elastin and Wounds-and-Injuries

Laser skin resurfacing (LSR) has been used for facial rejuvenation for the last 20 years. Posttreatment care after LSR is essential to decrease the risk of complications. Currently, no unified standards or criteria exist for invasive LSR posttreatment care. We aimed to identify the optimal wound care timing and choice of specific local, systemic, and general medical measures required to decrease complications.. We performed a systematic search of the PubMed/MEDLINE electronic databases and included only articles written and published in the English language, with no restrictions on the publication time (year).. The search yielded 316 potentially relevant articles, 133 of which met our review criteria. Most of the studies on this topic have focused on wound care during the early stage, typically the first 2 weeks. Closed dressings may offer a more ideal, moist wound environment. The use of medications must be judicious. The ongoing emergence of new methods and products warrants evaluation in future large clinical trials.. Familiarity with the complications following invasive LSR and the provision of optimal, effective, and timely posttreatment care may substantially decrease the risks associated with the treatment modality.

Topics: Antibiotic Prophylaxis; Bandages; Collagen; Cosmetic Techniques; Elastin; Epidermal Growth Factor; Humans; Hydroquinones; Lasers, Gas; Lasers, Solid-State; Low-Level Light Therapy; Melanocytes; Platelet-Rich Plasma; Rejuvenation; Severity of Illness Index; Skin; Skin Aging; Time Factors; Wound Healing; Wounds and Injuries

To provide information about the clinical presentation of hypertrophic scars and keloids based on their varied structural components.. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.. After completing this continuing education activity, you should be able to: ABSTRACT: Hypertrophic scars and keloids are firm, raised, erythematous plaques or nodules that manifest when the cicatrix fails to properly heal. They result from pathologic wound healing and often cause pain and decreased quality of life. The appearance of such cosmetically unappealing scars affects the confidence and self-esteem of many patients. These scars can also cause dysfunction by interfering with flexion and extension across joints. Both possess some unique and distinct histochemical and physiologic characteristics that set them apart morphologically and at the molecular level. While these entities have been the focus of research for many years, differentiating between them remains challenging for clinicians.This article reviews the clinical presentation of aberrant scars and illustrates how they can be differentiated. It outlines their pathophysiology and emphasizes the unique molecular mechanisms underlying each disorder. It also examines how altered expression levels and the distribution of several factors may contribute to their unique clinical characteristics and presentation. Further research is needed to elucidate optimal treatments and preventive measures for these types of aberrant scarring.

Topics: Biopsy, Needle; Cicatrix, Hypertrophic; Collagen; Combined Modality Therapy; Diagnosis, Differential; Disease Progression; Education, Medical, Continuing; Elastin; Female; Fibrillin-1; Humans; Immunohistochemistry; Keloid; Male; Prognosis; Risk Assessment; Severity of Illness Index; Wound Healing; Wounds and Injuries

Wound dressings have experienced continuous and significant changes over the years based on the knowledge of the biochemical events associated with chronic wounds. The development goes from natural materials used to just cover and conceal the wound to interactive materials that can facilitate the healing process, addressing specific issues in non-healing wounds. These new types of dressings often relate with the proteolytic wound environment and the bacteria load to enhance the healing. Recently, the wound dressing research is focusing on the replacement of synthetic polymers by natural protein materials to delivery bioactive agents to the wounds. This article provides an overview on the novel protein-based wound dressings such as silk fibroin keratin and elastin. The improved properties of these dressings, like the release of antibiotics and growth factors, are discussed. The different types of wounds and the effective parameters of healing process will be reviewed.

