Measures. Subjectively, when asked to compare current function with pre-injury status, the mean response was 66 ± 23%. The Observer Scar Assessment Scale scored 17 ± 5 points (possible range, 5-50), while the Patient Scar Assessment Scale scored 30 ± 11 points (possible range, 6-60).. Long-term functional and cosmetic outcomes 4.5 years after severe traumatic foot and ankle wounds treated with IDRTs were rated fair in the great majority of patients. Nevertheless, because complications and surgical revisions were few, potential benefits might be underestimated because of the initial combined injuries and their sequelae. In this way, for appropriately selected patients with severe traumatic foot and ankle soft-tissue defects, including subacute coverage, it appears that this treatment may be a viable first option.

Topics: Adult; Ankle Injuries; Chondroitin Sulfates; Cicatrix; Collagen; Esthetics; Female; Foot Injuries; Humans; Male; Patient Outcome Assessment; Retrospective Studies; Skin, Artificial; Soft Tissue Injuries

Wounds of both the oral mucosa and early-to-mid gestation foetuses have a propensity to heal scarless. Repair of skin wounds in adults, however, regularly results in scar formation. The extracellular matrix (ECM) plays an important role in the process of healing. The fate of scarless or scar forming healing may already be defined by the ECM composition, prior to wounding. In this study, the presence of several ECM components in oral mucosa (palatum) and skin was investigated.. Immunohistochemical stainings of different ECM components were performed on skin, obtained from abdominal dermolipectomy surgery, and oral mucosa, derived after pharynx reconstruction.. Expression of fibronectin, its splice variant ED-A, and chondroitin sulphate was elevated in oral tissue, whereas elastin expression was higher in skin. Tenascin-C, hyaluronic acid, biglycan, decorin, and syndecan-1 were expressed at similar levels in both tissues. Oral mucosa contained more blood vessels than skin samples. Finally, oral keratinocytes proliferated more, while dermal keratinocytes demonstrated higher differentiation.. Comparing ECM components of the skin and oral mucosa coincides with differences earlier observed between foetal and adult skin, and this might indicate that some ECM components are involved in the mode of repair.

Topics: Adult; Biglycan; Biomarkers; Child; Chondroitin Sulfates; Cicatrix; Decorin; Elastin; Extracellular Matrix; Female; Fibronectins; Humans; Hyaluronic Acid; Immunoenzyme Techniques; Keratinocytes; Male; Mouth Mucosa; Skin; Syndecan-1; Tenascin; Wound Healing

Dermatan sulfate (DS) is synthesized from chondroitin sulfate (CS) by epimerization of glucuronic acid of CS to yield iduronic acid. In the present study, the role of CS and DS was examined in mice that received transection of nigrostriatal dopaminergic pathway followed by injection of glycosaminoglycan degrading enzymes into the lesion site. Two weeks after injury, fibrotic and glial scars were formed around the lesion, and transected axons did not regenerate beyond the fibrotic scar. Injection of chondroitinase ABC (ChABC), which degrades both CS and DS, completely suppressed the fibrotic scar formation, reduced the glial scar, and promoted the regeneration of dopaminergic axons. Injection of the DS-degrading enzyme chondroitinase B (ChB) also yielded similar results. By contrast, injection of chondroitinase AC (ChAC), a CS-degrading enzyme, did not suppress the fibrotic and glial scar formation, but reduced CS immunoreactivity and promoted the axonal regeneration. Addition of transforming growth factor-β1 (TGF-β1) to a co-culture of meningeal fibroblasts and cerebral astrocytes induces a fibrotic scar-like cell cluster. The effect of TGF-β1 on cluster formation was suppressed by treatment with ChABC or ChB, but not by ChAC. TGF-β1-induced cell cluster repelled neurites of neonatal cerebellar neurons, but addition of ChABC or ChAC suppressed the inhibitory property of clusters on neurite outgrowth. The present study is the first to demonstrate that DS and CS play different functions after brain injury: DS is involved in the lesion scar formation, and CS inhibits axonal regeneration.

