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Sample records for conventional skin grafts

  1. Skin graft

    MedlinePlus

    ... that need skin grafts to heal Venous ulcers, pressure ulcers , or diabetic ulcers that do not heal Very ... chap 17. Read More Burns Patient Instructions Preventing pressure ulcers Surgical wound care - open Review Date 3/13/ ...

  2. Microsurgical management of complex fingertip injuries: comparison to conventional skin grafting.

    PubMed

    Rose, E H; Norris, M S; Kowalski, T A

    1988-01-01

    In selected cases of severe fingertip injuries, an aggressive approach using microvascular and microneural techniques can yield functional results equal or superior to conventional methods of treatment in less severe injuries. A series of 20 patients were treated microsurgically from 1983 to 1986 for severe acute distal finger injuries or their early sequelae--five distal replantations, eight neurovascular free tissue transfers, and nine distal neurorrhaphies/nerve grafts with or without vascular conduit. Concurrently, 33 simpler tip avulsions were treated with full-thickness skin grafts for comparison. In the microsurgical series, one replant and the distal 1 cm of a free toe flap necrosed. Replants averaged two-point discrimination of 9.8 mm and pulp pinch 65 percent of normal; free toe transfers, two-point of 6 mm, pulp pinch 58 percent; distal nerve reconstruction, two-point 6 mm. Operating time per digit averaged 5.0 hours for replants, 4.3 hours for toe flaps, and 1.5 hours for nerve repair/grafts. All patients returned to full pre-injury employment within six months. None required revisional surgery for dysesthetic fingertips. In the conventional skin graft series, greater than six months follow-up is available in 17 patients. Average two-point was 7 mm (range: 3 to greater than 15 mm) and pulp pinch 83 percent of normal. There were seven poor results with cold intolerance, numbness, and paresthesias, three of which required revisional surgery. The data suggest that microsurgical management of fingertip injuries achieves results comparable to skin grafts, despite the greater complexity of the initial injury. This approach has resulted in fewer secondary tip revisions. Operative times are acceptable. Parameters of sensory return are similar, although pulp pinch is slightly less. Disability times are comparable to the average in major pulp losses. Of importance, final permanent partial factors of disability are diminished in rating, due to retained digital

  3. Comparison between Conventional Mechanical Fixation and Use of Autologous Platelet Rich Plasma (PRP) in Wound Beds Prior to Resurfacing with Split Thickness Skin Graft

    PubMed Central

    P Waiker, Veena; Shivalingappa, Shanthakumar

    2015-01-01

    BACKGROUND Platelet rich plasma is known for its hemostatic, adhesive and healing properties in view of the multiple growth factors released from the platelets to the site of wound. The primary objective of this study was to use autologous platelet rich plasma (PRP) in wound beds for anchorage of skin grafts instead of conventional methods like sutures, staplers or glue. METHODS In a single center based randomized controlled prospective study of nine months duration, 200 patients with wounds were divided into two equal groups. Autologous PRP was applied on wound beds in PRP group and conventional methods like staples/sutures used to anchor the skin grafts in a control group. RESULTS Instant graft adherence to wound bed was statistically significant in the PRP group. Time of first post-graft inspection was delayed, and hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in plastic surgery unit were significantly less in the PRP group. CONCLUSION Autologous PRP ensured instant skin graft adherence to wound bed in comparison to conventional methods of anchorage. Hence, we recommend the use of autologous PRP routinely on wounds prior to resurfacing to ensure the benefits of early healing. PMID:25606477

  4. Skin graft - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100100.htm Skin graft - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  5. Photoacoustic detection of neovascularities in skin graft

    NASA Astrophysics Data System (ADS)

    Yamazaki, Mutsuo; Sato, Shunichi; Saitoh, Daizo; Ishihara, Miya; Okada, Yoshiaki; Ashida, Hiroshi; Obara, Minoru

    2005-04-01

    We previously proposed a new method for monitoring adhesion of skin graft by measuring photoacoustic (PA) signal originated from the neovascularities. In this study, immunohistochemical staining (IHC) with CD31 antibody was performed for grafted skin tissue to observe neovascularity, and the results were compared with PA signals. We also used a laser Doppler imaging (LDI) to observe blood flow in the grafted skin, and sensitivity of PA measurement and that of LDI were compared. In rat autograft models, PA signals were measured for the grafted skin at postgrafting times of 0-48 h. At 6 h postgrafting, PA signal was observed in the skin depth region of 500-600 mm, while the results of IHC showed that angiogenesis occurred at the depth of about 600 mm. Depths at which PA signal and angiogenesis were observed decreased with postgrafting time. These indicate that the PA signal observed at 6 h postgrafting originated from the neovascularities in the skin graft. Results of LDI showed no blood-originated signal before 48 h postgrafting. These findings suggest that PA measurement is effective in monitoring the adhesion of skin graft in early stage after transplantation.

  6. Novel expansion techniques for skin grafts

    PubMed Central

    Kadam, Dinesh

    2016-01-01

    The quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal–epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials. PMID:27274117

  7. Skin flaps and grafts -- self-care

    MedlinePlus

    ... drainage from the wound Drainage becoming thick, tan, green, or yellow, or smells bad (pus) Your temperature is above 100°F (37.8°C) for more than 4 hours Red streaks appear that lead away from the wound Alternative Names Autograft - self-care; Skin transplant - self-care; Split-skin graft - self- ...

  8. Recipient Wound Bed Characteristics Affect Scarring and Skin Graft Contraction

    DTIC Science & Technology

    2015-02-13

    skin grafting onto hypodermis vs. onto fascia. Compared to autografts grafted onto fascia, identical thickness autografts grafted onto fat demonstrated...reduced contraction, enhanced mobility and vascularity, and reduced topographical variability. Grafts onto fat also showed reduced levels of...skin grafts onto fat report better range of motion compared with patients who receive skin grafts directly onto fascia.3 The same study also found that

  9. Lendrum (-MSB) staining for fibrin identification in sealed skin grafts.

    PubMed

    Fisseler-Eckhoff, A; Müller, K M

    1994-05-01

    The significance and effect of fibrin sealant systems for woundhealing are still unknown, because of the use of insufficient, conventional staining methods for the demonstration of the fibrin components used by sealant systems. From 21 patients with extensive burns of 2nd and 3rd degree biopsies of the skin were obtained during consecutive operations to cover the defect of the skin with split-thickness skin grafting. In the present paper morphological results concerning the demonstration of fibrin components and morphological differences in woundhealing of sealed and unsealed skin grafts are presented using Lendrum (-MSB) staining. With this staining method it is possible to identify exogenous fibrin components of the sealant system and to differentiate between fresh and older fibrin components, due to colour changes depending on time.

  10. An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft

    PubMed Central

    Maruccia, Michele; Onesti, Maria G.; Sorvillo, Valentina; Albano, Antonio; Dessy, Luca A.; Carlesimo, Bruno; Tarallo, Mauro; Giudice, Giuseppe; Cigna, Emanuele; Ribuffo, Diego

    2017-01-01

    Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy), in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p < 0.0009, p < 0.0001). Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take. PMID:28299333

  11. Dupuytren Disease Infiltrating a Full-Thickness Skin Graft.

    PubMed

    Wade, Ryckie George; Igali, Laszlo; Figus, Andrea

    2016-08-01

    Although the role of the skin in the development and propagation of Dupuytren disease remains unclear, dermofasciectomy and full-thickness skin grafting (FTSG) appears to delay recurrence. In 2011, a 71-year-old, left-handed man presented with recurrent Dupuytren disease in the dominant hand. In 1991, he originally underwent a primary dermofasciectomy and FTSG for Dupuytren disease involving the palmar skin. Twenty years later, the left middle finger was drawn into flexion by a recurrent cord, and the old graft and adjacent palmar skin were clinically involved by fibromatosis. We performed a revision dermofasciectomy and FTSG. Microscopic analysis of the excised graft demonstrated dense infiltration of the entire skin graft by Dupuytren disease, with areas of active and burnt-out fibromatosis distinct from hypertrophic scarring. This report of Dupuytren fibromatosis infiltrating a skin graft raises questions about the pathophysiology of Dupuytren disease.

  12. PRFM enhance wound healing process in skin graft.

    PubMed

    Reksodiputro, Mirta; Widodo, Dini; Bashiruddin, Jenny; Siregar, Nurjati; Malik, Safarina

    2014-12-01

    Facial plastic and reconstructive surgery often used skin graft on defects that cannot be covered primarily by a local flap. However, wound healing using skin graft is slow, most of the time the graft is contractured and the take of graft is not optimal. Platelet rich fibrin matrix (PRFM) is a new generation of concentrated platelets that produce natural fibrin and reported to speed up the healing process. Application of PRFM in the skin graft implants is expected to increase the survival of the graft. We used porcine as animal models to elucidate the effect of autologous PRFM on wound healing in full-thickness (FTSG) and split-thickness (STSG) skin grafts. Survival level of the skin graft was determined by using ImageJ software based on the formation of collagen type 1 and graft take. We observed that the use of PRFM in FTSG and STSG increased type 1 collagen formation. We also found that PRFM addition in STSG gave the best skin graft take.

  13. [Skin graft, smoking and diabetes mellitus type 2].

    PubMed

    Pérez-Guisado, Joaquín; Fidalgo-Rodríguez, Félix T; Gaston, Kate L; Rioja, Luis F; Thomas, Steven J

    2012-01-01

    Smoking and hyperglycemia decrease the success of skin graft survival in specific circumstances. It is well known that smoking and diabetes mellitus (DM) type 2 increase the oxidative and impair the endothelial function. The objective of this retrospective study was to determine if smoking and DM type 2 are factors associated with lower skin graft survival, in different etiologies of the injury associated to the skin loss. It was a bicentric, retrospective, cross sectional case control study, carried out on 2457 medical patients who met the inclusion criteria. It was carried out over a 10 years period between January 2000-December 2009, at Reina Sofía University Hospital (Córdoba, Spain) and UAB Hospital at Birmingham (Alabama, USA). The percentage of successful graft for each group and its control were analyzed by Chi-square test. The confidence interval chosen for statistical differences was 95%. Smoking and DM type 2 decreased the percentage of skin graft survival when compared with their control groups. DM type 2 was associated with greater negative success on skin graft survival than smoking when compared with their control groups. There was a statistically significant drop in skin graft of 18% in smoking group (range: 68-86%) and 25% in DM type 2 group (53-78%). The OR showed a clear association between the risk factors studied and the lower skin graft success, being stronger for DM type 2. In conclusion, DM type 2 and smoking are factors associated to lower skin graft take.

  14. Feasibility of the Use of RapiGraft and Skin Grafting in Reconstructive Surgery

    PubMed Central

    Cho, In Gook; Kwon, Joon Hyun; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae

    2016-01-01

    Background Skin grafting is a relatively simple and thus widely used procedure. However, the elastic and structural quality of grafted skin is poor. Recently, various dermal substitutes have been developed to overcome this disadvantage of split-thickness skin grafts. The present study aims to determine the feasibility of RapiGraft as a new dermal substitute. Methods This prospective study included 20 patients with partial- or full-thickness skin defects; the patients were enrolled between January 2013 and March 2014. After skin defect debridement, the wound was divided into two parts by an imaginary line. Split-thickness skin grafting alone was performed on one side (group A), and RapiGraft and split-thickness skin grafting were used on the other side (group B). All patients were evaluated using photographs and self-questionnaires. The Manchester scar scale (MSS), a chromameter, and a durometer were used for the scar evaluation. The average follow-up period was 6 months. Results The skin graft take rates were 93% in group A and 89% in group B, a non-significant difference (P=0.082). Statistically, group B had significantly lower MSS, vascularity, and pigmentation results than group A (P<0.05 for all). However, the groups did not differ significantly in pliability (P=0.155). Conclusions The present study indicates that a simultaneous application of RapiGraft and a split-thickness skin graft is safe and yields improved results. Therefore, we conclude that the use of RapiGraft along with skin grafting will be beneficial for patients requiring reconstructive surgery. PMID:27689048

  15. Patient experiences living with split thickness skin grafts.

    PubMed

    Burnett, L N; Carr, E; Tapp, D; Raffin Bouchal, S; Horch, J D; Biernaskie, J; Gabriel, V

    2014-09-01

    The standard of care for deep burns is autologous split thickness skin grafting. Although adequate to resurface a deep wound, the resulting skin is chronically abnormal. The purpose of this study was to describe the experience of patients with split thickness skin grafts to help guide future investigations related to skin regeneration. In this study, an interpretive description qualitative methodology was employed. Subjects participated in a two-part single patient interview that was recorded and transcribed. A nurse with experience in clinical burn care coded and interpreted the data. Participants were recruited through presentation to a university based outpatient burn clinic for follow up from autologous split thickness skin grafting. Eight male patients and four female patients 20-62 years old ranging 2-29 months post-skin grafting were enrolled in the study. The most significant concerns voiced by patients were identified and organized into five themes: (1) a new normal, (2) split thickness skin graft symptoms, (3) appearance of new skin, (4) coping, and (5) participation in future clinical trials. Participants reported that the abnormalities related to their split thickness skin grafts were significant enough that they would be willing to participate in a future clinical trial investigating new cell-based therapies.

  16. Control of Surface Wound Infection: Skin Versus Synthetic Grafts

    PubMed Central

    Saymen, Dennis G.; Nathan, Paul; Holder, Ian Alan; Hill, Edward O.; Macmillan, Bruce G.

    1973-01-01

    Auto-, iso-, or xenografts of skin and synthetics placed on surface wounds freshly contaminated with Pseudomonas aeruginosa stabilizes the wound bacterial population in rats over a 24-h period. When these wounds contained a bacterial contamination established for 24 h prior to grafting, only skin and the synthetic polyhydroxyethylmethacrylate were effective in lowering the initial bacterial concentration. Polyurethane foam and nylon velour were not effective in the established infection model. Skin placed on a contaminated wound for 2 h or longer appeared to equilibrate with the underlying muscle so that the bacterial count per milligram of skin was similar to that of the muscle. It was suggested that this preparation would be useful to obtain an estimate of surface contamination without biopsy of the infected muscle. Skin grafts in place for 2 h significantly lowered the bacterial count in a wound with an established infection. A second decrease occurred between 4 and 24 h after grafting. Histological studies of contaminated and exposed panniculus muscle showed that leukocytes tend to migrate from the muscle surface to its base. Skin grafts and polyhydroxyethylmethacrylate appear to reverse the white cell migration so that the cells move toward the surface of the muscle with preservation of normal staining characteristics in the muscle. It is suggested that this alteration in cell movement after graft application might modify the white cell function and result in a greater bactericidal activity. Apparently, grafts lower bacterial levels in an established infection by modifying the host response to the surface contamination. Images PMID:4197768

  17. Distally based venous flap: a new technique for the correction of syndactyly without skin graft in adult patients.

    PubMed

    Cil, Yakup; Kocman, Atacan Emre; Yapici, Abdul Kerim

    2009-12-01

    Skin grafts and local flaps are conventional methods for repairing simple syndactyly. Skin grafts usually leave unsightly appearance and contracture formation. In this study, unipedicled distally based venous flap were raised from third or fourth metacarpal area of the hand for syndactyly treatment. The distally based venous flap was to provide skin coverage to one side of the finger, in order to avoid complications arising from using skin graft. Nine patients' syndactylies (5 simple incomplete and 4 simple complete syndactyly) were treated using this method. The mean follow-up period of the flaps was 14 months, ranging from 12 to 16 months. Mild edema and venous congestion occurred in all flaps. Superficial necrosis involving two flaps did not affect flap survival. All flaps survived completely. In this article, we have described a new surgical technique for the correction of syndactyly in a single surgical procedure that utilizes a distally based venous flap to provide skin coverage without skin graft.

  18. Foreskin-isolated keratinocytes provide successful extemporaneous autologous paediatric skin grafts.

    PubMed

    Mcheik, Jiad N; Barrault, Christine; Pedretti, Nathalie; Garnier, Julien; Juchaux, Franck; Levard, Guillaume; Morel, Franck; Lecron, Jean-Claude; Bernard, François-Xavier

    2016-03-01

    Severe burns in children are conventionally treated with split-thickness skin autografts or epidermal sheets. However, neither early complete healing nor quality of epithelialization is satisfactory. An alternative approach is to graft isolated keratinocytes. We evaluated paediatric foreskin and auricular skin as donor sources, autologous keratinocyte transplantation, and compared the graft efficiency to the in vitro capacities of isolated keratinocytes to divide and reconstitute epidermal tissue. Keratinocytes were isolated from surgical samples by enzymatic digestion. Living cell recovery, in vitro proliferation and epidermal reconstruction capacities were evaluated. Differentiation status was analysed, using qRT-PCR and immunolabelling. Eleven children were grafted with foreskin-derived (boys) or auricular (girls) keratinocyte suspensions dripped onto deep severe burns. The aesthetic and functional quality of epithelialization was monitored in a standardized way. Foreskin keratinocyte graft in male children provides for the re-epithelialization of partial deep severe burns and accelerates wound healing, thus allowing successful wound closure, and improves the quality of scars. In accordance, in vitro studies have revealed a high yield of living keratinocyte recovery from foreskin and their potential in terms of regeneration and differentiation. We report a successful method for grafting paediatric males presenting large severe burns through direct spreading of autologous foreskin keratinocytes. This alternative method is easy to implement, improves the quality of skin and minimizes associated donor site morbidity. In vitro studies have highlighted the potential of foreskin tissue for graft applications and could help in tissue selection with the prospect of grafting burns for girls.

  19. Pediatric penile reconstruction using autologous split-thickness skin graft.

    PubMed

    Diaz, E C; Corcoran, J F; Johnson, E K

    2016-06-01

    This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks. 3. A dermatome is used to harvest the STSG. Skin thickness for penis coverage at this age is usually 10-12/1000 of an inch. 4. Direct contact of the graft and wound bed is essential for graft uptake. Hemostasis of the wound bed is critical to prevent hematoma formation. Elimination of redundant tissue is also important to ensure maximal contact between the graft and underlying wound bed. 5. A pressure dressing or bolster is used to prevent shear, and provide contact between the graft and wound bed for at least the first 5 days. 6. A semi-occlusive dressing, Tegaderm, was used on the donor site and it is believed that it provides a moist environment conducive for epithelial and dermal healing. 7. Lymphedema can result if excess distal penile skin is not excised. It is prudent to limit the amount of mucosal collar or consider direct anastomosis to the glans.

  20. Bioengineered Self-assembled Skin as an Alternative to Skin Grafts

    PubMed Central

    Climov, Mihail; Medeiros, Erika; Farkash, Evan A.; Qiao, Jizeng; Rousseau, Cecile F.; Dong, Shumin; Zawadzka, Agatha; Racki, Waldemar J.; Al-Musa, Ahmad; Sachs, David H.; Randolph, Mark A.

    2016-01-01

    For patients with extensive burns or donor site scarring, the limited availability of autologous and the inevitable rejection of allogeneic skin drive the need for new alternatives. Existing engineered biologic and synthetic skin analogs serve as temporary coverage until sufficient autologous skin is available. Here we report successful engraftment of a self-assembled bilayered skin construct derived from autologous skin punch biopsies in a porcine model. Dermal fibroblasts were stimulated to produce an extracellular matrix and were then seeded with epidermal progenitor cells to generate an epidermis. Autologous constructs were grafted onto partial- and full-thickness wounds. By gross examination and histology, skin construct vascularization and healing were comparable to autologous skin grafts and were superior to an autologous bilayered living cellular construct fabricated with fibroblasts cast in bovine collagen. This is the first demonstration of spontaneous vascularization and permanent engraftment of a self-assembled bilayered bioengineered skin that could supplement existing methods of reconstruction. PMID:27482479

  1. Fractional CO2 laser treatment for a skin graft.

    PubMed

    Stephan, Farid E; Habre, Maya B; Helou, Josiane F; Tohme, Roland G; Tomb, Roland R

    2016-01-01

    Skin grafts are widely used in reconstructive and plastic surgery, leaving an inevitable scar appearance on the body, affecting the quality of life of the patients. Fractional ablative lasers have become a leading procedure for the treatment of acne and burn scars. We report a case of a skin graft showing excellent improvement in overall appearance after three sessions of fractional CO2 laser. The undamaged tissue left between the microthermal treatment zones is responsible of collagen formation and reepithelialization. Remodeling and collagen formation are observed even 6 months after a fractional CO2 laser session.

  2. The modified use of Surfasoft® in skin grafts: case series

    PubMed Central

    Salibi, A.; Chasapi, M.; Farroha, A.

    2016-01-01

    Summary Surfasoft® is a monofilament woven polyamide thread. Its use over skin grafts has always been combined with other occlusive dressings. Its rapid application and transparent property makes it an ideal primary dressing in the absence of any occlusive layers after the first two days following skin graft application. We describe this modified use in our case series. We modified the use of Surfasoft® in four different burns patients and one skin cancer case. Surfasoft® was predominantly used on difficult sites and secured with either staples or sutures. A secondary occlusive dressing was only applied in the first 48 hours, then removed, leaving Surfasoft® as a single dressing until it spontaneously separated from the graft approximately 7-10 days post op. Complete healing of grafts was defined when dressing was no longer required. The majority of burns were full thickness with an average TBSA of 6.5%. Distribution was mainly to the neck and upper torso areas. The skin cancer was located on the right shoulder region. Graft healing was completed in 3-4 weeks following surgery. No complications were reported. Advantages of the modified Surfasoft® in addition to factors associated with graft survival in our series are discussed. The modified Surfasoft® was shown to be a simple and reliable dressing for meshed STSGs in both burns and elective procedures. We believe that it can be effectively used in sites associated with poor tolerance to conventional dressing and when nursing resources are limited. PMID:28149250

  3. The modified use of Surfasoft® in skin grafts: case series.

    PubMed

    Salibi, A; Chasapi, M; Farroha, A

    2016-09-30

    Surfasoft® is a monofilament woven polyamide thread. Its use over skin grafts has always been combined with other occlusive dressings. Its rapid application and transparent property makes it an ideal primary dressing in the absence of any occlusive layers after the first two days following skin graft application. We describe this modified use in our case series. We modified the use of Surfasoft® in four different burns patients and one skin cancer case. Surfasoft® was predominantly used on difficult sites and secured with either staples or sutures. A secondary occlusive dressing was only applied in the first 48 hours, then removed, leaving Surfasoft® as a single dressing until it spontaneously separated from the graft approximately 7-10 days post op. Complete healing of grafts was defined when dressing was no longer required. The majority of burns were full thickness with an average TBSA of 6.5%. Distribution was mainly to the neck and upper torso areas. The skin cancer was located on the right shoulder region. Graft healing was completed in 3-4 weeks following surgery. No complications were reported. Advantages of the modified Surfasoft® in addition to factors associated with graft survival in our series are discussed. The modified Surfasoft® was shown to be a simple and reliable dressing for meshed STSGs in both burns and elective procedures. We believe that it can be effectively used in sites associated with poor tolerance to conventional dressing and when nursing resources are limited.

  4. Effects of ozone on how well split-thickness skin grafts according to Thiersch take in war wounds. Results of prospective study.

    PubMed

    Turcić, J; Hancević, J; Antoljak, T; Zic, R; Alfirević, I

    1995-01-01

    In a prospective study on 35 wounded persons we examined the effects of ozone on how well split-thickness skin grafts took in war wounds. Each of the 35 wounded persons hat at least two similar gunshot wounds, one on the lower leg or forearm and the other on the upper leg or upper arm. During the first 10 days all wounds were treated with 10% NaCl water solution dressings until the moment when healthy granulations were observed. Thereafter, the defects were covered with split-thickness skin grafts according to Thiersch. For technical reasons we treated grafts on the lower leg and forearm with ozone following the usual scheme. Grafts on the upper leg or upper arm were treated in the conventional way and they served as a control group. The results obtained in the group followed up are presented by percentage of graft takes after 10 days and accordingly compared with the results obtained in the control group. There was a higher percentage of takes in ozone-treated split-thickness skin grafts. More than 74.3% of the split-thickness skin grafts treated with ozone had a take of more than 75% of the covered surface as apposed to only 40% of the grafts treated with the conventional method. The results in these two groups were compared with a chi square matched pair test. Difference in take of the skin grafts in these two groups was statistically significant at P < 0.01.

  5. Use of split thickness plantar skin grafts in the treatment of hyperpigmented skin-grafted fingers and palms in previously burned patients.

    PubMed

    Moon, Suk-Ho; Lee, So-Young; Jung, Sung-No; Kim, Sang-Wha; Seo, Bommie F; Kwon, Ho; Sohn, Won-Il

    2011-06-01

    Palmar and finger burns are often seen in children, and are usually as a result of contact burns. Some patients with deep hand burns are treated with full-thickness or split-thickness skin grafts. Skin graft is commonly used for hand reconstruction. However, the grafted skin would be more pigmented than the adjacent skin and different from skin texture. 19 patients who showed hyperpigmentation after skin graft of finger and palm were treated. They all were injured by hand burns. We performed mechanical dermabrasion of the hyperpigmentation scar and application of a split thickness skin harvested from medial aspect of plantar of foot. Patients were asked about their level of satisfaction with the procedure and scar appearance was assessed using a five-point Likert scale. Also scar appearances were assessed using a Vancouver Scar Scale (VSS). The grafts were completely taken in all 19 patients. The color of the graft became similar to adjacent tissue. 15 patients were very satisfied, and four patients were relatively satisfied. The average score of the patients postoperative appearance improvement was 4.5 (improved to significantly improved postoperative appearance). Average VSS score was improved from 9.53 to 2.53. There was no hypertrophic scar on plantar donor site. The technique of the split-thickness plantar skin graft after mechanical dermabrasion is simple and provided good results in both color and texture for the patients who showed hyperpigmentation after grafting.

  6. The "stegosaurus" dressing: a simple and effective method of securing skin grafts in the burn patient.

    PubMed

    Fullerton, J K; Smith, C E; Milner, S M

    2000-10-01

    Skin grafts are vulnerable to shear stress, infection, and hematoma formation during the postoperative period, all of which reduce graft survival. Various methods of dressing application and materials have been described in the literature to try and prevent graft loss. The authors report the use of the "stegosaurus dressing" (Eggcrate Pad) in 6 patients to secure skin grafts. Patients chosen were those who were either noncompliant or who sustained burns in unfavorable anatomic sites. All grafts demonstrated complete take without infection and hematoma formation. This foam dressing provides an even pressure to the recipient bed, absorbs drainage, and protects the graft from shearing. It also demonstrates the versatility to be used in difficult nonburn skin graft areas. The stegosaurus dressing is easy to apply, inexpensive, and provides a very secure dressing over the skin graft.

  7. "The Dendritic Bonding Technique": A Newly-devised Technique for the Fixation of Mesh Skin Graft.

    PubMed

    Sakamoto, Yoshiaki; Kishi, Kazuo

    2012-07-01

    We describe a newly designed technique for the quick, easy, and cost-effective fixation of mesh skin grafts in a range of skin conditions and patients. We fixed the skin graft using octyl-2-cyanoacrylate (Dermabond; Ethicon), which was termed "Dendritic bonding." This technique exhibits several advantages over surgical stapling and suturing with absorbable sutures.

  8. Treatment of the leg ulcers by skin grafting.

    PubMed

    Jankūnas, Vytautas; Rimdeika, Rytis; Pilipaityte, Loreta

    2004-01-01

    The ulcers, located below the knees and remaining for 6 weeks and more, are called trophic leg ulcers. The leg ulcers of different etiology disable 0.8-1% of total Earth population. It was found that blood vessel problems in legs account for more than 80% of ulcers; even 65% from these are caused by venous diseases. In Lithuania about 8000 patients suffer from venous trophic ulcers. Regardless of modern methods the treatment of leg ulcers remains an extremely expensive process. The treatment cost of trophic ulcers is the highest of all surgical wounds and also requires a lot of personal investments. In order to assess the efficiency of autodermoplastics in the treatment of large venous ulcers in legs a prospective study was carried out of 111 patients who were treated in the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital from January 2001 to January 2004. The data was analyzed exceptionally of the operated 54 patients with venous origin ulcers open for more 6 months or exceeding 50 cm2. The above-mentioned patients were prepared for surgery by dressing the wounds with hydrocolloid Granuflex bandages and were operated by transplanting a 0.2-0.3 mm thick skin graft. The results were estimated by the surgeon during the dressings after the operation. The graft was taken in 35 (64.81%) cases; in 19 (35.19%) cases the graft was partially not taken and there were no cases when it was not taken at all. We came to the conclusions that skin graft transplantation is efficient in treatment of trophic venous leg ulcers larger than 50 cm2 and cures the trophic leg ulcers of vein origin completely in 2-3 weeks for 64.81% patients.

  9. The role of topical thrombin in skin grafting.

    PubMed Central

    Ofodile, F. A.; Sadana, M. K.

    1991-01-01

    A prospective study to evaluate the efficacy of thrombin as a hemostatic agent in burn patients was conducted on 24 patients undergoing debridement and skin grafting. All patients also acted as their own control. Results showed a 43.5% reduction in bleeding on the thrombin-treated sites compared with the control sites. There was no adverse effect on the rate of wound healing from the thrombin, and no difference in the nature of the scar seen at the thrombin-treated site compared with the control site. Images Figure 1 PMID:1875421

  10. Localization of the defect in skin diseases analyzed in the human skin graft-nude mouse model.

    PubMed

    Briggaman, R A

    1980-01-01

    Human skin can be grown away from its donor for prolonged periods as grafts on congenitally athymic "nude" mice. This system has been used to analyze the defect in several skin diseases, specifically to localize the site of the defect to the skin itself or to the epidermal or dermal components of the skin. In order to validate the use of the nude mouse human skin graft system in the analysis of skin defects, we have demonstrated that a systemic metabolic defect which involves the skin, namely essential fatty acid deficiency, can be differentiated from a defect residing primarily in the skin itself. Skin-marker systems have been developed for use with the nude mouse-human skin graft model to document the identity of human skin grafts and epidermal and dermal components of the grafts after prolonged periods of growth on the nude athymic mice. Y-body, a small fluorescent segment of the Y-chromosome seen in interphase cells, is used as a sex marker and serves to distinguish sex differences between the graft and the mouse recipient or between skin components of the graft. The ABH "blood-group" antigens are present on differentiated epidermal cell surfaces and identify the grafted epidermis according to the blood groups of the donor. In previous studies, lamellar ichthyosis was shown to be well maintained after prolonged periods of growth on nude athymic mice, indicating that the defect in this disease resides in the skin itself. Recombinant grafts composed of normal and lamellar ichthyosis epidermis and dermis further localize the defect to lamellar ichthyosis epidermis. Psoriasis is well maintained on the nude mouse-skin graft model. The epidermal hyperplasia and hyperproliferative epidermal cell kinetics of psoriasis are manifested in the grafts of active psoriasis maintained for prolonged periods on the nude mice, but the inflammatory component of psoriasis is absent. Recombinant graft studies utilizing normal and psoriatic epidermis and dermis demonstrate psoriasis

  11. Skin grafting and wound healing-the "dermato-plastic team approach".

    PubMed

    Hierner, Robert; Degreef, Hugo; Vranckx, Jan Jerome; Garmyn, Maria; Massagé, Patrick; van Brussel, Michel

    2005-01-01

    Autologous skin grafts are successfully used to close recalcitrant chronic wounds especially at the lower leg. If wound care is done in a dermato-plastic team approach using the "integrated concept," difficulties associated with harvesting the skin graft as well as the complexities associated with inducing closure at the donor and the recipient site can be minimized. In the context of wound healing, skin transplantation can be regarded as (1) a supportive procedure for epithelialization of the wound surface and (2) mechanical stability of the wound ground. By placing skin grafts on a surface, central parts are covered much faster with keratinocytes. Skin (wound) closure is the ultimate goal, as wound closure means resistance to infection. Depending on the thickness of the skin graft, different amounts of dermis are transplanted with the overlying keratinocytes. The dermal component determines the mechanical (resistance to pressure and shear forces, graft shrinkage), functional (sensibility), and aesthetic properties of the graft. Generally speaking, the thicker the graft the better the mechanical, functional, and aesthetic properties, however, the worse the neo- and revascularization. Skin grafts do depend entirely on the re- and neovascularization coming from the wound bed. If the wound bed is seen as a recipient site for tissue graft, the classification of Lexer (Die freien Transplantationen. Stuttgart: Enke; 1924) turned out to be of extreme value. Three grades can be distinguished: "good wound conditions," "moderate wound conditions," and "insufficient wound conditions." Given good wound conditions, skin grafting is feasible. Nevertheless, skin closure alone might not be sufficient to fulfill the criteria of successful defect reconstruction. In case of moderate or insufficient wound conditions, wound bed preparation is necessary. If wound bed preparation is successful and good wound conditions can be achieved, skin grafting is possible. If, however, this

  12. Keratoacanthoma formation after skin grafting: A brief report and pathophysiological hypothesis.

    PubMed

    Lee, Senhong; Coutts, Ian; Ryan, Andrew; Stavrakoglou, Anastasios

    2016-06-07

    Keratoacanthoma formation after skin grafting is rare. We report the third case in the literature of multiple keratoacanthomas developed at both split-thickness skin graft donor and recipient sites. We provide possible explanations for this poorly understood phenomenon and highlight its implications on treatment options.

  13. A different and safe method of split thickness skin graft fixation: medical honey application.

    PubMed

    Emsen, Ilteris Murat

    2007-09-01

    Honey has been used for medicinal purposes since ancient times. Its antibacterial effects have been established during the past few decades. Still, modern medical practitioners hesitate to apply honey for local treatment of wounds. This may be because of the expected messiness of such local application. Hence, if honey is to be used for medicinal purposes, it has to meet certain criteria. The authors evaluated its use for the split thickness skin graft fixation because of its adhesive and other beneficial effects in 11 patients. No complications such as graft loss, infection, and graft rejection were seen. Based on these results, the authors advised honey as a new agent for split thickness skin graft fixation. In recent years there has been a renewed interest in honey wound management. There are a range of regulated wound care products that contain honey available on the Drug Tariff. This article addresses key issues associated with the use of honey, outlining how it may be best used, in which methods of split thickness skin graft fixations it may be used, and what clinical outcomes may be anticipated. For this reason, 11 patients who underwent different diagnosis were included in this study. In all the patients same medical honey was used for the fixation of the skin graft. No graft loss was seen during both the first dressing and the last view of the grafted areas. As a result, it has been shown that honey is also a very effective agent for split thickness skin graft fixations. Because it is a natural agent, it can be easily used in all skin graft operation for the fixation of the split thickness skin grafts.

  14. Facial resurfacing with split-thickness skin grafts in xeroderma pigmentosum variant.

    PubMed

    Tayeb, Talel; Laure, Boris; Sury, Florent; Lorette, Gérard; Goga, Dominique

    2011-10-01

    Xeroderma Pigmentosum (XP) is a rare systemic disease which is transmitted through an incomplete sex-linked recessive gene. As a result of this, exposure to the ultraviolet (UV) rays of the sun causes malignant skin lesions. One of the most effective treatment options for the malignant lesions is full-face resurfacing with skin grafts. These grafts should be harvested from areas that have not been affected by UV exposure or have at least been minimally affected. The authors present a patient with XP whose face was resurfaced by split-thickness skin grafts taken from the buttocks.

  15. Bilayer Cryogel Wound Dressing and Skin Regeneration Grafts for the Treatment of Acute Skin Wounds.

    PubMed

    Priya, S Geetha; Gupta, Ankur; Jain, Era; Sarkar, Joyita; Damania, Apeksha; Jagdale, Pankaj R; Chaudhari, Bhushan P; Gupta, Kailash C; Kumar, Ashok

    2016-06-22

    In this study, the potential of cryogel bilayer wound dressing and skin regenerating graft for the treatment of surgically created full thickness wounds was evaluated. The top layer was composed of polyvinylpyrrolidone-iodine (PVP-I) cryogel and served as the antiseptic layer, while the bottom regenerative layer was made using gelatin cryogel. Both components of the bilayer showed typical features of a cryogel interconnected macropore network, rapid swelling, high water uptake capacity of about 90%. Both PVP and gelatin cryogel showed high tensile strength of 45 and 10 kPa, respectively. Gelatin cryogel sheets were essentially elastic and could be stretched without any visible deformation. The antiseptic PVP-I layer cryogel sheet showed sustained iodine release and suppressed microbial growth when tested with skin pathogens (zone of inhibition ∼2 cm for sheet of 0.9 cm diameter). The gelatin cryogel sheet degraded in vitro in weeks. The gelatin cryogel sheet supported cell infiltration, attachment, and proliferation of fibroblasts and keratinocytes. Microparticles loaded with bioactive molecules (mannose-6-phosphate and human fibrinogen) were also incorporated in the gelatin cryogel sheets for their role in enhancing skin regeneration and scar free wound healing. In vivo evaluation of healing capacity of the bilayer cryogel was checked in rabbits by creating full thickness wound defect (diameter 2 cm). Macroscopic and microscopic observation at regular time intervals for 4 weeks demonstrated better and faster skin regeneration in the wound treated with cryogel bilayer as compared to untreated defect and the repair was comparable to commercial skin regeneration scaffold Neuskin-F. Complete skin regeneration was observed after 4 weeks of implantation with no sign of inflammatory response. Defects implanted with cryogel having mannose-6-phosphate showed no scar formation, while the wound treated with bilayer incorporated with human fibrinogen microparticles showed

  16. The Use of Split-Thickness Skin Grafts on Diabetic Foot Ulcerations: A Literature Review

    PubMed Central

    McCartan, Brant; Dinh, Thanh

    2012-01-01

    Diabetic foot ulcerations are historically difficult to treat despite advanced therapeutic modalities. There are numerous modalities described in the literature ranging from noninvasive topical wound care to more invasive surgical procedures such as primary closure, skin flaps, and skin grafting. While skin grafting provides faster time to closure with a single treatment compared to traditional topical wound treatments, the potential risks of donor site morbidity and poor wound healing unique to the diabetic state have been cited as a contraindication to its widespread use. In order to garner clarity on this issue, a literature review was undertaken on the use of split-thickness skin grafts on diabetic foot ulcers. Search of electronic databases yielded four studies that reported split-thickness skin grafts as definitive means of closure. In addition, several other studies employed split-thickness skin grafts as an adjunct to a treatment that was only partially successful or used to fill in the donor site of another plastic surgery technique. When used as the primary closure on optimized diabetic foot ulcerations, split-thickness skin grafts are 78% successful at closing 90% of the wound by eight weeks. PMID:22666573

  17. [The use of preputial skin as cutaneous graft after circumcision. Report of 30 clinical cases].

    PubMed

    Chlihi, A; Benbrahim, A; Diouri, M; Terrab, S; Bahechar, N; Boukind, E H

    2002-06-01

    Through a study of 30 clinical cases, collected at the service center of plastic surgery and burns in Averroes University hospital at Casablanca, the authors underline the interest of using preputial skin as full-thickness skin graft for the treatment of burns and their sequelaes in non-circumcised boys, whose age ranged from one to four years. At this age, they are more exposed to domestic accidents. The preputial skin graft gives the advantage of the absence of scare prejudice at the donor site each time the circumcision is possible; and provides a skin of good elastic quality avoiding secondary retraction with a very favorable rate of graft intake. Although the application of this technique for other affections is possible, but remains limited by the hyperpigmentation of the graft.

  18. Skin grafting for necrotizing fasciitis in a child with nephrotic syndrome.

    PubMed

    Bagri, Narendra; Saha, Abhijeet; Dubey, Nandkishore K; Rai, Ashish; Bhattacharya, Sameek

    2013-11-01

    Necrotizing fasciitis is a rare complication of nephrotic syndrome in children, with a high mortality rate. We report a case with successful outcome with judicious intravenous antibiotics and skin grafting of the bilateral lower thighs.

  19. Biomarkers to assess graft quality during conventional and machine preservation in liver transplantation.

    PubMed

    Verhoeven, Cornelia J; Farid, Waqar R R; de Jonge, Jeroen; Metselaar, Herold J; Kazemier, Geert; van der Laan, Luc J W

    2014-09-01

    A global rising organ shortage necessitates the use of extended criteria donors (ECD) for liver transplantation (LT). However, poor preservation and extensive ischemic injury of ECD grafts have been recognized as important factors associated with primary non-function, early allograft dysfunction, and biliary complications after LT. In order to prevent for these ischemia-related complications, machine perfusion (MP) has gained interest as a technique to optimize preservation of grafts and to provide the opportunity to assess graft quality by screening for extensive ischemic injury. For this purpose, however, objective surrogate biomarkers are required which can be easily determined at time of graft preservation and the various techniques of MP. This review provides an overview and evaluation of biomarkers that have been investigated for the assessment of graft quality and viability testing during different types of MP. Moreover, studies regarding conventional graft preservation by static cold storage (SCS) were screened to identify biomarkers that correlated with either allograft dysfunction or biliary complications after LT and which could potentially be applied as predictive markers during MP. The pros and cons of the different biomaterials that are available for biomarker research during graft preservation are discussed, accompanied with suggestions for future research. Though many studies are currently still in the experimental setting or of low evidence level due to small cohort sizes, the biomarkers presented in this review provide a useful handle to monitor recovery of ECD grafts during clinical MP in the near future.

  20. Skin grafting in severely contracted socket with the use of 'Compo'.

    PubMed

    Betharia, S M; Kanthamani; Prakash, H; Kumar, S

    1990-01-01

    The results of split thickness autologous skin grafting along with the use of a dental impression material (Compo), a thermoplastic substance are presented in a series of 11 patients of acquired, severely contracted, anophthalmic sockets. Only the fornix fixation sutures and the central tarsorrhaphy were employed for the proper placement of graft without the use of retention devices. Artificial eyes were successfully fitted and retained subsequently after 6 weeks of grafting.

  1. Autogenous skin and fascia grafts as topical hemostatic agents in splenic injuries.

    PubMed

    Eitan, A; Munichor, M; Barzilai, A

    1989-01-01

    Splenic salvage techniques were developed since the immunologic importance of the spleen has been recognized. Various synthetic products, such as Avitan, Collastat Gel foam, Superstat, Thrombostat, were used and lately even pig skin was tested for its hemostatic ability. In this study, a canine splenic bleeding model was used to test autologous split-thickness skin-graft hemostatic effect, compared to pig skin, human skin and canine fascia. Lyophilized pig skin was tested on 12 splenic wounds, lyophilized human skin on 10, canine skin on 10, canine fascia on 10 and simple pad gauze on 10 other splenic wounds. Each animal served as its own control. Pig skin was more effective than canine skin (p less than 0.01), but the canine skin was more effective than human skin (p less than 0.01) and canine fascia (p less than 0.05). Long-term implantation of the canine skin graft caused fibrosis and epidermoid cyst formation, but they were of no clinical significance in the dog. In conclusion, autologous split thickness graft, always at hand, was found to be an effective hemostatic procedure and proved to be safe in the dog.

  2. Topical cyclosporin induces hair growth in human split skin grafted onto nude mice.

    PubMed

    Gilhar, A; Etzioni, A; Moscona, R

    1991-01-01

    Previously we observed that systemic CyA induces hair growth in an experimental model of human scalp skin graft transplanted onto nude mice. In the present study we investigated the role of topical CyA in the murine transplantation model, using human split-thickness skin grafts (HSTSG). Ten mice grafted with 1-mm-thick skin and another 10 mice grafted with 0.4-mm-thick skin were treated topically with CyA in olive oil. Ten other mice, treated with olive oil only, served as a control group. At the end of the study we observed hair growth only on the grafted skin of the CyA-treated group. Four out of 10 grafts showed hair growth in each of the groups. Quantitative analysis of transverse sections of cylindrical punch biopsy specimens of HSTSG before transplantation revealed anagen follicles, including small ones and telogen/catagen follicles, whereas specimens after skin transplantation showed terminal follicles mostly in the anagen phase. The present study provides further support to previous observations regarding the beneficial effect of CyA on hair growth.

  3. Radiation induced graft copolymerization of methyl methacrylate onto chrome-tanned pig skins

    NASA Astrophysics Data System (ADS)

    Pietrucha, K.; Pȩkala, W.; Kroh, J.

    Graft copolymerization of methyl methacrylate (MMA) onto chrome-tanned pig skins was carried out by the irradiation with 60Co ?-rays. The grafted polymethyl methacrylate (PMMA) chains were isolated by acid hydrolysis of the collagen backbone in order to characterize the graft copolymers. Proof of grafting was obtained through the detection of amino acid endgroups in the isolated grafts by reaction with ninhydrin. The grafting yield of MMA in aqueous emulsion was found to be higher than that for pure MMA and MMA in acetone. The degree of grafting increases with increasing monomer concentration in emulsion and reaches maximum at radiation dose ca 15 kGy. The yield of grafting is very high - ca 90% of monomer converts into copolymer and only 10% is converted into homopolymer. The present paper reports the physical properties of chrome-tanned pig skins after graft polymerization with MMA in emulsion. Modified leathers are more resistant against water absorption and abrasion in comparison with unmodified ones. They have more uniform structure over the whole surface, greater thickness and stiffness. The results reported seem to indicate that MMA may be used in the production of shoe upper and sole leathers. The mechanism of some of the processes occuring during radiation grafting of MMA in water emulsion on tanned leathers has been also suggested and discussed.

  4. Maintenance of the normal flora of human skin grafts transplanted to mice.

    PubMed

    Kearney, J N; Gowland, G; Holland, K T; Cunliffe, W J

    1982-10-01

    Full-thickness human cadaver skin was maintained on the dorso-lateral thoracic region of hairless mice whose immune rejection mechanism was suppressed using anti-mouse-thymocyte globulin. The bacterial profile of the pregrafted skin did not differ significantly from the normal human microflora. In contrast, the murine skin exhibited quantitative and qualitative differences from the human flora, in particular by the complete absence of Propionibacterium acnes, the dominant bacterium on sebum-rich areas of human skin. The normal microbial profile of the human grafts was maintained throughout the experimental period despite the novel environmental milieu. There was little contamination of the grafts from the normal murine flora. It was concluded that the grafted human skin would provide a realistic model for studying the ecology of human cutaneous micro-organisms.

  5. Loss of split thickness skin grafts due to non-group A beta-haemolytic streptococci.

    PubMed Central

    Wilson, G. R.; French, G. W.; Sully, L.

    1988-01-01

    Over a 17-month period 77 patients requiring a split skin graft for a burn injury have suffered loss of previously well taken graft due to the growth of a beta-haemolytic streptococcus. Of these only 42 were streptococci of Lancefield group A (Streptococcus pyogenes); 16 were group B, 3 group C and 16 group G. Some strains of groups B, C and G produce cytopathic and spreading factors capable of destroying the new skin graft and regenerating epithelium. We suggest that the non-group A streptococci may be more pathogenic than previously recognised in this particular respect. PMID:3046466

  6. Full-thickness skin graft interposition after temporomandibular joint ankylosis surgery. A study of 31 cases.

    PubMed

    Chossegros, C; Guyot, L; Cheynet, F; Blanc, J L; Cannoni, P

    1999-10-01

    Recurrence is a major problem after release of temporomandibular joint ankylosis. Early physiotherapy and choice of interpositional material are important in preventing recurrence. Currently, the most used technique is gap arthroplasty associated with coronoidectomy, temporalis muscle flap interposition and reconstruction of the condylar unit with a costochondral graft. Full-thickness skin graft interposition, using the technique described by Popescu & Vasiliu, can also be used. This retrospective review of 31 patients confirms the reliability of full-thickness skin graft interposition. Results were successful in 90% of the 20 patients with follow-up longer than one year.

  7. Utilization of the scrotum as a full thickness skin graft in a dog

    PubMed Central

    Wells, Sean; Gottfried, Sharon D.

    2010-01-01

    A 1.5-year-old, intact, male dog was presented for degloving wounds to the distal pelvic limbs due to vehicular trauma. Treatment involved serial debridement of the wounds and use of the scrotal skin as a full thickness, meshed skin graft applied to the dorsal aspect of the left pes with a successful outcome. PMID:21286329

  8. Enhanced angiogenesis in grafted skins by gene transfer of human hepatocyte growth factor using laser-induced stress waves

    NASA Astrophysics Data System (ADS)

    Terakawa, Mitsuhiro; Sato, Shunichi; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Okano, Hideyuki; Obara, Minoru

    2007-02-01

    We delivered a therapeutic gene, hepatocyte growth factor (HGF), to skin grafts of rats using laser-induced stress waves (LISWs) with the objective of enhancing their adhesion. The density and uniformity of neovascularities were enhanced significantly in the grafted skins that were transfected using LISWs, suggesting the efficacy of this method to improve the outcome of skin transplantation.