Topics: Animals; Anti-Bacterial Agents; Bandages; Collagen; Drug Delivery Systems; Elastin; Fibroins; Humans; Hydrolysis; Keratins; Polymers; Wound Healing; Wounds and Injuries

To report the first case series of gauze-based negative pressure wound therapy (NPWT) as an adjunct to collagen-elastin dermal template resurfacing and provide a brief overview of the current knowledge and controversies regarding NPWT in association with dermal templates.. In this prospective study, patients undergoing single stage resurfacing with Matriderm (Dr Suwelack Skin & Health Care, Germany) between September 2007 and September 2008 at Stoke Mandeville Hospital were identified and followed up. A gauze-based NPWT system (V1STA) was used to secure the dermal template and split skin graft to the wound bed. Rates of epithelialisation, the patients' analgesic requirements and patient concordance with the device were all recorded.. In the 10 patients studied (7 males and 3 females) this modality of vacuum therapy was found to be effective in all cases for bolstering single stage collagen-elastin dermal templates onto wounds, and contributed to excellent rates of epithelialisation (mean: 94%, range: 70-100%). Additionally, patient concordance with the device was excellent and the costs associated with its use were much lower compared with foam-based NPWT.. We recommend the consideration of gauze-based NPWT as cost-effective alternative to foam based modalities in association with the use of dermal templates.

Topics: Collagen; Elastin; Humans; Negative-Pressure Wound Therapy; Prospective Studies; Wound Healing; Wounds and Injuries

Treatment of fingers tissue loss is particularly challenging as it often necessitates advanced reconstructive techniques such as flaps or grafts, with esthetic and functional results that are not always as good as hoped for, with long healing times. Recently, along with tissue engineering development, numerous types of dermal substitute have been commercialized, with promising possibilities of treatment in finger tissue loss. In the author's unit, Matriderm. Between October 2017 and October 2018, 27 fingers have been included in this study. Patients have been divided in two groups: those treated with Matriderm. All outcomes were overlapping in patients treated with or without skin graft: mean VSS was 2.3, mean qDASH was 13.3, and mean 2-PD was 7.7 mm.. The results obtained allow to consider Matriderm

Topics: Collagen; Elastin; Fingers; Humans; Skin Transplantation; Skin, Artificial; Wound Healing; Wounds and Injuries

Recently, we reported that some wound dressings caused complement activation at the interface of wound dressing and blood. Since complement activation is associated with impaired wound healing, we investigated whether this activation of the complement cascade at the interface of wound dressings and blood does impair reepithelialization in a scratch wound healing assay. Although some samples showed higher levels of the complement activation marker SC5b-9 in our study, reepithelialization of the samples did not significantly differ from the control group. Further studies have to clarify if complement activation at the interface of wound dressings and blood plays a relevant role in the healing process especially in long-time experiments.

Topics: Bandages; Blood; Cell Movement; Cell Proliferation; Coated Materials, Biocompatible; Collagen; Complement Activation; Complement Membrane Attack Complex; Elastin; Fluorocarbon Polymers; Humans; In Vitro Techniques; Keratinocytes; Petrolatum; Polyesters; Re-Epithelialization; Skin, Artificial; Wound Healing; Wounds and Injuries

Chronic and complex full-thickness wounds have become increasingly prevalent. Besides autologous skin transplantation, innovative wound dressing products have gained interest, as the functional and esthetic outcome is still limited. In this respect, the effect of a novel modifiable collagen-gelatin fleece on the healing of deep dermal wounds was examined and compared with untreated controls and Matriderm(®). A total of 48 full-thickness skin defects were generated on six minipigs and treated with the novel collagen-gelatin fleece of different thicknesses in single or multiple application (n=36) or treated with Matriderm(®) in a single application (n=6), or the wounds were left untreated (n=6). Wound healing was analyzed planimetrically by wound closure per time and histologically with regard to epidermal thickness and cell density. Compared to untreated wounds, wound closure per time and histological skin quality with regard to the mean epidermal thickness and epidermal cell amount were enhanced in both treatment groups. Overall, the best results for the novel collagen-gelatin fleece were achieved for multiple applications with a thickness of 150g/m(2). The novel biomaterial shows accelerated and improved dermal wound repair in a minipig model. As the manufacturing process of the scaffold allows the integration of bioactive substances such as antibiotics and growth factors, we intend to design a composite biomaterial using this scaffold as a carrier matrix.