Topics: Animals; Astrocytes; Axons; Brain Injuries; Chondroitin Sulfates; Cicatrix; Coculture Techniques; Dermatan Sulfate; Disease Models, Animal; Fibroblasts; Fluorescent Antibody Technique; Immunohistochemistry; Male; Mice; Mice, Inbred ICR; Nerve Regeneration; Rats; Rats, Sprague-Dawley

In 2010 excellent aesthetic results after basal cell carcinoma excision and one-stage coverage with Integra without split thickness skin graft (STSG) were published in a series of 10 Asian patients. Our aim in this study was to verify these results in a series of Caucasian patients and evaluate this procedure as a possible new standard.. 6 patients with facial basal cell carcinoma were treated by regular excision with 3 mm safety margins and one-stage coverage with Integra without STSG, followed by a clinical evaluation and fotodocumentation.. In 3 patients local infection occurred with a complete loss of the Integra. 2 out of these 3 patients showed an unaesthetic scar and are considering another surgical approach for correction. The other 3 patients had an uneventful course, unfortunately 2 out of these patients (67%) developed an unaesthetic scar as well and are also considering surgical correction.. Because of aesthetically unsatisfactory results and high infection rates we abandoned this procedure after 6 patients only. Our standard remains excision with 3 mm safety margins, histological analysis and one-stage repair with local facial flaps.

Topics: Adult; Aged; Carcinoma, Basal Cell; Chondroitin Sulfates; Cicatrix; Collagen; Facial Neoplasms; Female; Follow-Up Studies; Humans; Male; Microsurgery; Middle Aged; Plastic Surgery Procedures; Postoperative Complications; Skin Neoplasms; Skin Transplantation; Surgical Wound Infection

This study looked at clinical and histological outcomes of patients treated with Integra more than 2 years earlier. Although previous studies have investigated the short-term clinical and histological results, there have been no studies to investigate longer-term changes.. Fourteen patients (23 sites) were assessed. Patients used a visual analogue scale to score characteristics of their scars. Objective evaluation of the reconstructions was carried out using the Cutometer MPA580. Punch biopsy specimens of the sites were stained and labeled immunohistochemically with S100, CD31, and CD34 antisera.. The highest scoring category by patients was softness (median, +45 percent). The lowest score was sweating, which all patients scored 0. The median Cutometer readings ranged from 39 to 52 percent of the control values. Histological examination showed three patterns of collagen arrangement; parallel arrangement was found in over 60 percent of specimens. Elastic fibers were identified in all specimens; however, all were of abnormal morphology. The majority of specimens showed evidence of nerve fiber regeneration although confined to the mid- or lower reticular dermis. There was no regeneration of skin adnexa.. This study showed significant improvements in patient-assessed mobility, softness, and appearance. Collagen and elastic fibrin were present in all specimens, nerve fiber regeneration was limited to the mid- or lower reticular dermis, and adnexal structures were absent. The typical wrinkled appearance of mature Integra reconstruction cannot be said to be entirely due to a lack of elastic fibers.

Topics: Adolescent; Adult; Biopsy; Chondroitin Sulfates; Cicatrix; Collagen; Dermis; Follow-Up Studies; Humans; Middle Aged; Plastic Surgery Procedures; Skin Aging; Skin Transplantation; Skin, Artificial; Time Factors; Treatment Outcome; Wound Healing; Young Adult

Loss of sensory function in scar after burn is common, although the basis for this loss is not clear. Additionally, little is known about the effects of different treatment modalities on sensory function and neuroanatomical outcomes in burn patients. Here, we investigated the effects of the use of the INTEGRA(®) dermal scaffold on neuroanatomy and sensory function in acute burn patients.. We hypothesized that the use of artificial dermal templates would inhibit or reduce reinnervation after excision, since regrowth of nerves requires complex molecular interactions. Therefore the primary objective of this study was to identify whether there is regrowth of nerve fibres in the INTEGRA(®) dermal scaffold. The secondary objective was to identify whether the INTEGRA(®) dermal scaffold reduced nerve regrowth or limited sensory function outcomes in acute burn patients.. Five patients treated with INTEGRA(®), cultured epithelial autograft spray (prepared using ReCell(®) (CEA)) and split skin graft (SSG) were assessed for sensory function in scar and uninjured contralateral control skin. Neuroanatomy of scar and control sites was assessed using immunohistochemistry for PGP9.5, CGRP and substance P neuronal markers. Nerve density and sensory function was also assessed in a comparative group (n=8) treated with CEA and SSG only.. Neuroanatomy was not significantly different in the INTEGRA(®) patients when compared to the CEA/SSG group only. The patients treated with INTEGRA(®) had worse sensory function than those with CEA/SSG only.. Peripheral nerves do reinnervate the INTEGRA(®) dermal scaffold. There is no statistically significant reduction in reinnervation observed when compared to a control group. It is possible that the use of artificial dermal constructs, while permissive for nerve regrowth, limit functionality when compared to nerves that regrow through dermal tissue. Further research to understand the causes of this, and into enhancing reinnervation in dermal scaffolds may improve sensory outcome in the most severely burned patients.