  9. Accelerated adhesion of grafted skins by laser-induced stress wave-based gene transfer of hepatocyte growth factor

    NASA Astrophysics Data System (ADS)

    Aizawa, Kazuya; Sato, Shunichi; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Obara, Minoru

    2009-02-01

    In our previous study, we delivered plasmid DNA coding for human hepatocyto growth factor (hHGF) to rat skin grafts based on laser-induced stress wave (LISW), by which production of CD31-positive cells in the grafted skins was found to be enhanced, suggesting improved angiogenesis. In this study, we validated the efficacy of this method to accelerate adhesion of grafted skins; reperfusion and reepithelialization in the grafted skins were examined. As a graft, dorsal skin of a rat was exsected and its subcutaneous fat was removed. Plasmid DNA expression vector for hHGF was injected into the graft; on its back surface a laser target with a transparent sheet for plasma confinement was placed, and irradiated with three nanosecond laser pulses at a laser fluence of 1.2 J/cm2 (532 nm; spot diameter, 3 mm) to generate LISWs. After the application of LISWs, the graft was transplanted onto its donor site. We evaluated blood flow by laser Doppler imaging and analyzed reepithelialization based on immunohistochemistry as a function of postgrafting time. It was found that both reperfusion and reepithelialization were significantly enhanced for the grafts with gene transfection than for normal grafts; reepithelialization was completed within 7 days after transplantation with the transfected grafts. These findings demonstrate that adhesion of grafted skins can be accelerated by delivering HGF gene to the grafts based on LISWs.

  10. Antecedent thermal injury worsens split-thickness skin graft quality: A clinically relevant porcine model of full-thickness burn, excision and grafting.

    PubMed

    Carlsson, Anders H; Rose, Lloyd F; Fletcher, John L; Wu, Jesse C; Leung, Kai P; Chan, Rodney K

    2017-02-01

    Current standard of care for full-thickness burn is excision followed by autologous split-thickness skin graft placement. Skin grafts are also frequently used to cover surgical wounds not amenable to linear closure. While all grafts have potential to contract, clinical observation suggests that antecedent thermal injury worsens contraction and impairs functional and aesthetic outcomes. This study evaluates the impact of antecedent full-thickness burn on split-thickness skin graft scar outcomes and the potential mediating factors. Full-thickness contact burns (100°C, 30s) were created on the backs of anesthetized female Yorkshire Pigs. After seven days, burn eschar was tangentially excised and covered with 12/1000th inch (300μm) split-thickness skin graft. For comparison, unburned wounds were created by sharp excision to fat before graft application. From 7 to 120days post-grafting, planimetric measurements, digital imaging and biopsies for histology, immunohistochemistry and gene expression were obtained. At 120days post-grafting, the Observer Scar Assessment Scale, colorimetry, contour analysis and optical graft height assessments were performed. Twenty-nine porcine wounds were analyzed. All measured metrics of clinical skin quality were significantly worse (p<0.05) in burn injured wounds. Histological analysis supported objective clinical findings with marked scar-like collagen proliferation within the dermis, increased vascular density, and prolonged and increased cellular infiltration. Observed differences in contracture also correlated with earlier and more prominent myofibroblast differentiation as demonstrated by α-SMA staining. Antecedent thermal injury worsens split-thickness skin graft quality, likely by multiple mechanisms including burn-related inflammation, microscopically inadequate excision, and dysregulation of tissue remodeling. A valid, reliable, clinically relevant model of full-thickness burn, excision and skin replacement therapy has been

  11. Effects of Negative Pressure Wound Therapy on Healing of Free Full-Thickness Skin Grafts in Dogs

    PubMed Central

    STANLEY, BRYDEN J.; PITT, KATHRYN A.; WEDER, CHRISTIAN D.; FRITZ, MICHELE C.; HAUPTMAN, JOE G.; STEFICEK, BARBARA A.

    2013-01-01

    Objective To compare healing of free, full-thickness, meshed skin grafts under negative pressure wound therapy (NPWT) with bolster dressings in dogs. Study design Randomized, controlled experimental study, paired design. Animals Dogs (n =5) Methods Full-thickness skin wounds (4 cm ×1.5cm) were created bilaterally on the antebrachia of 5 dogs (n = 10). Excised skin was grafted to the contralateral limb. Grafts were randomized to NPWT or bolster dressings (control; CON). NPWT was applied continuously for 7 days. Grafts were evaluated on days 2, 4, 7, 10, 14 and 17, biopsied on days 0, 4, 7, and 14, and had microbial culture on day 7. Outcome variables were: time to first appearance of granulation tissue, percent graft necrosis, and percent open mesh. Significance was set at P<.05. Histologic findings, culture results, and graft appearance were reported. Results Granulation tissue appeared earlier in the NPWT grafts compared with CON grafts. Percent graft necrosis and remaining open mesh area were both greater in CON grafts compared with NPWT grafts at most time points. Histologic results showed no significant difference in all variables measured, and all cultures were negative. Conclusions Variables of graft acceptance were superior when NPWT was used in the first week post-grafting. Fibroplasia was enhanced, open meshes closed more rapidly and less graft necrosis occurred with NPWT application. More preclinical studies are required to evaluate histologic differences. PMID:23550662

  12. Wound healing: the effect of macrophage and tumour derived angiogenesis factors on skin graft vascularization.

    PubMed Central

    Arnold, F.; West, D.; Kumar, S.

    1987-01-01

    Angiogenic factors prepared from rat Walker 256 mammary carcinoma, (TAF) and activated mouse peritoneal macrophages (MAF), were tested for their ability to stimulate vascularization during healing. They were applied to one of a pair of bilaterally symmetrical, autologous, isotopic, full thickness skin grafts in mice. Blood flow to treated and untreated graft pairs was compared by their uptake of injected 86Rb Cl, at 3 and 7 days after grafting. No difference was detected after treatment with either agent. We conclude that while angiogenic factors are important in vascularization during healing, this normally occurs at a near maximal rate and cannot be further enhanced. PMID:2443156

  13. Split skin graft application over an integrating, biodegradable temporizing polymer matrix: immediate and delayed.

    PubMed

    Greenwood, John Edward; Dearman, Bronwyn Louise

    2012-01-01

    The objective of this study is to further investigate the NovoSorb™ biodegradable polyurethane in generating dermal scaffolds; to perform a pilot study comparing the previously used spun mat against a recently developed NovoSorb™ foam, ascertaining the optimum structure of the matrix; and to evaluate the successful matrix as an immediate adjunct to split skin grafting and as a temporizing matrix in a prospective six-pig study. A pilot study comparing a previously investigated form of the polymer (spun mat) against a new structural form, a foam, was performed. This was followed by a six-pig study of the foam matrix with three treatment arms-autologous split skin graft alone, polymer foam with immediate engraftment, and polymer foam with delayed engraftment. The foams allowed less wound contraction than the spun mats. The foam structure is less dense (cheaper to produce and having less degradation products). The material remained in situ despite clinical wound infection. Proof of concept was achieved in both treatment modalities in the main study. Split skin graft applied immediately over the polymer foam was able to engraft successfully. The result was "thicker" to pinch and "flush" with the skin surrounding the wound. There was no significant difference in the degree of wound contraction between the graft alone and the polymer plus immediate graft groups. Split skin graft also "took" when applied to the surface of a polymer that had been applied to a wound 11 days earlier, again with a thicker result, flush with the surrounding skin. Split skin grafts alone left a persisting depression. However, a significant degree of wound contraction (compared with the other two groups) was observed in the polymer plus delayed graft group. This has prompted further investigation into "sealing" the polymer foam with a membrane, to prevent evaporative water loss, when the foam is to be used as a biodegradable temporizing matrix. The studies indicate that the Novo

  14. Quantification of texture match of the skin graft: function and morphology of the stratum corneum.

    PubMed

    Inoue, K; Matsumoto, K

    1986-01-01

    In an attempt to analyze the "texture match" of grafted skin, functional and morphological aspects of the stratum corneum were studied using the Skin Surface Hydrometer (IBS Inc.) and the scanning electron microscope. The results showed that hygroscopicity and water holding capacity of the stratum corneum played a crucial role in making the skin surface soft and smooth. Morphologically there were regional differences in the surface pattern and the mean area of corneocytes, suggesting that these differences affect skin texture. It is suggested that the present functional and morphological studies of the stratum corneum can provide a quantitative measure of the "texture match".

  15. Skin graft hypertrichosis associated with prostaglandin analog in the treatment of glaucoma.

    PubMed

    Shafi, Fariha; Madge, Simon N

    2014-01-01

    Prostaglandin analogs are commonly used in the treatment of glaucoma. They are a safe and effective treatment associated with few side effects. Common local side effects include conjunctival hyperemia, iris pigmentation, and eyelash hypertrichosis. The authors present a case of a patient using travoprost treatment for primary open-angle glaucoma, who underwent excision of a lower eyelid basal cell carcinoma and reconstruction with an upper eyelid tarsoconjunctival flap and overlying skin graft. The patient developed hypertrichosis of the skin graft attributable to prostaglandin analog use.

  16. Genetically Modified Porcine Skin Grafts for Treatment of Severe Burn Injuries

    DTIC Science & Technology

    2011-07-01

    graft survival: 2 days). See Figure 3 below. Task 2c Evaluate immune effects of skin graft on cellular and humoral responses (months 18-30...stabilization of criticall-ill patients. We intend to breed and maintain a herd of GalT-KO donor swine for this purpose as a new approach to the initial...of the cellular and humoral immune responses evoked. (Month 3 - Month 18) Task 1. Develop and compare survival of GalT-KO swine skin, normal swine

  17. Wolfe's part in the Italian Risorgimento and his skin graft.

    PubMed

    Sykes, Philip J

    2012-09-01

    A little known episode in the history of plastic surgery occurred during the Italian Risorgimento 150 years ago. Dr. J. R. Wolfe, who described the full-thickness graft which bears his name, was involved with Garibaldi in the war to unite Italy. He crossed swords with an English nurse, Jessie White Mario, and was thrown into prison. The events were recorded in the Lancet as "A Neapolitan Outrage." This article gives the details of the sad story and goes on to describe the first attempts at full-thickness grafting to correct ectropion. Wolfe was not the first to carry out this procedure and the name of Lawson is rarely remembered.

  18. Differentiation of cellular reaction to alloantigens and bacterial infection in human skin graft--immunosuppressive drugs or antibiotics.

    PubMed

    Moscicka-Wesolowska, M; Olszewski, W L; Zolich, D; Stelmach, E

    2002-01-01

    The human hand transplantations prompted revival of interest in evaluation of the rejection process of the grafted skin and its control with the antirejection drugs [1-3]. In case of first hand transplantation a combined immunosuppressive regimen was applied with currently available drugs resulting in acceptance of the entire composite graft. No major untoward systemic effects of antirejection therapy were observed. The most important clinical conclusion was that allogeneic skin can be accepted and function as in a normal extremity, although the attack of host cells on the graft can not be totally eliminated. Chronic perivascular and subepidermal infiltrates with recipient cells could be seen [4]. Another problem connected with skin transplantation is graft infection. Skin is inhabited by a specific spectrum of bacteria [5]. Allografted skin is more sensitive to bacterial penetration than normal skin due to local damage by the host-versus-graft cellular reaction and compromised immune reactivity to bacterial antigens by the immunosuppressive therapy. The histological pictures of rejecting skin represent a mixture of cellular reaction against the graft and penetrating microbes. Alloreaction requires modification of immunosuppressive regimen and infection is an indication for prolonged antibiotic therapy against skin bacterial flora. The question arises how to discriminate the alloreactive and bacterial changes in the skin graft. We studied the histological pictures of rejecting and infected human skin after transplantion to scid mice.

  19. Development of the mechanical properties of engineered skin substitutes after grafting to full-thickness wounds.

    PubMed

    Sander, Edward A; Lynch, Kaari A; Boyce, Steven T

    2014-05-01

    Engineered skin substitutes (ESSs) have been reported to close full-thickness burn wounds but are subject to loss from mechanical shear due to their deficiencies in tensile strength and elasticity. Hypothetically, if the mechanical properties of ESS matched those of native skin, losses due to shear or fracture could be reduced. To consider modifications of the composition of ESS to improve homology with native skin, biomechanical analyses of the current composition of ESS were performed. ESSs consist of a degradable biopolymer scaffold of type I collagen and chondroitin-sulfate (CGS) that is populated sequentially with cultured human dermal fibroblasts (hF) and epidermal keratinocytes (hK). In the current study, the hydrated biopolymer scaffold (CGS), the scaffold populated with hF dermal skin substitute (DSS), or the complete ESS were evaluated mechanically for linear stiffness (N/mm), ultimate tensile load at failure (N), maximum extension at failure (mm), and energy absorbed up to the point of failure (N-mm). These biomechanical end points were also used to evaluate ESS at six weeks after grafting to full-thickness skin wounds in athymic mice and compared to murine autograft or excised murine skin. The data showed statistically significant differences (p <0.05) between ESS in vitro and after grafting for all four structural properties. Grafted ESS differed statistically from murine autograft with respect to maximum extension at failure, and from intact murine skin with respect to linear stiffness and maximum extension. These results demonstrate rapid changes in mechanical properties of ESS after grafting that are comparable to murine autograft. These values provide instruction for improvement of the biomechanical properties of ESS in vitro that may reduce clinical morbidity from graft loss.

  20. Circumferential negative-pressure dressing (VAC) to bolster skin grafts in the reconstruction of the penile shaft and scrotum.

    PubMed

    Weinfeld, Adam Bryce; Kelley, Patrick; Yuksel, Eser; Tiwari, Pankaj; Hsu, Patrick; Choo, Joshua; Hollier, Larry H

    2005-02-01

    This paper presents 4 consecutive cases using negative-pressure dressings (VAC) to bolster skin grafts in male genital reconstruction. In this series reconstruction followed 1 case of tumor ablation and 3 cases of debridement of abscesses or Fornier's gangrene. The VAC was applied circumferentially to the penis to secure skin grafts either directly to the penile shaft or to facilitate skin grafting to the scrotum. Graft areas ranged from 75 to 250 cm. All cases resulted in successful genital wound coverage; minor complications are described. Three practical points are brought forth. First, the VAC facilitates skin grafting to the complex contour of male genitalia. Second, the VAC can be applied circumferentially to the penis without the need for perfusion monitoring or fears of avascular necrosis. Third, with the use of the VAC, bolster use can likely be discontinued as early as 72 hours with good graft adherence and survival.

  1. Split thickness skin grafting for recreation of the scrotum following Fournier's gangrene.

    PubMed

    Maguiña, Pirko; Palmieri, Tina L; Greenhalgh, David G

    2003-12-01

    Fournier's gangrene is an infection of the genitals and perineum that is treated with extensive soft tissue debridement, often leading to loss of scrotal skin. Multiple options for reconstruction of the scrotum are available. Four cases of recreation of the scrotum with meshed split thickness skin grafts (STSG) are presented. The discussion includes a comparison of STSG with other treatment options. We conclude that STSG are a safe, technically easy treatment option with satisfactory cosmetic and functional results.

  2. A Novel Nude Mouse Model of Hypertrophic Scarring Using Scratched Full Thickness Human Skin Grafts

    PubMed Central

    Alrobaiea, Saad M.; Ding, Jie; Ma, Zengshuan; Tredget, Edward E.

    2016-01-01

    Objective: Hypertrophic scar (HTS) is a dermal form of fibroproliferative disorder that develops following deep skin injury. HTS can cause deformities, functional disabilities, and aesthetic disfigurements. The pathophysiology of HTS is not understood due to, in part, the lack of an ideal animal model. We hypothesize that human skin with deep dermal wounds grafted onto athymic nude mice will develop a scar similar to HTS. Our aim is to develop a representative animal model of human HTS. Approach: Thirty-six nude mice were grafted with full thickness human skin with deep dermal scratch wound before or 2 weeks after grafting or without scratch. The scratch on the human skin grafts was made using a specially designed jig that creates a wound >0.6 mm in depth. The xenografts were morphologically analyzed by digital photography. Mice were euthanized at 1, 2, and 3 months postoperatively for histology and immunohistochemistry analysis. Results: The mice developed raised and firm scars in the scratched xenografts with more contraction, increased infiltration of macrophage, and myofibroblasts compared to the xenografts without deep dermal scratch wound. Scar thickness and collagen bundle orientation and morphology resembled HTS. The fibrotic scars in the wounded human skin were morphologically and histologically similar to HTS, and human skin epithelial cells persisted in the remodeling tissues for 1 year postengraftment. Innovation and Conclusions: Deep dermal injury in human skin retains its profibrotic nature after transplantation, affording a novel model for the assessment of therapies for the treatment of human fibroproliferative disorders of the skin. PMID:27366591

  3. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar

    PubMed Central

    Chae, Jin Kyung; Kim, Eun Jung; Park, Kun

    2016-01-01

    Background The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. Objective To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Methods Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Results Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. Conclusion In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion. PMID:27746642

  4. Hair Follicle Regeneration in Skin Grafts: Current Concepts and Future Perspectives

    PubMed Central

    Mahjour, Seyed Babak; Ghaffarpasand, Fariborz

    2012-01-01

    The repair and management of full-thickness skin defects resulting from burns and chronic wounds remain a significant unmet clinical challenge. For those skin defects exceeding 50%–60% of total body surface area, it is impractical to treat with autologous skin transplants because of the shortage of donor sites. The possibility of using tissue-engineered skin grafts for full-thickness wound repair is a promising approach. The primary goal of tissue-engineered skin grafts is to restore lost barrier function, but regeneration of appendages, such as hair follicles, has to be yet achieved. The successful regeneration of hair follicles in immunodeficient mice suggests that creating human hair follicles in tissue-engineered skin grafts is feasible. However, many limitations still need to be explored, particularly enriching isolated cells with trichogenic capacity, maintaining this ability during processing, and providing the cells with proper environmental cues. Current advances in hair follicle regeneration, in vitro and in vivo, are concisely summarized in this report, and key requirements to bioengineer a hair follicle are proposed, with emphasis on a three-dimensional approach. PMID:21883016

  5. Survival of skin graft between transgenic cloned dogs and non-transgenic cloned dogs.

    PubMed

    Kim, Geon A; Oh, Hyun Ju; Kim, Min Jung; Jo, Young Kwang; Choi, Jin; Park, Jung Eun; Park, Eun Jung; Lim, Sang Hyun; Yoon, Byung Il; Kang, Sung Keun; Jang, Goo; Lee, Byeong Chun

    2014-01-01

    Whereas it has been assumed that genetically modified tissues or cells derived from somatic cell nuclear transfer (SCNT) should be accepted by a host of the same species, their immune compatibility has not been extensively explored. To identify acceptance of SCNT-derived cells or tissues, skin grafts were performed between cloned dogs that were identical except for their mitochondrial DNA (mtDNA) haplotypes and foreign gene. We showed here that differences in mtDNA haplotypes and genetic modification did not elicit immune responses in these dogs: 1) skin tissues from genetically-modified cloned dogs were successfully transplanted into genetically-modified cloned dogs with different mtDNA haplotype under three successive grafts over 63 days; and 2) non-transgenic cloned tissues were accepted into transgenic cloned syngeneic recipients with different mtDNA haplotypes and vice versa under two successive grafts over 63 days. In addition, expression of the inserted gene was maintained, being functional without eliciting graft rejection. In conclusion, these results show that transplanting genetically-modified tissues into normal, syngeneic or genetically-modified recipient dogs with different mtDNA haplotypes do not elicit skin graft rejection or affect expression of the inserted gene. Therefore, therapeutically valuable tissue derived from SCNT with genetic modification might be used safely in clinical applications for patients with diseased tissues.

  6. Tissue-engineered dermo-epidermal skin grafts prevascularized with adipose-derived cells.

    PubMed

    Klar, Agnieszka S; Güven, Sinan; Biedermann, Thomas; Luginbühl, Joachim; Böttcher-Haberzeth, Sophie; Meuli-Simmen, Claudia; Meuli, Martin; Martin, Ivan; Scherberich, Arnaud; Reichmann, Ernst

    2014-06-01

    The major problem in skin grafting is that tissue-engineered skin grafts after their transplantation are initially entirely dependent on diffusion. Since this process is slow and inefficient, nutrients, growth factors, and oxygen will insufficiently be supplied and the regenerating graft will undergo a physiological crisis, resulting in scar-like dermal structures and shrinkage. The tissue-engineering of a vascular network in human dermo-epidermal skin substitutes (DESS) is a promising approach to overcome this limitation. Here we report, for the first time, on the use of the adipose stromal vascular fraction (SVF)-derived endothelial cell population to tissue-engineer DESS containing a highly efficient capillary plexus. To develop vascular networks in vitro, we employed optimized 3D fibrin or collagen type I hydrogel systems. Upon transplantation onto immune-deficient rats, these pre-formed vascular networks anastomosed to the recipient's vasculature within only four days. As a consequence, the neo-epidermis efficiently established tissue homeostasis, the dermis underwent almost no contraction, and showed sustained epidermal coverage in vivo. Overall, the here described rapid and efficient perfusion of SVF-based skin grafts opens new perspectives for the treatment of hitherto unmet clinical needs in burn/plastic surgery and dermatology.

  7. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area

    PubMed Central

    Jia-zi, Shi; Xiao, Zhai; Jun-hui, Li; Chun-yu, Xue; Hong-da, Bi

    2016-01-01

    Abstract Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing. Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at −150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up. All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements. NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus. PMID:27583890

  8. Laparoscopic greater omentum harvesting with split-thickness skin grafting for sternal wound dehiscence.

    PubMed

    Barragan, Barnard A; Halldorsson, Ari O; Wachtel, Mitchell S; Frezza, Eldo E

    2006-09-01

    Sternal wound dehiscence is a serious complication occasionally requiring soft tissue coverage. The greater omentum typically has been used as a last resort because of the underlying morbidity from a laparotomy. We present a case in which a laparoscopically created omental flap with subsequent split-thickness skin grafting was used to correct a large soft tissue defect that occurred after sternal wound dehiscence developed. A nonambulatory 49-year-old man who underwent coronary artery bypass grafting developed sternal wound dehiscence. Because a large soft tissue defect developed after multiple debridements, soft tissue coverage was required. A laparoscopically harvested omental flap spared this man's upper extremity musculature and provided a soft tissue bed for split-thickness skin grafting. This case helps to establish the role of laparoscopically harvested omentum. If the results suggested by this case are confirmed in a large series, omental flaps should be considered as options of first choice in the management of sternal wound dehiscence.

  9. Sequential Use of Hyperbaric Oxygen, Synthetic Skin Substitute and Skin Grafting in the Treatment of a Refractory Vasculitic Ulcer

    PubMed Central

    Akcali, Gökhan; Uzun, Günalp; Yapici, Abdül Kerim; Yildiz, Şenol

    2015-01-01

    Cutaneous leukocytoclastic vasculitis (CLCV) is a disorder characterized by the inflammation of the small vessels of the skin. CLCV may cause recurrent, drug-resistant, non-healing ulcers. Herein, we present a patient with a recalcitrant ulcer caused by CLCV, who was successfully treated with hyperbaric oxygen therapy and skin grafting. There is not any particular therapy/product that will heal all type of wounds. We can achieve better results provided that wound care products and advanced treatments are used at the right time. PMID:26199894

  10. Heat acclimation improves heat exercise tolerance and heat dissipation in individuals with extensive skin grafts.

    PubMed

    Schlader, Zachary J; Ganio, Matthew S; Pearson, James; Lucas, Rebekah A I; Gagnon, Daniel; Rivas, Eric; Kowalske, Karen J; Crandall, Craig G

    2015-07-01

    Burn survivors with extensive skin grafts have impaired heat dissipation and thus heat tolerance. This study tested the hypothesis that heat acclimation (HA) improves these factors in this population. Thirty-four burn survivors were stratified into highly [>40% body surface area (BSA) grafted, n = 15] and moderately (17-40% BSA grafted, n = 19) grafted groups. Nine healthy nonburned subjects served as controls. Subjects underwent 7 days of HA involving 90 min of exercise at ∼ 50% peak oxygen uptake in 40°C, 30% relative humidity. On days 1 and 7, subjects exercised in the heat at a fixed rate of metabolic heat production. Pre-HA, all controls and 18/19 subjects in the 17-40% group completed 90 min of exercise. Conversely, heat exercise tolerance was lower (P < 0.01) in the > 40% group, with 7/15 subjects not completing 90 min of exercise. Post-HA, heat exercise tolerance was similar between groups (P = 0.39) as all subjects, except one, completed 90 min of exercise. Pre-HA, the magnitude of the increase in internal temperature during exercise occurred sequentially (P ≤ 0.03) according to BSA grafted (>40%: 1.6 ± 0.5°C; 17-40%: 1.2 ± 0.3°C; control: 0.9 ± 0.2°C). HA attenuated (P < 0.01) increases in internal temperature in the control (by 0.2 ± 0.3°C), 17-40% (by 0.3 ± 0.3°C), and > 40% (by 0.3 ± 0.4°C) groups, the magnitude of which was similar between groups (P = 0.42). These data indicate that HA improves heat tolerance and dissipation in burn survivors with grafted skin, and the magnitude of these improvements are not influenced by the extent of skin grafting.

  11. Accelerated adhesion of grafted skin by laser-induced stress wave-based gene transfer of hepatocyte growth factor

    NASA Astrophysics Data System (ADS)

    Aizawa, Kazuya; Sato, Shunichi; Terakawa, Mitsuhiro; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Obara, Minoru

    2009-11-01

    Gene therapy using wound healing-associated growth factor gene has received much attention as a new strategy for improving the outcome of tissue transplantation. We delivered plasmid DNA coding for human hepatocyte growth factor (hHGF) to rat free skin grafts by the use of laser-induced stress waves (LISWs); autografting was performed with the grafts. Systematic analysis was conducted to evaluate the adhesion properties of the grafted tissue; angiogenesis, cell proliferation, and reepithelialization were assessed by immunohistochemistry, and reperfusion was measured by laser Doppler imaging as a function of time after grafting. Both the level of angiogenesis on day 3 after grafting and the increased ratio of blood flow on day 4 to that on day 3 were significantly higher than those in five control groups: grafting with hHGF gene injection alone, grafting with control plasmid vector injection alone, grafting with LISW application alone, grafting with LISW application after control plasmid vector injection, and normal grafting. Reepithelialization was almost completed on day 7 even at the center of the graft with LISW application after hHGF gene injection, while it was not for the grafts of the five control groups. These findings demonstrate the validity of our LISW-based HGF gene transfection to accelerate the adhesion of grafted skins.

  12. Demographic characteristics and outcome of burn patients requiring skin grafts: a tertiary hospital experience

    PubMed Central

    Shlash, Saud Othman Al; Madani, Jamal Omran Al; Deib, Jamal Ismail El; Alsubhi, Fatemah Suliman; Saifi, Sara Saud Al; Helmi, Ayman Mohammed Adel; Al-Mutairi, Sultan Khalaf; Khurram, Javed Akhtar

    2016-01-01

    Split thickness skin graft (STSG) and full thickness skin graft (FTSG) are the integral part of burn wound management. However the impact of these graft types on the outcome still remain a matter of controversy. The purpose of this study was to determine the demographic characteristics and outcome of graft surgery of the patients undergone STSG and FTSG at Plastic Surgery Department of Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia. This retrospective study included 85 burn patients who received STSG (56 cases) and FTSG (29 cases) at PSMMC during 2010-2015. Demographic characteristics (age, gender, etiology of burn, and area of burn) and outcome (graft loss, graft contraction, skin pigmentation, altered sensation, infection rate and duration of hospital stay) were recorded among the patients who received STSG or FTSG. Out of 85 patients 50 patients were male and 35 female with a ratio of 1.42:1. The patients under the age of 10 years comprised the largest burn group with 28 cases (32.9%) out of total 85 patients. The number of patients above the age of 30 years was relatively smaller. Flame (49.3%) and scald (27%) burns constituted the majority of burn cases. The incidence of contraction among STSG (12.5%) and in FTSG (17.2%) cases was similar. Altered sensation was observed in 7.05% of STSG patients and 13.7% of FTSG cases. Loss of graft was observed in 16% of STSG and 20.6% of FTSG patients. The pigmentation was quite similar in STSG (21.4%) and FTSG (24. 1%). The hospitalization time in FTSG (28 days) patients was also comparable with STSG (26.9 days) group. This study showed that majority of the skin graft cases at PSMMC were male under the age of 30 years mostly affected by flame or scald burns. The outcome following STSG and FTSG surgery was comparable with no significant advantage of one over the other. It may be deduced that both STSG and FTSG have relative merits and demerits and either of these grafting procedure may be

  13. FTY720 treatment prolongs skin graft survival in a completely incompatible strain combination.

    PubMed

    Lima, R S M; Nogueira-Martins, M F; Silva, H T; Pestana, J O M; Bueno, V

    2004-05-01

    FTY720 has shown potent immunomodulatory activity in a variety of animal organ transplant models. However, the in vivo immunosuppressive mechanism of FTY720 is still not fully understood. It has been suggested that the marked decrease in the number of peripheral blood lymphocytes during FTY720 administration could be responsible for its immunosuppressive effects. Our aims were: (1) to study the effects of FTY720 treatment on skin graft survival using a fully mismatched strain combination and (2) to evaluate lymphocyte numbers in different sites at 5 days after skin transplant. C57BL/6 mice and BALB/c mice were the donors and recipients respectively. BALB/c mice received FTY720 (1 mg/kg/d) orally for 4 consecutive days. Drug administration started 1 day before skin transplants. A small segment of tail skin was affixed on the right dorsal side of the mouse via sutures. The administration of FTY720 (4 mg/kg) prolonged skin graft survival from 12.6 +/- 2.2 days (no treatment) to 16.6 +/- 4.2 days. The histologic findings of rejection were similar for all groups. Five days after transplant, lymphocyte numbers were significantly increased in lymph nodes compared with nontransplanted or isogenic graft mice. FTY720 decreased lymphocyte numbers only in the spleen. In conclusion, FTY720 prolonged skin graft survival in a fully mismatched strain combination when administered for 4 days (day -1 to day +2) at a dose of 1 mg/kg/d. The decreased number of lymphocytes in the spleen suggests that the spleen may be a target of FTY720 activity, during the early posttransplant period.

  14. Construction of Skin Graft Seams in Burn Patients: A Prospective Randomized Double-Blinded Study.

    PubMed

    Isaac, Kathryn; Umraw, Nisha; Cartotto, Robert

    Prominent scars and contractures may form along the seams between adjacent skin grafts. Seams may be constructed either by approximating the graft edges (AP), or by slightly overlapping the graft edges (OV), but it is not known if one technique creates a less conspicuous seam scar. The purpose of this study was to compare seam scars between seams constructed using the AP and OV techniques. This was a prospective within-patient and within-seam controlled study in adult burn patients treated at an American Burn Association-verified burn center. At skin graft application and seam construction, study seams were divided in half. One half of the seam was made by approximating the graft edges (AP group), while the other half was made by overlapping graft edges (OV group), before identical staple or suture fixation of each half. The AP or OV technique was randomly assigned to the medial or lateral ends of transversely oriented seams or to the proximal and distal ends of longitudinally oriented seams. At 3, 6, and 12 months post surgery, a blinded rater compared the two halves of each study seam scar using the Vancouver Scar Score (VSS). Subjects were also blinded and rated each half of their study seam using a 0 (poor) to 10 (excellent) visual analogue scale. Values are shown as the median (Q1-Q3). There were 44 study seams among 19 subjects (age 51 [36-70] years, with % TBSA burn 10 [7-18], % BSA full-thickness burn 8 [6-15]). Study seams were constructed at 10 (4-15) days post burn. Study seam length was 14.5 (10.3-18.0) cm, with 25% transversely oriented and 75% longitudinally oriented, and with 35/44 seams (80%) between meshed grafts and 9/44 (20%) between sheet grafts. There were no significant differences in any of the individual domain VSS scores (height, pliability, vascularity, and pigmentation) or total VSS score between AP and OV seams at 3, 6, and 12 months. At 12 months, among the 30 study seams that were visible to the subjects, the visual analogue scale

  15. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

    SciTech Connect

    Pecoraro, Felice Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  16. Efficacy of bubaline fibrin glue on full-thickness pinch and punch skin grafting in a pig.

    PubMed

    Dejyong, Krittee; Kaewamatawong, Theerayuth; Brikshavana, Pasakorn; Durongphongtorn, Sumit

    2017-03-01

    Fibrin glue, which is formed from the action of thrombin (a serine protease) on fibrinogen, has been developed for use as an adhesive to increase the success of skin graft surgery. The objective of this study was to evaluate if bubaline fibrin glue would promote skin graft survival in pigs. The grafting was divided into two steps. First, granulation wound preparation was performed in a healthy swine by creating four full-skin depth wounds (3 × 12 cm(2)) at the dorsal part of the loin area on each side. Second, pinch and punch skin grafting, where eight skin discs (0.6 cm diameter) were regularly placed (0.6 cm distance apart) in the granulation tissue bed of each wound, was performed 5 days later. The bubaline fibrin glue was added prior to application of the 16 skin graft discs in two of the wounds, while no glue was added to the other 16 skin graft discs in the other two wounds. The number of surviving graft pieces and histological examination was evaluated after 3, 7, and 14 days post-operation and compared by pairing between the control and the bubaline fibrin glue groups. The number of grafts that remained at 3 and 7 days post-operation and the number of new microvessels at 3 days post-operation were significantly higher ( p < 0.05) in the bubaline fibrin glue group than in the control group. However, there was no significant difference in the number of fibroblasts, the intensity of scarring and the intensity of inflammation between the two groups, except for the significantly lower intensity of inflammation at 7 days post-operation in the bubaline fibrin glue group. In conclusion, bubaline fibrin glue has the advantage of decreasing the skin graft loss by approximately 31.3-37.5% compared with the control group and also promotes angiogenesis.

  17. Effect of human skin grafts on whole-body heat loss during exercise heat stress: a case report.

    PubMed

    Ganio, Matthew S; Gagnon, Daniel; Stapleton, Jill; Crandall, Craig G; Kenny, Glen P

    2013-01-01

    When exposed to heat stress, increases in cutaneous blood flow and sweating in well-healed grafted skin are severely attenuated, which could impair whole-body heat loss if skin grafts cover a large portion of total body surface area (TBSA). It is unknown to what extent whole-body heat loss is impaired when skin grafts cover a significant (eg, >50%) proportion of TBSA. The authors examined whole-body heat exchange during and after 60 min of cycling exercise in the heat (35°C; 25% relative humidity), at a fixed rate of metabolic heat production (~400 W) in a woman (age, 36 years; mass, 78.2 kg) with well-healed (17+ years) skin grafts covering 75% of TBSA. Her responses were compared with two noninjured control subjects. Whole-body evaporative and dry heat exchange were measured by direct calorimetry. While exercising in the same ambient conditions and at the same rate of heat production, relative evaporative heat loss of nongrafted skin in the grafted subject (ie, evaporative heat loss per m) was nearly twice that of the control subjects. However, total rate of evaporative heat loss reached only 59% of the amount required for heat balance in the skin-grafted subject compared with 92 ± 3% in controls. Thus, the increase in core temperature was 2-fold greater for the grafted (1.22°C) vs control (0.61 ± 0.19°C) individuals. This case study demonstrates that a large area of grafted skin greatly diminishes maximum evaporative heat loss during exercise in the heat, making a compensable environment for control subjects uncompensable for skin-grafted individuals.

  18. Composite vascularized skin/bone graft model: a viable source for vascularized bone marrow transplantation.

    PubMed

    Siemionow, Maria; Ulusal, Betul G; Ozmen, Selahattin; Ulusal, Ali E; Ozer, Kagan

    2004-01-01

    In this study, we introduce a new model for vascularized skin and bone marrow transplantation. Twenty-five Lewis (RT1(1)) rats were studied. Anatomic dissection studies were performed in 5 animals. In the experimental group, 10 isograft transplantations were performed between Lewis rats. Combined groin skin and femoral bone flaps were transplanted based on the femoral artery and vein. Transplants were evaluated on a daily basis. All flaps survived without problems over 100 days posttransplant. The skin component remained pink and pliable, and grew new hair. Histological examination of the femoral bone (except the femoral head) revealed active hematopoiesis with a viable compact and cancellous bone components on day 100 posttransplant. This model can be applied to tolerance induction studies across the major Histocompatibility (MHC) barrier, where bone will serve as donor of stem and progenitor cells, and the skin flap will serve as a monitor of graft rejection.

  19. K-wire assisted split-thickness skin graft harvesting from the anterior trunk.

    PubMed

    Yontar, Yalcin; Coruh, Atilla; Severcan, Mehmet

    2016-02-01

    Split thickness skin graft (STSG) harvesting from the anterior chest and abdominal wall skin is quite a difficult process. The main reason for the difficulty to perform this process is the unsuitable anatomic characteristics of the anterior trunk, such as irregular wavy-like surface over the ribs and lax abdominal wall skin resulting in collapse due to lack of adequate underneath supporting structures when a downward force is applied by the skin graft dermatome. Lower extremity and especially the thigh are generally chosen as the donor site where the STSGs are easily harvested from. However, extensive lower extremity burns, with or without other region burns, preclude harvesting auto STSGs from this invaluable anatomic site. We harvested K-wire assisted STSGs from the anterior chest and abdominal wall skin of 7 patients with lower extremity burns and also a patient that sustained motor vehicle collision. We encountered no problems in any of our patients both intra and postoperatively by using K-wire assisted STSG harvesting. All of the STSGs donor sites healed uneventfully without complications. In our opinion, K-wire assisted STSG harvesting must always be in the tool-box of any surgeon who deals with extensive burns with or without lower extremity burns and extensive traumas of lower extremities.

  20. Skin grafted latissimus dorsi flap for reconstruction of lateral aesthetic units of the face.

    PubMed

    Longo, Benedetto; Laporta, Rosaria; Pagnoni, Marco; Campanale, Antonella; Grippaudo, Francesca Romana; Santanelli Di Pompeo, Fabio

    2015-03-01

    Reconstruction of large defects of the lateral region of the face is rather challenging due to the unique color, texture, and thickness of soft tissues in this area. Microsurgical free flaps represent the gold standard, providing superior functional and aesthetic restoration. Purpose of this study was to assess reliability of skin-grafted latissimus dorsi (LD) flap, for a pleasant and symmetric reconstruction of the lateral aesthetic units of the face compared to a control group of patients addressed to perforator flaps. From November 2008 to June 2012, 5 patients underwent skin-grafted LD flap reconstruction of defects involving the lateral aesthetic units of the face, with 8.1 ± 0.5 × 9.7 ± 1.3 cm mean size. A 1-to-4 Likert scale was used to assess skin color, texture, shape, and bulkiness. Using the Pressure-Specified Sensory Device epicritic, proprioceptive, and protopathic sensitivities were tested. Outcomes were compared with those of a control group of 5 patients addressed to reconstruction with perforator flaps (3 anterolateral thigh flap, 2 vertical deep inferior perforator flap). At mean 21-month follow-up all flaps healed uneventfully without need for revisions, all developing more satisfactory results in terms of skin color (P = 0.028) and texture (P = 0.021) match, shape (P = 0.047) and bulkiness (P = 0.012) compared with perforator flaps. No differences in epicritic, proprioceptive, and protopathic sensitivities were observed (P > 0.05) between the two groups. Skin-grafted LD flap may be a suitable option for reconstruction of wide defects of the lateral aesthetic units of the face.

  1. Therapeutics for Graft-versus-Host Disease: From Conventional Therapies to Novel Virotherapeutic Strategies.

    PubMed

    Villa, Nancy Y; Rahman, Masmudur M; McFadden, Grant; Cogle, Christopher R

    2016-03-22

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a curative potential for many hematologic malignancies and blood diseases. However, the success of allo-HSCT is limited by graft-versus-host disease (GVHD), an immunological syndrome that involves inflammation and tissue damage mediated by donor lymphocytes. Despite immune suppression, GVHD is highly incident even after allo-HSCT using human leukocyte antigen (HLA)-matched donors. Therefore, alternative and more effective therapies are needed to prevent or control GVHD while preserving the beneficial graft-versus-cancer (GVC) effects against residual disease. Among novel therapeutics for GVHD, oncolytic viruses such as myxoma virus (MYXV) are receiving increased attention due to their dual role in controlling GVHD while preserving or augmenting GVC. This review focuses on the molecular basis of GVHD, as well as state-of-the-art advances in developing novel therapies to prevent or control GVHD while minimizing impact on GVC. Recent literature regarding conventional and the emerging therapies are summarized, with special emphasis on virotherapy to prevent GVHD. Recent advances using preclinical models with oncolytic viruses such as MYXV to ameliorate the deleterious consequences of GVHD, while maintaining or improving the anti-cancer benefits of GVC will be reviewed.

  2. Therapeutics for Graft-versus-Host Disease: From Conventional Therapies to Novel Virotherapeutic Strategies

    PubMed Central

    Villa, Nancy Y.; Rahman, Masmudur M.; McFadden, Grant; Cogle, Christopher R.

    2016-01-01

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a curative potential for many hematologic malignancies and blood diseases. However, the success of allo-HSCT is limited by graft-versus-host disease (GVHD), an immunological syndrome that involves inflammation and tissue damage mediated by donor lymphocytes. Despite immune suppression, GVHD is highly incident even after allo-HSCT using human leukocyte antigen (HLA)-matched donors. Therefore, alternative and more effective therapies are needed to prevent or control GVHD while preserving the beneficial graft-versus-cancer (GVC) effects against residual disease. Among novel therapeutics for GVHD, oncolytic viruses such as myxoma virus (MYXV) are receiving increased attention due to their dual role in controlling GVHD while preserving or augmenting GVC. This review focuses on the molecular basis of GVHD, as well as state-of-the-art advances in developing novel therapies to prevent or control GVHD while minimizing impact on GVC. Recent literature regarding conventional and the emerging therapies are summarized, with special emphasis on virotherapy to prevent GVHD. Recent advances using preclinical models with oncolytic viruses such as MYXV to ameliorate the deleterious consequences of GVHD, while maintaining or improving the anti-cancer benefits of GVC will be reviewed. PMID:27011200

  3. Transgenic expression of human cytoxic T-lymphocyte associated antigen4-immunoglobulin (hCTLA4Ig) by porcine skin for xenogeneic skin grafting.

    PubMed

    Wang, Yong; Yang, Hua-Qiang; Jiang, Wen; Fan, Na-Na; Zhao, Ben-Tian; Ou-Yang, Zhen; Liu, Zhao-Ming; Zhao, Yu; Yang, Dong-Shan; Zhou, Xiao-Yang; Shang, Hai-Tao; Wang, Lu-Lu; Xiang, Peng-Ying; Ge, Liang-Peng; Wei, Hong; Lai, Liang-Xue

    2015-04-01

    Porcine skin is frequently used as a substitute of human skin to cover large wounds in clinic practice of wound care. In our previous work, we found that transgenic expression of human cytoxicT-lymphocyte associated antigen4-immunoglobulin (hCTLA4Ig) in murine skin graft remarkably prolonged its survival in xenogeneic wounds without extensive immunosuppression in recipients, suggesting that transgenic hCTLA4Ig expression in skin graft may be an effective and safe method to prolong xenogeneic skin graft survival. In this work, using a transgene construct containing hCTLA4Ig coding sequence under the drive of human Keratine 14 (k14) promoter, hCTLA4Ig transgenic pigs were generated by somatic nuclear transfer. The derived transgenic pigs were healthy and exhibited no signs of susceptibility to infection. The hCTLA4Ig transgene was stably transmitted through germline over generations, and thereby a transgenic pig colony was established. In the derived transgenic pigs, hCTLA4Ig expression in skin was shown to be genetically stable over generations, and detected in heart, kidney and corneal as well as in skin. Transgenic hCTLA4Ig protein in pigs exhibited expected biological activity as it suppressed human lymphocyte proliferation in human mixed lymphocyte culture to extents comparable to those of commercially purchased purified hCTLA4Ig protein. In skin grafting from pigs to rats, transgenic porcine skin grafts exhibited remarkably prolonged survival compared to the wild-type skin grafts derived from the same pig strain (13.33 ± 3.64 vs. 6.25 ± 2.49 days, P < 0.01), further indicating that the transgenic hCTLA4Ig protein was biologically active and capable of extending porcine skin graft survival in xenogeneic wounds. The transgenic pigs generated in this work can be used as a reproducible resource to provide porcine skin grafts with extended survival for wound coverage, and also as donors to investigate the impacts of hCTLA4Ig on xenotransplantation of other organs

  4. Measuring skin penetration by confocal Raman microscopy (CRM): correlation to results from conventional experiments

    NASA Astrophysics Data System (ADS)

    Lunter, Dominique; Daniels, Rolf

    2016-03-01

    Confocal Raman microscopy has become an advancing technique in the characterization of drug transport into the skin. In this study the skin penetration of a local anesthetic from a semisolid preparation was investigated. Furthermore, the effect of the chemical enhancers propylene glycol and POE-23-lauryl ether on its penetration was investigated. The results show that confocal Raman microscopy may provide detailed information on the penetration of APIs into the skin and may elucidate their distribution within the skin with high resolution. The results of the CRM analysis are fully in line with those of conventional permeation and penetration experiments.

  5. Tissue-engineered skin preserving the potential of epithelial cells to differentiate into hair after grafting.

    PubMed

    Larouche, Danielle; Cuffley, Kristine; Paquet, Claudie; Germain, Lucie

    2011-03-01

    The aim of this study was to evaluate whether tissue-engineered skin produced in vitro was able to sustain growth of hair follicles in vitro and after grafting. Different tissues were designed. Dissociated newborn mouse keratinocytes or newborn mouse hair buds (HBs) were added onto dermal constructs consisting of a tissue-engineered cell-derived matrix elaborated from either newborn mouse or adult human fibroblasts cultured with ascorbic acid. After 7-21 days of maturation at the air-liquid interface, no hair was noticed in vitro. Epidermal differentiation was observed in all tissue-engineered skin. However, human fibroblast-derived tissue-engineered dermis (hD) promoted a thicker epidermis than mouse fibroblast-derived tissue-engineered dermis (mD). In association with mD, HBs developed epithelial cyst-like inclusions presenting outer root sheath-like attributes. In contrast, epidermoid cyst-like inclusions lined by a stratified squamous epithelium were present in tissues composed of HBs and hD. After grafting, pilo-sebaceous units formed and hair grew in skin elaborated from HBs cultured 10-26 days submerged in culture medium in association with mD. However, the number of normal hair follicles decreased with longer culture time. This hair-forming capacity after grafting was not observed in tissues composed of hD overlaid with HBs. These results demonstrate that epithelial stem cells can be kept in vitro in a permissive tissue-engineered dermal environment without losing their potential to induce hair growth after grafting.

  6. A Comparative Animal Study of Tendon Grafts Healing After Remnant-Preserving Versus Conventional Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Zhang, Lei; Jiang, Kan; Chai, Hao; Zhou, Mei; Bai, Jingping

    2016-01-01

    Background The aim of this study was to determine if anterior cruciate ligament (ACL) reconstruction by remnant preservation promotes cell proliferation, vascularization, proprioception recovery, and improved biomechanical properties of the tendon grafts. Material/Methods 75 New Zealand rabbits were randomly assigned into the control group (group A), conventional ACL reconstruction group (group B), ACL reconstruction using remnant preservation and graft through remnant sleeve technique group (group C), and ACL reconstruction using remnant preservation and remnant tensioning technique group (group D). The remnant and healing of tendon grafts in groups C and D were observed at 3, 6, and 12 weeks after surgery, and the mRNA expression levels of VEGF, NT-3 and GAP-43 in ACL (group A) or tendon graft samples (groups B, C, and D) were determined by real-time PCR. Tendon graft cell count, microvessel density (MVD), and proprioceptors were determined by H&E staining, CD34, and S-100 immunohistochemical staining. The biomechanical properties of the tendon graft at week 12 in groups B, C, and D were examined by using a tensile strength test. Results Remnant and tendon grafts were not healed at 3, 6, and 12 weeks after the operation in groups C and D. VEGF, NT-3, and GAP-43 mRNA expressions in groups B, C, and D were higher than those in group A (P<0.05), but no significant difference was observed between groups B, C, and D (P>0.05). Furthermore, tendon graft cell count, MVD, proprioception, and biomechanical properties showed no significant differences (P>0.05) among groups B, C, and D at various time points. Conclusions There was no significant difference in cell proliferation, vascularization, proprioception recovery, or biomechanical properties of the tendon grafts between remnant-preserving and conventional ACL reconstruction methods. PMID:27669454

  7. [Cognitive functions in elderly high-risk patients after off-pump coronary artery bypass grafting versus conventional bypass grafting - a randomised study - Secondary publication].