Topics: Animals; Collagen; Dermis; Elastin; Epidermis; Gelatin; Random Allocation; Swine; Swine, Miniature; Tissue Scaffolds; Wound Healing; Wounds and Injuries

Post-traumatic arthritis (PTA) is a rapidly progressive form of arthritis that develops due to joint injury, including articular fracture. Current treatments are limited to surgical restoration and stabilization of the joint; however, evidence suggests that PTA progression is mediated by the upregulation of pro-inflammatory cytokines, such as interleukin-1 (IL-1) or tumor necrosis factor-α (TNF-α). Although these cytokines provide potential therapeutic targets for PTA, intra-articular injections of anti-cytokine therapies have proven difficult due to rapid clearance from the joint space. In this study, we examined the ability of a cross-linked elastin-like polypeptide (xELP) drug depot to provide sustained intra-articular delivery of IL-1 and TNF-α inhibitors as a beneficial therapy. Mice sustained a closed intra-articular tibial plateau fracture; treatment groups received a single intra-articular injection of drug encapsulated in xELP. Arthritic changes were assessed 4 and 8 weeks after fracture. Inhibition of IL-1 significantly reduced the severity of cartilage degeneration and synovitis. Inhibition of TNF-α alone or with IL-1 led to deleterious effects in bone morphology, articular cartilage degeneration, and synovitis. These findings suggest that IL-1 plays a critical role in the pathogenesis of PTA following articular fracture, and sustained intra-articular cytokine inhibition may provide a therapeutic approach for reducing or preventing joint degeneration following trauma.

Topics: Amino Acid Sequence; Animals; Arthritis, Experimental; Cartilage Oligomeric Matrix Protein; Cartilage, Articular; Delayed-Action Preparations; Drug Delivery Systems; Elastin; Injections, Intra-Articular; Interleukin 1 Receptor Antagonist Protein; Interleukin-1; Male; Matrix Metalloproteinase 3; Mice, Inbred C57BL; Molecular Sequence Data; Peptides; Synovial Fluid; Temperature; Time Factors; Treatment Outcome; Tumor Necrosis Factor-alpha; Wounds and Injuries; X-Ray Microtomography

Dermal templates, such as Matriderm® and Integra®, are widely used in plastic and reconstructive surgery, often as two-step procedures. A recent development is the application of thin dermal templates covered with split thickness skin grafts in one-step procedures. In this experimental study, we compare the two thin matrices Matriderm® 1 mm and Integra® Single Layer in a one-step procedure with particular focus on neodermis formation.. Matriderm® 1 mm and Integra® Dermal Regeneration Template-Single Layer (1.3 mm) were compared in a rat model. In three groups of five animals each, a full thickness wound was covered with (a) Matriderm® 1 mm and neonatal rat epidermis, (b) Integra® Single Layer and neonatal rat epidermis, or, (c) neonatal rat epidermis only (control). Histological sections 2 weeks post transplantation were analyzed with regard to take of template and epidermis, neodermal thickness, collagen deposition, vascularization, and inflammatory response.. Take of both templates was complete in all animals. The Matriderm®-based neodermis was thinner but showed a higher cell density than the Integra®-based neodermis. The other parameters were similar in both matrices.. The two templates demonstrate a comparable biological behavior early after transplantation. The only difference was found regarding neodermal thickness, probably resulting from faster degradation of Matriderm®. These preliminary data suggest that both dermal templates appear similarly suitable for transplantation in a one-step procedure.