Topics: Adult; Burns; Cells, Cultured; Chondroitin Sulfates; Cicatrix; Collagen; Epithelium; Humans; Immunohistochemistry; Nerve Regeneration; Peripheral Nerves; Recovery of Function; Sensory Thresholds; Skin; Skin Transplantation; Touch Perception; Wound Healing

The artificial dermis Integra (Ethicon, Johnson & Johnson Medical, Norderstedt, Germany) is widely used in the treatment of excessive burn injuries. It is also used in reconstructive surgery when large soft-tissue defects could not be covered with local or free flaps. In this article a 25-year old patient who presented with an early childhood burn of the trunk and lower extremity was treated with Integra in combination with the vacuum assisted closure (V.A.C., KCI, Texas, U.S.A.) and split thickness skin grafting. The combination of the artificial dermal substitute with negative pressure therapy has lead to a complete healing of Integra and the skin graft. During the whole treatment sterile wound conditions were present and time-consuming dressing changes could be prevented. Hospital stay was shortened because the patient could be treated as an outpatient with an ambulant vacuum assisted closure device.

Topics: Adult; Burns; Buttocks; Chondroitin Sulfates; Cicatrix; Collagen; Humans; Leg; Male; Plastic Surgery Procedures; Skin Transplantation; Thorax; Vacuum

Tissue expansion is a valuable technique in soft tissue reconstruction. Osmotic expanders are self-inflating and obviate the need for repeated injections. In doing so, they eliminate port site problems and may reduce the potential to introduce infection. The use of such expanders has become more common in recent years. We report on our experience with the Osmed™ osmotic expanders over the last 5-years.

Topics: Adolescent; Adult; Alopecia; Burns; Child; Child, Preschool; Chondroitin Sulfates; Cicatrix; Collagen; Female; Humans; Male; Mefenamic Acid; Middle Aged; Osmosis; Prosthesis Design; Skin, Artificial; Surgical Wound Infection; Tissue Expansion Devices; Young Adult

Facial burns present significant acute and reconstructive challenges. It has long been our practice to excise facial burns unlikely to heal in a timely manner in order to reduce the risk of aesthetic and functionally debilitating scar contractures. We present our approach to the acute surgical management of facial burns.

Topics: Bandages; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Eye; Face; Humans; Postoperative Care; Skin Transplantation; Tissue and Organ Harvesting; Transplantation, Homologous

The formation of glial scar and cystic cavities restricts axon regeneration after spinal cord injury. Chondroitin sulphate proteoglycans (CSPGs) are regarded as the prominent inhibitory molecules in the glial scar, and their inhibitory effects may be abolished in part by chondroitinase ABC (ChABC), which can digest CSPGs. CSPGs are secreted mostly by reactive astrocytes, which form dense scar tissues. The intermediate filament protein vimentin underpins the cytoskeleton of reactive astrocytes. Previously we have shown that retroviruses carrying full-length antisense vimentin cDNA reduce reactive gliosis. Here we administered both antisense vimentin cDNA and ChABC to hemisected rat spinal cords. Using RT-PCR, Western blotting and immunohistochemistry, we found that the combined treatment reduced the formation of glial scar and cystic cavities through degrading CSPGs molecules and inhibiting intermediate filament proteins. The modified intra- and extra-cellular architecture may alter the physical and biochemical characteristics of the scar, and the combined therapy might be used to inhibit glial scar formation.