    PubMed

    Jensen, Birte Østergaard; Hughest, Pia; Rasmussen, Lars S; Pedersen, Preben U; Steinbrüchel, Daniel A

    2006-10-30

    It has been suggested that the risk of cerebral dysfunction is less with off-pump coronary artery bypass grafting (OPCAB) than with conventional coronary artery bypass grafting (CCAB). The study is a part of the Best Bypass Surgery Trial. A total of 120 elderly patients underwent psychometric testing with a neuropsychological test battery before as well as 3 months after surgery. Cognitive dysfunction was identified in 7.4% of the patients in the OPCAB group and 9.8% in the CCAB group. We found no significant difference after either OPCAB or CCAB.

  8. About ATMPs, SOPs and GMP: The Hurdles to Produce Novel Skin Grafts for Clinical Use

    PubMed Central

    Hartmann-Fritsch, Fabienne; Marino, Daniela; Reichmann, Ernst

    2016-01-01

    Background The treatment of severe full-thickness skin defects represents a significant and common clinical problem worldwide. A bio-engineered autologous skin substitute would significantly reduce the problems observed with today's gold standard. Methods Within 15 years of research, the Tissue Biology Research Unit of the University Children's Hospital Zurich has developed autologous tissue-engineered skin grafts based on collagen type I hydrogels. Those products are considered as advanced therapy medicinal products (ATMPs) and are routinely produced for clinical trials in a clean room facility following the guidelines for good manufacturing practice (GMP). This article focuses on hurdles observed for the translation of ATMPs from research into the GMP environment and clinical application. Results and Conclusion Personalized medicine in the field of rare diseases has great potential. However, ATMPs are mainly developed and promoted by academia, hospitals, and small companies, which face many obstacles such as high financial burdens. PMID:27781022

  9. [Urethroplasty with buccal mucosa graft or penile skin graft for anterior urethral stricture?].

    PubMed

    Rojas, Alejandro; Saavedra, Alvaro

    2015-06-04

    Currently the treatment for urethral stricture considers various techniques, including augmentation urethroplasty using tissue from different parts of the body. The more used are the buccal mucosa and penile skin, but are there any differences in success between both tissues? Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified one systematic review including 18 primary studies addressing this question, six of them prospective. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded there is uncertainty about the superiority of one technique over another because the certainty of the evidence is very low. A new systematic review is urgently needed on this topic as randomized studies have been published after the most recent review, which could provide greater certainty.

  10. Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand

    PubMed Central

    Kasdan, Morton L.; Wilhelmi, Bradon J.

    2016-01-01

    Background: The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. Methods: We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Results: Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. Conclusions: There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury. PMID:27555888

  11. Epidermal proliferation of nude mouse skin, pig skin, and pig skin grafts. Failure of nude mouse skin to respond to the tumor promoter 12- O-tetradecanoyl phorbol 13-acetate

    PubMed Central

    1980-01-01

    Human skin transplanted to nude mice offers a possible experimental system for the study of normal epidermal proliferation and differentiation, and for their pathological counterparts. Crucial to the development of such a system is the demonstration that such grafts retain the responsive features of donor skin. To document that donor proliferative characteristics are maintained in the grafts, a comparative analysis of agents that induce proliferation was made on skin of mice homozygous and heterozygous for nude, on pig skin, and on pig skin transplanted onto nude mice. A wave of epidermal proliferation could be induced in pig skin and pig skin grafted onto nude mice, but not in nude mouse skin after the topical application of 10 ng 12-O- tetradecanoyl phorbol 13-acetate (TPA). A 10-fold greater concentration of TPA or 5% croton oil induced proliferation in all species of epidermis studied. Mice, heterozygous for nude, showed a normal response to 10 ng TPA, suggesting that the ability to respond to TPA may be related, in part, to a recessive genetic trait. Nude mouse skin transplanted to a heterozygous littermate capable of responding to 10 ng TPA does not respond. These observations argue that: the graft retains its donor proliferative characteristics when transplanted to the nude, and the inability of the nude mouse to respond to lower doses of TPA may be related to absorption, the nude gene(s), or an inherent threshold to response. The lack of response to the promoter TPA provides a plausible explanation for the decreased incidence of tumors arising in nude mice during two-stage carcinogenesis experiments. PMID:7000965

  12. [Using skin graft for local control in stage IV breast cancer to improve quality of life].

    PubMed

    Suetsugu, Hiromi

    2014-11-01

    A 59-year-old woman was hospitalized in June 2012 for Stage IV bilateral breast cancer, axillary lymph-node metastasis, metastatic lung tumor, metastatic bone tumor, right carcinomatous pleuritis, and right-eye choroidal metastasis. Treatment for improvement of symptoms included steroids, continuous subcutaneous infusion of morphine hydrochloride, and thoracic drainage. Chemotherapy with zoledronic acid+TC therapy was administered, with only a small residual primary lesion of the right breast. Interstitial pneumonia caused by the chemotherapy occurred and the volume occupied, it was continued treatment is difficult. In October 2013, she experienced right axillary lymph node metastases, and progress of the right breast cancer, with pain and bleeding from the right breast tumor. Therefore, for the purpose of improving quality of life, Bt+Ax was administered in October 2013, but since the resected part of the right breast included an approximately 10 cm dermal infiltration, a preserved subcutaneous vascular network (PSVN) skin graft was performed using healthy skin. The patient recovered well, the pain and bleeding disappeared, and the patient was discharged following surgery. PSVN skin graft for the purpose of local control was useful in this case.

  13. Subjective and objective observation of skin graft recovery on Indonesian local cat with different periods of transplantation time

    PubMed Central

    Erwin; Gunanti; Handharyani, Ekowati; Noviana, Deni

    2016-01-01

    Aim: The success of a skin graft in a cat is highly dependent on the granulation formed by the base of recipient bed. Granulation by the base of recipient bed will form after several days after injury. This research aimed to observe subjective and objective profile of skin graft recovery on forelimb of cats with different periods of donor skin placement. Materials and Methods: Nine male Indonesian local cats aged 1-2 years old, weighing 3-4 kg were divided into three groups. The first surgery for creating defect wound of 2 cm×2 cm in size was performed in the whole group. The wound was left for several days with the respective interval for each group, respectively: Group I (for 2 days), Group II (for 4 days), and Group III (for 6 days). In the whole group, the second surgery was done by the harvesting skin of thoracic area which then applied on recipient bed of respective groups. Result: The donor skin on Group II was accepted faster compared to Group I and Group III. The donor skin did not show color differences compared to surrounding skin, painless, bright red in bleeding test had faster both hair growth and drug absorption. Test toward the size of donor skin and the effect of drugs did not show a significant difference between each group. Conclusion: The observe subjective and objective profile of skin graft recovery on forelimb of cats on Group II were accepted faster compared to Group I and III. PMID:27284224

  14. Decreasing Skin Graft Contraction through Topical Wound Bed Preparation with Anti-Inflammatory Agents

    DTIC Science & Technology

    2015-10-01

    AWARD NUMBER: W81XWH-14- 2 -0153 TITLE: Decreasing Skin Graft Contraction through Topical Wound Bed Preparation with Anti-Inflammatory Agents...number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE October 2015 2 . REPORT TYPE Annual 3. DATES COVERED 15 Sep 2014 – 14...NUMBER 5b. GRANT NUMBER W81XWH-14- 2 -0153 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Dr. Rodney Chan – 5d. PROJECT NUMBER 5e. TASK NUMBER E-Mail

  15. Reverse lateral supramalleolar adipofascial flap and skin grafting for one-stage soft tissue reconstruction of foot and ankle joint.

    PubMed

    Lee, Jae-Hoon; Chung, Duke-Whan

    2010-09-01

    The aim of this report is to present the clinical result and efficacy of reverse lateral supramalleolar adipofascial flap and skin grafting for one stage soft tissue reconstruction of the foot and ankle joints. Reconstruction using a reverse lateral supramalleolar adipofascial flap and skin grafting was performed in eight cases between January 2005 and March 2009. All the subjects were male with a mean age of 53 years. The mean follow-up period was 20 months. The reasons for soft tissue defects were diabetic foot, infected bursitis, open injuries of the foot, and chronic osteomyelitis. The mean size of the flaps was 3.5 (3-4) × 4.5 (4-6) cm. The flaps were elevated in the form of an adipofascial flap and split-thickness skin grafting was performed over the flaps and adjoining raw areas. Flaps survived in all cases. The implantation of the split-thickness skin graft over the flap was also successful in all cases. Neither partial necrosis in the adipofascial flap nor venous congestion was observed. At the last follow-up, there were no limited motions in the ankle and the toe. No cases complained of inconveniences in ambulation or had difficulties in selecting footwear. In cases that require a flap for the exposed bone or tendon of the foot with a small-sized defect, reverse lateral supramalleolar adipofascial flap and skin grafting is considered a useful method as it lowers the morbidity rate of the donor site and reconstructs soft tissues.

  16. Early burn wound excision and skin grafting postburn trauma restores in vivo neutrophil delivery to inflammatory lesions

    SciTech Connect

    Tchervenkov, J.I.; Epstein, M.D.; Silberstein, E.B.; Alexander, J.W.

    1988-12-01

    This study assessed the effect of early vs delayed postburn wound excision and skin grafting on the in vivo neutrophil delivery to a delayed-type hypersensitivity (DTH) reaction and a bacterial skin lesion (BSL). Male Lewis rats were presensitized to keyhole-limpet hemocyanin. Group 1 comprised sham controls. Groups 2 through 4 were given a 30% 3 degrees scald burn, but the burn wounds were excised, and skin was grafted on days 1, 3, and 7, respectively, after the burn. Group 5 comprised burn controls. Twelve days after burn trauma, all rats were injected at different intervals (during a 24-hour period) with a trio of intradermal injections of keyhole-limpet hemocyanin, Staphylococcus aureus 502A, and saline at different sites. In vivo neutrophil delivery to these dermal lesions was determined by injecting indium in 111 oxyquinoline-labeled neutrophils isolated from similarly treated groups of rats. Neutrophil delivery to DTH and BSL lesions was restored to normal by excision and skin grafting of the burn wound one day after burn trauma. Waiting three days after burn trauma to excise and skin graft the wound partially, but not completely, restored the in vivo neutrophil delivery to DTH and BSL lesions. Waiting one week to excise and skin graft a burn wound resulted in no improvement in neutrophil delivery to DTH and BSL dermal lesions. It was concluded that burn wound excision and skin grafting immediately after burn trauma restored in vivo neutrophil delivery to a BSL and DTH dermal lesion. This may, in part, explain the beneficial effect of early aggressive burn wound debridement in patients with burn injuries.

  17. Implant-supported fixed restoration of post-traumatic mandibular defect accompanied with skin grafting: A clinical report

    PubMed Central

    Noh, Kwantae; Choi, Woo-Jin

    2013-01-01

    Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology. PMID:23508120

  18. Evaluation of Human Amniotic Membrane as a Wound Dressing for Split-Thickness Skin-Graft Donor Sites

    PubMed Central

    Loeffelbein, Denys J.; Rohleder, Nils H.; Eddicks, Matthias; Baumann, Claudia M.; Stoeckelhuber, Mechthild; Wolff, Klaus-D.; Drecoll, Enken; Steinstraesser, Lars; Hennerbichler, Simone; Kesting, Marco R.

    2014-01-01

    Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative. PMID:25003117

  19. Differential cytokine expression in skin graft healing in inducible nitric oxide synthase knockout mice.

    PubMed

    Most, D; Efron, D T; Shi, H P; Tantry, U S; Barbul, A

    2001-10-01

    Inducible nitric oxide synthase (iNOS) and its product, nitric oxide, have been shown to play important roles in wound biology. The present study was performed to investigate the role of iNOS in modulating the cytokine cascade during the complex process of skin graft wound healing.Fifteen iNOS-knockout mice and 15 wild-type C57BL/6J mice were subjected to autogenous 1-cm2 intrascapular full-thickness skin grafts. Three animals in each group were killed on postoperative days 3, 5, 7, 10, and 14. Specimens were then analyzed using nonisotopic in situ hybridization versus mRNA of tumor growth factor-beta1, vascular endothelial growth factor, iNOS, endothelial nitric oxide synthase (eNOS), tumor necrosis factor-alpha, and basic fibroblast growth factor, as well as positive and negative control probes. Positive cells in both grafts and wound beds were counted using a Leica microgrid. Scar thickness was measured with a Leica micrometer. Data were analyzed using the unpaired Student's t test. Expression of iNOS was 2- to 4-fold higher in knockout mice than in wild-type mice on postoperative days 5, 7, and 14. Expression of eNOS was 2- to 2.5-fold higher in knockout mice than in wild-type mice on postoperative days 5 and 7. Tumor necrosis factor-alpha expression was 2- to 7-fold higher in knockout mice than in wild-type mice on all postoperative days. In contrast, expression levels of angiogenic/fibrogenic cytokines (vascular endothelial growth factor, basis fibroblast growth factor, and tumor growth factor-beta1) were 2.5- to 4-fold higher in wild-type mice than in knockout mice. Scars were 1.5- to 2.5-fold thicker in knockout mice than in wild-type mice at all time points. All of the above results represent statistically significant differences (p < 0.05). Significantly different patterns of cytokine expression were seen in knockout and wild-type mice. Although the scar layer was thicker in knockout mice, it showed much greater infiltration with inflammatory cells. These

  20. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft

    PubMed Central

    Sonker, Atul; Dubey, Anju; Bhatnagar, Ankur; Chaudhary, Rajendra

    2015-01-01

    Background and objectives: Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Materials and Methods: Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at −80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. Results: There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. Conclusion: This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality. PMID:26420935

  1. Adoptive transfer of unresponsiveness to allogeneic skin grafts with hepatic gamma delta + T cells.

    PubMed Central

    Gorczynski, R M

    1994-01-01

    C3H/HEJ mice injected with irradiated multiple minor incompatible B10.BR lymphoid cells via the portal vein showed delayed rejection of subsequent B10.BR skin grafts. Similar delayed rejection was produced by lateral tail vein injection of B10.BR hepatic mononuclear cells or H-2k cells pulsed in vivo with B10 minor histocompatibility antigens. Inhibition of C3H anti-B10.BR immunity in vivo (assessed by delayed graft rejection) and in vitro (assessed by B10.BR-induced lymphokine production) can be transferred by radioresistant, plastic-adherent F4/80+33D1-CD4-CD8-alpha beta TcR-gamma delta TcR- mononuclear hepatic cells from (C3H/HEJ x C3H.SW)F1 mice injected 36 hr earlier with 100 x 10(6) irradiated spleen cells. By 10 days post-injection, cells transferring delayed rejection are radiosensitive, plastic non-adherent, F4/80-33D1-CD4-CD8- alpha beta Tc+- gamma delta TcR+ cells. Injection of interleukin-2 (IL-2) in vivo into mice receiving pretreatment with B10.BR cells via the portal vein, or adoptive transfer into such mice of immune anti-B10.BR lymphoid cells, abolished delayed rejection on subsequent skin grafting. Delayed rejection or modulation of lymphokine production was associated in all cases with suppression of IL-2 production and preferential retention of IL-4 production from cells stimulated in vitro. PMID:8132216

  2. Comparisons between conventional optical imaging and parametric indirect microscopic imaging on human skin detection

    NASA Astrophysics Data System (ADS)

    Liu, Guoyan; Gao, Kun; Liu, Xuefeng; Ni, Guoqiang

    2016-10-01

    We report a new method, polarization parameters indirect microscopic imaging with a high transmission infrared light source, to detect the morphology and component of human skin. A conventional reflection microscopic system is used as the basic optical system, into which a polarization-modulation mechanics is inserted and a high transmission infrared light source is utilized. The near-field structural characteristics of human skin can be delivered by infrared waves and material coupling. According to coupling and conduction physics, changes of the optical wave parameters can be calculated and curves of the intensity of the image can be obtained. By analyzing the near-field polarization parameters in nanoscale, we can finally get the inversion images of human skin. Compared with the conventional direct optical microscope, this method can break diffraction limit and achieve a super resolution of sub-100nm. Besides, the method is more sensitive to the edges, wrinkles, boundaries and impurity particles.

  3. Negative Pressure Wound Therapy Applied Before and After Split-Thickness Skin Graft Helps Healing of Fournier Gangrene

    PubMed Central

    Ye, Junna; Xie, Ting; Wu, Minjie; Ni, Pengwen; Lu, Shuliang

    2015-01-01

    Abstract Fournier gangrene is a rare but highly infectious disease characterized by fulminant necrotizing fasciitis involving the genital and perineal regions. Negative pressure wound therapy (NPWT; KCI USA Inc, San Antonio, TX) is a widely adopted technique in many clinical settings. Nevertheless, its application and effect in the treatment of Fournier gangrene are unclear. A 47-year-old male patient was admitted with an anal abscess followed by a spread of the infection to the scrotum, which was caused by Pseudomonas aeruginosa. NPWT was applied on the surface of the scrotal area and continued for 10 days. A split-thickness skin graft from the scalp was then grafted to the wound, after which, NPWT utilizing gauze sealed with an occlusive dressing and connected to a wall suction was employed for 7 days to secure the skin graft. At discharge, the percentage of the grafted skin alive on the scrotum was 98%. The wound beside the anus had decreased to 4 × 0.5 cm with a depth of 1 cm. Follow-up at the clinic 1 month later showed that both wounds had healed. The patient did not complain of any pain or bleeding, and was satisfied with the outcome. NPWT before and after split-thickness skin grafts is safe, well tolerated, and efficacious in the treatment of Fournier gangrene. PMID:25654376

  4. Facial resurfacing with a monoblock full-thickness skin graft after multiple malignant melanomas excision in xeroderma pigmentosum.

    PubMed

    Ozmen, Selahattin; Uygur, Safak; Eryilmaz, Tolga; Ak, Betul

    2012-09-01

    Xeroderma pigmentosum is an autosomal recessive disease, characterized by vulnerability of the skin to solar radiation. Increase in sunlight-induced cancer is a direct consequence of an increase in mutated cells of the skin of patients with xeroderma pigmentosum. There is no specific technique for facial resurfacing in patients with xeroderma pigmentosum. In this article, a patient with xeroderma pigmentosum with multiple malignant melanomas on her face and radical excision of total facial skin followed by facial resurfacing with monoblock full-thickness skin graft from the abdomen is presented.

  5. Use of 1540nm fractionated erbium:glass laser for split skin graft resurfacing: a case study.

    PubMed

    Narinesingh, S; Lewis, S; Nayak, B S

    2013-09-01

    The field of laser skin resurfacing has evolved rapidly over the past two decades from ablative lasers, to nonablative systems using near-infrared, intense-pulsed light and radio-frequency systems, and most recently fractional laser resurfacing. Although fractional thermolysis is still in its infancy, its efficacy in in the treatment of skin disorders have been clearly demonstrated. Here we present a case report on the safety and efficacy of a 1540nm erbium:glass laser in the treatment of the waffle pattern of a meshed skin graft in a 38-year-old patient with type V skin in the Caribbean.

  6. Allograft tolerance in pigs after fractionated lymphoid irradiation. II. Kidney graft after conventional total lymphoid irradiation and bone marrow cell grafting

    SciTech Connect

    Fradelizi, D.; Mahouy, G.; de Riberolles, C.; Lecompte, Y.; Alhomme, P.; Douard, M.C.; Chotin, G.; Martelli, H.; Daburon, F.; Vaiman, M.

    1981-05-01

    Experiments with pigs have been performed in order to establish bone marrow chimerism and kidney graft tolerance between SLA genotyped semi-incompatible animals. Recipients were conditioned by means of conventional fractionated total lymphoid irradiation (TLI) delivered by a vertical cobalt source. The principal lymphoid regions of the pig, including thymus and spleen, were submitted to irradiation. Two protocols were tested: A = 250 cGy four times a week x 13 times (TLI) (two animals) and B = 350 cGy three times a week x 8 times (TLI) (four animals). Bone marrow cells were injected 24 h after the last irradiation. One day later, bilateral nephrectomy and the graft of one kidney from the bone marrow cell donor were performed simultaneously. Results convinced us that application of the TLI protocol to humans is not yet practicable and that further experimental work is needed.

  7. Transplantation of skin grafts and organs infected with Toxoplasma gondii as a source of toxoplasmosis in immunocompromised mice.

    PubMed

    Belal, Usama Salah; Norose, Kazumi; Mohamed, Rabie Mohamed; Naoi, Koji; Yano, Akihiko

    2011-01-01

    The possibility of Toxoplasma gondii infection resulting from transplantation of a skin graft and various organs has been investigated. The parasite was detected in very low numbers in all organs examined in wild-type (WT) BALB/c (B/c) mice that received skin grafts from infected interferon gamma knockout (GKO) B/c mice both with and without sulfamethoxazole treatment; all recipient mice survived. In contrast, transplantation of skin grafts from untreated infected WT B/c mice to naïve GKO B/c mice led to the death of all recipients within 20 days post-transplantation; T. gondii was found to be disseminated in all organs examined. Similar results were obtained after transplantation of skin from untreated and treated GKO B/c mice to naïve GKO B/c mice, whereas the recipient GKO B/c mice died within 10 days after intraperitoneal transplantation of lung, heart, brain or small intestine from infected untreated GKO B/c mice. These results indicate that skin grafts as well as various organs infected with T. gondii can be sources of infection in immunocompromised hosts. Toxoplasmosis should therefore be taken into consideration during organ transplantation to immunocompromised hosts.

  8. Dermal penetration and systemic distribution of sup 14 C-labeled vitamin E human skin grafted athymic nude mice

    SciTech Connect

    Klain, G.J.

    1989-03-13

    In vivo percutaneous penetration and tissue distribution of 14C-labeled vitamin E applied to human skin grafted onto athymic nude mice were determined. At 1 hr, mouse skin contained the highest level of radioactivity, followed by the muscle, blood, liver, lung, adipose tissue, spleen, kidney, brain, heart, and eyes. A linear increase with time in tissue radioactivity was observed throughout the 24 hr experimental period. At 4 and 24 hrs skin grafts were highly radioactive. At 4 hrs the epidermis and the upper portion of the dermis contained more radioactivity than the remaining portion of the dermis. In contrast, at 24 hrs the highest level of radioactivity was detected in the lower dermis. No radioactivity was detected in expired air while 0.2% of the dose was found in the urine. The data show that vitamin E does penetrate skin and that the dermis acts as a barrier or reservoir for this highly lipophilic compound.

  9. Estimates of ozone depletion and skin cancer incidence to examine the Vienna Convention achievements

    NASA Astrophysics Data System (ADS)

    Slaper, Harry; Velders, Guus J. M.; Daniel, John S.; de Gruijl, Frank R.; van der Leun, Jan C.

    1996-11-01

    DEPLETION of the ozone layer has been observed on a global scale1, and is probably related to halocarbon emissions. Ozone depletion increases the biologically harmful solar ultraviolet radiation reaching the surface of the Earth, which leads to a variety of adverse effects, including an increase in the incidence of skin cancer. The 1985 Vienna Convention provided the framework for international restrictions on the production of ozone-depleting substances. The consequences of such restrictions have not yet been assessed in terms of effects avoided. Here we present a new method of estimating future excess skin cancer risks which is used to compare effects of a 'no restrictions' scenario with two restrictive scenarios specified under the Vienna Convention: the Montreal Protocol, and the much stricter Copenhagen Amendments. The no-restrictions and Montreal Protocol scenarios produce a runaway increase in skin cancer incidence, up to a quadrupling and doubling, respectively, by the year 2100. The Copenhagen Amendments scenario leads to an ozone minimum around the year 2000, and a peak relative increase in incidence of skin cancer of almost 10% occurring 60 years later. These results demonstrate the importance of the international measures agreed upon under the Vienna Convention.

  10. Mesh skin graft and digital pad transfer to reconstruct the weight-bearing surface in a dog

    PubMed Central

    Rahal, Sheila C.; Mortari, Ana C.; Morishin Filho, Milton M.

    2007-01-01

    A 2-month-old dog was presented with injuries involving both hind paws. Only the 5th digit and its digital pad were present on the right paw. Following a full-thickness skin graft, the 5th digital pad was transferred distal to the metatarsal bones. The transferred pad permitted weight-bearing on the limb. PMID:18189047

  11. A continuous infusion of a minor histocompatibility antigen-immunodominant peptide induces a delay of male skin graft rejection.

    PubMed

    Sireci, Guido; Barera, Annalisa; Macaluso, Pasquale; Di Sano, Caterina; Bonanno, Cesira T; Pio La Manna, Marco; Di Liberto, Diana; Dieli, Francesco; Salerno, Alfredo

    2009-01-01

    We previously reported that an inhibition of antigen-specific Interferon-gamma release and cytotoxicity occurs after a continuous infusion of an HY immunodominant peptide although this treatment is not able to cause a significant delay of male skin grafts rejection. In vivo administration of high doses of an HY peptide, through mini-osmotic pumps, in naïve female mice was used to study the effects on the male skin grafts rejection. A continuous infusion of 1mg of an HY peptide induces a significant delay of male skin graft rejection. In vitro HY-specific Interferon-gamma release was inhibited adding peptide-specific suppressor cells: the ability to inhibit Interferon-gamma release was evident when two HY peptides were present on the same dendritic cells indicating that the suppressor cells exert "linked-suppression". The phenotype of the suppressor cells is CD8(+)CD28(-) and these cells express more CD62 ligand and FOXP3 than controls. Suppressor cells were able to cause a significant delay of rejection of male skin grafts when injected in naive female mice. The inhibitory effects of these suppressor cells seem to be due to the impairment of antigen presentation; down-regulation of B7 molecules on dendritic cells occurred. Taken all together, our data demonstrate that a continuous infusion of an immunodominant HY peptide induces a T CD8 suppressor subset able to inhibit immune responses to male tissues and cells.

  12. The role of "indirect" recognition in initiating rejection of skin grafts from major histocompatibility complex class II-deficient mice.

    PubMed Central

    Auchincloss, H; Lee, R; Shea, S; Markowitz, J S; Grusby, M J; Glimcher, L H

    1993-01-01

    In vitro studies have revealed several pathways by which T cells can respond to alloantigens, including CD4+ direct responses to allogeneic class II antigens, CD8+ direct responses to allogeneic class I antigens, and CD4+ "indirect" responses to peptides of alloantigens presented in association with responder class II molecules. In vivo studies of skin graft rejection, however, have so far provided clear evidence for the contribution of only the two direct pathways and not for indirect recognition. We have used major histocompatibility complex class II-deficient mice as donors to test the role of indirect recognition in rejection of skin grafts. Class II-deficient skin was always rejected without delay by normal recipients. Removal of recipient CD8+ cells (to leave the animals dependent on CD4+ function) or depletion of recipient CD4+ cells revealed that CD4+ cells were usually involved and sometimes absolutely required in this rapid rejection. Since the donor grafts lacked class II antigens, the CD4+ cells must have recognized donor antigens presented in association with recipient class II molecules. These results therefore indicate that indirect recognition can initiate rapid skin graft rejection. PMID:8475083

  13. Coverage of Deep Cutaneous Wounds Using Dermal Template in Combination with Negative-pressure Therapy and Subsequent Skin Graft

    PubMed Central

    Chang, Alexandre A.; Lobato, Rodolfo C.; Nakamoto, Hugo A.; Tuma, Paulo; Ferreira, Marcus C.

    2014-01-01

    Background: We consider the use of dermal matrix associated with a skin graft to cover deep wounds in the extremities when tendon and bone are exposed. The objective of this article was to evaluate the efficacy of covering acute deep wounds through the use of a dermal regeneration template (Integra) associated with vacuum therapy and subsequent skin grafting. Methods: Twenty patients were evaluated prospectively. All of them had acute (up to 3 weeks) deep wounds in the limbs. We consider a deep wound to be that with exposure of bone, tendon, or joint. Results: The average area of integration of the dermal regeneration template was 86.5%. There was complete integration of the skin graft over the dermal matrix in 14 patients (70%), partial integration in 5 patients (25%), and total loss in 1 case (5%). The wound has completely closed in 95% of patients. Conclusions: The use of Integra dermal template associated with negative-pressure therapy and skin grafting showed an adequate rate of resolution of deep wounds with low morbidity. PMID:25289363

  14. Using a castor oil-balsam of Peru-trypsin ointment to assist in healing skin graft donor sites.

    PubMed

    Carson, Stanley N; Wiggins, Christopher; Overall, Karen; Herbert, Jackie

    2003-06-01

    Skin graft donor sites are partial-thickness wounds that are commonly managed with gauze-type dressings. As such, they often cause more pain and difficulty in healing than the graft-recipient site. A retrospective study was conducted to ascertain the effects of using a castor oil-balsam of Peru-trypsin containing ointment on skin graft donor sites in 36 consecutive patients (16 female, 20 male). All donor sites were epithelialized after 11 days (range 6 to 11 days, mean 8 days) and no wound complications were observed. Given these healing results and product ease of use, this particular formulation has become the facilities' current treatment of choice and further study is indicated and warranted.

  15. Management of adult concealed penis using a meshed, split-thickness skin graft

    PubMed Central

    Boonjindasup, Aaron; Pinsky, Michael; Stewart, Carrie; Trost, Landon; Chaffin, Abigail; Jansen, David; Hellstrom, Wayne

    2016-01-01

    Introduction Concealed penis (CP) is a rare problem faced by urologists and plastic surgeons. CP occurs secondary to trauma, obesity, or infection. Surgical treatment is individualized and based on patient and provider variables. We aim to review our recent experience using meshed split-thickness skin grafting (STSG) for CP management. Methods A retrospective review was performed on patients who underwent STSG for CP at our institution. Records were reviewed for demographic, operative, and postoperative variables. Preoperative and postoperative photos were obtained to monitor cosmetic results. Results Eleven patients underwent CP release with meshed STSG placement. All cases showed improved functional phallic length and good cosmetic results, regardless of etiology. Conclusions STSG is a viable option for penile coverage for management of this difficult-to-treat CP population. This primary or salvage modality offers excellent cosmetic results and may be used following prior reconstructive attempts. PMID:28096930

  16. Transplanted bone marrow-derived circulating PDGFRα+ cells restore type VII collagen in recessive dystrophic epidermolysis bullosa mouse skin graft.

    PubMed

    Iinuma, Shin; Aikawa, Eriko; Tamai, Katsuto; Fujita, Ryo; Kikuchi, Yasushi; Chino, Takenao; Kikuta, Junichi; McGrath, John A; Uitto, Jouni; Ishii, Masaru; Iizuka, Hajime; Kaneda, Yasufumi

    2015-02-15

    Recessive dystrophic epidermolysis bullosa (RDEB) is an intractable genetic blistering skin disease in which the epithelial structure easily separates from the underlying dermis because of genetic loss of functional type VII collagen (Col7) in the cutaneous basement membrane zone. Recent studies have demonstrated that allogeneic bone marrow transplantation (BMT) ameliorates the skin blistering phenotype of RDEB patients by restoring Col7. However, the exact therapeutic mechanism of BMT in RDEB remains unclear. In this study, we investigated the roles of transplanted bone marrow-derived circulating mesenchymal cells in RDEB (Col7-null) mice. In wild-type mice with prior GFP-BMT after lethal irradiation, lineage-negative/GFP-positive (Lin(-)/GFP(+)) cells, including platelet-derived growth factor receptor α-positive (PDGFRα(+)) mesenchymal cells, specifically migrated to skin grafts from RDEB mice and expressed Col7. Vascular endothelial cells and follicular keratinocytes in the deep dermis of the skin grafts expressed SDF-1α, and the bone marrow-derived PDGFRα(+) cells expressed CXCR4 on their surface. Systemic administration of the CXCR4 antagonist AMD3100 markedly decreased the migration of bone marrow-derived PDGFRα(+) cells into the skin graft, resulting in persistent epidermal detachment with massive necrosis and inflammation in the skin graft of RDEB mice; without AMD3100 administration, Col7 was significantly supplemented to ameliorate the pathogenic blistering phenotype. Collectively, these data suggest that the SDF1α/CXCR4 signaling axis induces transplanted bone marrow-derived circulating PDGFRα(+) mesenchymal cells to migrate and supply functional Col7 to regenerate RDEB skin.

  17. Surface functionalization of bioactive glasses with natural molecules of biological significance, part II: Grafting of polyphenols extracted from grape skin

    NASA Astrophysics Data System (ADS)

    Zhang, Xin; Ferraris, Sara; Prenesti, Enrico; Verné, Enrica

    2013-12-01

    Polyphenols, as one of the most important family of phytochemicals protective substances from grape fruit, possess various biological activities and health-promoting benefits, for example: inhibition of some degenerative diseases, cardiovascular diseases and certain types of cancers, reduction of plasma oxidative stress and slowing aging. The combination of polyphenols and biomaterials may have good potential to reach good bioavailability and controlled release, as well as to give biological signaling properties to the biomaterial surfaces. In this research, conventional solvent extraction was developed for obtaining polyphenols from dry grape skins. The Folin&Ciocalteu method was used to determine the amount of total polyphenols in the extracts. Surface functionalization of two bioactive glasses (SCNA and CEL2) was performed by grafting the extracted polyphenols on their surfaces. The effectiveness of the functionalization was tested by UV spectroscopy, which analyzes the amount of polyphenols in the uptake solution (before and after functionalization) and on solid samples, and XPS, which analyzes the presence of phenols on the material surface.

  18. Surgical Methods for Full-Thickness Skin Grafts to Induce Alopecia Areata in C3H/HeJ Mice

    PubMed Central

    Silva, Kathleen A; Sundberg, John P

    2013-01-01

    Alopecia areata is a cell-mediated autoimmune disease of humans and many domestic and laboratory animal species. C3H/HeJ inbred mice spontaneously develop alopecia areata at a low frequency (approximately 20% by 12 mo of age). Transferring full-thickness skin grafts from affected, older mice to young mice of the same strain reliably reproduces alopecia areata, thus enabling investigators to study disease pathogenesis or intervention with a variety of therapeutic approaches. We here describe in detail how to perform full-thickness skin grafts and the follow-up procedures necessary to consistently generate mice with alopecia areata. These engrafted mice can be used to study the pathogenesis of cell-mediated autoimmune disease and for drug-efficacy trials. This standard protocol can be used for many other purposes when studying abnormal skin phenotypes in laboratory mice. PMID:24210015

  19. Differential immune response of congenic mice to ultraviolet-treated major histocompatibility complex class II-incompatible skin grafts

    SciTech Connect

    Vermeer, B.J.; Santerse, B.; Van De Kerckhove, B.A.; Schothorst, A.A.; Claas, F.H.

    1988-03-01

    The influence of ultraviolet (UVB) irradiation on the survival of H-2 class II-disparate skin grafts was studied in congenic mouse strains. Isolated skin was UVB irradiated in vitro at a dose of 40 mJ/cm/sup 2/ from both sides to remove Ia immunogenicity. Immediately after irradiation the skin was transplanted onto the flank of allogeneic mice. When B10.AQR grafts were transplanted onto B10.T(6R) recipients, a significant prolongation of the survival time was observed, while 50% of the UVB-treated grafts were not rejected at all. However, in the opposite direction--i.e., B10.T(6R) grafts onto B10.AQR recipients, no significant prolongation of the survival was observed. To test whether this effect was due to a difference in susceptibility of the donor skin to UVB irradiation or to a different immune response in the recipients, (B10.T(6R) x B10.AQR) grafts were transplanted onto the parent strains. Similar results were obtained, in that UVB-treated grafts did not show a prolonged survival in B10.AQR recipients, whereas a significant prolongation (50% of the grafts survived more than 100 days) was observed in B10.T(6R) recipients. UVB-treated (B10.T(6R) x B10.AQR)F1 grafts were also transplanted onto (B10.T(6R) x C57B1/10)F1, (B10.AQR x C57B1/10)F1, (B10.T(6R) x Balb/c)F1 and (B10.AQR x Balb/c)F1 recipients--but in none of these combinations was a prolonged survival time observed. These data suggest that, in contrast to all in vitro experiments, the abrogation of the immune response by UVB treatment of the stimulator cells is, in vivo, not a general phenomenon. The genetic constitution of the responder mice seems to play an important role in determining whether or not an immune response takes place.

  20. [Previously expanded full-thickness skin grafts. Technical principles. Indications in the repair of sequelae of burns. Apropos of 22 cases].

    PubMed

    Foyatier, J L; Gounot, N; Comparin, J P; Delay, E; Masson, C L; Latarjet, J

    1995-06-01

    Burns raise difficult repair problems. Previously expanded full-thickness skin grafts represent a good solution in many situations. Based on their experience of 22 cases, the authors present a review of the various indications for this technique.

  1. Two Simple Leg Net Devices Designed to Protect Lower-Extremity Skin Grafts and Donor Sites and Prevent Decubitus Ulcer

    DTIC Science & Technology

    2007-02-01

    Two Simple Leg Net Devices Designed to Protect Lower-Extremity Skin Grafts and Donor Sites and Prevent Decubitus Ulcer Travis L. Hedman, MPT, OCS... decubitus . Pressure ulcer is a serious health prob- lem and can cause pain, suffering, disability, and even death.1,2 The cost of treatment for a...single pressure decubitus has been estimated to be as high as $70,000.3 Therefore, prevention is paramount. The prevention of pressure ulcers is far less

  2. Approaches to repigmentation of vitiligo skin: new treatment with ultrasonic abrasion, seed-grafting and psoralen plus ultraviolet A therapy.

    PubMed

    Tsukamoto, Katsuhiko; Osada, Atsushi; Kitamura, Reiko; Ohkouchi, Masayuki; Shimada, Shinji; Takayama, Osami

    2002-10-01

    Vitiligo vulgaris is a common disease throughout the world although its pathogenesis is not yet known. The most frequent treatment used for vitiligo is PUVA (psoralen plus ultraviolet A) and topical steroids but against stable refractory vitiligo, various other surgical techniques have been developed such as autografting, epidermal grafting with suction blisters, epithelial sheet grafting, and transplantation of cultured melanocytes. We have discovered a new method using ultrasonic abrasion, seed-grafting and PUVA therapy. The ultrasonic surgical aspirator abrades only the epidermis of recipient sites. This easily and safely removes only the epidermis, even on spotty lesions or intricate regions which are difficult to remove using a conventional motor-driven grinder or liquid nitrogen. Epidermal seed-grafting can cover more area than sheet-grafting, and subsequent PUVA treatment can enlarge the area of pigmentation with coalescence of adjacent grafts. In this article, we provide a general overview of the current surgical therapies including our method for treating stable refractory vitiligo.

  3. Hair growth in human split-thickness skin grafts transplanted onto nude rats: the role of cyclosporin.

    PubMed

    Gilhar, A; Etzioni, A; Krueger, G G

    1990-01-01

    To date, there have been no descriptions of hair growth following transplantation of human split-thickness skin grafts (HSTSG) to congenitally athymic (nude) mice or rats. Recently, we noted hair growth in HSTSG from scalp skin (HSTSG-SS) transplanted onto rats treated with ciclosporin (CS). By definition, HSTSG-SS of 0.4 mm had all the anagen hairs cut from the papillae. Two months after engraftment, there was histological evidence of the formation of new papillae. Density of hair correlated with thickness of HSTSG, i.e. there were more hairs/square centimeter in HSTSG-SS of 1 mm thickness than in those of 0.4 mm thickness. New hairs appeared on an average of 1 cm2/week in HSTSG-SS that were 1 mm thick; by 10 weeks, the mean density was 7.9 hairs/cm2. In the thinner grafts, the density was 3.5 hairs/cm2 (p less than 0.025). The rate of growth in the thicker grafts ranged from 0 to 0.25 mm/day, with an average of 0.1 mm/day. At 10 weeks after grafting, the hairs had a mean length of 4.4 mm in the thicker and 1.7 mm in the thinner grafts (p less than 0.001). The average diameter of the hair shafts was 0.05 mm at the various times tested. These observations identify a previously unrecognized process of hair growth and present an in vivo model to study human hair growth process, including the role of CS in hair growth.

  4. Comparison of the Application of Allogeneic Fibroblast and Autologous Mesh Grafting With the Conventional Method in the Treatment of Third-Degree Burns.

    PubMed

    Moravvej, Hamideh; Hormozi, Abdoljalil Kalantar; Hosseini, Seyed Nejat; Sorouri, Rahim; Mozafari, Naser; Ghazisaidi, Mohammad Reza; Rad, Mahnaz Mahmoudi; Moghimi, Mohammad Hossein; Sadeghi, Shahin Mohammad; Mirzadeh, Hamid

    2016-01-01

    Wound healing is a multipart process involving different cell types and growth factors. Third-degree burns are usually treated by early excision and skin grafting. Tissue engineering has been developed in this field in response to limitations associated with autografts. Allogeneic fibroblasts on meshed split thickness skin grafts (STSGs) are known to have useful properties in wound healing and can be used to construct a new model of living skin substitute. Fourteen patients were chosen from June 2009 until December 2010 as the sample for this study. After debridement and wound excision, meshed STSG was used to cover the entire wound. Alloskin (allofibroblasts cultured on a combination of silicone and glycosaminoglycan) was applied on one side and petroleum jelly-impregnated gauze (Iran Polymer and Petrochemical Institute) was applied on the other. The healing time, scar formation, and pigmentation score were assessed for the patients. All analyses were undertaken with SPSS 17 software. Alloskin demonstrated good properties compared to petroleum jelly-impregnated gauze. The average healing time and hypertrophic scar formation were significantly different between the two groups. In addition, the skin pigmentation score in the alloskin group was closer to normal. Alloskin grafting, including fibroblasts on meshed STSG, may be a useful method to reduce healing time and scar size and may require less autologous STSG in extensive burns where a high percentage of skin is burned and there is a lack of available donor sites.

  5. Muscle transposition and skin grafting for salvage of below-knee amputation level after bilateral lower extremity thermal injury.

    PubMed

    Açikel, C; Peker, F; Akmaz, I; Ulkür, E

    2001-12-01

    Thermal injury to the lower extremity sometimes necessitates amputation around the knee joint. Knee function is so critical to prosthetic rehabilitation that every attempt should be made to salvage the knee joint. This report presents an unusual case of bilateral lower extremity flame burn requiring amputations. While the distal two-thirds of the legs and both feet were totally necrotic, the thermal damage was limited to skin and subcutaneous tissue sparing muscle and bone in the proximal one-third of the legs and posterior thighs. The below-knee amputation level was salvaged by muscle transposition over the anterior tibia and resurfacing of muscle cuffs with thick split-thickness skin grafts. The post-operative period was uneventful. Amputation stumps tolerated the below-knee prosthesis well and the patient attained independent functional prosthetic ambulation at the post-operative fourth month. It is known from the reconstruction of the plantar foot that skin-grafted muscle tissue tolerates weight bearing and shearing forces well. This principle can also be used for salvage aspects of the below-knee amputation level.

  6. The role of full-thickness skin grafting and steroid injection in the treatment of auricular keloids.

    PubMed

    Brown, Nefertiti A; Ortega, F Raymond

    2010-05-01

    Keloids are a response to wound healing that occurs due to hyperproliferation of dermal collagen in response to skin injury (Olabanji et al, Surg Pract. 2005;9:2-7). Multiple modalities have been described in the literature to target these lesions, but treatment and prevention remain a challenge because of the high rate of recurrence (Brissett and Sherris, Facial Plast Surg. 2001;17:263-272; Kelly, Dermatol Ther. 2004;17:212-218; Robles and Berg, Clin Dermatol. 2007;25:26-32; Porter, Otolaryngol Clin North Am. 2002;35:207-220, viii). We studied the rate of recurrence of auricular keloids through a technique previously described in the literature (Converse and Stallings, Plast Reconstr Surg. 1972;49:461-463), but over a series of patients. Keloids were treated with total excision in combination with coverage of the resulting defect with a full-thickness skin graft and intradermal injection of triamcinolone acetonide solution at the periphery of the donor and recipient sites. From April 2006 to February 2007, 10 patients with auricular keloids were done using this technique, and during an 11-month follow-up no recurrence was observed. These results support that full-thickness skin grafts can be used to address keloid lesions without recurrence.

  7. Reconstruction of anterior auricular conchal defect after malignancy excision: revolving-door flap versus full-thickness skin graft.

    PubMed

    Dessy, Luca Andrea; Figus, Andrea; Fioramonti, Paolo; Mazzocchi, Marco; Scuderi, Nicolò

    2010-05-01

    Skin tumours of the anterior auricular concha are not uncommon. Wider excision and immediate reconstruction are required to reduce the risks of recurrence of the disease, cartilage infection and external ear distortion. Many surgical methods have been described for reconstruction of conchal defects. Post-auricular island flaps, such as the revolving-door (RD) flap, and full-thickness skin grafts (FTSGs) are the most-performed procedures. Although the RD flap has been fully described, it is not widely accepted and many surgeons, in their daily practice, prefer to use FTSG. It is a common experience that FTSGs are more subjected to centripetal contraction, decreasing the structural firmness of the conchal cavity and affecting functional and aesthetic outcomes. Furthermore, FTSGs are more prone to delay in wound healing due to the difficult access to this region that hinders adequate tie-over dressings. Between March 2003 and January 2007, 40 patients affected by T1 and T2 non-melanotic skin cancer and T1 melanoma of the anterior conchal surface of the external ear were included in a prospective study and randomly assigned to the RD reconstructed group or to the FTSG reconstructed group to investigate, compare and define advantages and disadvantages of both the techniques. Visual Analogue Scale (VAS) was used to evaluate the overall outcome and the colour and texture match. No flap or skin graft total loss was observed. Six patients (30%) showed partial failure of FTSG. The RD group demonstrated excellent cosmetic outcome, ideal colour match, adequate structure of external ear, projection and shape. Wilcoxon matched-pairs rank-sum test demonstrated statistically significant higher scores for the RD group compared to the FTSG group (p<0.0001). The RD harvesting technique is easy and quicker than the FTSG technique. RD flap should be considered as the first choice for reconstruction of anterior auricular conchal defects following wider excision of skin tumours.

  8. Combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix

    PubMed Central

    Zhang, Xuyin; Han, Tiantian; Ding, Jingxin; Hua, Keqin

    2015-01-01

    Objective: The aim of this study was to introduce a new technique which is combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in patients with congenital atresia of cervix and to evaluate the feasibility and the safety of it. Methods: This is a prospective observational study of 10 patients with congenital atresia of cervix who underwent combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft for cervicovaginal reconstruction from February 2013 to August 2014 in our hospital. All of the surgical procedures were carried out by the same operation team. Patient data were collected including operating time, estimated blood loss, hospital stay post-surgery, complications, total cost, and median vaginal length at 3 month, resumption of menstruation, vaginal stenosis and stricture of the cervix postoperatively. Results: The operative procedure lasted 237±46 (175-380) min. The estimated blood loss was 160±76 (50-300) ml. The hospital stay post-surgery was 12±2 (9-18) days. None of the patients had complications or required a blood transfusion. The mean total cost was $3352±1025. The average vaginal length at 3 month was 8.3±1.1 (8-10) cm. All patients had resumption of menstruation. The patients were followed for a mean of 5±2 (1-10) months. Cervical or vaginal stenosis did not occur in any of the patients. Conclusions: Our experiences of combined laparoscopic and vaginal cervicovaginal reconstruction using split thickness skin graft in10 patients with congenital atresia of cervix were positive, with successful results and without complications, and cervical or vaginal stenosis. PMID:26309703

  9. Chronic transplantation immunity in newts: temperature susceptibility of an effector phase in allo-skin graft rejection.

    PubMed

    Kinefuchi, Kenjiroh; Kushida, Yoshihiro; Johnouchi, Masato; Shimizu, Yuiko; Ohneda, Hikaru; Fujii, Masato; Hosono, Masamichi

    2011-07-01

    Urodele amphibians are unique due to their greatly reduced immune responsiveness compared to bony fishes, which show acute immune responsiveness. In newts, the mean survival time of allogenic skin grafts in the transplantation immunity was 48.8 ± 8.3 days at 25°C, suggesting that it occurs in a chronic manner. The graft rejection process was categorized into three stages: a latent stage with frequent blood circulation, or the immune induction phase; a vascular stoppage stage with dominant infiltrating cells of T cells; and a rejection stage showing the change of the dominant cells to monocytes/macrophages, probably as effector cells, tetntatively referred to as the immune effector phase. The immune induction phase is susceptible to the cyclophosphamide (CY) mitosis inhibitor, but not to a temperature shift from 18 to 27°C, while the immune effector phase is susceptible to temperature shifts, but not CY-treatment, although the temperature shift failed to shorten the graft survival time to less than 25 days, which nearly equals that of the secondary set of grafts where the lack of complete blood circulation is remarkable and graft rejection is resistant to CY-treatment. In contrast, a very low temperature (5-10°C) completely prevented effector generation in newts; in frogs, however, it is reported that such low temperatures did not prevent the generation of effectors. Taken together, these data suggest that chronic responses in newts are due to effector cells other than cytotoxic T cells; possible effector cells are discussed.