Topics: Animals; Animals, Newborn; Chondroitin Sulfates; Collagen; Dermatologic Surgical Procedures; Disease Models, Animal; Elastin; Epidermis; Female; Follow-Up Studies; Plastic Surgery Procedures; Rats; Rats, Nude; Skin; Skin Transplantation; Skin, Artificial; Wound Healing; Wounds and Injuries

Reconstruction of full-thickness defects may benefit from integration of dermal substitutes, which serve as a foundation for split-thickness skin grafts, thus enhancing short and long-term results. We present a series of 7 patients who were treated between 2010 and 2012 for complicated full-thickness defects by the second-generation collagen/elastin matrix Matriderm® covered by a split-thickness skin graft. The defects resulted from malignancy resection, trauma, and post-burn scar reconstruction. Overall graft take was excellent and no complications were noted regarding the dermal substitute. Graft quality was close to normal skin in terms of elasticity, pliability, texture, and color. Good contour and cushioning of defects in weight bearing areas was also achieved. Matriderm was found to be a useful adjunct to full-thickness defect reconstruction, especially in difficult areas where the desired result is a scar of the highest quality possible.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Burns; Cattle; Cicatrix; Collagen; Elasticity; Elastin; Face; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasms; Plastic Surgery Procedures; Skin Transplantation; Skin, Artificial; Treatment Outcome; Wounds and Injuries; Young Adult

Chronic wounds are associated with poor epidermal and dermal remodeling. Previous work has shown the efficacy of keratinocyte growth factor (KGF) in reepithelialization and elastin in dermal wound healing. Here we demonstrate the fabrication of a fusion protein comprising of elastin-like peptides and KGF. This fusion protein retains the performance characteristics of KGF and elastin as evidenced by its enhancement of keratinocyte and fibroblast proliferation. It also preserved the characteristic elastin-like peptides inverse phase transitioning allowing the recombinant protein to be expressed in bacterial hosts (such as Escherichia coli) and purified rapidly and easily using inverse temperature cycling. The fusion protein self-assembled into nanoparticles at physiological temperatures. When applied to full thickness, wounds in Lepr(db) diabetic mice these particles enhanced reepithelialization and granulation, by 2- and 3-fold respectively, when compared to the controls. The data strongly suggests that these self-assembled nanoparticles may be beneficial in the treatment of chronic wounds resulting from diabetes or other underlying circulatory conditions.

Topics: Analysis of Variance; Animals; Blotting, Western; Elastin; Fibroblast Growth Factor 7; Male; Mice; Microscopy, Electron, Transmission; Multiprotein Complexes; Nanoparticles; Wound Healing; Wounds and Injuries

The aim of this study was to prove the effectiveness of MatriDerm(®) combined with skin grafting versus skin grafting alone in post-traumatic wounds treatment. At the Department of Plastic and Reconstructive Surgery of the University of Rome Tor Vergata, we treated 60 patients: 30 patients with dermal substitutes (MatriDerm(®)) combined with autologous skin graft and 30 with skin graft alone. Two weeks after the first treatment, 95% of wounds treated with MatriDerm(®) and skin graft showed a re-epithelisation, whereas it was 75-80% in the control group. We used the Manchester Scar Scale (MSS) and patient's self-estimation scale to assess the outcomes. Mann-Whitney U test was performed for the five items of the MSS and the results were combined to those of patient's self-estimation scale and the re-epithelialisation percentage to test the significance between the two groups. These data confirm the evidence of the clinical use of MatriDerm(®) technology in the healing of soft tissue wounds and prove the effectiveness of combining MatriDerm(®) and skin grafting for the first time. Furthermore, we observed a percentage reduction of wound contraction and in the same time an improvement of elasticity, quality of scars tissue and dermal architecture.

Topics: Adult; Aged; Collagen; Elastin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Retrospective Studies; Skin Transplantation; Skin, Artificial; Time Factors; Treatment Outcome; Wound Healing; Wounds and Injuries

We present an 80-year-old patient who presented a defect with exposed tendons on the dorsum of the hand after micrographic controlled tumour excision. The defect was closed using a combination of artificial collagen-elastin matrix (Matriderm) covered by an autologous split-skin graft in a 1-step approach resulting in rapid healing and good functional and cosmetic results.