Topics: Animals; Chondroitin ABC Lyase; Chondroitin Sulfates; Cicatrix; Cysts; DNA, Antisense; DNA, Complementary; Genetic Therapy; Nerve Regeneration; Neuroglia; Rats; Rats, Sprague-Dawley; Spinal Cord; Spinal Cord Injuries; Vimentin

There are currently limited treatment options available to modify the appearance of scarring due to deliberate self-harm (DSH). The authors present two cases of Integra dermal matrix use for resurfacing scars due to past DSH.. By excising the scars and resurfacing with Integra, we present and describe a novel technique for treating the visible stigmata of previous DSH.. No complications occurred, and patients noted improved appearance, skin quality and self-esteem following surgery. Both patients would recommend this treatment to others.. Integra dermal matrix substitute may be used successfully to treat scarring from previous DSH.

Topics: Adult; Arm Injuries; Chondroitin Sulfates; Cicatrix; Collagen; Female; Humans; Self-Injurious Behavior; Skin, Artificial; Treatment Outcome

Chondroitin sulfate increases around a lesion site after central nervous system injury and is believed to be an impediment to axonal regeneration, because administration of chondroitinase ABC, a chondroitin sulfate-degrading enzyme, promotes axonal regeneration of central neurons. To examine the physiological role of chondroitin sulfate up-regulation after injury, the nigrostriatal dopaminergic axons were unilaterally transected in mice, and chondroitinase ABC was then injected into the lesion site. In mice transected only, tyrosine hydroxylase-immunoreactive axons did not extend across the lesion at 1 or 2 weeks after the transection. Immunoreactivities of chondroitin sulfate side chains and core protein of NG2 proteoglycan increased in and around the lesion site, and a fibrotic scar containing type IV collagen deposits developed in the lesion center. In contrast, in mice transected and treated with chondroitinase ABC, numerous tyrosine hydroxylase-immunoreactive axons were regenerated across the lesion at 1 and 2 weeks after the transection. In these animals, chondroitin sulfate immunoreactivity remarkably decreased, and immunoreactivity of 2B6 antibody, which recognizes the stub of degraded chondroitin sulfate side chains, was enhanced. Furthermore, the formation of a fibrotic scar and a glia limitans that surrounds the former was completely prevented, although type IV collagen immunoreactivity remained in newly formed blood capillaries around the lesion site. We discuss the question of whether the chondroitin sulfate is acting as a direct inhibitor of axonal regeneration or whether the observed changes are due to a prevention of the fibrotic scar formation and a rearrangement of astrocytic membranes.

Topics: Animals; Axons; Brain Injuries; Chondroitin ABC Lyase; Chondroitin Sulfates; Cicatrix; Corpus Striatum; Dopamine; Male; Mice; Mice, Inbred ICR; Models, Animal; Nerve Regeneration; Neuroglia; Substantia Nigra

To analyze the amounts and distributions of nonsulfated and sulfated keratan sulfate (KS) and chondroitin/dermatan sulfate (CS/DS) disaccharides in the interface wound of human postmortem LASIK corneas in comparison with normal control corneas.. Corneal stromal tissue samples from central and paracentral hypocellular primitive stromal interface scars of human LASIK corneas and from similar regions of normal control corneas were collected by laser capture microdissection (LCM) and subsequently were digested with specific glycosidase enzymes. Digests were directly analyzed by electrospray ionization tandem mass spectrometry (ESI-MS/MS).. Concentrations of both monosulfated GlcNAc(6S)-beta-1,3-Gal (MSD2) and disulfated Gal (6S)-beta-1,4-GlcNAc(6S) (DSD) KS disaccharides from the LASIK interface scars were significantly lower than in normal control corneal stromas. No significant difference was found for the concentration of nonsulfated (NSD) KS disaccharides in LASIK interface scars compared with normal controls. The concentration of DeltaUA-beta-1,3-GalNAc(6S) (Deltadi-6S) CS/DS disaccharides from the LASIK interface scar was significantly higher than normal corneal stroma, whereas concentrations of DeltaUA-beta-1,3-GalNAc(4S) (Deltadi-4S) and nonsulfated Deltadi-0S CS/DS disaccharides demonstrated no significant differences from normal corneas.. The profiles of KS and CS/DS disaccharides in LASIK interface scars are significantly different from those in normal cornea stromal tissue, as revealed by LCM and ESI-MS/MS.