  10. Hemicellulose dressing versus rayon dressing in the re-epithelialization of split-thickness skin graft donor sites: a multicenter study.

    PubMed

    Ferreira, Lydia M; Blanes, Leila; Gragnani, Alfredo; Veiga, Daniela F; Veiga, Frederico P; Nery, Gilka B; Rocha, Gustavo Henrique H R; Gomes, Heitor C; Rocha, Mario G; Okamoto, Regina

    2009-08-01

    The aim of this study was to compare the effectiveness of a hemicellulose dressing with that of rayon dressing in the healing of split-thickness skin graft donor sites. Twenty-eight patients were selected from five different hospitals and randomized into two groups: hemicellulose dressing group and rayon dressing group. All patients underwent split-thickness skin grafting for various reasons, and the skin graft donor site wounds were covered with hemicellulose dressing (n=14) or rayon dressing (n=14). The donor site was assessed on postoperative days 1, 7, 14, 21, and 28 for hyperemia, pruritus, pain, exudate level, and adherence of the wound dressing. At the 60-day follow-up visit, the donor site was assessed again for pruritus and pain. Touch-pressure, thermal, and pain sensibility tests were performed preoperatively and on postoperative day 60 together with the assessment of color and texture of the re-epithelialized area. In all patients, re-epithelialization was completed between 14 and 21 days after surgery. There were no significant differences between the two groups with regard to pain, hyperemia, pruritus, exudate, and final appearance (color and texture) of the skin graft donor site. The rayon dressing provided significantly better adherence than the hemicellulose dressing, and both dressings showed similar results with regard to the parameters evaluated when used in the treatment of split-thickness skin graft donor sites.

  11. A Simple Strategy in Avulsion Flap Injury: Prediction of Flap Viability Using Wood's Lamp Illumination and Resurfacing with a Full-thickness Skin Graft

    PubMed Central

    Lim, Hyoseob; Han, Dae Hee; Lee, Il Jae

    2014-01-01

    Background Extensive degloving injuries of the extremities usually result in necrosis of the flap, necessitating comprehensive skin grafting. Provided there is a sufficient tool to evaluate flap viability, full-thickness skin can be used from a nonviable avulsed flap. We used a Wood's lamp to determine the viability of avulsed flaps in the operation field after intravenous injection of fluorescein dye. Methods We experienced 13 cases during 16 months. Fifteen minutes after the intravenous injection of fluorescein dye, the avulsed skin flaps were examined and non-fluorescent areas were marked under Wood's lamp illumination. The marked area was defatted for full-thickness skin grafting. The fluorescent areas were sutured directly without tension. The non-fluorescent areas were covered by defatted skin. Several days later, there was soft tissue necrosis within the flap area. We measured necrotic area and revised the flap. Results Among all the cases, necrotic area was 21.3% of the total avulsed area. However, if we exclude three cases, one of a carelessly managed patient and two cases of the flaps were inappropriately applied, good results were obtained, with a necrotic area of only 8.4%. Eight patients needed split-thickness skin grafts, and heel pad reconstruction was performed with free flap. Conclusions A full-thickness skin graft from an avulsed flap is a good method for addressing aesthetic concerns without producing donor site morbidity. Fluorescein dye is a useful, simple, and cost-effective tool for evaluating flap viability. Avulsed flap injuries can be managed well with Wood's lamp illumination and a full-thickness skin graft. PMID:24665420

  12. Prolongation of GFP-expressed skin graft after intrathymic injection of GFP positive splenocytes in adult rat

    NASA Astrophysics Data System (ADS)

    Hakamata, Yoji; Igarashi, Yuka; Murakami, Takashi; Kobayashi, Eiji

    2006-02-01

    GFP is a fluorescent product of the jellyfish Aequorea victoria and has been used for a variety of biological experiments as a reporter molecule. While GFP possesses advantages for the non-invasive imaging of viable cells, GFP-positive cells are still considered potential xeno-antigens. It is difficult to observe the precise fate of transplanted cells/organs in recipients without immunological control. The aim of this study was to determine whether intrathymic injection of GFP to recipients and the depletion of peripheral lymphocytes could lead to donor-specific unresponsiveness to GFP-expressed cell. LEW rats were administered intraperitoneally with 0.2 ml of anti-rat lymphocyte serum (ALS) 1 day prior to intrathymic injection of donor splenocytes or adeno-GFP vector. Donor cells and vector were non-invasively inoculated into the thymus under high frequency ultrasound imaging using an echo-guide. All animals subsequently received a 7 days GFP-expressed skin graft from the same genetic background GFP LEW transgenic rat. Skin graft survival was greater in rats injected with donor splenocytes (23.6+/-9.1) compared with adeno-GFP (13.0+/-3.7) or untreated control rats (9.5+/-1.0). Intrathymic injection of donor antigen into adult rats can induce donor-specific unresponsiveness. Donor cells can be observed for a long-term in recipients with normal immunity using this strategy.

  13. Early scrotal approximation after hemiscrotectomy in patients with Fournier’s gangrene prevents scrotal reconstruction with skin graft

    PubMed Central

    Akilov, Oleg; Pompeo, Alexandre; Sehrt, David; Bowlin, Paul; Molina, Wilson R.; Kim, Fernando J.

    2013-01-01

    Objective: We report the outcomes of an early loose closure of the scrotum with a modified U-stitch to minimize use of split thickens skin graft for patients with hemiscrotal tissue loss after surgical debridement. Methods: From January 2006 to August 2011, 28 male patients presented with Fournier’s gangrene, requiring major urological surgical care and scrotal debridement at Denver Health Medical Center. Surgical outcomes were compared between patients receiving a novel U-Stitch approximation and those treated by traditional management. Results: The mean age of the patients was 47.1 ± 10.2 years. In total 8 patients (2.2%) developed bacteremia and 3 (0.1%) had methicillin-resistant staphylococcus aureus (MRSA) infection. There was conversion from the U-Stitch approximation patients to traditional management. U-stitch patients required less hospitalization than patients requiring split-thickness skin graft (STSG) due to loss of >50% of the total scrotal tissue (11 vs. 35 days, p = 0.081). The U-stitch demonstrated non-inferiority to traditional treatment. Conclusion: Immediate loose scrotal wound approximation with efficient surgical debridement for Fournier’s gangrene may prevent testis exposure facilitating local wound treatment, decreasing the length of hospital stay in patients with Fournier’s gangrene involving the scrotum. Future randomized trials may validate these findings. PMID:23914264

  14. Local full-thickness skin graft of the donor arm--a novel technique for the reduction of donor site morbidity in radial forearm free flap.

    PubMed

    Riecke, B; Assaf, A T; Heiland, M; Al-Dam, A; Gröbe, A; Blessmann, M; Wikner, J

    2015-08-01

    A novel technique to reduce donor site morbidity after radial forearm free flap (RFFF) harvest, using a local full-thickness skin graft (FTSG), is described. Thirty consecutive patients undergoing RFFF for head and neck reconstruction were enrolled in a prospective study. Donor site defect closure was performed with spindle-shaped FTSGs excised from the wavelike skin incision made for the vascular pedicle. Both the removal site of the FTSG on the volar forearm and the covered RFFF donor site healed uneventfully in 29 cases, with no impairment of function related to the skin graft. No skin graft failure and no exposure, tenting, or adherence of the flexor tendons occurred. All patients expressed satisfaction with postoperative pain, the functional outcome, and cosmetic appearance. Primary donor site defect closure could be achieved in all cases with the use of a local FTSG. This graft can be gained at the access incision for the vascular pedicle, avoids expansion of the incision for a local flap technique, and does not prolong wound healing, and thus reduces both donor site and graft site morbidity of the RFFF. This technique leads to an inconspicuous aesthetic result with no apparent relevant functional deficits and avoids the need for a second donor site.

  15. Negative pressure wound therapy applied before and after split-thickness skin graft helps healing of Fournier gangrene: a case report (CARE-Compliant).

    PubMed

    Ye, Junna; Xie, Ting; Wu, Minjie; Ni, Pengwen; Lu, Shuliang

    2015-02-01

    Fournier gangrene is a rare but highly infectious disease characterized by fulminant necrotizing fasciitis involving the genital and perineal regions. Negative pressure wound therapy (NPWT; KCI USA Inc, San Antonio, TX) is a widely adopted technique in many clinical settings. Nevertheless, its application and effect in the treatment of Fournier gangrene are unclear. A 47-year-old male patient was admitted with an anal abscess followed by a spread of the infection to the scrotum, which was caused by Pseudomonas aeruginosa. NPWT was applied on the surface of the scrotal area and continued for 10 days. A split-thickness skin graft from the scalp was then grafted to the wound, after which, NPWT utilizing gauze sealed with an occlusive dressing and connected to a wall suction was employed for 7 days to secure the skin graft. At discharge, the percentage of the grafted skin alive on the scrotum was 98%. The wound beside the anus had decreased to 4 × 0.5 cm with a depth of 1 cm. Follow-up at the clinic 1 month later showed that both wounds had healed. The patient did not complain of any pain or bleeding, and was satisfied with the outcome. NPWT before and after split-thickness skin grafts is safe, well tolerated, and efficacious in the treatment of Fournier gangrene.

  16. Expanding the utility of modified vascularized femoral periosteal bone-flaps: An analysis of its form and a comparison with a conventional-bone-graft

    PubMed Central

    Hamada, Yoshitaka; Hibino, Naohito; Kobayashi, Anna

    2014-01-01

    Background Vascularized medial femoral condyle (MFC) corticoperiosteal bone-flap is a well-accepted technique when dealing with tissue defects or infection. Its role in refractory conditions and in the possible use for options concerning modifications of this bone-flap compared to a conventional iliac bone graft (conventional-graft) are rarely discussed. Methods We reviewed 21 consecutive cases concerning alternatives with some modifications of original MFC bone-flap surgery used to treat refractory conditions with bone defects, necrosis, or infection in the extremities. We present our devised approaches for this boneflap, and especially modifications of the grafted bone (including strut bone, perforator to the vastus medialis muscle, and the use of one vascular pedicle for some bone flaps) as well as the combined use of artificial bone as hybrid bone transplantation. We also compared the clinical results of 21 cases that received a conventional-graft. Results and Conclusions Following flap placement, 100% of the nonunion sites healed in an average of 2 months, which was significantly shorter than 5.5 months for the conventional-graft. The results showed the expanding possibility for options with regard to the form and options of this bone-flap as well as the shortening the duration of treatment, especially at the site of an infected distal tibia, insertion of the Achilles tendon on the posterior aspect of calcaneal osteomyelitis, distal end of the clavicle, clavicle or forearm with a bone defect, small bones with refractory conditions, and a femur without implant failure. However, it was not efficient for treating a forearm without bone defect. PMID:25983463

  17. Genetically Modified Porcine Skin Grafts for Treatment of Severe Burn Injuries

    DTIC Science & Technology

    2010-07-01

    and a sloughed epidermis (pg. 22, Appendix 2, s lide 6, yellow arrow), while B267 shows an intact epiderm is and dermis with only a m odest lym...partial viability on day 14, although with considerable inflammation. The graft bed was visible in this sample, confirming that the viable epidermis was in

  18. Effect of boar seminal plasma immunosuppressive factor on NK cell activity and skin graft survival.

    PubMed

    Veselsky, L; Holan, V; Soucek, J; Stanek, R; Hoskova, M

    1992-01-01

    The B 10 strain of mice was used to test the effect of the boar seminal vesicle immunosuppressive factor on the female mouse response to the male-specific transplantation antigen. Influence of this factor on human natural killer (NK) cell activity was also studied. No inhibitory effect of the immunosuppressive factor on graft survival was apparent during a time of more than 200 days, nor did the factor suppress NK cell activity.

  19. Severe post-burn neck contracture release and skin graft harvest using tumescent local anaesthesia as the sole anesthetic technique.

    PubMed

    Prasad, Mukesh Kumar; Puneet, Pulak; Rani, Kanchan; Shree, Divya

    2012-02-01

    Severe post-burn contractures in the neck often cause anatomical distortion and restriction of neck movements, resulting in varying degrees of difficulty in airway management. Any mode of anesthesia that may obviate the need for imperative airway control may be desirable in such situations in which a difficult airway may be anticipated. Here we present one such situation where tumescent local anesthesia was employed to manage a case of severe post-burn neck contractures posted for contracture release and split-skin grafting. The other benefits of this method were minimal blood loss and excellent postoperative analgesia. In conclusion, it can be emphasized that the application of tumescent anesthesia is an important anesthetic tool in patients with predicted difficult airway management.

  20. Mesenchymal stem cells increase skin graft survival time and up-regulate PD-L1 expression in splenocytes of mice.

    PubMed

    Moravej, Ali; Geramizadeh, Bita; Azarpira, Negar; Zarnani, Amir-Hassan; Yaghobi, Ramin; Kalani, Mehdi; Khosravi, Maryam; Kouhpayeh, Amin; Karimi, Mohammad-Hossein

    2017-02-01

    Recently, mesenchymal stem cells (MSCs) have gained considerable interests as hopeful therapeutic cells in transplantation due to their immunoregulatory functions. But exact mechanisms underlying MSCs immunoregulatory function is not fully understood. Herein, in addition to investigate the ability of MSCs to prolong graft survival time, the effects of them on the expression of PD-L1 and IDO immunomodulatory molecules in splenocytes of skin graft recipient mice was clarified. To achieve this goal, full-thickness skins were transplanted from C57BL/6 to BALB/c mice. MSCs were isolated from bone marrow of BALB/c mice and injected to the recipient mice. Skin graft survival was monitored daily to determine graft rejection time. On days 2, 5 and 10 post skin transplantation, serum cytokine levels and expression of PD-L1 and IDO mRNA and protein in the splenocytes of recipient mice were evaluated. The results showed that administration of MSCs prolonged skin graft survival time from 11 to 14 days. On days 2 and 5 post transplantation, splenocytes PD-L1 expression and IL-10 serum level in MSCs treated mice were higher than those in the controls, while IL-2 and IFN-γ levels were lower. Rejection in MSCs treated mice was accompanied by an increase in IL-2 and IFN-γ, and decrease in PD-L1 expression and IL-10 level. No difference in the expression of IDO between MSCs treated mice and controls was observed. In conclusion, we found that one of the mechanisms underlying MSCs immunomodulatory function could be up-regulating PD-L1 expression.

  1. Treatment of split-thickness skin graft-related forearm scar contractures with a carbon dioxide laser protocol: 3 case reports.

    PubMed

    Kroonen, Leo; Shumaker, Peter R; Kwan, Julia M; Uebelhoer, Nathan; Hofmeister, Eric

    2013-11-01

    Split-thickness skin grafts in the forearm can lead to motion restriction and disability through the dense scarring of the skin and formation of graft-tendon adhesions. Three patients were referred for laser treatment of motion-limiting scar-associated split-thickness skin grafts to the forearm. All patients had reached a plateau in range of motion despite aggressive hand therapy and underwent serial laser scar treatments at 6- to 8-week intervals. Treatments were performed in a clinic setting and were initiated 2 to 5 months after reconstructive surgery. Rapid subjective functional and objective improvements in range of motion were noted after laser therapy. Results were cumulative and durable at final follow-up ranging from 10 to 15 months after the initial treatment. No complications were noted. Fractionated carbon dioxide laser therapy is a promising adjunct to hand therapy when the main restraint to motion is superficial skin scarring and skin-tendon adhesions.

  2. Factitious disorder as a differential diagnosis for recurrent skin graft failure.

    PubMed

    Seoighe, D M; Dempsey, M; Lawlor, C; O'Dwyer, A M

    2011-04-01

    This case report presents the history of a 43-year-old man who sustained a relatively minor burn to his face but who subsequently suffered significant morbidity. Although the wound was grafted on a number of occasions, it failed to heal. Multiple investigations were carried out to determine the cause of recurrent wound breakdown. It had been suspected that the patient was interfering with the wound but this could not be proven initially. He was eventually diagnosed with factitious disorder and it was only when this was managed in the multi-disciplinary setting that his wound finally healed.

  3. Host responses in human skin after conventional intradermal injection or microneedle administration of virus-like-particle influenza vaccine.

    PubMed

    Pearton, Marc; Pirri, Daniela; Kang, Sang-Moo; Compans, Richard W; Birchall, James C

    2013-10-01

    Miniaturized microneedle devices are being developed for painlessly targeting vaccines to the immune cell populations in skin. As skin immunization studies are generally restricted to animal models however, where skin architecture and immunity is greatly different to human, surprisingly little is known about the local human response to intradermal (ID) vaccines. Here surgically excised human skin is used to explore for the first time the complex molecular and cellular host responses to a candidate influenza vaccine comprising nanoparticulate virus-like-particles (VLPs), administered via conventional hypodermic injection or reduced scale microneedles. Responses at the molecular level are determined by microarray analysis (47,296 discrete transcripts) and validated by quantitative PCR (96 genes). Cellular response is probed through monitoring migration of dendritic cells in viable skin tissue. Gene expression mapping, ontological analysis, and qPCR reveal up-regulation of a host of genes responsible for key immunomodulatory processes and host viral response, including cell recruitment, activation, migration, and T cell interaction following both ID and microneedle injection of VLPs; the response from the microneedles being more subtle. Significant morphological and migratory changes to skin dendritic cells are also apparent following microneedle VLP delivery. This is the first study displaying the global, multifaceted immunological events that occur at the site of vaccine deposition in human skin and will subsequently influence the degree and nature of innate and adaptive immune responses. An increased understanding of the detailed similarities and differences in response against antigen administered via different delivery modalities will inform the development of improved vaccines and vaccine delivery systems.

  4. One-stage Reconstruction of Soft Tissue Defects with the Sandwich Technique: Collagen-elastin Dermal Template and Skin Grafts

    PubMed Central

    Wollina, Uwe

    2011-01-01

    Background: A full-thickness soft tissue defect closure often needs complex procedures. The use of dermal templates can be helpful in improving the outcome. Objective: The objective was to evaluate a sandwich technique combining the dermal collagen–elastin matrix with skin grafts in a one-stage procedure. Materials and Methods: Twenty-three patients with 27 wounds were enrolled in this prospective single-centre observational study. The mean age was 74.8 ± 17.2 years. Included were full-thickness defects with exposed bone, cartilage and/ or tendons. The dermal collagen–elastin matrix was applied onto the wound bed accomplished by skin transplants, i.e. ‘sandwich’ transplantation. In six wounds, the transplants were treated with intermittent negative pressure therapy. Results: The size of defects was ≤875 cm2. The use of the dermal template resulted in a complete and stable granulation in 100% of wounds. Seventeen defects showed a complete closure and 19 achieved a complete granulation with an incomplete closure. There was a marked pain relief. No adverse events were noted due to the dermal template usage. Conclusions: Sandwich transplantation with the collagen–elastin matrix is a useful tool when dealing with full-thickness soft tissue defects with exposed bone, cartilage or tendons. PMID:22279382

  5. Dermal Papilla Cells Improve the Wound Healing Process and Generate Hair Bud-Like Structures in Grafted Skin Substitutes Using Hair Follicle Stem Cells

    PubMed Central

    Leirós, Gustavo José; Kusinsky, Ana Gabriela; Drago, Hugo; Bossi, Silvia; Sturla, Flavio; Castellanos, María Lía; Stella, Inés Yolanda

    2014-01-01

    Tissue-engineered skin represents a useful strategy for the treatment of deep skin injuries and might contribute to the understanding of skin regeneration. The use of dermal papilla cells (DPCs) as a dermal component in a permanent composite skin with human hair follicle stem cells (HFSCs) was evaluated by studying the tissue-engineered skin architecture, stem cell persistence, hair regeneration, and graft-take in nude mice. A porcine acellular dermal matrix was seeded with HFSCs alone and with HFSCs plus human DPCs or dermal fibroblasts (DFs). In vitro, the presence of DPCs induced a more regular and multilayered stratified epidermis with more basal p63-positive cells and invaginations. The DPC-containing constructs more accurately mimicked the skin architecture by properly stratifying the differentiating HFSCs and developing a well-ordered epithelia that contributed to more closely recapitulate an artificial human skin. This acellular dermal matrix previously repopulated in vitro with HFSCs and DFs or DPCs as the dermal component was grafted in nude mice. The presence of DPCs in the composite substitute not only favored early neovascularization, good assimilation and remodeling after grafting but also contributed to the neovascular network maturation, which might reduce the inflammation process, resulting in a better healing process, with less scarring and wound contraction. Interestingly, only DPC-containing constructs showed embryonic hair bud-like structures with cells of human origin, presence of precursor epithelial cells, and expression of a hair differentiation marker. Although preliminary, these findings have demonstrated the importance of the presence of DPCs for proper skin repair. PMID:25161315

  6. Engineering of epidermis skin grafts using electrospun nanofibrous gelatin/ polycaprolactone membranes.

    PubMed

    Duan, Huichuan; Feng, Bei; Guo, Xiangkai; Wang, Jiaming; Zhao, Li; Zhou, Guangdong; Liu, Wei; Cao, Yilin; Zhang, Wen Jie

    2013-01-01

    Skin engineering provides a new strategy for treating a wide variety of skin defects. In particular, electrospun nanofibrous membranes have been used as carriers for epidermis engineering. The aim of this study was to investigate the feasibility of a modified gelatin and polycaprolactone (GT/PCL) electrospun membrane for epidermis engineering. The biocompatibility of the membranes was evaluated by seeding HaCaT cells (human keratinocyte cell line) on the membrane and the mechanical properties of the membranes were determined with and without cells after culture. A cell proliferation assay showing that HaCaT cells attached and proliferated well on the membranes demonstrated that the membranes possess good biocompatibility. Mechanical tests showed that the membranes are strong enough to be handled during transplantation. Further in vivo transplantation studies revealed that epidermises engineered with GT/PCL membranes were able to repair skin defects in the nude mouse. These results demonstrate that GT/PCL electrospun membranes could be suitable scaffolds for skin engineering.

  7. Wound closure after split-thickness skin grafting is accelerated with the use of continuous direct anodal microcurrent applied to silver nylon wound contact dressings.

    PubMed

    Huckfeldt, Roger; Flick, A Bart; Mikkelson, Debbie; Lowe, Cindy; Finley, Phillip J

    2007-01-01

    Wound healing after graft closure of excised burn wounds is a critical factor in the recovery process after thermal injury. Processes that speed time to stable wound closure should lead to improved outcomes, shorter lengths of hospital stays, and decreased complications. A randomized clinical trial to test the ability of continuous direct anodal microcurrent application to silver nylon wound contact dressings was designed. Time for wound closure after split-thickness skin grafting was observed. Thirty patients with full-thickness thermal burns were randomized into two groups. The control group received postoperative dressing care using moistened silver nylon fabric covered with gauze after tangential burn wound excision and split-thickness skin grafting. The study group received an identical protocol with the addition of continuous direct anodal microcurrent application. Time to 95% wound closure was measured using digital photography. The digital photographs were evaluated by a burn surgeon blinded to the patient's randomization. An independent t-test was used to analyze the data. The study group experienced a 36% reduction in time to wound closure (mean of 4.6 days) as compared to the control group (mean of 7.2 days). This was statistically significant at a P value of <.05. The use of continuous direct anodal microcurrent decreased time to wound closure after split-thickness skin grafting.

  8. [Skin-sparing mastectomy: an alternative to conventional mastectomy in breast cancer].

    PubMed

    Ramos Boyero, Manuel

    2008-10-01

    Women who require or desire mastectomy for breast cancer one option should be immediate breast reconstruction. Skin-sparing mastectomy (SSM) describes the surgery that maximises breast skin and infra- mammary fold preservation, significantly improves the symmetry and natural appearance and a more satisfied patient. In multiple studies, SSM seems to be oncologically safe in patients undergoing mastectomy for invasive T1-T2 tumours, multicentric tumours, ductal carcinoma in situ or risk-reduction. However, the technique should be avoided in patients with inflammatory breast cancer or in those with extensive tumour involvement of the skin. SSM with nipple areola complex preservation appears to be oncologically safe, providing that the tumour is not close to the nipple and the retro-areolar tissue is free of tumour. Though adjuvant radiotherapy is not an absolute contraindication to SSM, it should be used with caution since it decreases the final cosmetic result.

  9. Combined vacuum-assisted closure treatment with laparoscopic mobilization of an omental flap and meshed skin grafts for reconstruction of infected sternotomy wounds: two cases.

    PubMed

    Veir, Zoran; Smud, Sanda; Bogdanić, Branko; Cvjeticanin, Bruno; Bagatin, Dinko; Dujmović, Anto; Duduković, Mladen; Ivrlac, Radojko; Bulić, Kresimir; Mijatović, Davor

    2009-12-01

    In cardiac surgery, poststernotomy wounds are life threatening complications, with mortality up to 50%. We described two patients, who underwent coronary artery bypass grafting and postoperatively developed a deep sternal wound infection. Reconstruction was combined with vacuum-assisted closure treatment, laparoscopic mobilization of an omental flap and split thickens skin grafts. The omental flap is a well-vascularized local flap with a large surface area and has excellent immunologic and angiogenic properties. Both patients recovered completely. In our opinion, vacuum-assisted closure treatment and laparoscopic mobilization of great omentum is suitable option for treating deep sternal wounds.

  10. Customized Tapered Stent-Grafts in the Endovascular Management of Internal Iliac Artery Aneurysms: A Useful Adjunct to Conventional Endovascular Options

    SciTech Connect

    Haslam, J. Elizabeth Hardman, John; Horrocks, Michael; Fay, Dominic

    2009-01-15

    The endovascular exclusion of an isolated iliac artery aneurysm is recognized as a safe and favorable alternative to open surgical repair, with low associated morbidity and mortality. It has particular advantages in the treatment of internal iliac artery aneurysm (IIAA) given the technical difficulties associated with open surgical repair deep within the pelvis. We describe the use of customized tapered stent-grafts in the exclusion of wide-necked IIAA in five male patients considered high-risk for conventional surgical repair, in whom the common and external iliac artery morphology precluded the use of standard endovascular devices. In each case, IIAA outflow was selectively embolized and the aneurysm neck excluded by placement of a customized tapered stent-graft across the internal iliac artery origin. This technique was extremely effective, with 100% technical success, no serious associated morbidity, and zero mortality. In all five patients sac size was stable or reduced on computed tomography follow-up of up to 3 years (mean, 24.4 months), with a primary patency rate of 100%. We therefore advocate the use of customized tapered stent-grafts as a further endovascular option in the management of IIAA unsuitable for conventional endovascular repair.

  11. Comparison of surgical techniques for stoma closure: A retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal

    PubMed Central

    WADA, YUMA; MIYOSHI, NORIKATSU; OHUE, MASAYUKI; NOURA, SHINGO; FUJINO, SHIKI; SUGIMURA, KEIJIROU; AKITA, HIROFUMI; MOTOORI, MASAAKI; GOTOH, KUNIHITO; TAKAHASHI, HIDENORI; KOBAYASHI, SHOGO; OHMORI, TAKESHI; FUJIWARA, YOSHIYUKI; YANO, MASAHIKO

    2015-01-01

    The aim of this study was to compare the incidence of postoperative complications, including superficial incisional surgical site infection (SSI) following purse-string skin closure (PS) and conventional skin closure with a drainage tube (CD) following stoma closure. A total of 55 consecutive patients who underwent loop colostomy and loop ileostomy closures in our hospital between October, 2011 and September, 2014 were retrospectively assessed. The patients were divided into two groups, namely the PS group (26 patients) and the CD group (29 patients). There were no significant differences in the characteristics of the patients between the two groups. The baseline and operative characteristics also did not differ significantly between the two groups. However the incidence of superficial incisional SSI was lower in the PS group compared to that in the CD group (0 vs. 13.8%, respectively; P=0.049). The overall incidence of complications did not differ significantly between the two groups (P=0.313). The duration of postoperative hospital stay in the PS group was shorter compared to that in the CD group. In conclusion, the results of this study suggest that PS may an effective technique to reduce the incidence of superficial incisional SSI. This technique appears to be superior to the conventional technique, allowing for better cosmesis. PMID:26137277

  12. Comparison of surgical techniques for stoma closure: A retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal.

    PubMed

    Wada, Yuma; Miyoshi, Norikatsu; Ohue, Masayuki; Noura, Shingo; Fujino, Shiki; Sugimura, Keijirou; Akita, Hirofumi; Motoori, Masaaki; Gotoh, Kunihito; Takahashi, Hidenori; Kobayashi, Shogo; Ohmori, Takeshi; Fujiwara, Yoshiyuki; Yano, Masahiko

    2015-05-01

    The aim of this study was to compare the incidence of postoperative complications, including superficial incisional surgical site infection (SSI) following purse-string skin closure (PS) and conventional skin closure with a drainage tube (CD) following stoma closure. A total of 55 consecutive patients who underwent loop colostomy and loop ileostomy closures in our hospital between October, 2011 and September, 2014 were retrospectively assessed. The patients were divided into two groups, namely the PS group (26 patients) and the CD group (29 patients). There were no significant differences in the characteristics of the patients between the two groups. The baseline and operative characteristics also did not differ significantly between the two groups. However the incidence of superficial incisional SSI was lower in the PS group compared to that in the CD group (0 vs. 13.8%, respectively; P=0.049). The overall incidence of complications did not differ significantly between the two groups (P=0.313). The duration of postoperative hospital stay in the PS group was shorter compared to that in the CD group. In conclusion, the results of this study suggest that PS may an effective technique to reduce the incidence of superficial incisional SSI. This technique appears to be superior to the conventional technique, allowing for better cosmesis.

  13. A polyurethane dressing is beneficial for split-thickness skin-graft donor wound healing.

    PubMed

    Akita, Sadanori; Akino, Kozo; Imaizumi, Toshifumi; Tanaka, Katsumi; Anraku, Kuniaki; Yano, Hiroki; Hirano, Akiyoshi

    2006-06-01

    Few comparative studies have been performed on the various wound-dressing materials or methods proposed for use. To clarify the efficacy of wound dressing, 35 patients (17 females, aged 44.8+/-26.86 years and 18 males, aged 35.4+/-29.70) were subjected to a prospective study comparing a polyurethane dressing and a hydrogel dressing for split-thickness skin donors from the lateral thighs. We examined their clinical usefulness such as accelerated healing time, frequency of changing the dressing, degree of pain, or amount of exudates, and performed moisture meter analysis at 1 month and 1 year after re-epithelialization, which reflects the quality of the stratum corneum and subsequent scarring. The polyurethane dressing was superior to hydrogel in the wound healing time, amount of exudates, and frequency of dressing changes: the hydrogel was better for regulating the degree of pain. There was a positive correlation between transepidermal water loss and the effective contact coefficient, which indicates skin barrier function and affected by skin surface electrolytes and reflects water content, in moisture meter analysis (r(2)=0.32, p<0.01). Transepidermal water loss returned to the control level at 1 year after healing with both dressings. The effective contact coefficient of the polyurethane wound was significantly lower than that of hydrogel at 1 month (p<0.01), while both dressing wounds demonstrated significantly higher values at both 1 month and 1 year compared to the control (p<0.01). The polyurethane dressing is therefore superior both clinically and in moisture meter analysis.

  14. Use of negative-pressure dressings and split-thickness skin grafts following penile shaft reduction and reduction scrotoplasty in the management of penoscrotal elephantiasis.

    PubMed

    Stokes, Tracey H; Follmar, Keith E; Silverstein, Ari D; Weizer, Alon Z; Donatucci, Craig F; Anderson, Everett E; Erdmann, Detlev

    2006-06-01

    From 1988 to 2005, 8 men who presented with penoscrotal elephantiasis underwent penile shaft degloving and reduction scrotoplasty, followed by transplantation of a split-thickness skin graft (STSG) to the penile shaft. The etiology of elephantiasis in these patients included self-injection of viscous fluid and postsurgical obstructive lymphedema. In the 6 most recent cases, negative-pressure dressings were applied over the STSG to promote graft take, and STSG take rate was 100%. The results of our series corroborate those of a previous report, which showed circumferential negative-pressure dressings to be safe and efficacious in bolstering STSGs to the penile shaft. Furthermore, these results suggest that the use of negative-pressure dressings may improve graft take in this patient population.

  15. Pedicled full-thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn.

    PubMed

    Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai

    2015-02-01

    Successful reconstruction of extensive anterior chest wall defect following major electrical burn represents a very challenging surgery. Herein we report the first case using pedicled full-thickness abdominal flap combined with skin grafting to treat this injury with severe infection and exposure of pericardium and ribs in a Chinese patient. Following the performance of chest debridement to remove necrotic and infected tissues and the injection of broad-spectrum antibiotics to reduce infection, a pedicled full-thickness abdominal flap was used to cover the exposed pericardium and ribs, and skin grafting from the right leg of the patient was done to cover the exposed vital tissues. The patient was followed up for a total of 3·5 years, and satisfactory cosmetic and functional outcomes were obtained without complications. This report provides an effective method for the surgeons who encounter similar cases where reconstruction of extensive anterior chest wall is required.

  16. Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model

    PubMed Central

    Hasatsri, Sukhontha; Angspatt, Apichai; Aramwit, Pornanong

    2015-01-01

    We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

  17. Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model.

    PubMed

    Hasatsri, Sukhontha; Angspatt, Apichai; Aramwit, Pornanong

    2015-01-01

    We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10(-6)). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10(-5)). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites.

  18. Successful removal of hyperkeratotic-lichenoid reaction to red ink tattoo with preservation of the whole tattoo using a skin grafting knife.

    PubMed

    Mlakar, Boštjan

    2015-01-01

    With the increasing popularity of tattoo body decorations, reports of medical complications with tattoos have increased in parallel. Although tattoo reactions can resolve spontaneously, they often last for months or even years, despite the various treatment methods. In our case, we present the successful removal of hyperkeratotic-lichenoid reaction to red ink using a simple and cheap skin grafting knife. The entire tattoo was preserved with a good aesthetic result with minimal scarring.

  19. Accelerated Healing with a Mesh Autograft/Allodermal Composite Skin Graft Treated with Silver Nylon Dressings with and without Direct Current in Rats

    DTIC Science & Technology

    2000-07-01

    of small number in the dermal allografts. Such cells are largely endothelial cells of the vessels, white blood cells, and cells of the excretory ...skin grafts are applied in a single procedure to provide permanent wound coverage without need for either systemic or local pharma- cologic...Radiation Biology in Cancer Research: Proceedings of the 32nd Annual Symposium on Fundamental Cancer Research at The University of Texas System

  20. Recurrent incisional hernia, enterocutaneous fistula and loss of the substance of the abdominal wall: plastic with organic prosthesis, skin graft and VAC therapy. Clinical case.

    PubMed

    Nicodemi, Sara; Corelli, Sergio; Sacchi, Marco; Ricciardi, Edoardo; Costantino, Annarita; Di Legge, Pietro; Ceci, Francesco; Cipriani, Benedetta; Martellucci, Annunziata; Santilli, Mario; Orsini, Silvia; Tudisco, Antonella; Stagnitti, Franco

    2015-01-01

    Surgical wounds dehiscence is a serious post-operatory complication, with an incidence between 0.4% and 3.5%. Mortality is more than 45%. Complex wounds treatment may require a multidisciplinary management. VAC Therapy could be an alternative treatment regarding complex wound. VAC therapy has been recently introduced on skin's graft tissue management reducing skin graft rejection. The use of biological prosthesis has been tested in a contaminated field, better than synthetic meshes, which often need to be removed. The Permacol is more resistant to degradation by proteases due to its cross-links. Surgery is still considered the best treatment for digestive fistula. A 58 years old obese woman come to our attention, she was operated for an abdominal hernia. She had a post-operatory entero-cutaneous fistula. She was submitted to bowel resection, the anastomosis has been tailored and the hernia of the abdominal wall has been repaired with biological mesh for managing such condition. She had a wound dehiscence with loss of substance and the exposure of the biological prosthesis, nearly 20 cm diameter. She was treated first with antibiotic therapy and simple medications. In addiction, antibiotic therapy was necessary late associated to 7 months with advanced medications allowed a small reduction's defect. Because of its, treatment went on for two more months using VAC therapy. Antibiotic's therapy was finally suspended. The VAC therapy allowed the reduction of the gap, between skin and subcutaneous tissue, and the defect's size preparing a suitable ground for the skin graft. The graft, managed with the vac therapy, was necessary to complete the healing process.

  1. Free vascularized tibial periosteal graft with monitoring skin island for limb reconstruction: Anatomical study and case report.

    PubMed

    Diaz-Gallardo, Paula; Knörr, Jorge; Vega-Encina, I; Corona, Pablo S; Barrera-Ochoa, Sergi; Rodriguez-Baeza, Alfonso; Mascarenhas, Vasco V; Soldado, Francisco

    2017-03-01

    Several types of vascularized periosteal flaps have recently been described for the treatment or prevention of complex non-union in pediatric patients. Among them, a vascularized tibial periosteal graft (VTPG), supplied by the anterior tibial vessels (ATV), has been used successfully as a pedicled flap in a few patients. The purpose of the study is to describe the periosteal branches of the ATV, as well as the cutaneous and muscular branches by means of an anatomical study. In addition, to report on the use of VTPG as a free flap with a monitoring skin island in a clinical case. A mean of 6.5 periosteal branches (range 5-7) were found. In all cases we located a cutaneous perforator branching from one of the periosteal branches located at the midlevel of the leg. We performed a two-stage reconstruction of a recalcitrant non-union and residual shortening of the right tibia in a 17-year-old boy. After nonunion focus distraction, we used a massive bone allograft fixed with a nail and covered by a VTPG as a biological resource. Allograft consolidation was achieved 5.5 months after surgery. At eighteen months after surgery, no complications were observed and the patient had resumed all his daily activities, despite a residual 2-cm limb-length discrepancy. VTPG may be considered as a valuable surgical option for bone reconstruction in complex biological scenarios in the young population. © 2015 Wiley Periodicals, Inc. Microsurgery 37:248-251, 2017.

  2. Randomized placebo-controlled human pilot study of cold atmospheric argon plasma on skin graft donor sites.

    PubMed

    Heinlin, Julia; Zimmermann, Julia L; Zeman, Florian; Bunk, Wolfram; Isbary, Georg; Landthaler, Michael; Maisch, Tim; Monetti, Roberto; Morfill, Gregor; Shimizu, Tetsuji; Steinbauer, Julia; Stolz, Wilhelm; Karrer, Sigrid

    2013-01-01

    Cold atmospheric plasma has already been shown to decrease the bacterial load in chronic wounds. However, until now it is not yet known if plasma treatment can also improve wound healing. We aimed to assess the impact of cold atmospheric argon plasma on the process of donor site healing. Forty patients with skin graft donor sites on the upper leg were enrolled in our study. The wound sites were divided into two equally sized areas that were randomly assigned to receive either plasma treatment or placebo (argon gas) for 2 minutes. Donor site healing was evaluated independently by two blinded dermatologists, who compared the wound areas with regard to reepithelialization, blood crusts, fibrin layers, and wound surroundings. From the second treatment day onwards, donor site wound areas treated with plasma (n = 34) showed significantly improved healing compared with placebo-treated areas (day 1, p = 0.25; day 2, p = 0.011; day 3, p < 0.001; day 4, p < 0.001; day 5, p = 0.004; day 6, p = 0.008; day 7, p = 0.031). Positive effects were observed in terms of improved reepithelialization and fewer fibrin layers and blood crusts, whereas wound surroundings were always normal, independent of the type of treatment. Wound infection did not occur in any of the patients, and no relevant side effects were observed. Both types of treatment were well tolerated. The mechanisms contributing to these clinically observed effects should be further investigated.

  3. Comparison among Op-site, polyvinyl chloride film and tulle gauze in the treatment of skin graft donor sitet.

    PubMed

    Poonyakariyagorn, Theerapong; Sirimaharaj, Wimon; Pinchai, Opart; Angspatt, Apichai

    2002-04-01

    A prospective analytic study was performed at the Division of Plastic and Reconstructive Surgery, Department of Surgery, King Chulalongkorn Memorial University Hospital and the Department of Surgery, Chiang Mai University Hospital to compare among Polyvinyl chloride film (PVC film), Op-site and tulle gauze in the treatment of skin graft donor site. From October 1998 to January 2000, 81 donor sites in the same number of patients were treated by three different methods; tulle gauze (26 patients), Op-site (27 patients) and PVC film (28 patients). Each wound was followed until it was completely healed and visual analogue scale was used for pain evaluation. Donor site dressed with PVC film had a healing time of 10.44 days which was not different from Op-site (10.54 days) but significantly faster (p<0.001) than tulle gauze (17.84 days). Pain as measured with visual analogue scale in the group of PVC film (1.48) was not different from Op-site (1.34) but significantly less than (p<0.001) tulle gauze (5.45). There was no difference in the rate of infection between each group. In conclusion, the authors found no difference between Op-site and PVC film in healing time and pain. Both of them were better than tulle gauze. The results demonstrate the usefulness of PVC film as a donor site dressing as it promises relatively rapid healing, less pain and is inexpensive.

  4. Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial

    PubMed Central

    Alvandipour, Mina; Gharedaghi, Babak; Khodabakhsh, Hamed

    2016-01-01

    Purpose Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. Methods This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. Results Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). Conclusion After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC. PMID:27626025

  5. Temporary skin grafts based on hybrid graphene oxide-natural biopolymer nanofibers as effective wound healing substitutes: pre-clinical and pathological studies in animal models.

    PubMed

    Mahmoudi, N; Eslahi, N; Mehdipour, A; Mohammadi, M; Akbari, M; Samadikuchaksaraei, A; Simchi, A

    2017-05-01

    In recent years, temporary skin grafts (TSG) based on natural biopolymers modified with carbon nanostructures have received considerable attention for wound healing. Developments are required to improve physico-mechanical properties of these materials to match to natural skins. Additionally, in-deep pre-clinical examinations are necessary to ensure biological performance and toxicity effect in vivo. In the present work, we show superior acute-wound healing effect of graphene oxide nanosheets embedded in ultrafine biopolymer fibers (60 nm) on adult male rats. Nano-fibrous chitosan-based skin grafts crosslinked by Genepin with physico-mechanical properties close to natural skins were prepared by electrospinning of highly concentrated chitosan- polyvinylpyrrolidone solutions containing graphene oxide (GO) nanosheets. No surfactants and organic solvents were utilized to ensure high biocompatibility of the fibrous structure. In vitro evaluations by human skin fibroblast cells including live and dead assay and MTT results show that GO promote cell viability of porous nanofibrous membrane while providing enhanced bactericidal capacity. In vivo studies on rat's skin determine accelerated healing effect, i.e. a large open wound (1.5 × 1.5 cm(2)) is fully regenerated after 14-day of post operation while healing is observed for sterile gauze sponge (as the control). Pathological studies support thick dermis formation and complete epithelialization in the presence of 1.5 wt% GO nanosheets. Over 99% wound healing occurs after 21 days for the injury covered with TSG containing 1.5 wt% GO while this would takes weeks for the control. Therefore, the developed materials have a high potential to be used as TSG as pre-clinical testing has shown.

  6. Comparison of aesthetic breast reconstruction after skin-sparing or conventional mastectomy in patients receiving preoperative radiation therapy.

    PubMed

    Chang, Eric I; Ly, Daphne P; Wey, Philip D

    2007-07-01

    Many options exist for the surgical treatment of breast cancer in terms of tumor extirpation and reconstruction. Skin-sparing mastectomy (SSM) with immediate reconstruction offers patients a superior result, but this can be jeopardized by preoperative radiotherapy. We compared the outcomes of reconstruction after SSM or conventional mastectomy (CM) in the previously irradiated breast. We evaluated 41 patients over an 8-year period, who were divided into 3 categories: preoperative radiotherapy prior to SSM (n = 8), CM after preoperative radiation therapy (n = 9), and no chest wall irradiation prior to SSM (n = 20). The first group demonstrated significantly higher frequency of native flap compromise and capsular contracture formation than the other 2 groups.SSM with TRAM or latissimus with implant reconstruction is an esthetically optimal option for the treatment of patients without previous radiotherapy. However, for patients with preoperative chest wall radiation, TRAM flap reconstruction was superior to latissimus flap with implant after SSM.

  7. Hypertonic Glucose Combined with Negative Pressure Wound Therapy to Prepare Wounds with Pseudomonas aeruginosa Infection for Skin Grafting: A Report of 3 Cases.

    PubMed

    Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai; Hong, Lei

    2015-06-01

    Soft tissue losses from acute or chronic trauma are a challenge for surgeons. To explore a method to expedite granulation tissue formation in preparation for a split-thickness skin graft (STSG), the medical records of 3 patients - 2 adult men with wounds related to trauma injury and 1 infant with necrotizing fasciitis, all infected with Pseudomonas aeruginosa - were reviewed. All wounds were surgically debrided and managed by applying gauze soaked in 50% glucose followed by continuous negative pressure wound therapy (NPWT) before definitive skin grafting. NPWT pressure was applied at -80 mm Hg for the 2 adult males (ages 39 and 25 years) and -50 mm Hg for the 7-month-old male infant. The dressings were changed every 2 to 3 days. No adverse events occurred, and wounds were successfully closed with a STSG after an average of 7 days. In 1 case, NPWT was able to help affix dressings in a difficult-to-dress area (genital region). The combination of hypertonic glucose and hand-made, gauze-based NPWT was found to be safe, well-tolerated, and effective in preparing the wound bed for grafting. Prospective, randomized, controlled clinical studies are needed to compare the safety, effectiveness, and efficacy of this method to other treatment approaches for P. aeruginosa-infected wounds.

  8. Sensing vascularization of ex-vivo produced oral mucosal equivalent (EVPOME) skin grafts in nude mice using optical spectroscopy

    NASA Astrophysics Data System (ADS)

    Vishwanath, Karthik; Gurjar, Rajan; Kuo, Shiuhyang; Fasi, Anthony; Kim, Roderick; Riccardi, Suzannah; Feinberg, Stephen E.; Wolf, David E.

    2014-03-01

    Repair of soft tissue defects of the lips as seen in complex maxillofacial injuries, requires pre-vascularized multi-tissue composite grafts. Protocols for fabrication of human ex-vivo produced oral mucosal equivalents (EVPOME) composed of epithelial cells and a dermal equivalent are available to create prelaminated flaps for grafting in patients. However, invivo assessment of neovascularization of the buried prelaminated flaps remains clinically challenging. Here, we use diffuse reflectance spectroscopy (DRS) and diffuse correlation spectroscopy (DCS) to non-invasively quantify longitudinal changes in the vessel density and blood-flow within EVPOME grafts implanted in the backs of SCID mice and subsequently to determine the utility of these optical techniques for assessing vascularization of implanted grafts. 20 animals were implanted with EVPOME grafts (1x1x0.05 cm3) in their backs. DRS and DCS measurements were obtained from each animal both atop the graft site and far away from the graft site, at one week post-implantation, each week, for four consecutive weeks. DRS spectra were analyzed using an inverse Monte Carlo model to extract tissue absorption and scattering coefficients, which were then used to extract blood flow information by fitting the experimental DCS traces. There were clear differences in the mean optical parameters (averaged across all mice) at the graft site vs. the off-site measurements. Both the total hemoglobin concentration (from DRS) and the relative blood flow (from DCS) peaked at week 3 at the graft site and declined to the off-site values by week 4. The optical parameters remained relatively constant throughout 4 weeks for the off-site measurements.

  9. Recurrent pyoderma gangrenosum after cesarean delivery successfully treated with vacuum-assisted closure and split thickness skin graft: a case report.

    PubMed

    Aydın, Serdar; Aydın, Çağrı Arıoğlu; Uğurlucan, Funda Güngör; Yaşa, Cenk; Dural, Özlem

    2015-04-01

    We describe the case of a 32-year-old woman (gravidity: 4; parity: 2) who underwent cesarean delivery at 37 weeks of gestation and presented with dehiscence and infection of the surgical wound. She had a history of wound infection and dehiscence of the scar from a previous cesarean delivery and dehiscence in the dorsal side of her left hand at the site of intravenous catheterization. The patient was initially diagnosed with a skin infection and later with pyoderma gangrenosum. No evidence of any underlying disease was found. The lesions were treated with systemic corticosteroids and azathioprine, but the lesions were unresponsive to treatment. This complicated case of pyoderma gangrenosum after cesarean delivery, which initially mimicked wound infection, was successfully treated with vacuum-assisted closure and split-thickness skin graft. This synergistic approach with vacuum-assisted closure could be an important treatment option for aggressive and slow-healing lesions.