Topics: Aged, 80 and over; Collagen; Elastin; Follow-Up Studies; Humans; Male; Mohs Surgery; Skin Transplantation; Skin, Artificial; Tendons; Transplantation, Autologous; Wound Healing; Wounds and Injuries

Apoptosis of vascular smooth muscle cells (VSMCs) occurs in vivo under both physiological and pathological settings. The clearance of apoptotic cells may be accomplished in part by the surrounding normal VSMCs. However, the fate of internalized apoptotic cells, the rate of intracellular degradation, and the consequences of these processes to VSMC biology are unknown. Electron microscopy and confocal fluorescence imaging showed that rat VSMCs effectively bound and internalized autologous apoptotic VSMCs in vitro. Within 2 hours, the internalized apoptotic cells were delivered to lysosomes, and the majority of these internalized cells and their proteins were efficiently degraded by 24 hours. After degradation was completed, the phagocytic VSMCs remained viable with normal rates of proliferation. Clearance of apoptotic cells by VSMCs did not induce the release of vascular wall matrix proteases but was associated with a 1.6-fold increase in transforming growth factor-beta1 release. Interestingly, clearance of apoptotic cells stimulated VSMCs to secrete monocyte-chemoattractant protein-1 and cytokine-induced neutrophil chemoattractant. The coordinated release of transforming growth factor-beta1 and chemokines suggests that autologous apoptotic cell clearance stimulates VSMCs to release molecules that specifically recruit professional phagocytes while simultaneously dampening the inflammatory response and preventing vascular injury.

Topics: Animals; Aorta; Apoptosis; Cell Proliferation; Cell Survival; Cells, Cultured; Chemokine CCL2; Chemokines; Elastin; Male; Microscopy, Confocal; Microscopy, Immunoelectron; Muscle, Smooth, Vascular; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; Phagocytosis; Rats; Rats, Sprague-Dawley; Transforming Growth Factor beta; Transforming Growth Factor beta1; Wounds and Injuries

Full-thickness square wounds were made in the webs of fruit bats. Elastin was laid down in the healing scars of these wounds in two forms--as single fibers under the regenerated epidermis, and as bundles of fine fibers taking their origin and orientation from the cut ends of the web elastin bundles. This process continued over a period of 6 months, during which time other components of the scar became reduced in amount. The arrangement of the new elastin in the scar tissue was thus a replica of that seen in the normal web. There are indications in this study that elastin imparts elasticity to the scar.

Topics: Animals; Chiroptera; Cicatrix; Disease Models, Animal; Elastin; Regeneration; Skin; Skin Physiological Phenomena; Wound Healing; Wounds and Injuries

Specimens from one case each of acquired and congenital cutis laxa were examined by electron microscopy. Elastic flbers of the dermis and subcutaneous arteries and veins were found to have similar changes. Elastin was diminished and microfilaments were visible throughout the entire fiber. Electron-dense, amorphous or granular layers that alternate with relatively electron-light layers were deficient. This electron-dense substance was unevenly aggregated within or in the vicinity of elastic fiber. In the congenital case, the aggregation and deposition fo the electron-dense substance was often pronounced. In the vein, deficient deposition of elastin and admixture of microfilaments and amorphous substance were also found. Such admixture was often encircled by fibroblasts or smooth muscle cells. In the artery, multiplication of basal lamina was seen. Collagen fibers and anchoring fibrils of the skin were normal.

Topics: Arteries; Biopsy; Collagen; Cutis Laxa; Elastin; Female; Histocytochemistry; Humans; Infant; Male; Microscopy, Electron; Middle Aged; Skin; Wounds and Injuries

Topics: Age Factors; Animals; Cartilage, Articular; Cattle; Chondroitin; Collagen; Connective Tissue; Elastin; Glycosaminoglycans; Humans; Knee Joint; Wounds and Injuries

Topics: Acrylic Resins; Animals; Burns; Cattle; Collagen; Connective Tissue; Elastin; Evaluation Studies as Topic; Humans; Mice; Occlusive Dressings; Rabbits; Skin Transplantation; Swine; Tissue Adhesives; Transplantation, Heterologous; Wounds and Injuries