Topics: Chondroitin Sulfates; Cicatrix; Cornea; Corneal Stroma; Dermatan Sulfate; Humans; Keratan Sulfate; Keratomileusis, Laser In Situ; Middle Aged; Myopia; Spectrometry, Mass, Electrospray Ionization

The precise contribution of different CS-GAGs to CSPG-mediated inhibition of axonal growth after CNS injury is unknown. Quantification of the CS-GAGs in uninjured and injured brain (scar tissue) using fluorophore-assisted carbohydrate electrophoresis (FACE) demonstrated that the dominant CS-GAG in the uninjured brain is CS-4 whereas, in glial scar, CS-2, CS-6, and CS-4,6 were over-expressed. To determine if the pattern of sulfation influenced neurite extension, we compared the effects of CS-GAGs with dominant CS-4, CS-6, or CS-4,6 sulfation to intact CSPG (aggrecan), chondroitin (CS-0), and hyaluronan on chick DRG neurite outgrowth. We report that CS-4,6 GAG, one of the upregulated CS-GAGs in astroglial scar, is potently inhibitory and is comparable to intact aggrecan, a CSPG with known inhibitory properties. Thus, a specific CS-GAG that is differentially over-expressed in astroglial scar is a potent inhibitor of neurite extension. These results may influence the design of more specific strategies to enhance CNS regeneration after injury.

Topics: Aggrecans; Animals; Brain Injuries; Chick Embryo; Chondroitin; Chondroitin Sulfates; Cicatrix; Extracellular Matrix Proteins; Female; Ganglia, Spinal; Gliosis; Growth Cones; Growth Inhibitors; Hyaluronic Acid; Lectins, C-Type; Neurites; Proteoglycans; Rats; Sulfates; Up-Regulation

Integra dermal regeneration template (Integra Life Sciences, Plainsboro, N.J.) is an effective treatment for full-thickness burns. It can also be useful in contracture release procedures; however, the clinical utility of a dermal regeneration template in contracture release procedures has not been adequately characterized. In this multicenter investigation, the outcomes of release procedures incorporating a dermal regeneration template for 89 consecutive patients, who underwent a total of 127 contracture releases, were retrospectively evaluated. The procedures involved the application of Integra, which includes a temporary silicone epidermal substitute and an artificial dermal layer. After formation of a neodermis, the silicone layer is removed and replaced with an epidermal autograft. Data on patient and contracture site history, treatment methods, physician assessments of range of motion or function, patient satisfaction, recurrence, and adverse events were collected with a standardized questionnaire. Release procedures for the study patients involved the neck, axilla, trunk, elbow, knee, hand, and other anatomical sites. The mean postoperative follow-up period was 11.4 months. At 76 percent of the release sites, range of motion or function was rated as good (significant improvement in range of motion or function) or excellent (maximal range of motion or function possible) by physicians. Responding patients expressed satisfaction with the overall results of treatment at 82 percent of the sites. No recurrence of contracture at 75 percent of the sites was observed during follow-up monitoring. Patient age and prior surgical treatment at the site did not significantly affect the results of treatment. However, outcomes were superior at mature sites, i.e., those for which more than 12 months had elapsed since the original injury. Postoperative complications rarely necessitated regrafting. These results indicate that a dermal regeneration template provides a useful alternative technique for contracture release procedures. The study data indicate that this approach leads to favorable functional outcomes and a high rate of patient satisfaction. This modality also seems to be versatile, because a range of anatomical sites are amenable to treatment with a dermal regeneration template, regardless of prior surgical treatment, and both pediatric and adult patients respond well to this form of therapy. Furthermore, Integra confers functional and cosmetic benefits simi

Topics: Adolescent; Adult; Aged; Biocompatible Materials; Child; Child, Preschool; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Plastic Surgery Procedures; Retrospective Studies; Skin Transplantation; Skin, Artificial; Time Factors; Treatment Outcome