  10. IL-17A and IL-2-expanded regulatory T cells cooperate to inhibit Th1-mediated rejection of MHC II disparate skin grafts.

    PubMed

    Vokaer, Benoît; Charbonnier, Louis-Marie; Lemaître, Philippe H; Spilleboudt, Chloé; Le Moine, Alain

    2013-01-01

    Several evidences suggest that regulatory T cells (Treg) promote Th17 differentiation. Based on this hypothesis, we tested the effect of IL-17A neutralization in a model of skin transplantation in which long-term graft survival depends on a strong in vivo Treg expansion induced by transient exogenous IL-2 administration. As expected, IL-2 supplementation prevented rejection of MHC class II disparate skin allografts but, surprisingly, not in IL-17A-deficient recipients. We attested that IL-17A was not required for IL-2-mediated Treg expansion, intragraft recruitment or suppressive capacities. Instead, IL-17A prevented allograft rejection by inhibiting Th1 alloreactivity independently of Tregs. Indeed, T-bet expression of naive alloreactive CD4+ T cells and the subsequent Th1 immune response was significantly enhanced in IL-17A deficient mice. Our results illustrate for the first time a protective role of IL-17A in CD4+-mediated allograft rejection process.

  11. Conventional Craniospinal Irradiation with Patient Supine and Source-Skin Distance (SSD) 100 cm for Spinal Field

    SciTech Connect

    Liu Xijun; Yu Jinming; Yu Yonghua; Yin Yong; Wang Bing; Zhang Yong; Kong Lei; Han Dali; Huo Zhijun; Fu Lei

    2011-01-01

    We describe a method of craniospinal irradiation (CSI) in the supine position and at a source-skin distance (SSD) of 100 cm for the spinal fields. The procedure is carried out with a 100-cm isocenter linear accelerator and conventional simulator, and the treatment is delivered with 2 opposed lateral cranial fields at source-axis distance (SAD) of 100 cm and 1 or 2 direct posterior spinal fields at SSD, 100 cm. The half beam-blocked cranial fields with a collimator rotation is used to match the superior border of the spinal field at the level of C2 vertebral body. The length of the spinal field is fixed, and is the same if 2 spinal fields are used. The position of the isocenter of the spine field is defined by longitudinally moving the couch a distance from the isocenter of the cranial fields and adjusting the SSD = 100 cm to the surface of the couch with the gantry rotated to the angle of 180 Degree-Sign (posteroanterior position), and the distance can be calculated easily according to a few parameters. It only needs a simple calculation without couch rotation, extended SSD, or markers. The inferior and superior borders of the spinal field do not require visualization under fluoroscopy when it is beyond the visual field of the simulator. The entire simulation takes no more than 20 minutes. Supine craniospinal treatment using this technique may substitute the traditional prone position as a potentially beneficial alternative to CSI.

  12. Reconstruction of infected and denuded scrotum and penis by combined application of negative pressure wound therapy and split-thickness skin grafting.

    PubMed

    Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai

    2013-08-01

    Trauma to the genital region and perineum can leave behind lifelong sequelae and pose significant challenges to surgeons in the restoration of functional ability and aesthetic status. Effective methods and techniques are indispensable during the treatment period. Negative pressure wound therapy (NPWT) is a widely accepted technique that is becoming a commonplace treatment in many clinical settings. The purpose of this case report was to introduce the efficacy of the concurrent usage of NPWT and split-thickness skin grafting (STSG) in the reconstruction of genital injuries. A man suffered a traffic accident that caused necrosis of the scrotum and penis associated with a severe infection caused by Pseudomonas aeruginosa and Enterobacter cloacea. After debridement, we adopted NPWT during the postoperative dressing changes and the application of meshed STSG. The outcomes showed that combination of NPWT and split-thickness skin grafts is safe, well-tolerated and efficient in the reconstruction of penoscrotal defects. This could be a versatile tool for reconstruction after perineal and penoscrotal trauma.

  13. CXCR3-mediated skin homing of autoreactive CD8 T cells is a key determinant in murine graft-versus-host disease.

    PubMed

    Villarroel, Vadim A; Okiyama, Naoko; Tsuji, Gaku; Linton, Jay T; Katz, Stephen I

    2014-06-01

    The pathomechanisms underlying the development of cutaneous graft-versus-host disease (GVHD) are incompletely defined. We previously reported that K14-mOVA mice expressing membrane ovalbumin (mOVA), driven by the keratin 14 (K14) promoter, developed GVHD-like mucocutaneous disease and weight loss following transfer of OVA-specific, CD8(+) OT-I T cells. In this study, we demonstrate that early in the course of disease, the kinetics of epidermal expression of C-X-C motif chemokine ligand 9 (CXCL9) and CXCL10, interferon-γ-inducible chemokines that bind the C-X-C motif chemokine receptor 3 (CXCR3) receptor, coincides with CXCR3 expression by OT-I cells in secondary lymphoid organs. Recruitment of OT-I cells into the skin began by day 5 with progressive accumulation through day 13 post transfer. Transfer of CXCR3-knockout (CXCR3KO) OT-I cells into K14-mOVA mice resulted in strikingly attenuated skin disease. CXCR3KO OT-I cells retained full activation and effector function, but preferentially accumulated in the spleen, in contrast to wild-type (WT) OT-I cells that accumulated in skin-draining lymph nodes. Moreover, OT-I cells accounted for a significantly reduced percentage of skin-infiltrating lymphocytes in mice receiving CXCR3KO OT-I cells compared with WT OT-I cells. These results identify CXCR3 as being critical to the skin-selective effector T-cell recruitment underlying autoreactive GVHD, suggesting CXCR3 as a potential target in the treatment of GVHD and related skin diseases.

  14. Bone marrow-derived conventional, but not cloned, mesenchymal stem cells suppress lymphocyte proliferation and prevent graft-versus-host disease in rats.

    PubMed

    Kitazawa, Yusuke; Li, Xiao-Kang; Xie, Lin; Zhu, Ping; Kimura, Hiromitsu; Takahara, Shiro

    2012-01-01

    Bone marrow-derived mesenchymal stem cells (MSCs) could exert a potent immunosuppressive effect, and therefore may have a therapeutic potential in T-cell-dependent pathologies. In the present study, we aimed to determine whether MSCs could be used to control graft-versus-host disease (GvHD), a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). MSCs were isolated from Lewis rat bone morrow and then cultured in 10% FBS DMEM at 37°C for 4 weeks. The enriched conventional MSCs and macrophages were purified by auto-MACS. Cloned MSCs were obtained by cloning using the limiting dilution method and expanded up to more than 6 months. The identity of MSCs was confirmed by their typical spindle-shaped morphology and immunophenotypic criteria, based on the absence of expression of CD45 and CD11b/c molecules. Both types of MSCs were also tested for their ability to differentiate into adipocytes. We showed that MSCs, like macrophages, exhibit immunomodulatory properties capable of inhibiting T-cell proliferation stimulated by alloantigens, anti-CD3e/CD28 mAbs, and ConA in a dose-dependent manner in vitro. After performing adoptive transfer, MSCs suppressed systemic Lewis to (Lewis × DA)F1 rat GvHD. In contrast to the immunosuppressive activities of conventional MSCs, the cloned MSCs enhanced T-cell proliferation in vitro and yielded no clinical benefit in regard to the incidence or severity of GvHD. Therefore, these rat models have shown intriguing differences in the suppression effects of lymphocyte proliferation and GvHD prevention between short-term cultured conventional MSCs and cloned MSCs.

  15. Efficacy and safety of a fibrin sealant for adherence of autologous skin grafts to burn wounds: results of a phase 3 clinical study.

    PubMed

    Foster, Kevin; Greenhalgh, David; Gamelli, Richard L; Mozingo, David; Gibran, Nicole; Neumeister, Michael; Abrams, Steven Zvi; Hantak, Edith; Grubbs, Lisa; Ploder, Bettina; Schofield, Neil; Riina, Louis H

    2008-01-01

    The objective of this phase 3, multicentered, prospective, randomized, evaluator-blinded, clinical study was to compare skin graft adherence utilizing a fibrin sealant containing 4 IU/ml thrombin (FS 4IU VH S/D [FS 4IU VH S/D will be marketed under the trade name ARTISS upon licensure in the United States]) to graft adherence utilizing staples in burn patients requiring wound excision and skin grafting. FS 4IU VH S/D was compared with staples in 138 patients. Patients had burn wounds measuring < or =40% of total body surface area with two comparable test sites measuring between 1 and 4% total body surface area each. Wound closure at day 28 was assessed using test site planimetry and review of day 28 photographs by three independent blinded evaluators (primary endpoint analysis). Secondary efficacy measures included hematoma/seroma on day 1, engraftment on day 5, and wound closure on day 14. Investigator and patient-reported outcomes were also assessed. The proportion of test sites with complete wound closure at day 28 was 70.3% in FS 4IU VH S/D treated sites and 65.8% in stapled sites, as assessed by planimetry. Blinded review of day 28 photographs confirmed that the rate of complete wound closure was similar between the two treatments, although the overall assessed rates of closure were lower than those determined by planimetry: FS 4IU VH S/D (43.3%) and staples (37.0%). The lower limit of the 97.5% confidence interval of the difference between FS 4IU VH S/D and staples was -0.029, which is above the predefined noninferiority margin of -0.1. Therefore, FS 4IU VH S/D is at least as efficacious as staples at the 97.5% one-sided level for complete wound closure by day 28. Hematoma/seroma on day 1 occurred at significantly (P < .0001) fewer FS 4IU VH S/D-treated sites (29.7% [95% CI 22.2-38.1%]) compared with stapled sites (62.3% [95% CI 53.7-70.4%]). Engraftment on day 5 was deemed to be 100% in 62.3% (95% CI 53.7-70.4%) of the FS 4IU VH S/D-treated sites and 55

  16. Failure to Influence the Rejection Time of Homologous Skin Grafts in the Rabbit by Prior Injection of Donor Blood*

    PubMed Central

    Piomelli, S.; Brooke, M. S.

    1961-01-01

    Intravenous injection of rabbits with homologous whole blood or erythrocytes did not influence the rejection time of subsequent grafts from the blood donors. In some animals warm agglutinins developed, and donor erythrocytes labelled with chromium had an immune disappearance slope. PMID:14486825

  17. [IV Consensus meeting of the Spanish Society of Liver Transplantation (SETH) 2012. Liver transplant with non-conventional grafts: Split liver transplantation and non-heart beating donors].

    PubMed

    Abradelo, Manuel; Fondevila, Constantino

    2014-03-01

    The disbalance between the number of candidates to liver transplant and the number of liver grafts leads to waiting list mortality. Two potential ways of increasing the number of liver grafts are split liver transplantation and the transplantation of grafts from non-heart beating donors. Both of them were discussed in a consensus meeting of the Spanish Society of Liver Transplantation in October 2012. This paper outlines the conclusions of that meeting.

  18. Δ9-Tetrahydrocannabinol attenuates allogeneic host-versus-graft response and delays skin graft rejection through activation of cannabinoid receptor 1 and induction of myeloid-derived suppressor cells

    PubMed Central

    Sido, Jessica M.; Nagarkatti, Prakash S.; Nagarkatti, Mitzi

    2015-01-01

    Immune cells have been shown to express cannabinoid receptors and to produce endogenous ligands. Moreover, activation of cannabinoid receptors on immune cells has been shown to trigger potent immunosuppression. Despite such studies, the role of cannabinoids in transplantation, specifically to prevent allograft rejection, has not, to our knowledge, been investigated previously. In the current study, we tested the effect of THC on the suppression of HvGD as well as rejection of skin allografts. To this end, we studied HvGD by injecting H-2k splenocytes into H-2b mice and analyzing the immune response in the draining ingLNs. THC treatment significantly reduced T cell proliferation and activation in draining LNs of the recipient mice and decreased early stage rejection-indicator cytokines, including IL-2 and IFN-γ. THC treatment also increased the allogeneic skin graft survival. THC treatment in HvGD mice led to induction of MDSCs. Using MDSC depletion studies as well as adoptive transfer experiments, we found that THC-induced MDSCs were necessary for attenuation of HvGD. Additionally, using pharmacological inhibitors of CB1 and CB2 receptors and CB1 and CB2 knockout mice, we found that THC was working preferentially through CB1. Together, our research shows, for the first time to our knowledge, that targeting cannabinoid receptors may provide a novel treatment modality to attenuate HvGD and prevent allograft rejection. PMID:26034207

  19. Δ⁹-Tetrahydrocannabinol attenuates allogeneic host-versus-graft response and delays skin graft rejection through activation of cannabinoid receptor 1 and induction of myeloid-derived suppressor cells.

    PubMed

    Sido, Jessica M; Nagarkatti, Prakash S; Nagarkatti, Mitzi

    2015-09-01

    Immune cells have been shown to express cannabinoid receptors and to produce endogenous ligands. Moreover, activation of cannabinoid receptors on immune cells has been shown to trigger potent immunosuppression. Despite such studies, the role of cannabinoids in transplantation, specifically to prevent allograft rejection, has not, to our knowledge, been investigated previously. In the current study, we tested the effect of THC on the suppression of HvGD as well as rejection of skin allografts. To this end, we studied HvGD by injecting H-2(k) splenocytes into H-2(b) mice and analyzing the immune response in the draining ingLNs. THC treatment significantly reduced T cell proliferation and activation in draining LNs of the recipient mice and decreased early stage rejection-indicator cytokines, including IL-2 and IFN-γ. THC treatment also increased the allogeneic skin graft survival. THC treatment in HvGD mice led to induction of MDSCs. Using MDSC depletion studies as well as adoptive transfer experiments, we found that THC-induced MDSCs were necessary for attenuation of HvGD. Additionally, using pharmacological inhibitors of CB1 and CB2 receptors and CB1 and CB2 knockout mice, we found that THC was working preferentially through CB1. Together, our research shows, for the first time to our knowledge, that targeting cannabinoid receptors may provide a novel treatment modality to attenuate HvGD and prevent allograft rejection.

  20. Comparison of thin-film resistance heat-transfer gages with thin-skin transient calorimeter gages in conventional hypersonic wind tunnels

    NASA Technical Reports Server (NTRS)

    Miller, C. G., III

    1981-01-01

    Thin film gages deposited at the stagnation region of small (8.1-mm-diameter) hemispheres and gages mounted flush with the surface of a sharp-leading-edge flat plate were tested in the Langley continuous-flow hypersonic tunnel and in the Langley hypersonic CF4 tunnel. Two substrate materials were tested, quartz and a machinable glass-ceramic. Small hemispheres were also tested utilizing the thin-skin transient calorimeter technique usually employed in conventional tunnels. One transient calorimeter model was a thin shell of stainless steel, and the other was a thin-skin insert of stainless steel mounted into a hemisphere fabricated from a machinable-glass-ceramic. Measured heat-transfer rates from the various hemispheres were compared with one another and with predicted rates. The results demonstrate the feasibility and advantages of using-film resistance heat-transfer gages in conventional hypersonic wind tunnels over a wide range of conditions.

  1. Culturing adult human bone marrow stem cells on gelatin scaffold with pNIPAAm as transplanted grafts for skin regeneration.

    PubMed

    Perng, Cherng-Kang; Kao, Chung-Lan; Yang, Yi-Ping; Lin, Han-Tso; Lin, Wen-Bin; Chu, Yue-Ru; Wang, Hsiao-Jung; Ma, Hsu; Ku, Hung-Hai; Chiou, Shih-Hwa

    2008-03-01

    Skin tissue engineering is a possible solution for the treatment of extensive skin defect. The ultimate goal of skin tissue engineering is to restore the complete functions of native skin, but until now the structures and functions of skins are only partially restored. By negative immunoselection (CD45 and glycophorin A), we isolated and cultivated adult human bone marrow stem cells (hBMSCs) that are of multilineage differentiation potential. In this study, we first demonstrated that by using gelatin/thermo-sensitive poly N-isopropylacrylamide (pNIPAAm) and the immunocompromised mice model, the hBMSCs possess the differentiation potential of epidermis and the capability of healing skin wounds. The in vitro observations and the results of the scanning electron microscope showed that the hBMSCs can attach and proliferate in the gelatin/thermo-sensitive pNIPAAm. To further monitor the in vivo growth effect of the hBMSCs in the skin-defected nude mice, the green fluorescence protein (GFP) gene was transduced into the hBMSCs by the murine stem cell viral vector. The results showed that the rates of cell growth and wound recovery in the hBMSC-treated group were significantly higher than those in the control group, which was only treated with the gelatin/pNIPAAm (p < 0.01). More importantly, the re-epithelialization markers of human pan-cytokeratin and E-cadherin were significantly increased on day 7, day 14, and day 21 after the hBMSC-scaffold with the pNIPAAM in the mice with skin defects (p < 0.05). Moreover, the stem cell markers of human CD13 and CD105 were gradually decreased during the period of wound healing. In sum, this novel method provides a transferring system for cell therapies and maintains its temperature-sensitive property of easy-peeling by lower-temperature treatment. In addition, the in vitro and in vivo GFP imaging systems provide a new imaging modality for understanding the differentiation process and the effective expression of stem cells in wound

  2. A novel way to treat skin tears.

    PubMed

    Moradian, Scott; Klapper, Andrew M

    2016-04-01

    Skin tears are one of the most commonly treated wounds in the elderly population. In their most basic form, they are essentially traumatic random pattern flaps. We postulate that the injured blood flow to these skin flaps should be ignored and the tissue should be treated as a skin graft. A case report is presented of an 86-year-old female with an 8 × 3·5 cm skin tear to her right upper extremity after a hip fracture. In addition to conventional wound closure strips re-approximating the tissues, a disposable negative pressure wound therapy device was placed to act as bolster. Upon its removal on day 5, the opposed skin tear tissue was found to be 100% viable. We therefore propose that this update may be an improvement over classical skin tear treatments and should be followed up with a case series.

  3. I-TAC is a dominant chemokine in controlling skin intragraft inflammation via recruiting CXCR3+ cells into the graft.

    PubMed

    Li, Baohua; Xu, Wei; Xu, Lin; Jiang, Zhenggang; Wen, Zhenke; Li, Kang; Xiong, Sidong

    2010-01-01

    Chemokines play a critical role in the acute transplant rejection. In order to provide an overview of the chemokine expression during the course of acute allograft rejection, the intragraft expression profile of 11 chemokines representative of all four chemokine subfamilies was analyzed in a murine skin transplantation model of acute rejection. It was found that RANTES/CCL5, TARC/CCL17 and FKN/CX(3)CL1 were expressed at equivalent levels in iso- and allografts. However, the other eight chemokines expression was up-regulated to some extent in allograft compared with that in isograft. The levels of MIP-1alpha/CCL3, MIP-3alpha/CCL20 and CTACK/CCL27 were progressively increased from early stage (day 3 post-transplantation) to late stage (day 11). Mig/CXCL9, IP-10/CXCL10, I-TAC/CXCL11, CXCL16 and LTN/XCL1 expression was elevated at middle stage (day 7), and peaked at late stage. Among the up-regulated chemokines, I-TAC was the most obviously elevated chemokine. Therefore, the effect of I-TAC on the skin acute allograft rejection was evaluated. Block of I-TAC by the intradermal injection of anti-I-TAC monoclonal antibody (mAb) reduced the number of CXCR3(+) cells in skin allograft and significantly prolonged the skin allograft survival. The mAb treatment did not influence the proliferation of the intragraft infiltrating cells in response to the allogeneic antigens, but significantly decreased the number of the infiltrating cells and consequently lowered the secretion of IFN-gamma and TNF-alpha. These data indicate I-TAC might be a dominant chemokine involved in the intradermal infiltration and I-TAC-targeted intervening strategies would have potential application for the alleviation of acute transplant rejection.

  4. Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series.

    PubMed

    Dahmardehei, Mostafa; Kazemikhoo, Nooshafarin; Vaghardoost, Reza; Mokmeli, Soheila; Momeni, Mahnoush; Nilforoushzadeh, Mohammad Ali; Ansari, Fereshteh; Amirkhani, Amir

    2016-04-01

    Significant populations in burn centers are diabetic burn patients. Healing process in these patients is more difficult due to diabetes complications. The gold standard treatment for patients with grade 3 burn ulcer is split-thickness skin grafting (STSG), but in the diabetic patients, the rate of graft failure and amputation is high due to impaired tissue perfusion. The technique of low level laser therapy (LLLT) improves tissue perfusion and fibroblast proliferation, increases collagen synthesis, and accelerates wound healing. The purpose of this case report is introducing a new therapeutic method for accelerating healing with better prognosis in these patients. The protocols and informed consent were reviewed according to the Medical Ethics, Board of Shahid Beheshti Medical Sciences (IR.SBMU.RAM.REC.13940.363). Diabetic type 2 patients with 13 grade 3 burn ulcers, candidate for amputation, were enrolled in the study. We used a 650-nm red laser light, 2 J/Cm for the bed of the ulcer and an 810-nm infrared laser light 6 J/Cm(2) for the margins along with intravenous laser therapy with a 660-nm red light, before and after STSG for treating grade 3 burn ulcers in 13 diabetic ulcers. The results of this study showed complete healing in the last 8 weeks for all patients who were candidates for amputation. In this case series, we present 13 cases of diabetic ulcer with type 3 burn wound, candidate for amputation, who healed completely using LLLT and STSG. This is the first time that these two techniques are combined for treatment of burn ulcer in diabetic patients. Using LLLT with STSG might be a promising treatment for burn victims especially diabetic patients.

  5. Topical Enzyme-Replacement Therapy Restores Transglutaminase 1 Activity and Corrects Architecture of Transglutaminase-1-Deficient Skin Grafts

    PubMed Central

    Aufenvenne, Karin; Larcher, Fernando; Hausser, Ingrid; Duarte, Blanca; Oji, Vinzenz; Nikolenko, Heike; Del Rio, Marcela; Dathe, Margitta; Traupe, Heiko

    2013-01-01

    Transglutaminase-1 (TG1)-deficient autosomal-recessive congenital ichthyosis (ARCI) is a rare and severe genetic skin disease caused by mutations in TGM1. It is characterized by collodion babies at birth, dramatically increased transepidermal water loss (TEWL), and lifelong pronounced scaling. The disease has a tremendous burden, including the problem of stigmatization. Currently, no therapy targeting the molecular cause is available, and the therapeutic situation is deplorable. In this study, we developed the basis for a causative therapy aiming at the delivery of the enzyme to the inner site of the keratinocytes’ plasma membrane. We prepared sterically stabilized liposomes with encapsulated recombinant human TG1 (rhTG1) and equipped with a highly cationic lipopeptide vector to mediate cellular uptake. The liposomes overcame the problems of insufficient cutaneous delivery and membrane penetration and provided excellent availability and activity of rhTG1 in primary keratinocytes. To demonstrate the general feasibility of this therapeutic approach in a humanized context, we used a skin-humanized mouse model. Treatment with rhTG1 liposomes resulted in considerable improvement of the ichthyosis phenotype and in normalization of the regenerated ARCI skin: in situ monitoring showed a restoration of TG1 activity, and cholesterol clefts vanished ultrastructurally. Measurement of TEWL revealed a restoration of epidermal barrier function. We regard this aspect as a major advance over available nonspecific approaches making use of, for example, retinoid creams. We conclude that this topical approach is a promising strategy for restoring epidermal integrity and barrier function and provides a causal cure for individuals with TG1 deficiency. PMID:24055110

  6. Increasing the Affinity Between Carbon-Coated LiFePO4/C Electrodes and Conventional Organic Electrolyte by Spontaneous Grafting of a Benzene-Trifluoromethylsulfonimide Moiety.

    PubMed

    Delaporte, Nicolas; Perea, Alexis; Lebègue, Estelle; Ladouceur, Sébastien; Zaghib, Karim; Bélanger, Daniel

    2015-08-26

    The grafting of benzene-trifluoromethylsulfonimide groups on LiFePO4/C was achieved by spontaneous reduction of in situ generated diazonium ions of the corresponding 4-amino-benzene-trifluoromethylsulfonimide. The diazotization of 4-amino-benzene-trifluoromethylsulfonimide was a slow process that required a high concentration of precursors to promote the spontaneous grafting reaction. Contact angle measurements showed a hydrophilic surface was produced after the reaction that is consistent with grafting of benzene-trifluoromethylsulfonimide groups. Elemental analysis data revealed a 2.1 wt % loading of grafted molecules on the LiFePO4/C powder. Chemical oxidation of the cathode material during the grafting reaction was detected by X-ray diffraction and quantified by inductively coupled plasma atomic emission spectrometry. Surface modification improves the wettability of the cathode material, and better discharge capacities were obtained for modified electrodes at high C-rate. In addition, electrochemical impedance spectroscopy showed the resistance of the modified cathode was lower than that of the bare LiFePO4/C film electrode. Moreover, the modified cathode displayed superior capacity retention after 200 cycles of charge/discharge at 1 C.

  7. A Previously Discounted Flap Now Reconsidered: MatriDerm and Split-Thickness Skin Grafting for Tendon Cover Following Dorsalis Pedis Fasciocutaneous Flap in Lower Limb Trauma

    PubMed Central

    Dunne, Jonathan A.; Wilks, Daniel J.; Rawlins, Jeremy M.

    2014-01-01

    Objective: The dorsalis pedis flap has reliable vascularity; however, its use is limited by reports of donor site morbidity including infection, delayed healing, exposure of tendons, and later contractures. The purpose of this study was to demonstrate its continued role in lower limb trauma when the donor site is reconstructed with MatriDerm to avoid complications. Methods: A 65-year-old man presented with a displaced, Gustilo 3b open transverse fracture of his left distal fibula. He had a 2 cm2 open wound over his lateral malleolus. Results: Following review of possible local options, a dorsalis pedis fasciocutaneous flap was deemed best for coverage, and the donor site was closed with 1-mm MatriDerm dermal matrix and a 6/1000 inch split-thickness skin graft (STSG) in a single stage. Three months postoperatively, the foot had excellent function and cosmesis, with toes in a neutral position and a full range of movement. Conclusions: The dorsalis pedis flap is a valuable reconstructive option for defects of the foot and ankle. Its major limitation donor site morbidity can be overcome by the additional application of a dermal substitute such as MatriDerm under the STSG. PMID:24917893

  8. Cultured Skin Substitutes Reduce Donor Skin Harvesting for Closure of Excised, Full-Thickness Burns

    PubMed Central

    Boyce, Steven T.; Kagan, Richard J.; Yakuboff, Kevin P.; Meyer, Nicholas A.; Rieman, Mary T.; Greenhalgh, David G.; Warden, Glenn D.

    2002-01-01

    Objective Comparison of cultured skin substitutes (CSS) and split-thickness skin autograft (AG) was performed to assess whether donor-site harvesting can be reduced quantitatively and whether functional and cosmetic outcome is similar qualitatively in the treatment of patients with massive cutaneous burns. Summary Background Data Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been shown to close full-thickness skin wounds in preclinical and clinical studies with acceptable functional and cosmetic results. Methods Qualitative outcome was compared between CSS and AG in 45 patients on an ordinal scale (0, worst; 10, best) with primary analyses at postoperative day 28 and after about 1 year for erythema, pigmentation, pliability, raised scar, epithelial blistering, and surface texture. In the latest 12 of the 45 patients, tracings were performed of donor skin biopsies and wounds treated with CSS at postoperative days 14 and 28 to calculate percentage engraftment, the ratio of closed wound:donor skin areas, and the percentage of total body surface area closed with CSS. Results Measures of qualitative outcome of CSS or AG were not different statistically at 1 year after grafting. Engraftment at postoperative day 14 exceeded 75% in the 12 patients evaluated. The ratio of closed wound:donor skin areas for CSS at postoperative day 28 was significantly greater than for conventional 4:1 meshed autografts. The percentage of total body surface area closed with CSS at postoperative day 28 was significantly less than with AG. Conclusions The requirement for harvesting of donor skin for CSS was less than for conventional skin autografts. These results suggest that acute-phase recovery of patients with extensive burns is facilitated and that complications are reduced by the use of CSS together with conventional skin grafting. PMID:11807368

  9. Initial basal cell carcinomas diagnosed in the National Campaign for Skin Cancer Prevention are smaller than those identified by the conventional medical referral system*

    PubMed Central

    Wakiyama, Thweicyka Pinheiro; França, Maria Laura Marconi; Carvalho, Larissa Pierri; Marques, Mariangela Esther Alencar; Miot, Hélio Amante; Schmitt, Juliano Vilaverde

    2017-01-01

    BACKGROUND Basal cell carcinoma is the malignant tumor most often diagnosed in the National Campaign for Skin Cancer Prevention (NCSCP). Little is known about the profile of these lesions compared to the profile of lesions diagnosed by conventional routes of public dermatological care. OBJECTIVE To identify if basal cell carcinomas identified in prevention campaigns and referred to surgery are smaller than those routinely removed in a same medical institution. METHODS Cross-sectional study including tumors routed from 2011-2014 campaigns and 84 anatomopathological reports of outpatients. RESULTS The campaigns identified 223 individuals with suspicious lesions among 2,531 examinations (9%), with 116 basal cell carcinomas removed. Anatomopathological examinations revealed that the primary lesions identified in the national campaigns were smaller than those referred to surgery by the conventional routes of public health care (28 [13-50] x 38 [20-113] mm2, p <0.01). On the other hand, after a mean follow-up of 15.6 ± 10.3 months, 31% of cases identified in campaigns showed new basal cell carcinoma lesions. STUDY LIMITATIONS Retrospective study and inaccuracies in the measurements of the lesions. CONCLUSIONS The NCSCP promotes an earlier treatment of basal cell carcinomas compared to patients referred to surgery by the conventional routes of public health care, which can result in lower morbidity rates and better prognosis. PMID:28225952

  10. Bone graft

    MedlinePlus

    Autograft - bone; Allograft - bone; Fracture - bone graft; Surgery - bone graft; Autologous bone graft ... Fuse joints to prevent movement Repair broken bones (fractures) that have bone loss Repair injured bone that ...

  11. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods

    PubMed Central

    2014-01-01

    Background The Malassezia yeasts which belong to the physiological microflora of human skin have also been implicated in several dermatological disorders, including pityriasis versicolor (PV), atopic dermatitis (AD), and psoriasis (PS). The Malassezia genus has repeatedly been revised and it now accommodates 14 species, all but one being lipid-dependent species. The traditional, phenotype-based identification schemes of Malassezia species are fraught with interpretative ambiguities and inconsistencies, and are thus increasingly being supplemented or replaced by DNA typing methods. The aim of this study was to explore the species composition of Malassezia microflora on the skin of healthy volunteers and patients with AD and PS. Methods Species characterization was performed by conventional, culture-based methods and subsequently molecular techniques: PCR-RFLP and sequencing of the internal transcribed spacer (ITS) 1/2 regions and the D1/D2 domains of the 26S rRNA gene. The Chi-square test and Fisher’s exact test were used for statistical analysis. Results Malassezia sympodialis was the predominant species, having been cultured from 29 (82.9%) skin samples collected from 17 out of 18 subjects under the study. Whereas AD patients yielded exclusively M. sympodialis isolates, M. furfur isolates were observed only in PS patients. The isolation of M. sympodialis was statistically more frequent among AD patients and healthy volunteers than among PS patients (P < 0.03). Whether this mirrors any predilection of particular Malassezia species for certain clinical conditions needs to be further evaluated. The overall concordance between phenotypic and molecular methods was quite high (65%), with the discordant results being rather due to the presence of multiple species in a single culture (co-colonization) than true misidentification. All Malassezia isolates were susceptible to cyclopiroxolamine and azole drugs, with M. furfur isolates being somewhat more drug tolerant

  12. Lipid-colloid dressing shows improved reepithelialization, pain relief, and corneal barrier function in split-thickness skin-graft donor wound healing.

    PubMed

    Tanaka, Katsuya; Akita, Sadanori; Yoshimoto, Hiroshi; Houbara, Seiji; Hirano, Akiyoshi

    2014-09-01

    Donor-site wound healing was tested with a nonadherent petrolatum- and hydrocolloid-impregnated polyester, a lipid-colloid dressing, and a nonadherent polyester dressing, supplemented with petrolatum manually by a physician onsite. Ten patients, 1 woman and 9 men (22 to 79 years old; average 58.4 ± 17.54 years), were enrolled in this prospective comparison study. The split-thickness skin graft was 14.5 ± 7.49 cm long × 8.2 ± 4.07 cm wide (5.5-27 cm long and 4.0-14.0 wide) and 14/1000 inches (0.356 mm) deep. The degree of reepithelialization in lipid-colloid dressing was significantly better than that in polyester mesh dressing, with 1.7 ± 1.00 and 2.8 ± 0.83 for the lipid-colloid dressing and polyester mesh dressing, respectively (P < .05), and degree of pain was significantly lower in lipid-colloid dressing than that in polyester dressing, 1.7 ± 1.11 and 2.9 ± 1.12 for the lipid-colloid dressing and polyester mesh dressing, respectively (P < .01). In moisture meter analyses, the values of effective contact coefficient and corneal thickness in lipid-colloid at wound healing was significantly smaller than those in polyester mesh (effective contact coefficient: 11.7 ± 1.87% and 15.6 ± 3.09% for lipid-colloid and polyester mesh, respectively, P < .05; corneal thickness: 31.1 ± 6.65 µm and 40.7 ± 8.69 µm for lipid-colloid and polyester mesh, respectively, P < .05). No significant difference was observed at 1 month after healing. The nonadherent lipid-colloid polyester dressing has superior wound healing and pain relief and demonstrates better corneal barrier function delineated by effective contact coefficient and corneal thickness at healing in split-thickness donors.

  13. Comparison of permeatal medial placement of graft without raising the tympano-meatal flaps to conventional methods of myringoplasty: An experience at tertiary care hospital in Pakistan

    PubMed Central

    Niazi, Saleem Asif; Hassan, Zaheer Ul; Atif, Khaula; Ullah, Saeed

    2016-01-01

    Objective: To compare the results of permeatal approach without raising the tympano-meatal flap to end-aural or post-aural approach in myringoplasty. Methods: This Quasi-experimental study was carried out in CMH (Combined Military Hospital) Peshawar, from August 2006 to July 2013. Three hundred fifty patients of chronic suppurative otitis media (CSOM) with dry central; small, medium and large perforations were selected. They were divided into two groups depending upon the type of approach. In Group-A (n-200); permeatal approach without raising tympano-meatal flap was used; while in Group-B (n-150) end-aural or post-aural approach was used. Subjects were followed up for two years; graft take was checked regularly by examinations of ear under microscope. Data was collected on structured Performa and analysed by SPSS-17. Results: Male and female were 74% and 26% respectively; Age ranged from 15 to 46 Years. There was no significant difference in the graft success at the end of two years in Group-A(80%) and Group-B(85%) (p-0.261). Type of approach had a significant impact on duration of surgery(p<0.001) and post-operative recovery time(p<0.001). Conclusion: The permeatal approach and end-aural/post-aural approach had almost equal graft success rates, but former is more useful as it causes lesser morbidity, decreased post-operative hospital stay and reduced operative time. It is under-utilized and should be employed more frequently. PMID:27648041

  14. Formulation, Characterisation, and in Vitro Skin Diffusion of Nanostructured Lipid Carriers for Deoxyarbutin Compared to a Nanoemulsion and Conventional Cream

    PubMed Central

    Tofani, Rendra P.; Sumirtapura, Yeyet C.; Darijanto, Sasanti T.

    2016-01-01

    The long-term use of topical hydroquinone as an anti-hyperpigmentation treatment has well-known, unwanted effects. Deoxyarbutin (4-[(tetrahydro-2H-pyran-2-yl)oxy]phenol) is a relatively new tyrosinase inhibitor, with stronger inhibitory potency than hydroquinone, that exhibited decreased cytotoxicity against melanocytes and other cells. This study developed novel nanostructured lipid carriers (NLCs) for improved topical delivery of deoxyarbutin (dArb), leading to improved depigmenting efficacy. dArb is a hydrophobic substance, but it easily degrades in aqueous medium and is thermolabile. Screening and optimisation of the solid lipid, liquid lipid, surfactant, co-surfactant and production methods were performed to choose the optimum particle size and stability for NLCs. One percent dArb NLCs were obtained from a combination of cetyl palmitate (CP) and caprylic/capric tryglicerides (Myr) in 12% total lipids using poloxamer 188 (P-188) and polyethylene glycol (PEG) 400 as a surfactant and co-surfactant, respectively, with a particle diameter of approximately 500 nm and a polydispersity index (PI) <0.4. These NLCs were produced using the simple method of high-shear homogenisation (10,000 rpm, 5 minutes) and ultrasonication (3.5 min). The compatibility between the substances in the formula was evaluated using Fourier Transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). The morphology of the NLCs was observed using transmission electron microscopy (TEM). In vitro penetration of dArb NLCs was evaluated and compared to the nanoemulsion (NE) and conventional emulsion (CR) delivery methods across Spangler’s membrane (SS). Delivery improvement was clearly observed, and after 8 h of application, dArb gel-NLCs showed the highest dArb penetration, followed by liquid NLCs, NE, and CR.

  15. Bioinspired design of nanostructured elastomers with cross-linked soft matrix grafting on the oriented rigid nanofibers to mimic mechanical properties of human skin.

    PubMed

    Wang, Zhongkai; Jiang, Feng; Zhang, Yaqiong; You, Yezi; Wang, Zhigang; Guan, Zhibin

    2015-01-27

    Human skin exhibits highly nonlinear elastic properties that are essential to its physiological functions. It is soft at low strain but stiff at high strain, thereby protecting internal organs and tissues from mechanical trauma. However, to date, the development of materials to mimic the unique mechanical properties of human skin is still a great challenge. Here we report a bioinspired design of nanostructured elastomers combining two abundant plant-based biopolymers, stiff cellulose and elastic polyisoprene (natural rubber), to mimic the mechanical properties of human skin. The nanostructured elastomers show highly nonlinear mechanical properties closely mimicking that of human skin. Importantly, the mechanical properties of these nanostructured elastomers can be tuned by adjusting cellulose content, providing the opportunity to synthesize materials that mimic the mechanical properties of different types of skins. Given the simplicity, efficiency, and tunability, this design may provide a promising strategy for creating artificial skin for both general mechanical and biomedical applications.

  16. Skin flaps in reconstructive surgery.

    PubMed

    Pavletic, M M

    1990-01-01

    A skin flap (pedicle graft) is a partially detached segment of skin and subcutaneous tissue that includes a blood supply essential to its survival. As a result, skin flaps are capable of closing a variety of defects, including poorly vascularized wound beds that are incapable of maintaining free grafts. In many cases, skin flaps can bypass economically many of the potential problems associated with healing by second intention. This article presents an overview of pedicle grafts, with emphasis on the clinical use of local flap techniques.

  17. Bone grafts.

    PubMed

    Hubble, Matthew J W

    2002-09-01

    Bone grafts are used in musculoskeletal surgery to restore structural integrity and enhance osteogenic potential. The demand for bone graft for skeletal reconstruction in bone tumor, revision arthroplasty, and trauma surgery, couple with recent advances in understanding and application of the biology of bone transplantation, has resulted in an exponential increase in the number of bone-grafting procedures performed over the last decade. It is estimated that 1.5 million bone-grafting procedures are currently performed worldwide each year, compared to a fraction of that number 20 years ago. Major developments also have resulted in the harvesting, storage, and use of bone grafts and production of graft derivatives, substitutes, and bone-inducing agents.

  18. Feasibility of Human Skin Grafts on An Isolated But Accessible Vascular Supply on Athymic Rats As a System to Study Percutaneous Penetration and Cutaneous Injury

    DTIC Science & Technology

    1986-06-01

    drug delivery and cutaneous toxicology. Heretofore, to assess percutaneous absorption of a topically applied agent in human subjects, investigators...vascular characteristics (8). Our current work involves the validation of the flap model for transdermal flux, drug disposition, and skin metabolism...reported to enhance the effectiveness of ALS and cyclosporine in prolonging the survival of allografts (44), the preliminary data from two rats

  19. Graft vasculopathy in clinical hand transplantation.

    PubMed

    Kaufman, C L; Ouseph, R; Blair, B; Kutz, J E; Tsai, T M; Scheker, L R; Tien, H Y; Moreno, R; Ozyurekoglu, T; Banegas, R; Murphy, E; Burns, C B; Zaring, R; Cook, D F; Marvin, M R

    2012-04-01

    Allogeneic hand transplantation is now a clinical reality. While results have been encouraging, acute rejection rates are higher than in their solid-organ counterparts. In contrast, chronic rejections, as defined by vasculopathy and/or fibrosis and atrophy of skin and other tissues, as well as antibody mediated rejection, have not been reported in a compliant hand transplant recipient. Monitoring vascularized composite allograft (VCA) hand recipients for rejection has routinely involved punch skin biopsies, vascular imaging and graft appearance. Our program, which has transplanted a total of 6 hand recipients, has experience which challenges these precepts. We present evidence that the vessels, both arteries and veins may also be a primary target of rejection in the hand. Two of our recipients developed severe intimal hyperplasia and vasculopathy early post-transplant. An analysis of events and our four other patients has shown that the standard techniques used for surveillance of rejection (i.e. punch skin biopsies, DSA and conventional vascular imaging studies) are inadequate for detecting the early stages of vasculopathy. In response, we have initiated studies using ultrasound biomicroscopy (UBM) to evaluate the vessel wall thickness. These findings suggest that vasculopathy should be a focus of frequent monitoring in VCA of the hand.

  20. Integra as a Dermal Replacement in a Meshed Composite Skin Graft in a Rat Model: A One-Step Operative Procedure

    DTIC Science & Technology

    2002-01-01

    one-step procedure in rats with full thickness skin injuries.7 Cryopre- served cellular and decellularized porcine allogeneic dermis, in conjunction...MATERIALS AND METHODS Experimental Animals White female Lewis rats (Harlan, Houston, TX) weigh- ing 220 25 g were used as experimental animals . In...conducting the research described in this report, the investi- gators adhered to the Animal Welfare Act and other federal statutes and regulations relating to

  1. Comparison of structural changes in skin and amnion tissue grafts for transplantation induced by gamma and electron beam irradiation for sterilization.

    PubMed

    Mrázová, H; Koller, J; Kubišová, K; Fujeríková, G; Klincová, E; Babál, P

    2016-06-01

    Sterilization is an important step in the preparation of biological material for transplantation. The aim of the study is to compare morphological changes in three types of biological tissues induced by different doses of gamma and electron beam radiation. Frozen biological tissues (porcine skin xenografts, human skin allografts and human amnion) were irradiated with different doses of gamma rays (12.5, 25, 35, 50 kGy) and electron beam (15, 25, 50 kGy). Not irradiated specimens served as controls. The tissue samples were then thawn and fixed in 10 % formalin, processed by routine paraffin technique and stained with hematoxylin and eosin, alcian blue at pH 2.5, orcein, periodic acid Schiff reaction, phosphotungstic acid hematoxylin, Sirius red and silver impregnation. The staining with hematoxylin and eosin showed vacuolar cytoplasmic changes of epidermal cells mainly in the samples of xenografts irradiated by the lowest doses of gamma and electron beam radiation. The staining with orcein revealed damage of fine elastic fibers in the xenograft dermis at the dose of 25 kGy of both radiation types. Disintegration of epithelial basement membrane, especially in the xenografts, was induced by the dose of 15 kGy of electron beam radiation. The silver impregnation disclosed nuclear chromatin condensation mainly in human amnion at the lowest doses of both radiation types and disintegration of the fine collagen fibers in the papillary dermis induced by the lowest dose of electron beam and by the higher doses of gamma radiation. Irradiation by both, gamma rays and the electron beam, causes similar changes on cells and extracellular matrix, with significant damage of the basement membrane and of the fine and elastic and collagen fibers in the papillary dermis, the last caused already by low dose electron beam radiation.

  2. DNA Vaccine Encoding HPV16 Oncogenes E6 and E7 Induces Potent Cell-mediated and Humoral Immunity Which Protects in Tumor Challenge and Drives E7-expressing Skin Graft Rejection

    PubMed Central

    Chandra, Janin; Dutton, Julie L.; Li, Bo; Woo, Wai-Ping; Xu, Yan; Tolley, Lynn K.; Yong, Michelle; Wells, James W.; R. Leggatt, Graham; Finlayson, Neil

    2017-01-01

    We have previously shown that a novel DNA vaccine technology of codon optimization and the addition of ubiquitin sequences enhanced immunogenicity of a herpes simplex virus 2 polynucleotide vaccine in mice, and induced cell-mediated immunity when administered in humans at relatively low doses of naked DNA. We here show that a new polynucleotide vaccine using the same technology and encoding a fusion protein of the E6 and E7 oncogenes of high-risk human papillomavirus type 16 (HPV16) is immunogenic in mice. This vaccine induces long-lasting humoral and cell-mediated immunity and protects mice from establishment of HPV16-E7-expressing tumors. In addition, it suppresses growth of readily established tumors and shows enhanced efficacy when combined with immune checkpoint blockade targeted at PD-L1. This vaccine also facilitates rejection of HPV16-E7-expressing skin grafts that demonstrate epidermal hyperplasia with characteristics of cervical and vulvar intraepithelial neoplasia. Clinical studies evaluating the efficacy of this vaccine in patients with HPV16+ premalignancies are planned. PMID:28166181

  3. Prosthetic Arteriovenous Graft Contact Dermatitis Masquerading as an Arteriovenous Graft Infection in a Hemodialysis Patient

    PubMed Central

    Ramagiri-Vinod, Nagadarshini; Tahir, Hassan; Narukonda, Sandhya; Joshi, Medha

    2016-01-01

    Prosthetic arteriovenous (AV) graft is the second most common vascular access of choice in hemodialysis patients. Rare complications of such grafts are increasingly seen due to rising population of patients on hemodialysis. Infections and thrombosis are the most common complications. Though metallic implants are known to cause hypersensitivity skin reactions, prosthetic AV grafts are rarely known to cause such kind of reactions due to inert nature of materials used in their preparation. We present a case of 54-year-old male who developed contact dermatitis after AV graft creation which was mistreated initially as infection. PMID:27493977

  4. Skin Dictionary

    MedlinePlus

    ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ...

  5. Human acellular dermal matrix grafts for rhinoplasty.

    PubMed

    Sherris, David A; Oriel, Brad S

    2011-09-01

    Rhinoplasty often relies on graft material for structural support in the form of cartilage, bone grafts, or fascia. In addition, pliable grafts are often helpful for contouring and can function as a barrier. Unfortunately, grafts carry the disadvantage of requiring an additional donor site, with associated complications. Human acellular dermal matrix (ADM) biological implants offer an exciting alternative for structural support and nonstructural implantation in rhinoplasty procedures. To examine the efficacy of ADM placement in rhinoplasty and septoplasty, the authors report the results from a series of 51 patients. In this series, there were no cases of infection, skin discoloration, seroma formation, septal perforation, significant resorption, extrusion, or other complications related to ADM placement. Therefore, the authors believe that ADM offers a safe and effective alternative to traditional grafting methods for functional and aesthetic rhinoplasty.

  6. Autologous keratinocyte suspension in platelet concentrate accelerates and enhances wound healing – a prospective randomized clinical trial on skin graft donor sites: platelet concentrate and keratinocytes on donor sites

    PubMed Central

    2013-01-01

    Background Wound healing involves complex mechanisms, which, if properly chaperoned, can enhance patient recovery. The abilities of platelets and keratinocytes may be harnessed in order to stimulate wound healing through the formation of platelet clots, the release of several growth factors and cytokines, and cell proliferation. The aim of the study was to test whether autologous keratinocyte suspensions in platelet concentrate would improve wound healing. The study was conducted at the Lausanne University Hospital, Switzerland in 45 patients, randomized to three different topical treatment groups: standard treatment serving as control, autologous platelet concentrate (PC) and keratinocytes suspended in autologous platelet concentrate (PC + K). Split thickness skin graft donor sites were chosen on the anterolateral thighs of patients undergoing plastic surgery for a variety of defects. Wound healing was assessed by the duration and quality of the healing process. Pain intensity was evaluated at day five. Results Healing time was reduced from 13.9 ± 0.5 days (mean ± SEM) in the control group to 7.2 ± 0.2 days in the PC group (P < 0.01). An addition of keratinocytes in suspension further reduced the healing time to 5.7 ± 0.2 days. Pain was reduced in both the PC and PC + K groups. Data showed a statistically detectable advantage of using PC + K over PC alone (P < 0.01). Conclusion The results demonstrate the positive contribution of autologous platelets combined with keratinocytes in stimulating wound healing and reducing pain. This strikingly simple approach could have a significant impact on patient care, especially critically burned victims for whom time is of the essence. Clinical trial registry information Protocol Record Identification Number: 132/03 Registry URL: http://www.clinicaltrials.gov PMID:23570605

  7. Proximal Tibial Bone Graft

    MedlinePlus

    ... All Site Content AOFAS / FootCareMD / Treatments Proximal Tibial Bone Graft Page Content What is a bone graft? Bone grafts may be needed for various ... the proximal tibia. What is a proximal tibial bone graft? Proximal tibial bone graft (PTBG) is a ...

  8. Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is ... bypass multiple coronary arteries during one surgery. Coronary Artery Bypass Grafting Figure A shows the location of ...

  9. The effect of conventional surgery and piezoelectric surgery bone harvesting techniques on the donor site morbidity of the mandibular ramus and symphysis.

    PubMed

    Altiparmak, N; Soydan, S S; Uckan, S

    2015-09-01

    The aim of this study was to evaluate the morbidity following bone harvesting at two different intraoral donor sites, mandibular symphysis and ramus, and to determine the effects of piezoelectric and conventional surgical graft harvesting techniques on donor site morbidity. Intraoral block bone grafts were harvested from the symphysis (n=44) and ramus (n=31). The two donor site groups were divided into two subgroups according to the surgical graft harvesting method used (conventional or piezoelectric surgery). Intraoperative and postoperative pain was assessed using a visual analogue scale (VAS). Donor site morbidity and the harvesting techniques were compared statistically. Of 290 teeth evaluated in the symphysis group, four needed root canal treatment after surgery. The incidence of transient paresthesia in the mucosa was significantly higher in the symphysis group than in the ramus group (P=0.004). In the symphysis group, the incidence of temporary skin and mucosa paresthesia was lower in the piezoelectric surgery subgroup than in the conventional surgery subgroup (P=0.006 and P=0.001, respectively). No permanent anaesthesia of any region of the skin was reported in either donor site group. VAS scores did not differ between the ramus and symphysis harvesting groups, or between the piezoelectric and conventional surgery subgroups. When the symphysis was chosen as the donor site, minor sensory disturbances of the mucosa and teeth were recorded. The use of piezoelectric surgery during intraoral harvesting of bone blocks, especially from the symphysis, can reduce these complications.

  10. Skin Diseases: Skin Health and Skin Diseases

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Skin Health and Skin Diseases Past Issues / Fall 2008 Table of Contents ... acne to wrinkles Did you know that your skin is the largest organ of your body? It ...

  11. Instantaneous Conventions

    PubMed Central

    Misyak, Jennifer; Noguchi, Takao; Chater, Nick

    2016-01-01

    Humans can communicate even with few existing conventions in common (e.g., when they lack a shared language). We explored what makes this phenomenon possible with a nonlinguistic experimental task requiring participants to coordinate toward a common goal. We observed participants creating new communicative conventions using the most minimal possible signals. These conventions, furthermore, changed on a trial-by-trial basis in response to shared environmental and task constraints. Strikingly, as a result, signals of the same form successfully conveyed contradictory messages from trial to trial. Such behavior is evidence for the involvement of what we term joint inference, in which social interactants spontaneously infer the most sensible communicative convention in light of the common ground between them. Joint inference may help to elucidate how communicative conventions emerge instantaneously and how they are modified and reshaped into the elaborate systems of conventions involved in human communication, including natural languages. PMID:27793986

  12. A new mechanism associated with compositae graft success.

    PubMed

    Son, Daegu; Jeong, Hoijoon; Choi, Taehyun; Kim, Junhyung; Han, Kihwan

    2010-11-01

    It is believed that the subcutaneous fat of the skin compositae grafts acts as a mechanical barrier limiting vascularisation. This study aims to determine a new mechanism associated with compositae graft take. Ten 3×3 cm rectangular full-thickness skin compositae grafts on the back of a pig were taken and then randomly changed to another place. Silicone sheets were then inserted between the graft and the recipient to block the direct contact of the dermis at the lateral surface of the graft and control the number of surface contacts. The take rate was measured using the digital VISITRAK(®). The microcirculation of the graft was evaluated by microangiograms using a latex-lead oxide solution. There was a 20.5% graft take in all four surface-blocked groups. The microangiograms showed vessel connections not only between the vessels of the dermis, but also between the subcutaneous fat of the graft and perforators from the basal surface of the wound. The subcutaneous layer does not produce a barrier but works as a significant source of vessel communication. Direct vessel-to-vessel anastomosis between the vessels of the subcutaneous fat at the graft and the basal surface of the recipient wound are another important mechanism for the success of compositae grafts.

  13. Studies on Local Immunosuppression in Skin Grafting.

    DTIC Science & Technology

    These malignant diseases in man included malignant melanoma, Kaposi ’ hemorrhagic sarcoma , adrenocarcinoma of the breast, epidermoid carcinoma of...the lower female genitourinary tract, mycosis fungoides, and reticulum cell sarcoma . Previous findings of the feasibility and clinical effectiveness of

  14. Cutaneous graft-versus-host disease after hematopoietic stem cell transplant - a review*

    PubMed Central

    Villarreal, Cesar Daniel Villarreal; Alanis, Julio Cesar Salas; Pérez, Jose Carlos Jaime; Candiani, Jorge Ocampo

    2016-01-01

    Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplants (allo-HSCT) associated with significant morbidity and mortality. The earliest and most common manifestation is cutaneous graft-versus-host disease. This review focuses on the pathophysiology, clinical features, prevention and treatment of cutaneous graft-versus-host disease. We discuss various insights into the disease's mechanisms and the different treatments for acute and chronic skin graft-versus-host disease. PMID:27438202

  15. Skin Cancer

    MedlinePlus

    ... version of this page please turn Javascript on. Skin Cancer What is Skin Cancer? Skin cancer is the most common type ... of approximately 9,480 Americans in 2013. Can Skin Cancer Be Treated? Most basal cell and squamous ...

  16. Electrostrictive Graft Elastomers

    NASA Technical Reports Server (NTRS)

    Su, Ji (Inventor); Harrison, Joycelyn S. (Inventor); St.Clair, Terry L. (Inventor)

    2003-01-01

    An electrostrictive graft elastomer has a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules. The polar graft moieties have been rotated by an applied electric field, e.g., into substantial polar alignment. The rotation is sustained until the electric field is removed. In another embodiment, a process for producing strain in an elastomer includes: (a) providing a graft elastomer having a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules; and (b) applying an electric field to the graft elastomer to rotate the polar graft moieties, e.g., into substantial polar alignment.

  17. Fat grafting in facial rejuvenation.

    PubMed

    Marten, Timothy J; Elyassnia, Dino

    2015-04-01

    Patients with significant facial atrophy and age-related loss of facial fat generally achieve suboptimal improvement from both surface treatments of facial skin and surgical lifts. Restoring lost facial volume by fat grafting is a powerful technique that is now acknowledged by most plastic surgeons and other physicians engaged in treating the aging face as one of the most important advances in aesthetic surgery. Properly performed, the addition of fat to areas of the face that have atrophied because of age or disease can produce a significant and sustained improvement in appearance that is unobtainable by other means.

  18. Helical type coronary bypass graft performance: Experimental investigations.

    PubMed

    Bernad, Sandor I; Bosioc, Alin I; Bernad, Elena S; Craina, Marius L

    2015-01-01

    Optimal graft design has been an objective of many researchers to find correlations between hemodynamics and graft failure. Compared to planar grafts, the helical graft configurations improve hemodynamic performance including the promotion of flow mixing and reduction of flow stagnation regions. In order to evaluate the advantages and disadvantages of the suggested helical type bypass graft model in comparison to a conventional bypass graft configuration, three experimental models were designed and evaluated. The character of complex vortex structures created in the area between the heel and the occluded section depends on the flow parameters (in the case of the straight graft). We have identified two vortices in the symmetrical plane (proximal and distal to the anastomosis). In the new design of the two-turn helical graft, the stagnation point is eliminated from the anastomoses at different time intervals compared to the conventional straight bypass model The present study indicated that the magnitude of the pressure drop along a helical graft was considerably increased compared to a traditional graft which, while still physiologically advantageous, can be surpassed by an optimal geometry model.

  19. Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions.

    PubMed

    Monárrez-Espino, Joel; Enciso-Moreno, José Antonio; Laflamme, Lucie; Serrano, Carmen J

    2014-11-01

    A cohort of 123 adult contacts was followed for 18-24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as <0.35 to ≥0.35 (C) or <0.35 to >0.70 (BZ) and reversion was defined as ≥0.35 to <0.35 (C) or ≥0.35 to <0.20 (BZ); TST (mm) conversion was defined as <5 to ≥5 (C) or <5 to >10 (BZ) and reversion was defined as ≥5 to <5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.

  20. [Autologous fat grafting and rhinoplasty].

    PubMed

    Nguyen, P S; Baptista, C; Casanova, D; Bardot, J; Magalon, G

    2014-12-01

    Revision rhinoplasty can be very challenging especially in cases of thin skin. Autologous fat graft is utilized in numerous applications in plastic surgery; however, its use relative to the nasal region remains uncommon. Adipose tissue, by virtue of its volumetric qualities and its action on skin trophicity, can be considered to be a gold standard implant. From 2006 until 2012, we have treated patients by lipofilling in order to correct sequelae of rhinoplasty. The mean quantity of adipose tissue injected was 2.1cm(3) depending on the importance of the deformity and the area of injection: irregularity of the nasal dorsum, visible lateral osteotomies, saddle nose. Following the course of our practice, we conceived micro-cannulas that allow a much greater accuracy in the placement of the graft and enable to perform interventions under local anesthesia. These non-traumatic micro-cannulas do not cause post-operative ecchymosis and swelling which shorten the recovery time for the patient. On patients who have undergone multiple operations, lipofilling can be a simple and reliable alternative to correct imperfections that may take place after a rhinoplasty.

  1. Dynamic, Nondestructive Imaging of a Bioengineered Vascular Graft Endothelium

    PubMed Central

    Lu, Peng; Xu, Yong; Rylander, Christopher G.; Wang, Ge; Sapoznik, Etai; Criswell, Tracy; Lee, Sang Jin; Soker, Shay; Rylander, Marissa Nichole

    2013-01-01

    Bioengineering of vascular grafts holds great potential to address the shortcomings associated with autologous and conventional synthetic vascular grafts used for small diameter grafting procedures. Lumen endothelialization of bioengineered vascular grafts is essential to provide an antithrombogenic graft surface to ensure long-term patency after implantation. Conventional methods used to assess endothelialization in vitro typically involve periodic harvesting of the graft for histological sectioning and staining of the lumen. Endpoint testing methods such as these are effective but do not provide real-time information of endothelial cells in their intact microenvironment, rather only a single time point measurement of endothelium development. Therefore, nondestructive methods are needed to provide dynamic information of graft endothelialization and endothelium maturation in vitro. To address this need, we have developed a nondestructive fiber optic based (FOB) imaging method that is capable of dynamic assessment of graft endothelialization without disturbing the graft housed in a bioreactor. In this study we demonstrate the capability of the FOB imaging method to quantify electrospun vascular graft endothelialization, EC detachment, and apoptosis in a nondestructive manner. The electrospun scaffold fiber diameter of the graft lumen was systematically varied and the FOB imaging system was used to noninvasively quantify the affect of topography on graft endothelialization over a 7-day period. Additionally, results demonstrated that the FOB imaging method had a greater imaging penetration depth than that of two-photon microscopy. This imaging method is a powerful tool to optimize vascular grafts and bioreactor conditions in vitro, and can be further adapted to monitor endothelium maturation and response to fluid flow bioreactor preconditioning. PMID:23585885

  2. Skin Conditions

    MedlinePlus

    Your skin is your body's largest organ. It covers and protects your body. Your skin Holds body fluids in, preventing dehydration Keeps harmful ... it Anything that irritates, clogs, or inflames your skin can cause symptoms such as redness, swelling, burning, ...

  3. Aging Skin

    MedlinePlus

    ... email address Submit Home > Healthy Aging > Wellness Healthy Aging Aging skin More information on aging skin When it ... treated early. Return to top More information on Aging skin Read more from womenshealth.gov Varicose Veins ...

  4. Spiritual and religious aspects of skin and skin disorders

    PubMed Central

    Shenefelt, Philip D; Shenefelt, Debrah A

    2014-01-01

    Skin and skin disorders have had spiritual aspects since ancient times. Skin, hair, and nails are visible to self and others, and touchable by self and others. The skin is a major sensory organ. Skin also expresses emotions detectable by others through pallor, coldness, “goose bumps”, redness, warmth, or sweating. Spiritual and religious significances of skin are revealed through how much of the skin has been and continues to be covered with what types of coverings, scalp and beard hair cutting, shaving and styling, skin, nail, and hair coloring and decorating, tattooing, and intentional scarring of skin. Persons with visible skin disorders have often been stigmatized or even treated as outcasts. Shamans and other spiritual and religious healers have brought about healing of skin disorders through spiritual means. Spiritual and religious interactions with various skin disorders such as psoriasis, leprosy, and vitiligo are discussed. Religious aspects of skin and skin diseases are evaluated for several major religions, with a special focus on Judaism, both conventional and kabbalistic. PMID:25120377

  5. Skin abscess

    MedlinePlus

    Abscess - skin; Cutaneous abscess; Subcutaneous abscess; MRSA - abscess; Staph infection - abscess ... Skin abscesses are common and affect people of all ages. They occur when an infection causes pus ...

  6. Facial reconstruction for radiation-induced skin cancer

    SciTech Connect

    Panje, W.R.; Dobleman, T.J. )

    1990-04-01

    Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction.

  7. Skin Biomes.

    PubMed

    Fyhrquist, N; Salava, A; Auvinen, P; Lauerma, A

    2016-05-01

    The cutaneous microbiome has been investigated broadly in recent years and some traditional perspectives are beginning to change. A diverse microbiome exists on human skin and has a potential to influence pathogenic microbes and modulate the course of skin disorders, e.g. atopic dermatitis. In addition to the known dysfunctions in barrier function of the skin and immunologic disturbances, evidence is rising that frequent skin disorders, e.g. atopic dermatitis, might be connected to a dysbiosis of the microbial community and changes in the skin microbiome. As a future perspective, examining the skin microbiome could be seen as a potential new diagnostic and therapeutic target in inflammatory skin disorders.

  8. Grafting functional antioxidants on highly crosslinked polyethylene

    NASA Astrophysics Data System (ADS)

    Al-Malaika, S.; Riasat, S.; Lewucha, C.

    2016-05-01

    The problem of interference of antioxidants, such as hindered phenols, with peroxide-initiated crosslinking of polyethylene was addressed through the use of functional (reactive) graftable antioxidants (g-AO). Reactive derivatives of hindered phenol and hindered amine antioxidants were synthesised, characterised and used to investigate their grafting reactions in high density polyethylene; both non-crosslinked (PE) and highly peroxide-crosslinked (PEXa). Assessment of the extent of in-situ grafting of the antioxidants, their retention after exhaustive solvent extraction in PE and PEXa, and the stabilising performance of the grafted antioxidants (g-AO) in the polymer were examined and benchmarked against conventionally stabilised crosslinked & non-crosslinked polyethylene. It was shown that the functional antioxidants graft to a high extent in PEXa, and that the level of interference of the g-AOs with the polymer crosslinking process was minimal compared to that of conventional antioxidants which bear the same antioxidant function. The much higher level of retention of the g-AOs in PEXa after exhaustive solvent extraction, compared to that of the corresponding conventional antioxidants, accounts for their superior long-term thermal stabilising performance under severe extractive conditions.

  9. Poly(2-hydroxyethyl methacrylate) (PHEMA) grafted polyethylene/polypropylene (PE/PP) nonwoven fabric by γ-initiation: Synthesis, characterization and benefits of RAFT mediation

    NASA Astrophysics Data System (ADS)

    Kodama, Yasko; Barsbay, Murat; Güven, Olgun

    2014-12-01

    Polyethylene/polypropylene (PE/PP) nonwoven fabrics were functionalized by γ-initiated RAFT mediated grafting of 2-hydroxyethyl methacrylate (HEMA), and the characterization of the grafted samples was carried out using various techniques. FTIR and XPS analysis showed an increase in the oxygenated content till a certain degree of grafting. The results implied a grafting process following the concept of ‘front mechanism’. The initial grafting occurred on the topmost surface layer, and then moved further into the bulk of the polymer matrix. Reversible addition-fragmentation chain transfer (RAFT) mediated grafting yielded a better controlled grafting when compared to those obtained in conventional grafting.

  10. Skin regeneration for giant pigmented nevus using autologous cultured dermal substitutes and epidermis separated from nevus skin.

    PubMed

    Kobayashi, Shinji; Kubo, Kentarou; Matsui, Hiromichi; Torikai, Katuyuki; Kuroyanagi, Yoshimitsu

    2006-02-01

    We have developed a modality of treatment of giant pigmented nevus of intradermal type. This method involves application of autologous cultured dermal substitute (CDS), followed by grafting of epidermis separated from the patient's nevus skin. To prepare the wound bed, autologous CDS was applied onto a full-thickness skin defect after complete excision of the nevus. The excised nevus skin was preserved for 1 week, after which the epidermis was separated from the nevus skin by enzymatic treatment with dispase. The epidermis thus obtained was grafted onto the resulting wound bed. This procedure was used to treat a giant pigmented nevus on a 7-year-old patient. The grafted region was soft with good tone 1 year after epidermis grafting. These results indicate that the present method can achieve complete excision of giant nevus, with esthetically acceptable results, although it requires careful monitoring for a long time.

  11. Evaluation of animal models for predicting skin penetration in man.

    PubMed

    Reifenrath, W G; Chellquist, E M; Shipwash, E A; Jederberg, W W

    1984-04-01

    The human skin grafted athymic nude mouse, pig skin grafted athymic nude mouse, hairless dog, and weanling Yorkshire pig were evaluated as models for predicting skin penetration in man. Nine radiolabeled compounds previously tested on man were applied topically (4 micrograms/cm2) to each animal. These compounds included caffeine, benzoic acid, N,N-diethyl-m-toluamide, three steroids, and three insecticides. To correct for incomplete excretion of the label following topical absorption, percentage penetration was calculated by dividing the percentage of the topically applied radioactive dose recovered in the excreta by the corresponding percentage after parenteral administration and multiplication by 100. In the case of the grafted athymic nude mouse, calculated values of percentage penetration were confirmed because significant correlations (r = 0.78 for the human skin grafted athymic nude mouse and r = 0.97 for the pig skin grafted athymic nude mouse) were found between the calculated values and percentage penetration determined by summing radioactivity recovered in the urine, feces, tissues, and carcass. The results revealed a significant correlation between human skin grafted athymic nude mouse values and human values (r = 0.74, p = 0.05), and between weanling Yorkshire pig values and human values (r = 0.83, p = 0.05). In contrast, no significant correlation existed between human values and those of the hairless dog and pig skin grafted athymic nude mouse. The disposition of radioactivity following topical application of the radiolabeled nerve agent analog ( diisopropylfluorophosphonate ) and simulant (diethyl malonate) was determined in the weanling pig and the human skin grafted athymic nude mouse.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Spreader Grafts in Functional Rhinoplasty.

    PubMed

    Kim, Leslie; Papel, Ira D

    2016-02-01

    Management of the middle vault is paramount to achieving optimal aesthetic and functional outcomes in rhinoplasty. The ideal treatment for middle vault complications, such as internal nasal valve collapse, inverted-V deformity, and middle vault dorsal asymmetry, is prevention. Risk factors for middle vault problems in rhinoplasty that may be identified in preoperative consultation include short nasal bones, long and weak upper lateral cartilages, thin skin, previous trauma or surgery, preoperative positive Cottle maneuver, tension nose deformity, and anteriorly positioned inferior turbinates. When any of these risk factors are identified, preventive measures should be pursued. These include preservation of middle vault support structures, judicious resection in dorsal hump reduction, use of conservative osteotomies, and reconstruction of the cartilaginous middle vault with structural grafting. Spreader grafts have become the workhorse in middle vault reconstruction. They are invaluable in restoring nasal dorsal aesthetic lines, repairing or maintaining the internal nasal valve, and buttressing a corrected crooked nose. Functional and aesthetic problems related to the middle nasal vault are among the most common reasons for patients seeking revision rhinoplasty. Although complications in rhinoplasty are inevitable, underlying their etiology and instituting prophylactic treatment can significantly help reduce their occurrence.

  13. [Cutaneous and mucosal graft for labial defect after animal bite in children].

    PubMed

    Beltramina, G; Kadlub, N; Cassier, S; Constantinescu, G; Vazquez, M P; Picard, A

    2012-06-01

    Animal bite is frequently involved in children labial defect. The need for labial surgical repair is to restore anatomy and function. Local and regional flap is usually described for labial reconstructions. Few authors recommend mucosal and skin graft. In the present study, we described skin and mucosal graft for reconstruction of complex labial defect. This surgical technique can be applied in very young children with reasonable expectations of excellent functional and aesthetic outcome.

  14. Calcar bone graft

    SciTech Connect

    Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

    1986-01-01

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

  15. Grafts in "closed" rhinoplasty.

    PubMed

    Scattolin, A; D'Ascanio, L

    2013-06-01

    Rhinoplasty is a fascinating and complex surgical procedure aiming at attaining a well-functioning and aesthetically pleasant nose. The use of grafts is of the utmost importance for the nasal surgeon to achieve such results. However, the philosophy and technical use of nasal grafts are different in "closed" and "open" rhinoplasty. The aim of this paper is not detailed description of the numerous grafts reported in the literature; we will describe the main principles of grafts use in "closed" rhinoplasty derived from our experience, with special reference to the philosophical and technical differences in their employment between "closed" and "open" rhinoplasty. Some cases are reported as an example of graft use in "endonasal" approach rhinoplasty.

  16. Subdominant H60 antigen-specific CD8 T-cell response precedes dominant H4 antigen-specific response during the initial phase of allogenic skin graft rejection

    PubMed Central

    Yoo, Kang Il; Jeon, Ji Yeong; Ryu, Su Jeong; Nam, Giri; Youn, Hyewon; Choi, Eun Young

    2015-01-01

    In allogeneic transplantation, including the B6 anti-BALB.B settings, H60 and H4 are two representative dominant minor histocompatibility antigens that induce strong CD8 T-cell responses. With different distribution patterns, H60 expression is restricted to hematopoietic cells, whereas H4 is ubiquitously expressed. H60-specific CD8 T-cell response has been known to be dominant in most cases of B6 anti-BALB.B allo-responses, except in the case of skin transplantation. To understand the mechanism underlying the subdominance of H60 during allogeneic skin transplantation, we investigated the dynamics of the H60-specific CD8 T cells in B6 mice transplanted with allogeneic BALB.B tail skin. Unexpectedly, longitudinal bioluminescence imaging and flow cytometric analyses revealed that H60-specific CD8 T cells were not always subdominant to H4-specific cells but instead showed a brief dominance before the H4 response became predominant. H60-specific CD8 T cells could expand in the draining lymph node and migrate to the BALB.B allografts, indicating their active participation in the anti-BALB.B allo-response. Enhancing the frequencies of H60-reactive CD8 T cells prior to skin transplantation reversed the immune hierarchy between H60 and H4. Additionally, H60 became predominant when antigen presentation was limited to the direct pathway. However, when antigen presentation was restricted to the indirect pathway, the expansion of H60-specific CD8 T cells was limited, whereas H4-specific CD8 T cells expanded significantly, suggesting that the temporary immunodominance and eventual subdominance of H60 could be due to their reliance on the direct antigen presentation pathway. These results enhance our understanding of the immunodominance phenomenon following allogeneic tissue transplantation. PMID:25676063

  17. Skin Infections

    MedlinePlus

    ... to the touch may have yellow drainage Of cellulitis: a red, inflamed area on the skin that is tender to the touch may occur in an area of a scratch or cut redness often spreads rapidly over the skin's surface ...

  18. Skin Pigment

    MedlinePlus

    ... Diseases Take Big Slice Out of America's Health, Economy (News) Health Tip: Use Caution When Applying Hair Dye Additional ... Skin Diseases Take Big Slice Out of America's Health, Economy THURSDAY, March 2, 2017 (HealthDay News) -- Skin diseases ...

  19. Sagging Skin

    MedlinePlus

    ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ...

  20. [Surgical Treatment of Medial Epicanthus by Skin Replacement].

    PubMed

    Pfeiffer, M J

    2016-01-01

    Epicanthus is a skin fold covering the inner angle of the eyelid. This fold is typical in the Asian population. It can be observed in a great variety of degrees. In the Caucasian population, epicanthus is associated with some syndromes, such as blepharophimosis syndrome and Down's syndrome. The epicanthal fold originates from excessive tension in the skin and is caused by skin deficit and/or by bridging subcutaneous tissue. The epicanthal fold can be surgically corrected by reducing tension and fully replacing the skin defect by skin redraping or skin grafting.

  1. Skin Aging

    MedlinePlus

    Your skin changes as you age. You might notice wrinkles, age spots and dryness. Your skin also becomes thinner and loses fat, making it ... heal, too. Sunlight is a major cause of skin aging. You can protect yourself by staying out ...

  2. Sensitive skin.

    PubMed

    Misery, L; Loser, K; Ständer, S

    2016-02-01

    Sensitive skin is a clinical condition defined by the self-reported facial presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin may occur in individuals with normal skin, with skin barrier disturbance, or as a part of the symptoms associated with facial dermatoses such as rosacea, atopic dermatitis and psoriasis. Although experimental studies are still pending, the symptoms of sensitive skin suggest the involvement of cutaneous nerve fibres and neuronal, as well as epidermal, thermochannels. Many individuals with sensitive skin report worsening symptoms due to environmental factors. It is thought that this might be attributed to the thermochannel TRPV1, as it typically responds to exogenous, endogenous, physical and chemical stimuli. Barrier disruptions and immune mechanisms may also be involved. This review summarizes current knowledge on the epidemiology, potential mechanisms, clinics and therapy of sensitive skin.

  3. Bone graft substitutes.

    PubMed

    Bhatt, Reena A; Rozental, Tamara D

    2012-11-01

    Replacement of missing bone stock is a reconstructive challenge to upper extremity surgeons and decision-making with regards to available choices remains difficult. Preference is often given to autograft in the form of cancellous, cortical, or corticocancellous grafts from donor sites. However, the available volume from such donor sites is limited and fraught with potential complications. Advances in surgical management and medical research have produced a wide array of potential substances that can be used for bone graft substitute. Considerations in selecting bone grafts and substitutes include characteristic capabilities, availability, patient morbidity, immunogenicity, potential disease transmission, and cost variability.

  4. Probable graft-vs-graft reaction in an infant after exchange transfusion and marrow transplantation.

    PubMed

    Lauer, B A; Githens, J H; Hayward, A R; Conrad, P D; Yanagihara, R T; Tubergen, D G

    1982-07-01

    A newborn with graft-vs-host (GVH) disease following an exchange transfusion was treated by attempting to eradicate the incompatible graft and to reconstitute the child hematologically and immunologically with a bone marrow transplant. The patient was a female term infant (blood group B, Rh+ Coombs test positive) who received a one-unit group O, Rh- exchange transfusion from an unrelated female donor for hyperbilirubinemia due to ABO incompatibility on day 2. Signs of acute GVH disease began on day 8 and the clinical diagnosis was supported by skin biopsy. With antithymocyte globulin and high dose dexamethasone, the GVH reaction improved somewhat. Cyclophosphamide, 200 mg/kg total dose, was given over four days followed by a marrow graft from a brother who was HLA-A, B identical, and probably also D locus compatible in mixed lymphocyte culture. All signs of GVH resolved with cyclophosphamide treatment and hematologic reconstitution was evident by 14 days after transplant. Two weeks later the GVH reaction and aplastic anemia recurred and Y chromatin was detected in only 6% of marrow cells. The infant died on day 80. Autopsy showed disseminated candidiasis, disseminated cytomegalovirus infection, thymic dysplasia, hypoplastic marrow, and other histopathologic changes consistent with GVH disease. The persistence of female cells in blood and bone marrow and the destruction of the reconstituted marrow suggest that the original incompatible transfusion-derived graft was not eliminated and that it ultimately rejected the histocompatible marrow graft.

  5. Biology of human skin transplanted to the nude mouse: I. Response to agents which modify epidermal proliferation.

    PubMed

    Krueger, G G; Shelby, J

    1981-06-01

    To accept human skin transplanted to the congenitally athymic (nude) mouse as a system to study human skin and its physiologic and pathologic states, it must be demonstrated that skin so maintained retains its function as a biologic unit. We have found that responses of grafted human skin and nude mouse skin to various agents differ. This difference in response has been utilized to assess barrier function and proliferative capacity of human skin grafts. Human skin grafts undergo a proliferative response when 10 ng of the tumor promoter, 12-O-tetradecanoyl phorbol 13-acetate (TPA) is applied. Nudes do not respond to this dose. Increasing the dose to 100 ng of TPA evokes a response in both. However, only in the human skin grafts can this response be blocked with betamethasone valerate (BV). In that human skin grafts do not take on their hosts' responsiveness, and the response of domestic pig skin to these agents before and after grafting is identical, the conclusion is reached that human skin appears to retain its inherent biologic unit function. The data also demonstrate some of the potential of this system to study kinetics of the epidermis of human skin.

  6. Evaluation of the variable depth resolution of active dynamic thermography on human skin

    NASA Astrophysics Data System (ADS)

    Prindeze, Nicholas J.; Hoffman, Hilary A.; Carney, Bonnie C.; Moffatt, Lauren T.; Loew, Murray H.; Shupp, Jeffrey W.

    2015-06-01

    Active dynamic thermography (ADT) is an imaging technique capable of characterizing the non-homogenous thermal conductance of damaged tissues. The purpose of this study was to determine optimal stimulation parameters and quantify the optical resolution of ADT through various depths of human skin. Excised tissue from plastic surgery operations was collected immediately following excision. A total of 12 thin to thick split-thickness grafts were harvested from 3 patients. Grafts were placed on top of a 3D printed resolution chart and thermal stimulation was applied from a 300W halogen lamp array for between 0.5-10 seconds to determine optimal parameters. Video was captured with a thermal camera, and analysis was performed by reconstructing an image from thermal gradients. In this study ADT resolved 0.445+/-0 lp/mm at a depth of 0.010", 0.356+/-0.048 lp/mm at a depth of 0.015", 0.334+/-0.027 lp/mm at a depth of 0.020" and 0.265+/-0.022 lp/mm at a depth of 0.025". The stimulus energy required for maximum resolution at each depth was 3- 4s, 8s, 12s and 12s respectively. ADT is a sensitive technique for imaging dermal structure, capable of resolving detail as fine as 1124 μm, 1427 μm, 1502 μm and 1893 μm in thin to thick split-thickness skin grafts respectively. This study has characterized a correlation between stimulus input and maximal resolution at differing depths of skin. It has also defined the functional imaging depth of ADT to below the sub-cutis, well below conventional spectrophotometric techniques.

  7. Vascularized Nerve Grafts and Vascularized Fascia for Upper Extremity Nerve Reconstruction

    PubMed Central

    Kostopoulos, Vasileios K.

    2009-01-01

    Since 1976, experimental and clinical studies have suggested the superiority of vascularized nerve grafts. In this study, a 27-year experience of the senior author is presented regarding vascularized nerve grafts and fascia for complex upper extremity nerve reconstruction. The factors influencing outcomes as well as a comparison with conventional nerve grafts is presented. Since 1981, 21 vascularized nerve grafts, other than vascularized ulnar nerve, were used for reconstruction of nerve injuries in the upper extremity. Indications were prolonged denervation time, failure of the previously used conventional nerve grafts, and excessive scar in the recipient site. Injury was in the hand/wrist area (n = 5), in the forearm (n = 4), in the elbow (n = 2), in the arm (n = 4), or in the plexus (n = 6). Vascularized sural (n = 9), saphenous (n = 8), superficial radial (n = 3), and peroneal (superficial and deep) nerves were used. The mean follow-up was 31.4 months. Vascularized nerve grafts for upper extremity injuries provided good to excellent sensory return in severely scarred upper extremities in patients in whom conventional nerve grafts had failed. They have also provided relief of causalgia after painful neuroma resection and motor function recovery in selective cases even for above the elbow injuries. Small diameter vascularized nerve grafts should be considered for bridging long nerve gaps in regions of excessive scar or for reconstructions where conventional nerve grafts have failed. PMID:19381727

  8. Skin aging and dry skin.

    PubMed

    Hashizume, Hideo

    2004-08-01

    Skin aging appears to be the result of both scheduled and continuous "wear and tear" processes that damage cellular DNA and proteins. Two types of aging, chronological skin aging and photoaging, have distinct clinical and histological features. Chronological skin aging is a universal and inevitable process characterized primarily by physiologic alterations in skin function. In this case, keratinocytes are unable to properly terminally differentiate to form a functional stratum corneum, and the rate of formation of neutral lipids that contribute to the barrier function slows, causing dry, pale skin with fine wrinkles. In contrast, photoaging results from the UVR of sunlight and the damage thus becomes apparent in sun-exposed skin. Characteristics of this aging type are dry and sallow skin displaying fine wrinkles as well as deep furrows, resulting from the disorganization of epidermal and dermal components associated with elastosis and heliodermatitis. Understanding of the functions of the skin and the basic principles of moisturizer use and application is important for the prevention of skin aging. Successful treatment of dry skin with appropriate skin care products gives the impression of eternal youth.

  9. Campfire burns of the palms in crawling infants in Saudi Arabia: results following release and graft of contractures.

    PubMed

    Al-Qattan, Mohammad M

    2009-01-01

    In Saudi Arabia, camping in the desert is commonly practiced by families. A campfire is usually lit and unsupervised crawling infants are at risk of burns from these campfires. During a 12-year period, a total of 53 children with hand contractures related to campfire burns were treated. The mean age at the time of burn was 9 months (range: 5-12 months). All patients presented with isolated palmar contractures of one (n=24) or both (n=29) hands. Surgical release and skin grafting were performed for a total of 82 hands. Full-thickness skin grafts from the groin area were used in mild cases, and thick split-thickness skin grafts harvested from the thigh were used in severe contractures. Graft take ranged from 90 to 100% "take" in all patients. Follow-up ranged from 6 months to 10 years. Recurrence of contracture was calculated for 30 children (52 grafted hands) who had follow-up for more than 5 years. Twenty hands (group I) had thick split-thickness skin grafts, and 10 (50%) of these required a second release and grafting procedure. The remaining 32 hands (group II) had full-thickness grafts and only 3 (9.4%) required a second release and grafting procedure. The difference was statistically significant (P=.003), indicating that group I are more likely to require secondary surgery on long-term follow-up.

  10. Bioglass Activated Skin Tissue Engineering Constructs for Wound Healing.

    PubMed

    Yu, Hongfei; Peng, Jinliang; Xu, Yuhong; Chang, Jiang; Li, Haiyan

    2016-01-13

    Wound healing is a complicated process, and fibroblast is a major cell type that participates in the process. Recent studies have shown that bioglass (BG) can stimulate fibroblasts to secrete a multitude of growth factors that are critical for wound healing. Therefore, we hypothesize that BG can stimulate fibroblasts to have a higher bioactivity by secreting more bioactive growth factors and proteins as compared to untreated fibroblasts, and we aim to construct a bioactive skin tissue engineering graft for wound healing by using BG activated fibroblast sheet. Thus, the effects of BG on fibroblast behaviors were studied, and the bioactive skin tissue engineering grafts containing BG activated fibroblasts were applied to repair the full skin lesions on nude mouse. Results showed that BG stimulated fibroblasts to express some critical growth factors and important proteins including vascular endothelial growth factor, basic fibroblast growth factor, epidermal growth factor, collagen I, and fibronectin. In vivo results revealed that fibroblasts in the bioactive skin tissue engineering grafts migrated into wound bed, and the migration ability of fibroblasts was stimulated by BG. In addition, the bioactive BG activated fibroblast skin tissue engineering grafts could largely increase the blood vessel formation, enhance the production of collagen I, and stimulate the differentiation of fibroblasts into myofibroblasts in the wound site, which would finally accelerate wound healing. This study demonstrates that the BG activated skin tissue engineering grafts contain more critical growth factors and extracellular matrix proteins that are beneficial for wound healing as compared to untreated fibroblast cell sheets.

  11. Skin optics

    SciTech Connect

    van Gemert, M.J.; Jacques, S.L.; Sterenborg, H.J.; Star, W.M.

    1989-12-01

    Quantitative dosimetry in the treatment of skin disorders with (laser) light requires information on propagation of light in the skin related to the optical properties of the individual skin layers. This involves the solution of the integro-differential equation of radiative transfer in a model representing skin geometry, as well as experimental methods to determine the optical properties of each skin layer. These activities are unified under the name skin optics. This paper first reviews the current status of tissue optics, distinguishing between the cases of: dominant absorption, dominant scattering, and scattering about equal to absorption. Then, previously published data as well as some current unpublished data on (human) stratum corneum, epidermis and dermis, have been collected and/or (re)analyzed in terms of absorption coefficient, scattering coefficient, and anisotropy factor of scattering. The results are that the individual skin layers show strongly forward scattering (anisotropy factors between 0.7 and 0.9). The absorption and scattering data show that for all wavelengths considered scattering is much more important than absorption. Under such circumstances, solutions to the transport equation for a multilayer skin model and finite beam laser irradiation are currently not yet available. Hence, any quantitative dosimetry for skin treated with (laser) light is currently lacking.

  12. Foot ischemia after a free fibula flap harvest: immediate salvage with an interpositional sapheneous vein graft.

    PubMed

    Saydam, Funda Akoz; Basaran, Karaca; Ceran, Fatih; Mert, Bulent

    2014-09-01

    The most dreaded major donor-site complication of free fibula flap is a foot ischemia, which is fortunately rare. Various authors have discussed the efficacy of the use of preoperative imaging methods including color Doppler, magnetic resonance angiography, and conventional angiography. A 25-year-old man presented with a 10-cm mandibular defect after a facial gunshot injury. Lower extremity color Doppler revealed triphasic peroneal, tibialis anterior, and posterior artery flows. A fibula osteocutaneous flap was harvested, and the mandible was reconstructed. However, the suture sites at the donor site began to demonstrate signs of necrosis, abscess formation, and widespread cellulitis beginning from postoperative day 9. Angiogram of the lower extremity on the 13th day demonstrated no flow in the right posterior tibial artery distal to the popliteal artery, whereas the anterior tibial artery had weak flow with collateral filling distally. An emergency bypass with a saphenous vein graft between the popliteal artery and the distal posterior tibial artery was performed. Repeated debridements, local wound care, and vacuum-assisted closure were applied. A skin graft was placed eventually. The extremity healed without severe functional disability. In conclusion, although the arterial anatomy is completely normal in preoperative evaluation, vascular complications may still ocur at the donor fibula free flap site. In addition, emergency cardiovascular bypass surgery, as we experienced, may be necessary for limb perfusion.

  13. Immune tolerance of mesenchymal stem cells and induction of skin allograft tolerance.

    PubMed

    Ma, Tengxiao; Wang, Xiao; Jiang, Duyin

    2017-03-01

    Mesenchymal stem cells not only possess reparative properties, but also have immunomodulatory effect. Owing to the properties, they have been proposed to be hopeful candidates for cell therapy in the process of organ transplantation. In the preclinical researches, it shows that MSCs is capable of prolonging graft survival and inducing tolerance in some cases. Various mechanisms of immune tolerance were reported before, such as tolerogenic dendritic cells, induction of apoptosis, regulatory T cells, mixed chimerism, soluble factors and anergy. Furthermore, the induction of immune tolerance may be influenced by the dose, route and optimal timing of MSCs administration. Allograft of skin can provisionally restore the function of skin barrier and offer a good environment to expand micro-skin auto-graft; however, at the same time, it can cause strong immune rejection, which leads to the failure of skin graft. The review aims at analyzing the mechanisms of immunosuppression mediated by MSCs, and the induction of tolerance of skin graft by MSCs.

  14. Skin findings in newborns

    MedlinePlus

    Newborn skin characteristics; Infant skin characteristics; Neonatal care - skin ... the first few weeks of the baby's life. Newborn skin will vary, depending on the length of the pregnancy. Premature infants have thin, transparent skin. The skin of a ...

  15. Skin Infections

    MedlinePlus

    ... it can get infected by them. Some common types of skin infections are Bacterial: Cellulitis and impetigo. Staphylococcal infections can also affect the skin. Viral: Shingles, warts, and herpes simplex Fungal: Athlete's foot and yeast infections Parasitic: Body lice, head lice, and scabies ...

  16. Grafting in revision rhinoplasty.

    PubMed

    Bussi, M; Palonta, F; Toma, S

    2013-06-01

    Rhinoplasty is one of the most difficult aesthetic surgery procedures with a high rate of revision. In revision rhinoplasty the surgeon should explore the patient's concerns and then verify the possibility to satisfy expectations after complete internal and external examination of the nose. For the vast majority of complex secondaries, an open approach is the only reasonable method. In fact, in secondary nasal surgery, because of the scarring process following the primary operation, dissection is tedious, and landmarks are lost. One of the main objectives for the surgeon who approaches secondary rhinoplasty is to restore the structural support of the nose and to replace the lost volume of soft tissues. To achieve this purpose, the surgeon must often rely on grafts. An ideal grafting material must be easy to sculpt, resistant to trauma, infection and extrusion, mechanically stable, inert and readily available. For all these reasons, autogenous cartilage grafts harvested from septum, auricular concha and rib represent the first choice in rhinoplasty. In order to obtain a camouflage graft that provides natural contouring to the nose, temporalis fascia can be used. All these carefully trimmed grafts are useful in tip revision surgery, in secondary surgery of the dorsum and to resolve or reduce functional problems.

  17. Grafts for Ridge Preservation

    PubMed Central

    Jamjoom, Amal; Cohen, Robert E.

    2015-01-01

    Alveolar ridge bone resorption is a biologic phenomenon that occurs following tooth extraction and cannot be prevented. This paper reviews the vertical and horizontal ridge dimensional changes that are associated with tooth extraction. It also provides an overview of the advantages of ridge preservation as well as grafting materials. A Medline search among English language papers was performed in March 2015 using alveolar ridge preservation, ridge augmentation, and various graft types as search terms. Additional papers were considered following the preliminary review of the initial search that were relevant to alveolar ridge preservation. The literature suggests that ridge preservation methods and augmentation techniques are available to minimize and restore available bone. Numerous grafting materials, such as autografts, allografts, xenografts, and alloplasts, currently are used for ridge preservation. Other materials, such as growth factors, also can be used to enhance biologic outcome. PMID:26262646

  18. Graft-versus-host disease

    MedlinePlus

    GVHD; Bone marrow transplant - graft-versus-host disease; Stem cell transplant - graft-versus-host disease; Allogeneic transplant - ... GVHD may occur after a bone marrow, or stem cell, transplant in which someone receives bone marrow ...

  19. Upper eyelid reconstruction by making a skin defect similar to skin removal in blepharoplasty.

    PubMed

    Takahashi, Yasuhiro; Mito, Hidenori; Nakamura, Yasuhisa; Kakizaki, Hirohiko

    2014-09-01

    A 49-year-old man had a sebaceous gland carcinoma in the right upper eyelid. The tumor was excised with an additional 5-mm safety margin. The posterior lamellar reconstruction was performed with a reverse modified Hughes flap and residual conjunctiva. The anterior lamellar reconstruction was performed by making a skin defect similar to a skin removal in blepharoplasty. The skin excision part was designed next to the upper portion of the defect, and the excised skin was grafted to the lower portion of the defect. The skin was closed after making 3 buried double eyelid anchors. The conjunctival pedicle was severed 2 weeks postoperatively. Three months later, the appearance was acceptable without a harmful functional outcome. The basic concepts of our procedure were to make an accustomed scenery, such as a defect similar to a skin removal in blepharoplasty, from an unfamiliar one, such as a defect after a tumor excision, and to make good use of the excised tissue.

  20. Aesthetic Total Reconstruction of Lower Eyelid Using Scapha Cartilage Graft on a Vascularized Propeller Flap

    PubMed Central

    Watanabe, Hidekata; Masumoto, Kazuyuki; Kikuchi, Mamoru; Satake, Yoshiyasu; Yanai, Tetsu; Harada, Yoshimi; Ishihara, Yasuhiro; Yasuta, Masato

    2016-01-01

    Background: The aim of this study was to review the results of a cohort of patients based on our experience with a new technique for total lower eyelid reconstruction after a large defect caused by malignant tumor and trauma. A scapha cartilage graft with small skin on a vascularized propeller flap was used for 16 cases requiring lower eyelid reconstruction. Methods: Patients were identified from a database, and a retrospective case note review was conducted. The scapha cartilage graft was sutured to the margin of the defect of the palpebral conjunctiva and tarsus. The propeller flap, rotated by a perforator-based lateral orbital flap or a subcutaneous-based nasolabial flap, was vascularized on the scapha cartilage graft as anterior lining of the lower eyelid. The follow-up, including results of slit-lamp examination, lasted for varying periods, but often it was for 12 months. Results: The scapha cartilage graft with small skin on a vascularized propeller flap was viable in all cases. Slit-lamp examination detected no irritation or injury of the conjunctiva and cornea, and visual acuity was maintained in all cases. A deformity in the donor helix by this technique was also improved by getting a smaller skin harvested from the scapha. Conclusion: Use of the scapha cartilage graft with small skin on a vascularized propeller flap allows for a good fit to the orbit, short operative time under local anesthesia, good graft viability, and a good esthetic result with minimal donor site morbidity. PMID:27200258

  1. Bone Grafts in Craniofacial Surgery

    PubMed Central

    Elsalanty, Mohammed E.; Genecov, David G.

    2009-01-01

    Reconstruction of cranial and maxillofacial defects is a challenging task. The standard reconstruction method has been bone grafting. In this review, we shall describe the biological principles of bone graft healing, as pertinent to craniofacial reconstruction. Different types and sources of bone grafts will be discussed, as well as new methods of bone defect reconstruction. PMID:22110806

  2. Grafting effects on vegetable quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the United States, vegetable grafting is rare and few experiments have been done to determine optimal grafting procedures and production practices for different geographical and climatic regions in America. Grafting vegetables to control soilborne disease is a common practice in Asia, parts of E...

  3. Skin Cancer

    MedlinePlus

    ... exposure to ultraviolet light, which is found in sunlight and in lights used in tanning salons.What ... the safe-sun guidelines.1. Avoid the sun.Sunlight damages your skin. The sun is strongest during ...

  4. Your Skin

    MedlinePlus

    ... wear sunscreen and protective clothing, such as a hat, to prevent painful sunburns. Protecting your skin now ... happens in a split second, without you ever thinking about it. previous continue Dermis = Lots of Blood ...

  5. Skin Cancer

    MedlinePlus

    ... States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, ... If not treated, some types of skin cancer cells can spread to other tissues and organs. Treatments ...

  6. Skin Bioprinting: Impending Reality or Fantasy?

    PubMed

    Ng, Wei Long; Wang, Shuai; Yeong, Wai Yee; Naing, May Win

    2016-09-01

    Bioprinting provides a fully automated and advanced platform that facilitates the simultaneous and highly specific deposition of multiple types of skin cells and biomaterials, a process that is lacking in conventional skin tissue-engineering approaches. Here, we provide a realistic, current overview of skin bioprinting, distinguishing facts from myths. We present an in-depth analysis of both current skin bioprinting works and the cellular and matrix components of native human skin. We also highlight current limitations and achievements, followed by design considerations and a future outlook for skin bioprinting. The potential of bioprinting with converging opportunities in biology, material, and computational design will eventually facilitate the fabrication of improved tissue-engineered (TE) skin constructs, making bioprinting skin an impending reality.

  7. Senescent Skin

    PubMed Central

    Kushniruk, William

    1974-01-01

    The cutaneous surface is continually influenced by aging and environmental factors. A longer life span is accompanied by an increase in the frequency of problems associated with aging skin. Although most of these changes and lesions are not life threatening, the premalignant lesions must be recognized and treated. The common aging and actinic skin changes are discussed and appropriate management is described. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:20469067

  8. [Experimental and clinical study of skin stored by vitrification].