We have previously demonstrated that enzymatic digestion of chondroitin sulfate proteoglycan (CSPG) at the scar promotes the axonal regrowth of Clarke's nucleus (CN) neurons into an implanted peripheral nerve graft after hemisection of the spinal cord. The present study examined whether degradation of CSPG using chondroitinase ABC promoted the regeneration of CN neurons through the scar into the rostral spinal cord in neonatal and adult rats. Following hemisection of the spinal cord at T11, either vehicle or chondroitinase ABC was applied onto the lesion site. The postoperative survival periods were 2 and 4 weeks. The regenerated CN neurons were retrogradely labeled by Fluoro-Gold injected at spinal cord level C7. In the sham group, there was no regeneration of injured CN neurons in both neonatal and adult rats. Treatment with 2.5 unit/ml chondroitinase ABC in neonates resulted in 11.8 and 8.3% of the injured CN neurons regenerated into the rostral spinal cord at 2 and 4 weeks, respectively. In adults, 9.4 and 12.3%, at 2 and 4 weeks, respectively, of the injured CN neurons regenerated their axons to the rostral spinal cord. The immunoreactivity for the carbohydrate epitope of CSPG was dramatically decreased around the lesion site after treatment with chondroitinase ABC compared to sham control in both neonatal and adult animals. Our results show that axonal regeneration in the spinal cord can be promoted by degradation of CSPG with chondroitinase ABC. This result further suggests that CSPG is inhibitory to the regeneration of neurons in the spinal cord after traumatic injury.

Topics: Age Factors; Animals; Animals, Newborn; Axons; Chondroitin ABC Lyase; Chondroitin Sulfate Proteoglycans; Chondroitin Sulfates; Cicatrix; Disease Models, Animal; Female; Immunohistochemistry; Nerve Regeneration; Neurons; Rats; Rats, Sprague-Dawley; Spinal Cord Injuries

Integra artificial skin was introduced in 1981 and its use in acute surgical management of burns is well established, but Integra has also been used in patients undergoing reconstructive surgery. Over a period of 25 months, the authors used Integra to cover 30 anatomic sites in 20 consecutive patients requiring reconstructive surgery and then analyzed the clinical and histologic outcomes. The most common reason for surgery was release of contracture followed by resurfacing of tight or painful scars. The authors assessed patients' satisfaction using a visual analog scale and scar appearance using a modified Vancouver Burn Index Scale. They evaluated the progress of wound healing by examining weekly punch-biopsy specimens with standard and immunohistochemical stains. Patients reported a 72 percent increase in range of movement, a 62 percent improvement in softness, and a 59 percent improvement in appearance compared with their preoperative states. Pruritus and dryness were the main complaints, and neither was improved much. Four distinct phases of dermal regeneration could be demonstrated histologically: imbibition, fibroblast migration, neovascularization, and remodeling and maturation. Full vascularization of the neodermis occurred at 4 weeks. The color of the wound reflected the state of neodermal vascularization. No adnexa, nerve endings, or elastic fibers were seen in any of the specimens. The new collagen was histologically indistinguishable from normal dermal collagen. The authors conclude that Integra is a useful tool in reconstructive surgery. The additional cost of its use can be justified by its distinct benefits compared with current methodology.

Topics: Adolescent; Adult; Biocompatible Materials; Child; Child, Preschool; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Dermatologic Surgical Procedures; Epidermis; Humans; Middle Aged; Neovascularization, Physiologic; Patient Satisfaction; Plastic Surgery Procedures; Skin; Skin, Artificial; Transplantation, Autologous; Wound Healing

We report on our experience with Integra application in 22 patients treated from February 1996 through April 1999. Nine patients suffered a primary burn injury and 13 patients had secondary unstable scars. Integra is artificial skin that consists of a collagen/glycosaminoglycane matrix and a silicon layer. It was first used by Burke and Yannas in 1980 in the USA. The mechanical and biological features of Integra protect the tissue from fluid loss and bacterial invasion in the acutely burned patient. The integra-induced formation of a neodermis leads to functionally and aesthetically highly acceptable scar formation. We present our clinical experience with Integra in long-term follow-up.

Topics: Adult; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Female; Humans; Male; Middle Aged; Silicones; Skin Transplantation; Skin, Artificial; Wound Healing

Hyaluronan, found in high concentrations in fetal tissues, appears to have a major role in preventing scar formation in fetal wounds. Nevertheless, its role in inhibiting wound contractures associated with scar formation has not been clearly demonstrated. Our current study evaluated the effects of hyaluronan using an in vitro floating collagen fibrillar matrix (CFM) contraction model. The results demonstrated that the contraction of CFM by fibroblasts was significantly reduced when high concentrations (> 1 mg/mL) of hyaluronan were present in the media. This phenomenon is unique to hyaluronan, because chondroitin sulfate was ineffective in this connection. Fibroblast migration and proliferation studies indicated that high concentrations of hyaluronan stimulated cell migration and had no cytotoxic effects. Some possible mechanisms by which high concentrations of hyaluronan reduced CFM contraction by fibroblasts were proposed. Because the viscosity of a hyaluronan solution is much greater than that of chondroitin sulfate, and this increases with concentration, we investigated whether this property in itself was an important factor in inhibiting CFM contraction. No direct correlation was found between the viscosity of glycosaminoglycans and their ability to reduce CFM contraction.

Topics: Animals; Cattle; Cell Division; Cell Movement; Cells, Cultured; Chondroitin Sulfates; Cicatrix; Collagen; DNA; Fibroblasts; Glycosaminoglycans; Humans; Hyaluronic Acid; Viscosity

Studies have been made of the glycosaminoglycan (GAG) composition of implants of keloid and hypertrophic scars in athymic nude mice in order to evaluate these implants as a model for studies of causation and therapy of these abnormal human scars. Changes in weight of implanted tissue were also recorded. Pieces of keloid, hypertrophic scar or normal human skin were placed in subcutaneous pockets of athymic nude mice and left for various times up to 246 days. The uronic acid content of the scar implants did not change significantly until after 80 days when the level decreased; the uronic acid level of normal skin increased slightly during the 110 days studied. The initially high percentage of chondroitin-4-sulfate of keloid and hypertrophic scar tissue decreased in the implants (averaging a 50% decrease at 164 days for keloids and at 176 days for hypertrophic scars). The average weight of the scar implants increased slightly after implantation and then decreased when expressed either as wet or dry weight. The regression lines of weight on time indicated an average loss of 50% dry weight at 66 days for keloid implants and 68 days for hypertrophic scars. Normal human skin increased in net weight until 20 days and dry weight until 40 days and then decreased, losing about 20% of weight (either wet or dry) at 110 days. On the basis of the glycosaminoglycan changes, the model should be useful for short term studies of therapy and causation.

Topics: Adolescent; Adult; Animals; Chondroitin Lyases; Chondroitin Sulfates; Cicatrix; Female; Glycosaminoglycans; Humans; Keloid; Male; Mice; Mice, Nude; Middle Aged; Regression Analysis; Skin Transplantation; Uronic Acids

Parallel histological stains and immunohistological stains were made of hypertrophic scars and normal scars in order to identify the type of cells and associated proteoglycans present in perivascular cuffs in hypertropic scars. Tissue sections were treated with monoclonal antibodies which specifically recognize T-cells and unsulphated, 4-sulphated and 6-sulphated chondroitin proteoglycans. There was a striking association between the perivascular lymphocytic infiltration and chondroitin-4-sulphate, which may be an important contributory factor in the development of hypertrophic scars.

Topics: Adolescent; Chondroitin Sulfates; Cicatrix; Humans; Hypertrophy; Immunohistochemistry; Proteoglycans; Skin; T-Lymphocytes; Wound Healing

Ultrastructural localization of proteoglycans (PGs) in 1-week- to 2-year-old scar was determined by staining with cuprolinic blue dye (CBD) after specific enzymatic digestion of keratan sulfate (KS) glycosaminoglycans (GAGs) or chondroitin sulfate glycosaminoglycans (CSs). High critical electrolyte conditions were maintained for CBD-staining, specific for high-sulfated GAGs. Although KS was detected in the 1-week-old wound, no CBD-stained KS was seen in the anterior stroma adjacent to the wound. The CS was present throughout the 1-week-old wound and adjacent stroma, and PGs were biosynthetically 35SO4-labeled in normal stroma. Subsequently, radioactivity from labeled PGs in normal stroma adjacent to the wound moved into scar tissue during healing. Marked sensitivity of PGs to Chondroitinase ABC indicated an abundance of CS in 2-week-old scars. Punctate CBD-staining and immunohistochemical evidence suggested chemically altered KS is present in the 2-week-old anterior scar. The pattern of CBD-staining in 1- and 2-week scars, after chondroitinase treatment, suggested KS in the younger scar is similar to adult high-sulfated GAG, whereas KS in the 2-week scar contains primarily newly synthesized low-sulfated KS. The latter is consistent with previous immunochemical and biochemical analyses. Cytochemical and immunohistochemical evidence indicated that KS is not present in the 2-week-old posterior scar. By the week 8 of healing, CBD-stained KS was present throughout most of the scar, except along the posterior margin, consistent with earlier stages of healing. The CBD-stained structures in the first 8 weeks of healing were reminiscent of stained GAGs in normal developing cornea. This fetal-like CBD-staining pattern seen in scar, however, changed to that of the normal adult by the 2nd year of healing. The significance of these observations relate to our contention that healing adult cornea recapitulates some ontogenetic events of the normal cornea, and that the nonuniform distribution and chemical properties of GAGs in scar tissue are a function of the movement of existing proteoglycans and de novo synthesis of altered macromolecules.