    PubMed

    Zhu, Z M

    1991-11-01

    To improve the quality of stored skin, vitrification storage method (rapid cooling) was introduced. G group cryoprotective solution (20% DMSO and 6% propylene glycol in kreb's Ringer phosphate solution) was selected from 7 different kinds of solution with low toxicity and high cryoprotective activity. G group solution was proved very effective in cryopreservation of small and large pieces of guinea pig skin. Fresh cadaveric skin, 0.3-0.4 mm in thickness, with an area of 500-1,000 sq.cm was soaked in G group solution for 30 min. After being sealed in plastic bags, the skin was put directly into liquid nitrogen. The skin was thawed in 40 degrees C water bath before use. The cooling rate was about 2160 degrees C/min (by fine transient thermometer). The viabilities of stored skin measured by oxygen consumption (microelectrolyte method) and succinic dehydrogenase (by modified Hershey's method) were about 70% as prestored value, and were 20% higher than those stored by slow cooling method. 250000 sq.cm of vitrified skin stored for one to two years were used in 135 operations for major full thickness burns after tangential excision or excision of eschar. The taken-rate was over 94%. The color of skin turned to red within 3-4 days after grafting. There was no blister formation on the surface of grafted skin. If autologous micro-skin were put underneath the stored skin or small pieces of autologous skin were inserted into the small holes of the stored skin, the wounds healed smoothly within six weeks after operation and no further grafting was needed.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Clinical application and long-term follow-up study of porcine acellular dermal matrix combined with autoskin grafting.

    PubMed

    Jiong, Chen; Jiake, Chai; Chunmao, Han; Yingen, Pan; Qiuhe, Wu; Zhouxi, Fang; Xiangsheng, Feng

    2010-01-01

    The purpose of this study was to investigate the clinical effects of porcine acellular dermal matrix combined with autoskin grafting on full-thickness skin defects using long-term clinical follow-up study and histologic examination. One hundred fifty-two patients with deep burn or trauma hospitalized from February 2000 to July 2003 were repaired with porcine acellular dermal matrix and split-thickness autoskin graft. Take rate of the grafts was calculated on 1 week after operation. Scar hyperplasia was examined on 1, 3, 6, and 12 months after operation. At the same time, the contracture rates of grafted areas were also calculated. Skin biopsy was performed on five patients for histologic examination, as well as transmission electron microscopy 78 months after operation. The take rate of grafts of 116 patients (76.3%) was 100%, and the take rate of the rest of the patients (36 patients, 23.7%) was more than 95%. No one needed skin transplantation for the second time. One hundred twenty-seven patients were followed up on 1 month after operation; grafts showed mild contraction. There was slight cicatricle at skin junction with tender texture. There was no obvious pruritus and blister. One hundred one patients were followed up on 3 months after operation. The graft contraction showed obvious relief with good articular function. Eighty-two patients were followed up on 6 months after operation. The color and texture of the grafts were similar to normal skin without obvious cicatricial hyperplasia. Fifty-eight patients were followed up on 12 months after operation. The grafts were similar to normal skin without obvious rejection. There were no significant differences between the contracture rates at 3, 6, and 12 months and 1 month after the second surgery. Sixteen patients were followed up on 78 months after operation. The appearance of grafts was slightly dry compared with normal skin. Tissue structure of grafts was similar to normal skin with sweat gland-like structure

  10. Acrylonitrile grafted to PVDF

    SciTech Connect

    Yang, Jin; Eitouni, Hany Basam

    2015-03-31

    PVDF-g-PAN has been synthesized by grafting polyacrylonitrile onto polyvinylidene fluoride using an ATRP/AGET method. The novel polymer is ionically conducive and has much more flexibility than PVDF alone, making it especially useful either as a binder in battery cell electrodes or as a polymer electrolyte in a battery cell.

  11. Grafting for disease resistance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The primary purpose of grafting vegetables worldwide has been to provide resistance to soilborne diseases. The potential loss of methyl bromide as a soil fumigant combined with pathogen resistance to commonly used pesticides will make resistance to soil born pathogens even more important in the futu...

  12. Grafting for disease resistance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The primary purpose of grafting vegetables worldwide has been to provide resistance to soil-borne diseases. The potential loss of methyl bromide as a soil fumigant combined with pathogen resistance to commonly used pesticides will make resistance to soil-borne pathogens even more important in the fu...

  13. Comparative Analysis of Early Excision and Grafting vs Delayed Grafting in Burn Patients in a Developing Country.

    PubMed

    Puri, Vinita; Khare, Nishant A; Chandramouli, M V; Shende, Nilesh; Bharadwaj, Sumit

    2016-01-01

    The present study attempts to compare how the patients who undergo early excision and grafting behave as compared with patients who are treated along usual conservative lines of management in centers where the resources are less than optimal. The data of 20 female patients were analyzed. Age of the patients ranged between 20 and 30 years, percentage area burn ranged between 20 and 40%, and percentage area resurfaced by skin grafting 5 to 10%. The patients were divided into two groups of 10 patients each. Group I included those patients who underwent early excision and grafting within 5 days of burn injury. Group II included those patients who were treated conservatively and the residual raw area was grafted 3 weeks or more after sustaining the burn. The two groups were compared for the amount of blood loss, transfusion requirement, graft take, and the total hospital stay. Statistical significance was tested by the application of Mann-Whitney U test. The mean percentage area burn was 29.1 ± 5.6% in group I and 24.7 ± 4.9% in group II. Mean percentage area resurfaced by skin grafting in group I was 9.4 ± 2.3% and 8.1 ± 1.6% in group II. Graft take in group I was 90 ± 7.8%, whereas that in group II was 95 ± 6.7%. Mean blood loss in group I and group II was 346 ± 17.6 ml and 241 ± 14.7 ml respectively. (P = .001). Mean transfusion requirement in the perioperative period was 1.6 pints in group I and 1.1 pints in group II. The mean hospital stay in the patients who underwent early excision and grafting was 15.1 ± 4.1 days, whereas that in the patients who underwent delayed grafting was 36.2 ± 6.3 days (P = .001). Early excision and grafting decreases the hospital stay of burn patients. The present study suggests that it has a definite applicability even in places where the resources might be less than optimal.

  14. Skin ulceration due to cement.

    PubMed Central

    Robinson, S M; Tachakra, S S

    1992-01-01

    Despite legislation that requires manufacturers to inform the public about the dangers of contact with cement, severe ulceration from cement contact still occurs. We present a retrospective study of seven patients presenting to this department over a 2-year period. All were male and employed in the building trade, their injuries being sustained whilst at work. The injuries were to the lower limb, often multiple and required a median of seven visits before healing was complete. One required hospital admission and skin grafting. PMID:1449582

  15. The versatile autogenous rib graft in septorhinoplasty.

    PubMed

    Sherris, D A; Kern, E B

    1998-01-01

    In the graft depleted revision rhinoplasty patient and the patient with major tissue needs, alternatives to septal and conchal cartilage grafts are needed. The costal cartilage graft and rib bone/costal cartilage combination graft are excellent alternatives. In this study 14 patients received 40 grafts from 20 autogenous ribs harvested during septorhinoplasty. Materials were harvested for use as septal replacement grafts, cantilevered grafts, dorsal onlay grafts, columellar struts, and tip grafts. Patient followup was 6 to 31 months, and no evidence of graft resorption or warpage was evident during that period. Complications of harvest were minimal, and harvest techniques are detailed.

  16. Adaptive skin detection based on online training

    NASA Astrophysics Data System (ADS)

    Zhang, Ming; Tang, Liang; Zhou, Jie; Rong, Gang

    2007-11-01

    Skin is a widely used cue for porn image classification. Most conventional methods are off-line training schemes. They usually use a fixed boundary to segment skin regions in the images and are effective only in restricted conditions: e.g. good lightness and unique human race. This paper presents an adaptive online training scheme for skin detection which can handle these tough cases. In our approach, skin detection is considered as a classification problem on Gaussian mixture model. For each image, human face is detected and the face color is used to establish a primary estimation of skin color distribution. Then an adaptive online training algorithm is used to find the real boundary between skin color and background color in current image. Experimental results on 450 images showed that the proposed method is more robust in general situations than the conventional ones.

  17. Bone Graft Substitution and Augmentation.

    PubMed

    Nauth, Aaron; Lane, Joseph; Watson, J Tracy; Giannoudis, Peter

    2015-12-01

    Selection of appropriate bone graft or bone graft substitute requires careful recognition of the bone healing needs of the patient's specific clinical problem and a thorough understanding of the different properties possessed by the available bone grafts and substitutes. Although autogenous iliac crest bone graft remains the gold standard of treatment for delayed unions, nonunions, and bone defects, there are a number of promising alternatives available, and emerging evidence suggests that they can be very effective when used in the proper setting. Among these, reamer-irrigator-aspirator bone graft, bone marrow concentrate, bone morphogenetic proteins, and calcium phosphate cements have received a great deal of attention in the literature. This review describes these grafts in detail along with the evidence for their use. In addition, a framework is provided for selecting the appropriate graft or substitute based on their provided properties.

  18. Fatal pyoderma gangrenosum with pathergy after coronary artery bypass grafting.

    PubMed

    Bryan, Charles S

    2012-01-01

    Surgeons and others who perform invasive procedures should be aware of the possibility of pyoderma gangrenosum and the risk of pathergy in patients who have a history of unexplained skin ulcers or poor wound-healing. We report the case of a 70-year-old man in whom diffuse erythema over the anterior chest wall and marked leukocytosis developed after coronary artery bypass grafting. This prompted débridement and opening of the sternotomy wound. The cause of the erythema was pyoderma gangrenosum that expressed the pathergy phenomenon. The pyoderma gangrenosum subsequently involved the saphenous vein harvest site, a chest-tube site, and a previously healed abdominal scar. The patient died when an exposed saphenous vein graft was perforated. To our knowledge, this is the 9th reported case of pathergy due to pyoderma gangrenosum after coronary artery bypass grafting and the first with a fatal outcome.

  19. Corneal grafting and banking.

    PubMed

    Ehlers, Niels; Hjortdal, Jesper; Nielsen, Kim

    2009-01-01

    Corneal transplantation was conceptualized at the end of the 18th century, but it took more than 100 years before human corneal grafting was introduced. The greatest step forward was the demonstration by Filatov that corneal tissue can be collected and used post mortem. The history of eye banking includes the development of preservation techniques. Storage in cold to minimize microbial growth and tissue disintegration was first choice but during the last 30 years this has been taken over by warm storage (organ culture) where the donor cornea proves its sterility and vitality before being transferred to the recipient. The long-term organ culture storage makes exchange between centres possible and allows for histocompatibility matching. The internationalization led to the establishing of the European Eye Bank Association but also to an increasing number of governmental regulations. Developments in years to come may lead to control of graft biomechanics and optics. This technical development tends to favour a centralization.

  20. [Grafting of carotid arteries].

    PubMed

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D

    2005-01-01

    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  1. Dacron Graft Aneurysm Treated by Endovascular Stent-Graft

    SciTech Connect

    Ofer, Amos; Nitecki, Samy; Hoffman, Aaron; Engel, Ahuva

    2001-01-15

    A 72-year old man who underwent aorto-bifemoral bypass with insertion of a Dacron graft 18 years previously presented with an aneurysm in the left limb of his graft. Angiography also demonstrated a bilateral occlusion of the popliteal arteries. Computed tomography (CT) angiography was performed and showed a localized dilation of 3 cm in the left limb of the graft, which had a diameter of 14 mm throughout. In view of the technical difficulties of a surgical procedure, an endovascular stent was considered. Through a left femoral arteriotomy, a stent graft was inserted and deployed in the left limb of the graft. This resulted in total exclusion of the Dacron graft aneurysm. To the best of our knowledge, this is the first report of such a procedure.

  2. Siloxane-grafted membranes

    DOEpatents

    Friesen, D.T.; Obligin, A.S.

    1989-10-31

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional group. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  3. Siloxane-grafted membranes

    DOEpatents

    Friesen, Dwayne T.; Obligin, Alan S.

    1989-01-01

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional groups. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  4. Cartilage putty: a novel use of fibrin glue with morselised cartilage grafts for rhinoplasty surgery.

    PubMed

    Stevenson, Susan; Hodgkinson, Peter D

    2014-11-01

    Cartilage grafts have multiple purposes within rhinoplasty surgery. The senior author has previously used wrapped diced cartilage grafts but found it difficult to maintain the integrity of the graft "package" during placement. Introduction of Tisseel fibrin glue stabilises the cartilage fragments producing a rubbery mass that can be used like "cartilage putty." This malleable construct can be inserted and moulded with less risk of dispersal. This technique has now been used on nineteen patients. It has provided a valuable method of reconstruction especially in complex cases such as revision rhinoplasty and patients with a thin dorsal skin envelope. There has been no evidence of graft absorption or requirement for additional surgery to date. The addition of Tisseel to wrapped diced cartilage grafts, has proven in this series of complex rhinoplasty patients, to be a useful adjunct which aids insertion and contouring. Furthermore, beneficial effects on healing have been demonstrated which contributes to good quality long-term cosmetic results. Level of Evidence V.

  5. [Transfusion associated graft versus host disease following cardiovascular surgery].

    PubMed

    Aybey, Bekir; Coşkun, Diler; Aytaç, Jale

    2006-01-01

    In this report, a case of transfusion-associated graft versus host disease that developed following coronary arter bypass grafting and mitral annuloplasty operations, has been presented. The diagnosis of 62 year-old male patient was based on the presence of typical findings as fever, liver function disorders, skin rash and hypoplastic bone marrow findings that began ten days after the operation; with the exclusion of other pathologies (e.g. drug eruptions, viral infections, septicemia, scalded skin syndrome and toxic epidermal necrolysis) and histopathological findings of skin biopsy. There was a history of five units of blood transfusion of which one was from a close relative. The blood from the relative was thought to be responsible for the disease. With this case, we wanted to emphasize once more that transfusion of the blood of a relative must be avoided in patients who have undergone major operations such as cardiovascular surgery. The irradiation of these bloods before transfusion may be effective to prevent graft versus host disease.

  6. Skin lumps

    MedlinePlus

    ... DM. Dermal and subcutaneous tumors. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical ... Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  7. Evaluation of dermal-epidermal skin equivalents ('composite-skin') of human keratinocytes in a collagen-glycosaminoglycan matrix(Integra artificial skin).

    PubMed

    Kremer, M; Lang, E; Berger, A C

    2000-09-01

    Integra artificial skin (Integra LifeSciences Corp., Plainsboro, NJ, USA) is a dermal template consisting of bovine collagen, chondroitin-6-sulphate and a silastic membrane manufactured as Integra. This product has gained widespread use in the clinical treatment of third degree burn wounds and full thickness skin defects of different aetiologies. The product was designed to significantly reduce the time needed to achieve final wound closure in the treatment of major burn wounds, to optimise the sparse autologous donor skin resources and to improve the durable mechanical quality of the skin substitute. The clinical procedure requires two stages. The first step creates a self neodermis, the second creates a self epidermis on the neodermis. However, it is desirable to cover major burn wounds early in a single step by a skin substitute consisting of a dermal equivalent seeded in vitro with autologous keratinocytes ('composite-skin') out of which a full thickness skin develops in vivo.The goal of this experimental study was to develop a method to integrate human keratinocytes in homogeneous distribution and depth into Integra Artificial Skin. The seeded cell-matrix composites were grafted onto athymic mice in order to evaluate their potential to reconstitute a human epidermis in vivo. We were able to demonstrate that the inoculated human keratinocytes reproducibly displayed a homogeneous pattern of distribution, adherence, proliferation and confluence. The cell-matrix composites grafted in this model exhibited good wound adherence, complete healing, minor wound contraction and had the potential to reconstitute an elastic, functional and durable human skin. Histologically we were able to show that the inoculated human keratinocytes in vivo colonised the matrix in a histomorphologically characteristic epidermal pattern (keratomorula, keratinocyte bubbling) and developed a persisting, stratified, keratinising epidermis which immunohistologically proved to be of human

  8. Selection of a right posterior sector graft for living donor liver transplantation.

    PubMed

    Yoshizumi, Tomoharu; Ikegami, Toru; Kimura, Koichi; Uchiyama, Hideaki; Ikeda, Tetsuo; Shirabe, Ken; Maehara, Yoshihiko

    2014-09-01

    Right posterior sector (RPS) grafts have been used to overcome graft size discrepancies, the major concern of living donor liver transplantation. Previous studies have reported the volumetry-based selection of RPS grafts without anatomical exclusion. We reviewed our data and established selection criteria for RPS grafts. The procurement of RPS grafts [conventional (n = 3) and extended (n = 5)] was performed for 8 of 429 recipients at our center. Extended RPS grafts contained the drainage area of the right hepatic vein. The mean graft weight (GW) according to 3-dimensional computed tomography volumetry was 488 g, and the GW/standard liver weight (SLW) ratio was 42.6%. The mean actual GW was 437 g, and the GW/SLW ratio was 38.4%. One donor exhibited standard bifurcation of the right portal vein (PV) and the left PV, and 2 donors exhibited trifurcation of the left PV, the right anterior portal vein (APV), and the posterior PV. The remaining 5 donors exhibited APV branching from the left PV, which is the most suitable anatomy for RPS grafts. Two recipients died of sepsis or small-for-size graft syndrome. One underwent retransplantation because of an intractable bile leak and fibrosing cholestatic hepatitis. Intractable bile duct (BD) stenosis developed in 4 of the 6 survivors. In conclusion, with the significant complications and potential concerns associated with RPS grafts, these grafts should be used very rarely and with extreme caution. Donors with the standard bifurcation of the PV and the posterior BD running through the dorsal side of the posterior PV are not suitable candidates for RPS grafts. Extended RPS graft procurement is recommended for easier parenchymal transection.

  9. Treatment of large segmental bone defects with reamer-irrigator-aspirator bone graft: technique and case series.

    PubMed

    McCall, Todd A; Brokaw, David S; Jelen, Bradley A; Scheid, D Kevin; Scharfenberger, Angela V; Maar, Dean C; Green, James M; Shipps, Melanie R; Stone, Marcus B; Musapatika, Dana; Weber, Timothy G

    2010-01-01

    Treatment of large segmental defects using conventional autogenous iliac crest bone graft can be limited by volume of cancellous bone and donor site morbidity. The reamer-irrigator-aspirator (RIA) technique allows access to a large volume of cancellous bone graft containing growth factors with potency equal to or greater than autograft material from the iliac crest. The purpose of this study was to evaluate the effectiveness of RIA-harvested autogenous bone graft for treating large segmental defects of long bones.

  10. Human Split-Thickness Skin Allograft from Brain-Dead Donors

    PubMed Central

    Khodadadi, A.; Olang, O; Makhllough, A; Nozary Heshmati, B.; Azmoudeh Ardalan, F.; Tavakoli, S. A.

    2016-01-01

    Background: Looking for an appropriate skin substitute for temporary and permanent coverage of wounds remains one of the main obstacles of medical researchers. Objective: To investigate the rate of inflammation, symbiosis, and survival of grafted allograft skin from brain-dead donors (BDDs) in rabbits. Methods: After receiving negative serologic tests of BDDs, we prepared partial thickness skin grafts. They were then used in treating wounds of 5 rabbits in comparison with split-thickness skins taken from cardiac dead donors. Results: On histopathological examinations, we found no difference between the skins. All samples were separated from the baseline in 15–20 days. Conclusion: Gamma-irradiated freeze-dried human split-thickness skin taken from BDDs is safe and can be used for the treatment of deep skin burns. PMID:27721966

  11. Helical CT Angiography of Abdominal Aortic Aneurysms Treated with Suprarenal Stent Grafting: A Pictorial Essay

    SciTech Connect

    Sun Zhonghua

    2003-06-15

    The endovascular repair of abdominal aorticaneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating patients with inappropriate aneurysm necks.Unlike open repair, the success of endoluminal repair cannot be ascertained by means of direct examination and thus relies on imaging results. The use of conventional angiography for arterial imaging has become less dominant, while helical computed tomography angiography(CTA) has become the imaging modality of choice for both preoperative assessment and postoperative followup after treatment with stent graft implants. There is an increasing likelihood that radiologists will become more and more involved in the procedure of aortic stent grafting and in giving the radiological report on these patients treated with stent grafts. It is necessary for radiologists to be familiar with the imaging findings, including common and uncommon appearances following aortic stent grafting. The purpose of this pictorial essay is to describe and present normal and abnormal imaging appearances following aortic stent grafting based on helical CTA.

  12. Mycobacterium fortuitum infection of the scalp after a skin graft.

    PubMed

    Smith, Blaine D; Liras, Ioannis N; De Cicco, Ignacio A; Aisenberg, Gabriel Marcelo

    2016-10-19

    Mycobacterium fortuitum is a non-tuberculous mycobacterium found in the soil and water of most regions of the world, and it can cause disease in immunocompetent and immunocompromised hosts. We present a 52-year-old man who developed a scalp abscess under a free flap for cranium coverage after a motor vehicle accident. Culture of material drained from the abscess grew M. fortuitum.

  13. Skin Cancer Foundation

    MedlinePlus

    ... Host a Fundraising Event | About Us | Store The Skin Cancer Foundation The Skin Cancer Foundation is the ... Handbook A "Sunscreen Gene"? Skin Cancer Facts & Statistics Skin Cancer Treatment Glossary Information on medications and procedures ...

  14. Skin Pigmentation Disorders

    MedlinePlus

    Pigmentation means coloring. Skin pigmentation disorders affect the color of your skin. Your skin gets its color from a pigment called melanin. Special cells in the skin make melanin. When these cells become damaged or ...

  15. Femoral impaction grafting

    PubMed Central

    Scanelli, John A; Brown, Thomas E

    2013-01-01

    Femoral impaction grafting is a reconstruction option applicable to both simple and complex femoral component revisions. It is one of the preferred techniques for reconstructing large femoral defects when the isthmus is non-supportive. The available level of evidence is primarily derived from case series, which shows a mean survivorship of 90.5%, with revision or re-operation as the end-point, with an average follow-up of 11 years. The rate of femoral fracture requiring re-operation or revision of the component varies between several large case series, ranging from 2.5% to 9%, with an average of 5.4%. PMID:23362469

  16. Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery.

    PubMed

    He, Guo-Wei; Taggart, David P

    2016-03-01

    Spasm of arterial grafts in coronary artery bypass grafting surgery is still a clinical problem, and refractory spasm can occasionally be lethal. Perioperative spasm in bypass grafts and coronary arteries has been reported in 0.43% of all coronary artery bypass grafting surgery, but this may be an underestimate. Spasm can develop not only in the internal mammary artery but more frequently in the right gastroepiploic and radial artery. The mechanism of spasm can involve many pathways, particularly those involving regulation of the intracellular calcium concentration. Endothelial dysfunction also plays a role in spasm. Depending on the clinical scenario, the possibility of spasm during and after coronary artery bypass grafting should be confirmed by angiography. If present, immediate intraluminal injection of vasodilators is often effective, although other procedures such as an intraaortic balloon pump or extracorporeal membrane oxygenation may also become necessary to salvage the patient. Prevention of spasm involves many considerations, and the principles are discussed in this review article.

  17. Cutting Balloon-Assisted Angioplasty of an Anastomotic Carotid-Brachial Bypass Graft Stenosis: A Case Report

    SciTech Connect

    Prabhudesai, Vikramaditya; Orme, Richard Fox, Anthony D.

    2004-08-15

    Neointimal hyperplasia leads to anastomotic stenosis in bypass grafts. These stenoses are often resistant to conventional balloon dilatation. We present a case of a carotid-brachial bypass graft stenosis, which was treated by a 5-mm cutting balloon angioplasty with a good angiographic and clinical result.

  18. Immobilization of bacteria in microgel grafted onto macroporous polyethylene

    NASA Astrophysics Data System (ADS)

    Trelles, J. A.; Quiroga, F.; Britos, C.; Smolko, Eduardo E.; Grasselli, Mariano

    2010-03-01

    The development of " Green Chemistry" requires new materials to replace the conventional organic chemistry by biological catalysts, to produce fine chemicals in an environmentally friendly manner. Microbial whole cells can be directly used as biocatalysts, providing a simple and cheap methodology since enzyme isolation and purification are avoided. High-density polyethylene (HDPE) is a very stable polymer though it can be activated by gamma radiation to induce grafting. Glycidyl methacrylate was grafted onto macroporous HDPE and PP in the range of 1-6%, proportional to the initial monomer concentration. Grafted polymers were further chemically modified with ethylenediamine to generate a cationic hydrogel of micron-size thickness onto the internal polymer surfaces. Modified polymers were able to immobilize Gram-positive and Gram-negative bacteria that can catalyze a chemical reaction as efficient as free cells do.

  19. Cutaneous skin tag

    MedlinePlus

    Skin tag; Acrochordon; Fibroepithelial polyp ... have diabetes. They are thought to occur from skin rubbing against skin. ... The tag sticks out of the skin and may have a short, narrow stalk connecting it to the surface of the skin. Some skin tags are as long as ...

  20. Cicatricial eyebrow reconstruction with a dense-packing one- to two-hair grafting technique.

    PubMed

    Wang, Jiping; Fan, Jincai

    2004-11-01

    Scarring eyebrow loss is usually repaired with a hair-bearing island scalp flap or scalp strip grafting technique. The results, however, are usually not desirable with regard to appearance. In this article, a one- or two-hair graft with a dense-packing technique was developed for cicatricial eyebrow reconstruction. It was carried out by harvesting a scalp strip close to the hairline of the back, then dividing it into a series of one- or two-hair grafts, and finally implanting the grafts into the prepared recipient holes of the eyebrow with a desired hair direction. With the authors' experience in treating 96 patients (154 eyebrows) in cases of burn, skin grafting, traumatic scarring, and chemical peeling scar after tattoo removal, the eyebrows could be restored in only one session. In general, 150 to 200 grafts with 200 to 250 hairs were needed for a complete male eyebrow reconstruction and 100 to 150 grafts with 150 to 200 hairs were needed for a complete female eyebrow reconstruction. The maximal hair density was 91.5 hairs/cm per session. Over a 6-month follow-up period, the mean graft survival rate reached 98.1 percent. All of the patients achieved satisfactory results, with a very natural appearance. These results indicate that the above-mentioned technique could be a practical, effective, and probably ideal method for cicatricial eyebrow reconstruction.

  1. Spermatogonial stem cell enrichment using simple grafting of testis and in vitro cultivation.

    PubMed

    Lim, Jung Jin; Seol, Dong Won; Choi, Kyung Hee; Shin, Dong Hyuk; Kim, Hyung Joon; Song, Seung-Hun; Lee, Dong Ryul

    2014-08-01

    Enrichment of spermatogonial stem cells (SSCs) from the mammalian adult testis faces several limitations owing to their relatively low numbers among many types of advanced germ cells and somatic cells. The aim of the present study was to improve the isolation efficiency of SSCs using a simple tissue grafting method to eliminate the existing advanced germ cells. Sliced testis parenchyma obtained from adult ICR or EGFP-expressing transgenic mice were grafted heterotropically under the dorsal skin of nude mice. The most advanced germ cells disappeared in the grafted tissues after 2-4 weeks. Grafted tissues were dissociated enzymatically and plated in culture dishes. During in vitro culture, significantly more SSCs were obtained from the grafted testes than from non-grafted controls, and the isolated SSCs had proliferative potential and were successfully maintained. Additionally, EGFP-expressing SSCs derived from graft parenchyma were transplanted into bulsufan-treated recipient mice testes. Finally, we obtained EGFP-expressing pups after in vitro fertilization using spermatozoa derived from transplanted SSCs. These results suggest that subcutaneous grafting of testis parenchyma and the subsequent culture methods provide a simple and efficient isolation method to enrich for SSCs in adult testis without specific cell sorting methods and may be useful tools for clinical applications.

  2. Successful use of a gastrocnemius flap for an exposed PTFE femorodistal graft: a case report.

    PubMed

    Nabulyato, W M; Alsahiem, H; Szepelak, K; Boyle, J R; Malata, C M

    2014-10-01

    Peripheral vascular disease (PVD) is a condition requiring aggressive management to minimise the associated increased morbidity and mortality. Femoro-distal bypass grafting is used in patients with extensive occlusion affecting the crural arteries and poor limb function, but is associated with infection, wound dehiscence and graft exposure. We report a case of a 73-year-old male with history of PVD and occluded ipsilateral femoro-distal bypass graft who underwent limb salvage surgery with a left 6 mm heparin-bonded polytetrafluoroethylene femoro-distal bypass graft in September 2011. He later presented with exposure of the graft over the lateral aspect of the knee following wound dehiscence. During surgery, the exposed portion of the graft was covered by a lateral gastrocnemius muscle flap with an overlying split thickness skin graft. Minor donor site healing problems were noted, but he otherwise made an excellent recovery. While gastrocnemius muscle flaps have been used to cover soft tissue tibial defects secondary to sarcoma and exposed knee joint prostheses, our case adds to the limited literature demonstrating successful salvage of an exposed synthetic graft as a viable alternative to amputation. We therefore recommend prompt referral to plastic services for the management of these complex wounds.

  3. Effect of a selective thromboxane synthase inhibitor on arterial graft patency and platelet deposition in dogs

    SciTech Connect

    McDaniel, M.D.; Huntsman, W.T.; Miett, T.O.; Cronenwett, J.L.

    1987-08-01

    This study examined the effect of selective thromboxane synthase inhibition and nonselective cyclooxygenase inhibition on vascular graft patency and indium 111-labeled platelet deposition in 35 mongrel dogs undergoing carotid artery replacement with 4 mm X 4 cm polytetrafluoroethylene (PTFE) (one side) and Dacron (opposite side) end-to-end grafts. Aspirin-dipyridamole therapy improved one-week graft patency, from 46% in untreated dogs to 93% in treated dogs. Thromboxane synthase inhibition (U-63557A) improved graft patency in these dogs to 81%. Both drug treatments reduced platelet deposition on Dacron and PTFE grafts by 48% to 68% compared with control dogs. Dacron grafts accumulated significantly more platelets than PTFE grafts but had comparable patency rates. Low-dose aspirin therapy had no significant effect on either graft patency or platelet deposition. All treatment groups showed a 60% to 76% reduction in serum thromboxane B2, but only thromboxane synthase inhibitor treatment increased plasma 6-keto-prostaglandin F1 alpha by 100%. Selective thromboxane synthase inhibition improved small-caliber prosthetic graft patency to the same extent as did conventional cyclooxygenase inhibition in this preliminary study.

  4. Pediatric burn wound impetigo after grafting.

    PubMed

    Aikins, Kimberly; Prasad, Narayan; Menon, Seema; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Modern burn care techniques have reduced the risk of infection of the acute burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial abscesses and ulceration has been termed burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric burns were treated with skin grafts, with 7% developing burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with conservative management (96 days), followed by antibacterial dressings (37 days), oral antibiotics (36 days), topical steroids (16 days), and oral antibiotics in combination with topical steroids (13.5 days). Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral antibiotics plus topical steroids should be considered.

  5. Polyether/Polyester Graft Copolymers

    NASA Technical Reports Server (NTRS)

    Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

    1986-01-01

    Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

  6. Graft selection in cerebral revascularization.

    PubMed

    Baaj, Ali A; Agazzi, Siviero; van Loveren, Harry

    2009-05-01

    Cerebral revascularization constitutes an important treatment modality in the management of complex aneurysms, carotid occlusion, tumor, and moyamoya disease. Graft selection is a critical step in the planning of revascularization surgery, and depends on an understanding of graft and regional hemodynamics, accessibility, and patency rates. The goal of this review is to highlight some of these properties.

  7. Grafting effects on vegetable quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vegetable grafting began in the 1920s to control soil-borne disease. It is now a common practice in Asia, parts of Europe, and the Middle East. In Japan and Korea most of the cucurbits and tomatoes (Lycopersicon esculentum Mill.) grown are grafted. This practice is rare in the U.S. and there have...

  8. Continuous ACL graft, results

    PubMed Central

    Díaz, Jorge Luis; Vega, Marcelo; Matesevach, Ivan

    2017-01-01

    Objectives: describe our technique using hamstring graft that respects the proximal continuity of Semitendinosus and uses the superior biological potential of the distal periosteum., preserving and stressing the ST reinforce the retropulsión and dynamic control of external rotation of the knee. Here the technique, results, difficulties and foundations. Methods: The sample of this research was composed of 229 cases operated between 01/03/97 and 01/03/13 in Arthroscopy Private Center., 166 male and 63 female, the postop follow-up was 86 months. Evaluated with IKDC, Lysholm, Hamstring EMG. Comparative histology study in rabbits. Results: IKDC and Lysholm score showed 93% of very good results. Conclusion: Dynamic ACL reconstruction achieves a static-dynamic stabilization of the knee. Grafts have a plus in their biological potential (proximal continuity - osteo-periosteal insertion of the tendons in the femoral tunnel). The hamstring maintains its functionality (EMG). 93% satisfactory results (IKDC, Lysholm). It is a valid surgical option in ACL injuries.

  9. [Stent Grafting for Aortic Dissection].

    PubMed

    Uchida, Naomichi

    2016-07-01

    The purpose of stent graft for aortic dissection is to terminate antegrade blood flow into the false lumen through primary entry. Early intervention for primary entry makes excellent aortic remodeling and emergent stent grafting for complicated acute type B aortic dissection is supported as a class I. On the other hand stent grafting for chronic aortic dissection is controversial. Early stent grafting is considered with in 6 months after on-set if the diameter of the descending aorta is more than 40 mm. Additional interventions for residual false lumen on the downstream aorta are still required. Stent graft for re-entry, candy-plug technique, and double stenting, other effective re-interventions were reported. Best treatment on the basis of each anatomical and physical characteristics should be selected in each institution. Frozen elephant trunk is alternative procedure for aortic dissection without the need to take account of proximal anatomical limitation and effective for acute type A aortic dissection.

  10. Review of Cutaneous Graft-vs-Host Disease.

    PubMed

    Ballester-Sánchez, R; Navarro-Mira, M; Sanz-Caballer, J; Botella-Estrada, R

    2016-04-01

    Graft-vs-host disease (GVHD) is a multisystem disease that arises as a complication of allogeneic hematopoietic stem cell transplant. It is due to recognition of the recipient's tissues by immune cells from the donor. The skin and mucous membranes are the organs most commonly affected. GVHD is classified as acute or chronic depending on the pathophysiology and clinical presentation. Acute GVHD typically presents with the triad of rash, diarrhea, and hyperbilirubinemia, and treatment is based on systemic corticosteroid and immunosuppressant therapy. The cutaneous manifestations of chronic GVHD are divided into sclerodermiform and nonsclerodermiform, and the mucous membranes and skin appendages may also be affected. The diagnosis is mainly clinical, but skin biopsy can help in doubtful cases. Treatment can be topical, systemic, or physical, depending on the size, site, and depth of the lesions and the involvement of other organs.

  11. Radiation grafting on natural films

    NASA Astrophysics Data System (ADS)

    Lacroix, M.; Khan, R.; Senna, M.; Sharmin, N.; Salmieri, S.; Safrany, A.

    2014-01-01

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37-40 N mm-1) and puncture deformation (PD=6.5-9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282-296 N mm-1 and PD of 5.0-5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films.

  12. Progress and opportunities for tissue-engineered skin

    NASA Astrophysics Data System (ADS)

    MacNeil, Sheila

    2007-02-01

    Tissue-engineered skin is now a reality. For patients with extensive full-thickness burns, laboratory expansion of skin cells to achieve barrier function can make the difference between life and death, and it was this acute need that drove the initiation of tissue engineering in the 1980s. A much larger group of patients have ulcers resistant to conventional healing, and treatments using cultured skin cells have been devised to restart the wound-healing process. In the laboratory, the use of tissue-engineered skin provides insight into the behaviour of skin cells in healthy skin and in diseases such as vitiligo, melanoma, psoriasis and blistering disorders.

  13. Vascularized bone grafts for the treatment of carpal bone pathology.

    PubMed

    Derby, Brian M; Murray, Peter M; Shin, Alexander Y; Bueno, Reuben A; Mathoulin, Christophe L; Ade, Tim; Neumeister, Michael W

    2013-03-01

    Primary bone healing fails to occur in 5-15 % of scaphoid bones that undergo fracture fixation. Untreated, occult fractures result in nonunion up to 12 % of the time. Conventional bone grafting is the accepted management in the treatment algorithm of scaphoid nonunion if the proximal pole is vascularized. Osteonecrosis of the proximal scaphoid pole intuitively suggests a need for transfer of the vascularized bone to the nonunion site. Scaphoid nonunion treatment aims to prevent biological and mechanical subsidence of the involved bone, destabilization of the carpus, and early degenerative changes associated with scaphoid nonunion advanced collapse. Pedicled distal radius and free vascularized bone grafts (VBGs) offer hand surgeons an alternative treatment option in the management of carpal bone nonunion. VBGs are also indicated in the treatment of avascular necrosis of the scaphoid (Preiser's disease), lunate (Kienböck's disease), and capitate. Relative contraindications to pedicled dorsal radius vascularized bone grafting include humpback deformity, carpal instability, or collapse. The free medial femoral condyle bone graft has offered a novel treatment option for the humpback deformity to restore geometry of the carpus, otherwise not provided by pedicled grafts. In general, VBGs are contraindicated in the setting of a carpal bone without an intact cartilaginous shell, in advanced carpal collapse with degenerative changes, and in attempts to salvage small or collapsed bone fragments. Wrist salvage procedures are generally accepted as the more definitive treatment option under such circumstances. This manuscript offers a current review of the techniques and outcomes of VBGs to the carpal bones.

  14. Hyperbaric Oxygen Therapy for the Compromised Graft or Flap

    PubMed Central

    Francis, Ashish; Baynosa, Richard C.

    2017-01-01

    Significance: Tissue grafts and flaps are used to reconstruct wounds from trauma, chronic disease, tumor extirpation, burns, and infection. Despite careful surgical planning and execution, reconstructive failure can occur due to poor wound beds, radiation, random flap necrosis, vascular insufficiency, or ischemia–reperfusion (IR). Traumatic avulsions and amputated composite tissues—compromised tissue—may fail from crush injury and excessively large sizes. While never intended, these complications result in tissue loss, additional surgery, accrued costs, and negative psychosocial patient effects. Recent Advances: Hyperbaric oxygen (HBO) has demonstrated utility in the salvage of compromised grafts/flaps. It can increase the likelihood and effective size of composite graft survival, improve skin graft outcomes, and enhance flap survival. Mechanisms underlying these beneficial effects include increased oxygenation, improved fibroblast function, neovascularization, and amelioration of IR injury. Critical Issues: Common strategies for the compromised graft or flap include local wound care, surgical debridement, and repeated reconstruction. These modalities are associated with added costs, time, need for reoperation, morbidity, and psychosocial effects. Preservation of the amputated/avulsed tissues minimizes morbidity and maximizes the reconstructive outcome by salvaging the compromised tissue and obviating additional surgery. HBO is often overlooked as a potential tool that can limit these issues. Future Directions: Animal studies demonstrate a benefit of HBO in the treatment of compromised tissues. Clinical studies support these findings, but are limited to case reports and series. Further research is needed to provide multicenter prospective clinical studies and cost analyses comparing HBO to other adjunctive therapies in the treatment of compromised grafts/flaps. PMID:28116225

  15. Decomposing Composing Conventions.

    ERIC Educational Resources Information Center

    Beers, Terry

    Recent research has invited critiques of the authoritative descriptions of composing found in many rhetoric textbooks. The concept of "convention" may be especially useful in rethinking the teleological basis of these textbook descriptions. Conventions found in composition textbooks need to be unmasked as arbitrary concepts which serve…

  16. Structurally Enhanced Self-Plasticization of Poly(vinyl chloride) via Click Grafting of Hyperbranched Polyglycerol.

    PubMed

    Lee, Kyu Won; Chung, Jae Woo; Kwak, Seung-Yeop

    2016-12-01

    A highly self-plasticized poly(vinyl chloride) (PVC) is demonstrated for the first time via click grafting of hyperbranched polyglycerol (HPG). The plasticizing effect of the grafted HPG on PVC is systematically investigated by various analytical methods. The amorphous and bulky dendritic structure of HPG efficiently increases the free volume of the grafted PVC, which leads to a remarkably lower glass transition temperature comparable to that of the conventional plasticized PVC. Viscoelastic analysis reveals that HPG considerably improves the softness of the grafted PVC at room temperature and promotes the segmental motion in the system. The HPG-grafted PVC films exhibit an exceptional stretchability unlike the mixture of PVC and HPG because the covalent attachment of HPG to PVC allows it to maintain its homogeneous and well-organized architecture under tensile stretching. The work provides valuable insights into the design of highly flexible and stretchable polymeric materials by means of introducing hyperbranched side chains.

  17. A practical approach to MRI of coronary artery bypass graft patency and flow.

    PubMed

    van Rossum, A C; Galjee, M A; Post, J C; Visser, C A

    1997-06-01

    Direct visualization of coronary artery bypass grafts can be obtained non-invasively by magnetic resonance imaging. Several studies demonstrated a high sensitivity and somewhat lower specificity for detection of vein-graft patency, using the conventional spin-echo and gradient-echo techniques. In addition, the true functional status can be assessed by determining the flowrate within the graft using phase velocity mapping. Important limitations of the previously applied techniques include the inability to accurately evaluate the different segments of jump grafts and the presence of graft stenoses. Further improvement is to be expected from the recent introduction of breath-hold imaging sequences and the forthcoming introduction of bloodpool-avid contrast agents.

  18. 3D Stereoscopic Visualization of Fenestrated Stent Grafts

    SciTech Connect

    Sun Zhonghua; Squelch, Andrew; Bartlett, Andrew; Cunningham, Kylie; Lawrence-Brown, Michael

    2009-09-15

    The purpose of this study was to present a technique of stereoscopic visualization in the evaluation of patients with abdominal aortic aneurysm treated with fenestrated stent grafts compared with conventional 2D visualizations. Two patients with abdominal aortic aneurysm undergoing fenestrated stent grafting were selected for inclusion in the study. Conventional 2D views including axial, multiplanar reformation, maximum-intensity projection, and volume rendering and 3D stereoscopic visualizations were assessed by two experienced reviewers independently with regard to the treatment outcomes of fenestrated repair. Interobserver agreement was assessed with Kendall's W statistic. Multiplanar reformation and maximum-intensity projection visualizations were scored the highest in the evaluation of parameters related to the fenestrated stent grafting, while 3D stereoscopic visualization was scored as valuable in the evaluation of appearance (any distortions) of the fenestrated stent. Volume rendering was found to play a limited role in the follow-up of fenestrated stent grafting. 3D stereoscopic visualization adds additional information that assists endovascular specialists to identify any distortions of the fenestrated stents when compared with 2D visualizations.

  19. Solid phase graft copolymerization of acrylic monomers onto thermoplastics and their use as blend compatibilizers

    NASA Astrophysics Data System (ADS)

    Subramanian, Srinivas

    This research work is an extension of some of the earlier work done on the development of solid phase grafting technique to graft various monomers onto polymers as well as postulation of the usefulness of the graft copolymers thus synthesized. Polystyrene grafted with acrylic acid, previously developed in bench scale, was synthesized in pilot-plant scale batches. Process parameter studies on the grafting of acrylic acid onto polypropylene and developmental studies on the grafting of maleic anhydride onto polystyrene were also done. Polymers grafted with polar molecules such as maleic anhydride and acrylic acid have been used to compatibilize immiscible blends of polar and non-polar polymers. On the same note, the applicability of the solid phase graft copolymers as blend compatibilizers were investigated and their performance was compared to commercially available compatibilizers. Solid phase graft copolymerization process is a technique to synthesize graft copolymers. Some of its salient features are use of minimal solvent to conduct the reaction and easy equipment modification. It is a low pressure and low temperature process. This technique provides a viable alternative to the environmentally hazardous, and time consuming conventional process currently in use. Hence, development of this technique could be beneficial not only to the plastics industry, but also to mankind. Also, this technique provides a low-cost and extremely easy method to develop graft copolymers such as acrylic acid functionalized polymers that are rapidly gaining popularity as blend compatibilizers and polymer reinforcing agents. A study that proves the potential of these solid phase graft copolymers as good blend compatibilizers for industrially important immiscible polymers will develop interest in the industries about this grafting process. The free radical solid phase graft copolymerization process was carried in a modified Brabender-type mixer fitted with specially designed blades to

  20. Facile one-step catalytic grafting of N-hydroxysuccinimidyl-ester-functionalized methallylsilane onto silica for enzyme immobilization.

    PubMed

    Jung, Un-Young; Park, Jung-Woo; Han, Eun-Hee; Kang, Sin-Gun; Lee, Sera; Jun, Chul-Ho

    2011-02-01

    A one-step grafting method of NHS-ester group is described for the immobilization of enzymes onto a silica surface at room temperature. Pure NHS-ester functionalized methallylsilane was prepared as a grafting reagent and showed remarkable grafting efficiency with acid catalysts at room temperature. As a result, mesoporous silica balls bearing a covalently immobilized enzyme could be obtained with a high loading rate compared to conventional multistep grafting methods. This one-step procedure offers the advantages of precise measurement of the high loading efficiency of the NHS-ester group, and the exclusive formation of only the NHS-ester group, which reduces the presence of unreacted functionalities.

  1. Skin Keratins

    PubMed Central

    Wang, Fengrong; Zieman, Abigail; Coulombe, Pierre A.

    2016-01-01

    Keratins comprise the type I and type II intermediate filament-forming proteins and occur primarily in epithelial cells. They are encoded by 54 evolutionarily conserved genes (28 type I, 26 type II) and regulated in a pairwise and tissue type-, differentiation-, and context-dependent manner. Keratins serve multiple homeostatic and stress-enhanced mechanical and nonmechanical functions in epithelia, including the maintenance of cellular integrity, regulation of cell growth and migration, and protection from apoptosis. These functions are tightly regulated by posttranslational modifications as well as keratin-associated proteins. Genetically determined alterations in keratin-coding sequences underlie highly penetrant and rare disorders whose pathophysiology reflects cell fragility and/or altered tissue homeostasis. Moreover, keratin mutation or misregulation represents risk factors or genetic modifiers for several acute and chronic diseases. This chapter focuses on keratins that are expressed in skin epithelia, and details a number of basic protocols and assays that have proven useful for analyses being carried out in skin. PMID:26795476

  2. Vulvar lichen sclerosus: A new regenerative approach through fat grafting.

    PubMed

    Boero, Veronica; Brambilla, Massimiliano; Sipio, Elisa; Liverani, Carlo A; Di Martino, Mirella; Agnoli, Benedetta; Libutti, Giada; Cribiù, F M; Del Gobbo, Alessandro; Ragni, Enrico; Bolis, Giorgio

    2015-12-01

    OBJECTIVE. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. METHODS. Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. RESULTS. 34 out of 36 patients (94%) showed a better vulvar trophismof the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia major a and minor a, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p b 0001) and FSFI (p b 0001). CONCLUSIONS. Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life.

  3. The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

    PubMed Central

    Yu, Yang; Zhang, Fan; Gao, Ming-Xin; Li, Hai-Tao; Li, Jing-Xing; Song, Wei; Huang, Xin-Sheng; Gu, Cheng-Xiong

    2013-01-01

    OBJECTIVES Intraoperative transit time flow measurement (TTFM) is widely used to assess anastomotic quality in coronary artery bypass grafting (CABG). However, in sequential vein grafting, the flow characteristics collected by the conventional TTFM method are usually associated with total graft flow and might not accurately indicate the quality of every distal anastomosis in a sequential graft. The purpose of our study was to examine a new TTFM method that could assess the quality of each distal anastomosis in a sequential graft more reliably than the conventional TTFM approach. METHODS Two TTFM methods were tested in 84 patients who underwent sequential saphenous off-pump CABG in Beijing An Zhen Hospital between April and August 2012. In the conventional TTFM method, normal blood flow in the sequential graft was maintained during the measurement, and the flow probe was placed a few centimetres above the anastomosis to be evaluated. In the new method, blood flow in the sequential graft was temporarily reduced during the measurement by placing an atraumatic bulldog clamp at the graft a few centimetres distal to the anastomosis to be evaluated, while the position of the flow probe remained the same as in the conventional method. This new TTFM method was named the flow reduction TTFM. Graft flow parameters measured by both methods were compared. RESULTS Compared with the conventional TTFM, the flow reduction TTFM resulted in significantly lower mean graft blood flow (P < 0.05); in contrast, yielded significantly higher pulsatility index (P < 0.05). Diastolic filling was not significantly different between the two methods and was >50% in both cases. Interestingly, the flow reduction TTFM identified two defective middle distal anastomoses that the conventional TTFM failed to detect. Graft flows near the defective distal anastomoses were improved substantially after revision. CONCLUSIONS In this study, we found that temporary reduction of graft flow during TTFM seemed to

  4. Research Techniques Made Simple: Skin Carcinogenesis Models: Xenotransplantation Techniques.

    PubMed

    Mollo, Maria Rosaria; Antonini, Dario; Cirillo, Luisa; Missero, Caterina

    2016-02-01

    Xenotransplantation is a widely used technique to test the tumorigenic potential of human cells in vivo using immunodeficient mice. Here we describe basic technologies and recent advances in xenotransplantation applied to study squamous cell carcinomas (SCCs) of the skin. SCC cells isolated from tumors can either be cultured to generate a cell line or injected directly into mice. Several immunodeficient mouse models are available for selection based on the experimental design and the type of tumorigenicity assay. Subcutaneous injection is the most widely used technique for xenotransplantation because it involves a simple procedure allowing the use of a large number of cells, although it may not mimic the original tumor environment. SCC cell injections at the epidermal-to-dermal junction or grafting of organotypic cultures containing human stroma have also been used to more closely resemble the tumor environment. Mixing of SCC cells with cancer-associated fibroblasts can allow the study of their interaction and reciprocal influence, which can be followed in real time by intradermal ear injection using conventional fluorescent microscopy. In this article, we will review recent advances in xenotransplantation technologies applied to study behavior of SCC cells and their interaction with the tumor environment in vivo.