Topics: Animals; Antibodies, Monoclonal; Chondroitin Sulfates; Cicatrix; Cornea; Glycosaminoglycans; Immunohistochemistry; Indoles; Keratan Sulfate; Organometallic Compounds; Proteoglycans; Rabbits; Wound Healing

An experimental investigation of the ability of the chondroitinsulphate preparation produced from cattle tracheas, of rumalon and chonsuride to stimulate the regeneration of cutaneous coverings in case of their injury was carried out. A strength of the surgical cicatrix and its elongation at rupture in two weeks' injections of chondroitinsulphate increased in comparison with control. A stimulating effect of chondroitinsulphate to regeneration of flesh wound in case of local single action didn't differ essentially from the effect of chonsuride. In case of application of the preparations, an area of wound for the rats received chondroitinsulphate was already on the eighth day twice as less in comparison with the animals treated with chonsuride. Thus, a stimulating effect of chondroitinsulphate preparation to the regeneration of damaged cutaneous coverings by both parenteral and local administration was shown.

Topics: Animals; Chondroitin; Chondroitin Sulfates; Cicatrix; Drug Evaluation, Preclinical; Male; Rats; Rats, Inbred Strains; Stimulation, Chemical; Time Factors; Tissue Extracts; Wound Healing

Fibroblast cultures established from explants of mature scar and skin tissue were analyzed with regard to extracellular glycosaminoglycan (GAG) composition and response to interleukin-1 (IL-1). Following a serum-free 48 hour label with [3H]glucosamine, pericellular and medium GAGs were isolated by precipitation with cetylpyridinium chloride (CPC) and analyzed by cellulose acetate electrophoresis. In addition, susceptibility of the precipitates to Streptomyces hyaluronidase, chondroitinase ABC and heparitinase was determined. Labeled conditioned medium from the scar-derived cells contained both dermatan sulfate (DS) and hyaluronate (HA), as compared to medium from the control (skin-derived) cells which contained predominantly DS. IL-1 induced the appearance of chondroitin 4-sulfate (C4-S) in the medium of the scar cells with no concurrent effect on either DS or HA, and increased the amount of HA in the medium fraction of normal skin cells. The pericellular fraction of the scar-derived cells contained chondroitin 6-sulfate (C6-S) and DS; addition of IL-1 resulted in a shift from DS to heparan sulfate (HS), and the emergence of a pericellular GAG profile similar to that of normal dermal fibroblasts.

Topics: Animals; Cells, Cultured; Chondroitin Sulfates; Cicatrix; Dermatan Sulfate; Fibroblasts; Glycosaminoglycans; Hyaluronic Acid; Interleukin-1; Rabbits; Skin; Wound Healing

Topics: Adult; Breast; Chondroitin; Chondroitin Sulfates; Cicatrix; Connective Tissue; Cytoskeleton; Female; Fibroblasts; Glycosaminoglycans; Histocytochemistry; Humans; Microscopy, Electron; Middle Aged; Prostheses and Implants

The collagen fibers of the nodules and whorl-like figures in hypertrophic scars are "coated" with proteoglycans, mainly chondroitin-4-sulfate. The latter was shown to prevent collagenase from breaking down collagen. This suggests that the presence of great amounts of chondroitin-4-sulfate in hypertrophic scars may contribute to the overabundance of collagen deposition which is characteristic of this abnormal healing process.

Topics: Child; Child, Preschool; Chondroitin Sulfates; Cicatrix; Collagen; Humans; Hypertrophy; Microbial Collagenase; Proteoglycans