  5. Utilization of skin flap for reconstruction of the genitalia after an electric burn.

    PubMed

    Castro, Rodrigo B; Oliveira, Ana B; Favorito, Luciano A

    2006-01-01

    The objective of this article is to describe a case of an electric burn to the genitalia causing scrotal and testicular lesion, and the subsequent reconstruction using a skin graft. The patient was a 10-year-old boy who was victim of an electric burn that harmed the genitalia. There was extended skin loss, penile, scrotal and partial testicular lesion. The treatment consisted of plastic surgery to reconstruct the genitalia with skin flaps grafted on the left thigh, the scrotum and the base of the penis. The patient recovered well and was discharged after two weeks. We concluded that in severe cases of electric burns to the genitalia, skin graft offer a good therapeutic option.

  6. Late-onset acute graft-versus-host disease mimicking hand, foot, and mouth disease

    PubMed Central

    Mahabal, Gauri; George, Leni; Bindra, Mandeep; George, Biju

    2016-01-01

    Acute skin graft-versus-host disease (GVHD) classically presents as a pruritic erythematous maculopapular rash. We describe a patient who underwent allogeneic hematopoietic stem cell transplantation and presented with a hand foot and mouth disease like clinical presentation. Histopathology was suggestive of acute GVHD. This case is being reported to make dermatologists aware of this unusual presentation of GVHD. PMID:27990387

  7. Computational fluid dynamics evaluation of the cross-limb stent graft configuration for endovascular aneurysm repair.

    PubMed

    Shek, Tina L T; Tse, Leonard W; Nabovati, Aydin; Amon, Cristina H

    2012-12-01

    The technique of crossing the limbs of bifurcated modular stent grafts for endovascular aneurysm repair (EVAR) is often employed in the face of splayed aortic bifurcations to facilitate cannulation and prevent device kinking. However, little has been reported about the implications of cross-limb EVAR, especially in comparison to conventional EVAR. Previous computational fluid dynamics studies of conventional EVAR grafts have mostly utilized simplified planar stent graft geometries. We herein examined the differences between conventional and cross-limb EVAR by comparing their hemodynamic flow fields (i.e., in the "direct" and "cross" configurations, respectively). We also added a "planar" configuration, which is commonly found in the literature, to identify how well this configuration compares to out-of-plane stent graft configurations from a hemodynamic perspective. A representative patient's cross-limb stent graft geometry was segmented using computed tomography imaging in Mimics software. The cross-limb graft geometry was used to build its direct and planar counterparts in SolidWorks. Physiologic velocity and mass flow boundary conditions and blood properties were implemented for steady-state and pulsatile transient simulations in ANSYS CFX. Displacement forces, wall shear stress (WSS), and oscillatory shear index (OSI) were all comparable between the direct and cross configurations, whereas the planar geometry yielded very different predictions of hemodynamics compared to the out-of-plane stent graft configurations, particularly for displacement forces. This single-patient study suggests that the short-term hemodynamics involved in crossing the limbs is as safe as conventional EVAR. Higher helicity and improved WSS distribution of the cross-limb configuration suggest improved flow-related thrombosis resistance in the short term. However, there may be long-term fatigue implications to stent graft use in the cross configuration when compared to the direct

  8. Mycotic Abdominal Aortic Aneurysm Secondary to Septic Embolism of a Thoracic Aorta Graft Infection.

    PubMed

    Blanco Amil, Carla Lorena; Vidal Rey, Jorge; López Arquillo, Irene; Pérez Rodríguez, María Teresa; Encisa de Sá, José Manuel

    2016-05-01

    Mycotic aneurysms account for 1% of abdominal aortic aneurysms. There are very few cases published that describe the formation of mycotic aneurysms after septic embolism due to graft infection. We present the first case to our knowledge to be described in the literature of a mycotic aneurysm caused by septic embolism derived from a thoracic aorta graft infection, treated with conventional surgery leading to a successful outcome and evolution.

  9. Clinical and Economic Benefits of Autologous Epidermal Grafting

    PubMed Central

    Kirsner, Robert S

    2016-01-01

    Chronic wounds are an increasingly prevalent disease with a significant healthcare burden. These wounds often do not respond to standard of care therapy alone, requiring the use of adjuvant therapies. Epidermal grafting, previously utilized primarily for correction of leukoderma, is increasingly being recognized as a beneficial therapy for wounds, both acute and chronic. Epidermal grafting has been shown to be effective in the management of chronic wounds, with successful healing in refractory patients. It has not only been shown to be effective, but it is also associated with lower cost and morbidity than traditional skin grafting techniques as well as improved donor site healing. Through the use of a novel epidermal harvesting system, the CelluTome™ Epidermal Harvesting System (KCI, an Acelity company, San Antonio, TX), this treatment modality has become more standardized, reproducible, and easy to use as well as less time consuming, making its use in the clinical setting more convenient and beneficial. Epidermal grafting, therefore, represents a promising, efficacious, and cost-effective option for treatment of refractory non-healing wounds. PMID:27994993

  10. Antibiotic therapy of aortic graft infection: treatment and prevention recommendations.

    PubMed

    Hodgkiss-Harlow, Kelley D; Bandyk, Dennis F

    2011-12-01

    Surgical site infection (SSI) after aortic intervention, an uncommon but serious vascular condition, requires patient-specific antibiotic therapy. Effective treatment and prevention requires the vascular surgeon to be cognizant of changing SSI microbiology, advances in antibiotic delivery, and patient characteristics. The majority of aortic graft infections are caused by Gram-positive bacteria, with methicillin-resistant Staphylococcus aureus now the prevalent pathogen. Nasal carriage of methicillin-sensitive or methicillin-resistant S aureus strains, diabetes mellitus, recent hospitalization, a failed arterial reconstruction, and the presence of a groin incision are important SSI risk factors. Overall, the aortic SSI rate is higher than predicted by the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance risk category system; ranging from 5% after open or endovascular aortic interventions to as high as 10% to 15% after aortofemoral bypass or uni-aortoiliac grafting with femorofemoral bypass. Perioperative measures to reduce S aureus nares and skin colonization, administration of antibiotic prophylaxis, meticulous wound closure/care, and therapy directed to optimize patient host defense regulation mechanisms (eg, temperature, oxygenation, blood sugar) can minimize SSI occurrence. Antibiotic therapy for aortic graft infection should utilize bactericidal drugs that penetrate bacteria biofilms and can be delivered to the surgical site both parenterally and locally in the form of antibiotic-impregnated beads or prosthetic grafts.

  11. Are Aortic Stent Grafts Safe in Pregnancy?

    PubMed Central

    Khandanpour, Nader; Mehta, Tapan A.; Adiseshiah, M.; Meyer, Felicity J.

    2015-01-01

    Aortic stent grafts are increasingly used to treat aortic aneurysms and also other aortic pathologies. The safety of aortic stent grafts in pregnancy has never been studied or reported. We report on two cases of aortic stent grafts in pregnant women and discuss the effect of pregnancy on these aortic stent grafts. PMID:26229702

  12. Activity of host-derived T cells which differentiate in nude mice grafted with co-isogenic or allogeneic thymuses.

    PubMed

    Kindred, B; Loor, F

    1974-05-01

    If nude mice are grafted with a neonatal thymus, host type precursor cells develop within the graft thymus and after about 6 wk the T-cell population of the thymus, spleen, and lymph nodes is of host type. However, immunological responsiveness produced in nude mice in this manner is incomplete: (a) the ability to react to T-cell mitogens in vitro is greater than in untreated nudes but lower than in normal mice; (b) the response to T-cell dependent antigens is less than normal; and (c) the rejection of skin grafts is slower than in normal animals. Whether host precursor cells which differentiate in an allogeneic thymus are able to reject skin grafts from thymus donor strain appears to depend on the strain combination used.

  13. Behavior of grafted polymers on nanofillers and their influence on polymer nanocomposite properties

    NASA Astrophysics Data System (ADS)

    Dukes, Douglas Michael

    Polymer nanocomposites continue to receive wide-spread acclaim for their potential to improve composite materials beyond conventional macroscale fillers. The improvement lies both in the altered properties of the particle itself and in the interaction region surrounding the filler. As the surface area of the filler increases, a greater volume fraction of this interphase region is present in the composite. However, simply minimizing the particle size to maximize surface area introduces additional problems; the larger specific surface area promotes aggregation to reduce the surface energy. Since the composite's properties are largely tied to the morphology, aggregation prevents control over the dispersion state of the filler, and thus the properties. Therefore, disaggregation and morphology control are vital to achieving designable nanocomposites. To accomplish both tasks, this thesis focuses on the behavior of grafted polymer coatings on nanoparticles and their in uence on the macroscopic properties. Grafted chains play an integral role in both morphology control and reinforcement. To investigate the behavior of polymer brushes on nanoparticles, polystyrene was grafted on 15 nm silica particles at varying graft densities and molecular weights. Dynamic light scattering studies in dilute solution were performed to obtain the brush height as a function of both graft density and molecular weight. Three distinct regimes of behavior exist, the "mushroom", the semi-dilute polymer brush (SDPB), and the concentrated polymer brush (CPB) regimes. In the CPB regime, which is an extraordinary configuration of highly-stretched chains on densely grafted surfaces, the brush height h was found to scale as h ∝ N4/5, where N is the degree of polymerization. This result is contrary to the observed scaling of the CPB in flat interface systems, where h ∝ N1. To explore the behavior of grafted chains in the melt, molecular dynamics simulations were performed on grafted nanoparticles

  14. The nude mouse model for the study of human skin disorders.

    PubMed

    Gilhar, A; Etzioni, A

    1994-01-01

    Normal human skin grafted onto the nude mouse can be maintained without any signs of rejection throughout the life-span of the animal. Indeed, the nude mouse model is a powerful tool for understanding the pathological process of the skin. Until now many skin diseases such as psoriasis, cutaneous lupus, pemphigus and vitiligo have been looked at using the nude mouse model, which has helped to clarify the role of the various factors involved.

  15. Skin (Pressure) Sores

    MedlinePlus

    ... Treatments and Side Effects Managing Cancer-related Side Effects Skin Problems Pressure Sores A skin or pressure sore ... Content Usage Policy . Skin Problems Dry Skin Itching Skin Color Changes Pressure Sores Scars ... and Paying for Treatment Treatments and Side Effects Survivorship: During and After Treatment Caregivers and Family ...

  16. A Quiet Convention.

    ERIC Educational Resources Information Center

    Suggs, Welch

    2003-01-01

    Describes how discussion of governance and academic standards dominated the proceedings at the first NCAA convention of Myles Brand's presidency. The new president also offered a qualified endorsement of Title IX. (EV)

  17. Minamata Convention on Mercury

    EPA Pesticide Factsheets

    On November 6, 2013 the United States signed the Minamata Convention on Mercury, a new multilateral environmental agreement that addresses specific human activities which are contributing to widespread mercury pollution

  18. Lichenoid Variant of Chronic Cutaneous Graft Versus Host Reaction Post Blood Transfusion: A Rare Event Post Blood Transfusion.

    PubMed

    Ramakrishnaiah, Pushpa Kodipalya; Lakshman, Archana; Aradhya, Sacchidanand Sarvajnamurthy; Veerabhadrappa, Nataraja Holavanahally

    2015-01-01

    Chronic graft versus host disease (GVHD) is a less frequently seen disease that occurs post solid organ or bone marrow transplantation. Chronic GVHD occurring post blood transfusion is an even more uncommon disease. It can present either as a lichenoid disease or as a sclerodermatous disease involving multiple systems. In this article, we report a case of chronic graft versus host reaction occurring in skin secondary to blood transfusion.

  19. Lichenoid Variant of Chronic Cutaneous Graft Versus Host Reaction Post Blood Transfusion: A Rare Event Post Blood Transfusion

    PubMed Central

    Ramakrishnaiah, Pushpa Kodipalya; Lakshman, Archana; Aradhya, Sacchidanand Sarvajnamurthy; Veerabhadrappa, Nataraja Holavanahally

    2015-01-01

    Chronic graft versus host disease (GVHD) is a less frequently seen disease that occurs post solid organ or bone marrow transplantation. Chronic GVHD occurring post blood transfusion is an even more uncommon disease. It can present either as a lichenoid disease or as a sclerodermatous disease involving multiple systems. In this article, we report a case of chronic graft versus host reaction occurring in skin secondary to blood transfusion. PMID:26538747

  20. Histoplasma infection of aortofemoral bypass graft.

    PubMed

    Patel, Nishit; Bronze, Michael S

    2014-05-01

    Histoplasma infection of vascular grafts is extremely rare. To our knowledge, there are only 4 cases reported with Histoplasma capsulatum infection of the aortic graft. All had previous disseminated histoplasmosis and atherosclerotic peripheral vascular disease. They were treated surgically with explantation of the infected graft and reimplantation of new graft in extra-anatomic uninfected site. The authors present a new case of H capsulatum infection of aortofemoral bypass graft, but unlike the other cases, this case was managed without surgical intervention.

  1. Dermabrasion and Thin Epidermal Grafting for Treatment of Large and Small Areas of Postburn Leukoderma: A Case Series and Review of the Literature.

    PubMed

    Driscoll, Daniel N; Levy, Alexander N; Gama, Amon-Ra

    2016-01-01

    Deep burn injuries can have serious aesthetic consequences as it often results in scar tissue and pigmentary changes of the skin. The focus of this article is to report our experience and results using dermabrasion and thin split-thickness skin grafting as a technique for restoring skin pigmentation after burn injuries. Patient records were obtained from a pediatric burn hospital medical record database from 1990 to 2007. Both charts and photographs were retrospectively reviewed. The treatment was evaluated for body region treated, surface area involved, effectiveness of treatment, and number of treatments required. Indications for the procedure included longstanding depigmentation, defined as greater than 1 year, and a patient wiling to have a donor site. The areas of vitiligo were marked and dermabraded with a mechanical dermabrader. Thin epidermal grafts with a thickness of 6 thousands of an inch were harvested with an air-powered dermatome. The grafts were affixed to the dermabraded bed and dressed open or with nonstick gauze for areas of the face and wrapped for areas in the extremities. Eleven patients underwent 16 procedures. The average size of the graft per procedure was 87 cm (4-500 cm). All results were consistent and long-lasting at follow-up. Postburn leukoderma of long duration is well treated by dermabrasion and thin split-thickness skin grafting. This study is unique in describing grafting on multiple occasions and for larger areas than previously described, with two patients undergoing grafting more than 200 cm.

  2. Posttransplantation quality of life: more than graft function.

    PubMed

    Habwe, Violet Q

    2006-04-01

    Whereas newer immunosuppressive therapies have increased patient and graft survival, long-term treatment with these drugs has been linked to medical and physical complications that may impact on posttransplantation quality of life. Immunosuppression-related physical side effects that can alter appearance--including hirsutism, gingival hyperplasia, weight gain, cushingoid facies, hand tremors, alopecia, and skin disorders--are among the most bothersome to patients and may have serious psychosocial implications. In addition, physical side effects may influence patient adherence to their prescribed treatment regimens and result in more serious complications, such as acute rejection, graft loss, rehospitalization, and even mortality. Therefore, strategies for minimizing side effects of immunosuppressive therapy and improving medication adherence are integral to better long-term transplant recipient management.

  3. Asian Rhinoplasty: Correction of the Short Nose with a Septal Integration Graft

    PubMed Central

    Kim, Hyunsoo; Han, Kihwan

    2015-01-01

    Correction of the short nose is the most challenging part in a rhinoplasty. It is even more difficult in Asians compared with Caucasians due to the thicker skin soft tissue envelope and weaker cartilaginous frameworks. Additionally, most of the Asian patients need augmentation of the nasal dorsum, and projection of the nasal tip at the same time of short nose surgery, which makes short nose correction more complex. Septal extension grafts can effectively and concomitantly correct a short nose. However, the amount of the septal cartilage is not sufficient as a source for the graft often; therefore, the authors devised a septal integration graft in which a septal cartilage graft was fixed to the caudal septum (columellar L-strut) in an end-to-end position to save an amount of the septal cartilage for correction of the short nose. A septal integration graft application resulted in lengthening of the short nose. In addition, the retracted columella and the acute columellar labial angle were improved aesthetically. Therefore, the authors suggest a septal integration graft, a modification of the septal extension graft, for correction of the short nose in an Asian rhinoplasty. PMID:26648807

  4. [Kidney grafts from elderly donors].

    PubMed

    Hiesse, Christian; Pessione, Fabienne; Cohen, Sophie

    2003-06-07

    FROM AN EPIDEMIOLOGICAL POINT OF VIEW: The epidemiology of renal transplantation had greatly changed over the past 10 years. The increasing number of patients with renal failure and candidates for transplantation increases the demand for grafts, whereas the sampling rate of organs remains stable. The mean age of the donors is rising, hence underlining the question of the use of organs of so-called "borderline" quality. THE WEAK POINTS OF ELDERLY GRAFTS: Aging of the kidneys affects the structure of the parenchyma and renal function, which decreases, notably in hypertensive persons. The elderly graft exhibits a critical mass of nephrons that is insufficient to fulfil the functional requirements of a poorly equipped recipient. The recipient is more sensitive to the added agressions: prolonged ischemia and immunological and medicinal agressions. THE RESULTS OF RENAL GRAFT FROM ELDERLY DONORS: They are quantitatively and qualitatively inferior to those of renal transplants from "ideal" donors. The donor's age is a significant factor influencing negatively influences the survival of the transplanted kidney, but dependent on past vascular history. Good results regarding the maintenance of dialysis are obtained by selecting the donors and by avoiding added risk factors. THE ASSESSMENT OF A GRAFT FROM AN ELDERLY DONOR: This, basically, relies on clinical criteria: donor's history, cause of death and accurate measurement of the renal function. A biopsy of the graft, at the time of sampling, provides useful information. TRANSPLANTATION STRATEGY OF A GRAFT FROM AN ELDERLY DONOR: Donor-recipient matching by age is a common approach. Grafting of both kidneys in the same recipient is a method presently under assessment. The episode of ischemia must be reduced and the immunosuppressive therapy adapted.

  5. Bone Grafting: Sourcing, Timing, Strategies, and Alternatives.

    PubMed

    Egol, Kenneth A; Nauth, Aaron; Lee, Mark; Pape, Hans-Christoph; Watson, J Tracy; Borrelli, Joseph

    2015-12-01

    Acute fractures, nonunions, and nonunions with bone defects or osteomyelitis often need bone graft to facilitate union. There are several factors to consider when it is determined that a bone graft is needed. These factors include the source of the bone graft (autograft vs. allograft), proper timing for placement of the bone graft, strategies to avoid further complications (particularly in the setting of osteomyelitis), and with the development of a variety of bone graft substitutes, whether alternatives to autograft are available and appropriate for the task at hand. Autograft bone has commonly been referred to as the "gold standard" of bone grafts, against which the efficacy of other grafts has been measured. The best timing for when to place a bone graft or substitute is also somewhat controversial, particularly after an open fracture or a potentially contaminated bed. The treatment of infected nonunions, particularly those that require a graft to facilitate healing, can be quite challenging. Typically, the infection is completely eradicated before placement of a bone graft, but achieving a sterile bed and the timing of a bone graft require strategic thinking and planning. This review outlines the benefits of autografts, the most suitable sites for harvesting bone grafts, the timing of bone graft procedures, the potential risks and benefits of grafting in the face of infection, and the currently available bone graft extenders.

  6. Costal Grafting in Mandibular Reconstruction

    PubMed Central

    Bourlet, Jerôme; Château, Joseph; Jacquemart, Mathieu; Dufour, Clémence; Mojallal, Ali; Gleizal, Arnaud

    2015-01-01

    Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8 PMID:26893990

  7. Interventions in Infrainguinal Bypass Grafts

    SciTech Connect

    Mueller-Huelsbeck, S. Order, B.-M.; Jahnke, T.

    2006-02-15

    The interventional radiologist plays an important role in the detection and prevention of infrainguinal bypass failure. Early detection and evaluation of flow-limiting lesions effectively preserve graft (venous bypass and polyester or expanded polytetrafluoroethylene bypass) patency by identifying stenoses before occlusion occurs. Delay in treatment of the at-risk graft may result in graft failure and a reduced chance of successful revascularization. For this reason, surveillance protocols form an important part of follow-up after infrainguinal bypass surgery. As well as having an understanding of the application of imaging techniques including ultrasound, MR angiography, CT angiography and digital subtraction angiography, the interventional radiologist should have detailed knowledge of the minimally invasive therapeutic options. Percutaneous transluminal angioplasty (PTA), or alternatively cutting balloon angioplasty, is the interventional treatment of choice in prevention of graft failure and occlusion. Further alternatives include metallic stent placement, fibrinolysis, and mechanical thrombectomy. Primary assisted patency rates following PTA can be up to 65% at 5 years. When the endovascular approach is unsuccessful, these therapeutic options are complemented by surgical procedures including vein patch revision, jump grafting, or placement of a new graft.

  8. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  9. Stages of Skin Cancer

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  10. Skin Cancer Treatment

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  11. Basal cell skin cancer

    MedlinePlus

    ... occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. This type of skin ... skin cancer is to reduce your exposure to sunlight . Always use sunscreen: Apply sunscreen with sun protection ...

  12. Skin Condition Finder

    MedlinePlus

    ... SKIN CONDITIONS HEALTH TOPICS FOR PROFESSIONALS Rash and Skin Condition Finder 1 Select Age Group Infant Child ... Toe Toe Webspace Toe Nail CLOSE About the Skin Condition Finder Have a health question or concern? ...

  13. Skin Complications of IBD

    MedlinePlus

    ... Home > Resources > Skin Complications of IBD Go Back Skin Complications of IBD Email Print + Share After arthritis, ... about 5% of people with inflammatory bowel disease. SKIN DISORDERS COMMONLY SEEN IN IBD ERHTHEMA NODOSUM The ...

  14. Scalded skin syndrome

    MedlinePlus

    Ritter disease; Staphylococcal scalded skin syndrome (SSS) ... Scalded skin syndrome (SSS) is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a toxin that causes the skin ...

  15. Skin Allergy Quiz

    MedlinePlus

    ... time. Some common medications that can cause skin allergy include penicillin, sulfa drugs, barbiturates and anticonvulsants just to mention a few. Some of the symptoms from drug allergies might be hives, skin rash, itchy skin or ...

  16. Learning about Skin Cancer

    MedlinePlus

    ... Why Deadly Skin Cancers Spread 2000 News Release Learning About Skin Cancer What are the most common ... skin surface. When a melanoma becomes thick and deep, the disease often spreads to other parts of ...

  17. Soluble Epoxide Hydrolase Inhibition and Epoxyeicosatrienoic Acid Treatment Improve Vascularization of Engineered Skin Substitutes

    PubMed Central

    Hahn, Jennifer M.; McFarland, Kevin L.; Combs, Kelly A.; Lee, Kin Sing Stephen; Inceoglu, Bora; Wan, Debin; Boyce, Steven T.; Hammock, Bruce D.

    2016-01-01

    Background: Autologous engineered skin substitutes comprised of keratinocytes, fibroblasts, and biopolymers can serve as an adjunctive treatment for excised burns. However, engineered skin lacks a vascular plexus at the time of grafting, leading to slower vascularization and reduced rates of engraftment compared with autograft. Hypothetically, vascularization of engineered skin grafts can be improved by treatment with proangiogenic agents at the time of grafting. Epoxyeicosatrienoic acids (EETs) are cytochrome P450 metabolites of arachidonic acid that are inactivated by soluble epoxide hydrolase (sEH). EETs have multiple biological activities and have been shown to promote angiogenesis. Inhibitors of sEH (sEHIs) represent attractive therapeutic agents because they increase endogenous EET levels. We investigated sEHI administration, alone or combined with EET treatment, for improved vascularization of engineered skin after grafting to mice. Methods: Engineered skin substitutes, prepared using primary human fibroblasts and keratinocytes, were grafted to full-thickness surgical wounds in immunodeficient mice. Mice were treated with the sEHI 1-trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl) urea (TPPU), which was administered in drinking water throughout the study period, with or without topical EET treatment, and were compared with vehicle-treated controls. Vascularization was quantified by image analysis of CD31-positive areas in tissue sections. Results: At 2 weeks after grafting, significantly increased vascularization was observed in the TPPU and TPPU + EET groups compared with controls, with no evidence of toxicity. Conclusions: The results suggest that sEH inhibition can increase vascularization of engineered skin grafts after transplantation, which may contribute to enhanced engraftment and improved treatment of full-thickness wounds. PMID:28293507

  18. Mobile teledermatology for skin cancer screening

    PubMed Central

    Markun, Stefan; Scherz, Nathalie; Rosemann, Thomas; Tandjung, Ryan; Braun, Ralph P.

    2017-01-01

    Abstract Skin cancer screening has undoubted potential to reduce cancer-specific morbidity and mortality. Total-body exams remain the prevailing concept of skin cancer screening even if effectiveness and value of this method are controversial. Meanwhile, store and forward teledermatology was shown to be a reliable instrument for several diagnostic purposes mostly in specialized dermatology settings. The objective of this study was to evaluate most convenient mobile teledermatology interventions as instruments for skin cancer screening in a representative population. Prospective diagnostic study with visitors of a skin cancer screening campaign in Switzerland. Histopathology was used as reference standard. Mobile teledermatology with or without dermoscopic images was assessed for performance as a screening test (i.e., rule-in or rule-out the need for further testing). Outcomes were sensitivity, specificity, and predictive values. Seven cases of skin cancer were present among 195 skin lesions. All skin cancers were ruled-in by teledermatology with or without dermoscopic images (sensitivity and negative predictive value 100%). The addition of dermoscopic images to conventional images resulted in higher specificity (85% vs. 77%), allowing reduction of unnecessary further testing in a larger proportion of skin lesions. Store and forward mobile teledermatology could serve as an instrument for population-based skin cancer screening because of favorable test performance. PMID:28272243

  19. Natural considerations for skin of color.

    PubMed

    Baumann, Leslie; Rodriguez, David; Taylor, Susan C; Wu, Jessica

    2006-12-01

    Changing US demographics indicate that dermatologists will treat an increasing number of individuals of color. Early research on cutaneous anatomy and physiology was performed mostly in white populations. However, new research is elucidating similarities and differences in skin of color and white skin with regard to skin barrier, pigmentation, and sensitivity. Two of the most important issues are skin lightening and brightening. Products for use on skin of color typically should be gentle because of the proclivity of more deeply pigmented skin to develop pigmentary abnormalities in response to skin irritation or trauma. Increasing patient interest in natural remedies has been matched by research on the use of natural ingredients in dermatology. The relative gentleness of many of these products, coupled with excellent efficacy, makes natural ingredients such as soy and licorice excellent choices in the treatment of disorders such as postinflammatory hyperpigmentation (PIH) and melasma. For daily skin care, ingredients such as oatmeal and feverfew are good choices for gentle cleansing and moisturizing of dry, sensitive, or ashy skin. Sun protection is an increasing concern due to rising rates of melanoma. Several botanical products are useful in augmenting photoprotection with conventional sunscreens.

  20. ARGET ATRP for versatile grafting of cellulose using various monomers.

    PubMed

    Hansson, Susanne; Ostmark, Emma; Carlmark, Anna; Malmström, Eva

    2009-11-01

    In recent years, cellulose-based materials have attracted significant attention. To broaden the application areas for cellulose, polymers are often grafted to/from the surface to modify its properties. This study applies ARGET (activators regenerated by electron transfer) ATRP (atom transfer radical polymerization) when straightforwardly grafting methyl methacrylate (MMA), styrene (St), and glycidyl methacrylate (GMA) from cellulose in the form of conventional filter paper in the presence of a sacrificial initiator. The free polymer, formed from the free initiator in parallel to the grafting, was characterized by (1)H NMR and SEC, showing that sufficient control is achieved. However, the analyses also indicated that the propagation from the surface cannot be neglected compared to the propagation of the free polymer at higher targeted molecular weights, which is an assumption often made. The grafted filter papers were evaluated with FT-IR, suggesting that the amount of polymer on the surface increased with increasing monomer conversion, which the FE-SEM micrographs of the substrates also demonstrated. Water contact angle (CA) measurements implied that covering layers of PMMA and PS were formed on the cellulose substrate, making the surface hydrophobic, in spite of low DPs. The CA of the PGMA-grafted filter papers revealed that, by utilizing either aprotic or protic solvents when washing the substrates, it was possible to either preserve or hydrolyze the epoxy groups. Independent of the solvent used, all grafted filter papers were essentially colorless after the washing procedure because of the low amount of copper required when performing ARGET ATRP. Nevertheless, surface modification of cellulose via ARGET ATRP truly facilitates the manufacturing since no thorough freeze-thaw degassing procedures are required.

  1. Skin friction drag measurements by LDV.

    PubMed

    Mazumder, M K; Wanchoo, S; McLeod, P C; Ballard, G S; Mozumdar, S; Caraballo, N

    1981-08-15

    A laser Doppler velocimeter employing a microscope objective as the receiving lens has been developed for measuring fluid velocity inside the boundary layer flow field with a spatial resolution of 40 microm. The method was applied for direct measurement of aerodynamic skin friction drag from the measured velocity gradient at the wall. Experimental results obtained on skin friction and on velocity components in a turbulent boundary layer on a low speed wind tunnel showed good agreement with previously reported data using conventional instruments such as hot-wire anemometers and Preston tubes. The method thus provides a tool for measurement and control of skin friction on aerodynamic bodies without perturbing the flow field.

  2. Synthesis and swelling-deswelling kinetics of poly(N-isopropylacrylamide) hydrogels grafted with LCST modulated polymers.

    PubMed

    Kaneko, Y; Nakamura, S; Sakai, K; Kikuchi, A; Aoyagi, T; Sakurai, Y; Okano, T

    1999-01-01

    Two types of thermo-responsive hydrogels are synthesized to obtain comb-type grafted gels with different lower critical solution temperatures (LCSTs) between graft chains and cross-linked backbone networks: these are poly(N-isopropylacrylamide) (PIPAAm) cross-linked hydrogels grafted with poly(N-isopropylacryl amide-co-N,N-dimethylacrylamide) (poly(IPAAm-co-DMAAm)) maintaining a freely mobile end and poly(IPAAm-co-DMAAm) cross-linked hydrogels grafted with PIPAAm chains. The effect of graft chain hydrophilic/hydrophobic balance as well as its mobility on deswelling kinetics of these grafted gels are investigated through the polymer LCST modulation and external temperature changes. The deswelling rate of poly(IPAAm-co-DMAAm)-grafted PIPAAm gel increases with increasing in temperature. This gel shows a discontinuous increase of the deswelling rate when the temperature is applied from below to above the graft chain LCST (37 degrees C). The deswelling rate of PIPAAm-grafted poly(IPAAm-co-DMAAm) gel increases continuously when the temperature is applied from below to above the graft chain LCST (31 degrees C). Due to the strong hydrophilicity of backbone network, the hydrophobic aggregation force weak. In contrast to the graft-type gels, normal-type poly(IPAAm-co-DMAAm) cross-linked gel without graft chains demonstrates the discontinuous decrease for the deswelling rate when the temperature is applied from below to above the polymer LCST (36 degrees C), entrapping water inside the gel due to the formation of an impermeable dense skin layer at the gel surface. These gel deswelling mechanisms are discussed in terms of gel structures.

  3. [Graft or CVC? A prosthetic graft is the better choice].

    PubMed

    Cifarelli, M

    2009-01-01

    For more than 30 years, research and industry have attempted to introduce into clinical practice solutions and products that could remedy the impossibility to use native veins. Vascular grafts of various types have been created that would approach the ideal characteristics as closely as possible with low antigenic power, high resistance to infections, low risk of thrombosis, and easy pierceability but high resistance to puncturing. For this purpose various materials, either totally synthetic such as PTFE, biological homologous or heterologous, or biosynthetic with mixed components have been created. In addition, different configurations to improve the hemodynamic outline of synthetic grafts have been studied: grafts of varying caliber, conical or equipped with cuffs, and various systems of wall reinforcement to increase the resistance to punctures. But each of these types favors one aspect over another: biological grafts show better compliance with the native vein but offer less resistance to punctures and ectatic processes; synthetic grafts, instead, tend to be more vulnerable to intimal hyperplasia at the venous anastomosis, which is the Achilles' heel of grafts. In recent years, the use of tunneled central venous catheters (CVCs) has grown exponentially. This has offered a new, important solution to the vascular access problem, but the extensive use of CVCs is not always justified. In comparison with grafts, CVCs have various disadvantages including insertion-related complications, possible malfunctioning, risk of infections and thrombosis, but above all a high risk of steno-occlusion of central veins. Also in this field, research and industry are offering more and more reliable and secure products. More resistant, flexible, tolerable and less thrombogenic materials are being used and various configurations which would offer the best performance with the least insertion-related risks have been introduced: double-lumen CVCs with input and output staggered in oval

  4. Patency of femoropopliteal and femorotibial grafts after outflow revascularization (jump grafts) to bypass distal disease.

    PubMed

    Andros, G; Harris, R W; Dulawa, L B; Oblath, R W; Salles-Cunha, S X

    1984-11-01

    Repair of failing femorodistal bypass grafts with secondary distal "jump" grafts was performed 34 times in 33 patients. Indication for operation was limb salvage for all distal jump grafts and for 85% of the initial femorodistal bypass grafts. Autogenous vein bypass grafts were used in 28 of 33 initial femorodistal grafts (85%) and in 29 of 34 secondary jump grafts (85%). Sixteen of the 33 initial grafts in jeopardy extended to the infrapopliteal level (48%) and 19 of the jump grafts terminated in foot or ankle arteries (56%). The 12 jump grafts performed in the first 2 months of the initial graft were associated with high rates (9%) of graft thrombosis and amputation. Early loss of viability of initial grafts probably resulted from technical and judgment errors or underestimation of distal disease. Progression of distal disease produced late failure after 1 year of implantation of the initial grafts. The 1-year patency rate of the initial femorodistal grafts was 63% but only 32% of these grafted limbs were viable and were not at risk of amputation. Distal jump grafts produced a 49% improvement in limb viability (to an 81% limb salvage rate) and an 11% increase in the initial graft patency rate (to 74%) at 1 year.

  5. Chronic graft versus host disease and nephrotic syndrome.

    PubMed

    Barbouch, Samia; Gaied, Hanene; Abdelghani, Khaoula Ben; Goucha, Rim; Lakhal, Amel; Torjemen, Lamia; Hamida, Fethi Ben; Abderrahim, Ezzedine; Maiz, Hedi Ben; Adel, Khedher

    2014-09-01

    Disturbed kidney function is a common complication after bone marrow transplantation. Recently, attention has been given to immune-mediated glomerular damage related to graft versus host disease (GVHD). We describe a 19-year-old woman who developed membranous glomerulonephritis after bone marrow transplantation (BMT). Six months later, she developed soft palate, skin and liver lesions considered to be chronic GVHD. Fifteen months after undergoing BMT, this patient presented with nephrotic syndrome. A renal biopsy showed membranous glomerulonephritis associated with a focal segmental glomerulosclerosis. She was started on corticosteroid treatment with good outcome.

  6. Adipose-Derived Stem Cells Improve Efficacy of Melanocyte Transplantation in Animal Skin

    PubMed Central

    Lim, Won-Suk; Kim, Chang-Hyun; Kim, Ji-Young; Do, Byung-Rok; Kim, Eo Jin; Lee, Ai-Young

    2014-01-01

    Vitiligo is a pigmentary disorder induced by a loss of melanocytes. In addition to replacement of pure melanocytes, cocultures of melanocytes with keratinocytes have been used to improve the repigmentation outcome in vitiligo treatment. We previously identified by in vitro studies, that adipose-derived stem cells (ADSCs) could be a potential substitute for keratinocytes in cocultures with melanocytes. In this study, the efficacy of pigmentation including durability of grafted melanocytes and short-term safety was examined in the nude mouse and Sprague-Dawley rat after grafting of primary cultured human melanocytes, with or without different ratios of primary cultured human ADSCs. Simultaneous grafting of melanocytes and ADSCs, which were separately cultured and mixed on grafting at the ratios of 1:1, 1:2, or 1:3, showed better efficacy than that of pure melanocytes. Grafting of melanocytes cocultured with ADSCs resulted in a similar outcome as the grafting of cell mixtures. Skin pigmentation by melanocytes : ADSCs at the ratios of 1:1 and 1:2 was better than at 1:3. No significant difference was observed between the 1-week and 2-week durations in coculturing. Time-course microscopic examination showed that the grafted melanocytes remained a little longer than 6-week post-grafting. No inflammatory cell infiltration was observed in the grafted skin and no melanocytes were detectable in other organs. Collectively, grafting of melanocytes and ADSCs was equally safe and more effective than grafting of melanocytes alone. Despite the absence of significant differences in efficacy between the group of 1:1 and that of 1:2 ratio, 1:2 ratio for 1-week coculturing may be better for clinical use from the cost-benefit viewpoint. PMID:25143812

  7. Skin to skin care:heat balance.

    PubMed Central

    Karlsson, H

    1996-01-01

    Skin to skin care has been practised in primitive and high technology cultures for body temperature preservation in neonates. Regional skin temperature and heat flow was measured in moderately hypothermic term neonates to quantitate the heat transfer occurring during one hour of skin to skin care. Nine healthy newborns with a mean rectal temperature of 36.3 degrees C were placed skin to skin on their mothers' chests. The mean (SD) rectal temperature increased by 0.7 (0.4) degrees C to 37.0 degrees C. The heat loss was high (70 Wm-2) from the unprotected skin of the head to the surrounding air. Minute heat losses occurred from covered areas; and heat was initially gained from areas in contact with the mother's skin. The total dry heat loss during skin to skin care corresponded to heat loss during incubator care at 32-32.5 degrees C. The reduced heat loss, and to a minor extent, the initial heat flux from the mothers allowed heat to be conserved, leading to rewarming. PMID:8949698

  8. Convention Problems - 1787.

    ERIC Educational Resources Information Center

    Hanson, Deroy L.

    Designed to motivate eighth-grade civics students in the study of the United States Constitution, this game is intended to simulate the basic problems faced by the delegates to the Philadelphia Convention of 1787. The four parts of the game introduce the governmental concepts of the bicameral legislature, the executive branch, the judicial branch,…

  9. Craniofacial Bone Grafting: Wolff's Law Revisited

    PubMed Central

    Oppenheimer, Adam J.; Tong, Lawrence; Buchman, Steven R.

    2008-01-01

    Bone grafts are used for the reconstruction of congenital and acquired deformities of the facial skeleton and, as such, comprise a vital component of the craniofacial surgeon's armamentarium. A thorough understanding of bone graft physiology and the factors that affect graft behavior is therefore essential in developing a more intelligent use of bone grafts in clinical practice. This article presents a review of the basic physiology of bone grafting along with a survey of pertinent concepts and current research. The factors responsible for bone graft survival are emphasized. PMID:22110789

  10. Off-pump coronary artery bypass grafting in octogenarians

    PubMed Central

    2016-01-01

    Enhanced life expectancy has confronted cardiac surgery with a rapidly growing population of octogenarians needing coronary artery bypass grafting (CABG). Octogenarians are deemed a high-risk patient population with increased postoperative morbidity and mortality following conventional CABG using cardiopulmonary bypass (CPB). In such patients reducing the invasiveness of the surgical procedure by avoiding CPB may be tried in an attempt to improve outcomes. The increasing performance of off-pump coronary artery bypass (OPCAB) grafting within certain centers reflects surgeon preference to avoid the inherent risks of CPB and cardioplegic arrest including hemodilution, nonpulsatile arterial flow, global myocardial ischemia, atherosclerotic embolization from aortic manipulation, and systemic inflammatory response. Although OPCAB grafting is a well-established surgical myocardial revascularization strategy, its actual benefits in terms of morbidity and mortality remain questionable in the general population. In the higher risk octogenarian patients, however, there is a potential for more tangible clinical benefits when CPB is avoided. This review article provides an overview of the impact of OPCAB grafting on postoperative mortality and morbidity in octogenarians. PMID:27942398

  11. Anterior Cruciate Ligament Graft Choices

    PubMed Central

    Macaulay, Alec A.; Perfetti, Dean C.; Levine, William N.

    2012-01-01

    Context: Reconstruction of the anterior cruciate ligament (ACL) is a common surgical procedure; however, there is no consensus to what the best graft option is to replace the injured ACL. The main options available consist of allografts and autografts, which include patellar tendon, hamstring tendon, and quadriceps tendon autografts. Evidence Acquisition: The PubMed database was searched in August 2010 for English-language articles pertaining to ACL grafts. Results: Postoperative outcome variables were analyzed to determine similarities and differences among the different graft options. These variables include stability, strength, function, return to sports, patient satisfaction, complications, and cost. Conclusions: Both allografts and the 3 main options for autografts can provide excellent results in ACL reconstruction and lead to a high percentage of satisfied patients. However, differences exist among the graft choices. Both the similarities and the differences are important to discuss with a patient who will be undergoing ACL reconstruction so that he or she has the best information available when making a choice of graft. PMID:23016071

  12. Exploratory clinical trial of combination wound therapy with a gelatin sheet and platelet-rich plasma in patients with chronic skin ulcers: study protocol

    PubMed Central

    Morimoto, Naoki; Kakudo, Natsuko; Matsui, Makoto; Ogura, Tsunetaka; Hara, Tomoya; Suzuki, Kenji; Yamamoto, Masaya; Tabata, Yasuhiko; Kusumoto, Kenji

    2015-01-01

    Introduction Chronic skin ulcers, such as diabetic ulcers, venous leg ulcers and pressure ulcers, are intractable and increasing in prevalence, representing a costly problem in healthcare. We developed a combination therapy with a gelatin sheet, capable of providing sustained release of platelet-rich plasma (PRP). The objective of this study is to investigate the safety and efficacy of autologous PRP covered with a hydrocolloid dressing and PRP covered with a gelatin sheet in the treatment of chronic skin ulcers. Methods and analysis Thirty patients with chronic skin ulcers who have not healed with conventional therapy for at least 1 month are being recruited. The patients will receive PRP after debridement, and the wounds will be covered with a hydrocolloid dressing or gelatin sheet. The efficacy will be evaluated according to the time from the beginning of PRP application to secondary healing or the day on which wound closure is achieved with a relatively simple surgical procedure, such as skin grafting or suturing. All patients will be followed up until 6 weeks after application to observe adverse events related to the application of PRP and the dressings. This study was designed to address and compare the safety and efficacy of PRP covered with a hydrocolloid dressing versus a gelatin sheet. If successful, this combination therapy may be an alternative to bioengineered skin substitutes containing living cells and lead to substantial progress in the management of chronic skin ulcers. Ethics and dissemination The study protocol was approved by the Institutional Review Board of Kansai Medical University (KMU Number 0649-1, 4 August 2014: V.1.0). The findings of this trial will be disseminated through peer-reviewed journals, and national and international scientific meetings as well as to the patients. Trial registration number UMIN000015689. PMID:25968005

  13. Microvascular regeneration in meshed skin transplants after severe burns.

    PubMed

    Meier, T O; Guggenheim, M; Vetter, S T; Husmann, M; Haile, S R; Amann-Vesti, B R

    2011-09-01

    Function of the skin lymphatics as well as blood perfusion of a meshed transplant is crucial for the healing. The lymphatic regeneration and arterial perfusion of skin transplants after severe burns of the extremities had been studied in eight patients by microlymphography, laser doppler perfusion imaging and transcutaneous oxygen pressure measurements 1, 6 and 18 months after transplantation. One month after transplantation, only fragmented as well as many giant lymphatic skin vessels were present in the transplant. After 6 months a normal lymphatic network had developed in all grafts. The extension of the dye in the lymphatics decreased from 4.5 (0-16) at 1 month to 3.0 (1-6) mm after 18 months, indicating improved lymph drainage capacity. The permeability of the lymphatics in the graft was normal. After 1 month, median laser flux in the transplant was 155.6% (105-246%) of the normal skin but it normalised within 18 months. By contrast, transcutaneous oxygen measurement (TcPO(2)) increased from 44 (21-47) to 55 (50-76) mmHg. In meshed transplants used to cover severely burned skin morphological and functional normal lymphatics develop within 6 months and the initially increased laser flux due to inflammatory reaction normalises. Our results provide important insights into the healing process of skin transplants after burn.

  14. Skin Care and Aging

    MedlinePlus

    ... version of this page please turn Javascript on. Skin Care and Aging How Aging Affects Skin Your skin changes with age. It becomes thinner, ... to make it feel and look better. Dry Skin and Itching Click for more information Many older ...

  15. Acne in ethnic skin.

    PubMed

    Halder, Rebat M; Brooks, Howard L; Callender, Valerie D

    2003-10-01

    Acne is the most common disorder observed in ethnic skin. Clinical presentation is different than in white skin. Postinflammatory hyperpigmentation is a common sequelae of acne in darker skin. The management of acne in ethnic skin is based largely on the prevention and treatment of hyperpigmentation.

  16. Surgical treatment of skin lesions in lupus erythematosus

    PubMed Central

    Lewandowicz, Edward; Zieliński, Tomasz; Iljin, Aleksandra; Fijałkowska, Marta; Kasielska-Trojan, Anna

    2014-01-01

    Lipodystrophies are a wide group of diseases with various etiology, mainly genetic, metabolic or autoimmune. The treatment of these diseases is chronic and not always effective. Major concerns for patients with lipodystrophies are also esthetic defects, especially deformities in the face, neck and upper limbs. There are many surgical methods that can be used to improve patient's appearance like fillers, autologous fat transfer and skin flaps. The aim of this paper is to present and discuss surgical techniques used for correction of lipoatrophy and other skin lesions present in lupus erythematosus. In the first presented patient, lipodermal grafts were performed in two stages (first – to both zygomatic areas, the second – to both nasolabial folds). Moreover, the patient was qualified for arm scar plasty. Deepithelialized skin in the affected area was covered with advanced local skin flaps. In the second patient, an extensive scarring lesion on the scalp was excised and the defect was closed with an expanded scalp flap. Patients with lipodystrophies may require aesthetic surgical procedures to improve their appearance. In patients with lupus erythematosus, autologous fat graft in the face area seems to be a safe and effective method of refilling the volume of atrophic tissues. On the basis of our experience, it is worth emphasizing that the process of fat graft resorption is typical. In patients with scalp scars, an effective method of their removal and hairline restoring is usage of the tissue expander. PMID:25610357

  17. Plant grafting: new mechanisms, evolutionary implications

    PubMed Central

    Goldschmidt, Eliezer E.

    2014-01-01

    Grafting, an old plant propagation practice, is still widely used with fruit trees and in recent decades also with vegetables. Taxonomic proximity is a general prerequisite for successful graft-take and long-term survival of the grafted, composite plant. However, the mechanisms underlying interspecific graft incompatibility are as yet insufficiently understood. Hormonal signals, auxin in particular, are believed to play an important role in the wound healing and vascular regeneration within the graft union zone. Incomplete and convoluted vascular connections impede the vital upward and downward whole plant transfer routes. Long-distance protein, mRNA and small RNA graft-transmissible signals currently emerge as novel mechanisms which regulate nutritional and developmental root/top relations and may play a pivotal role in grafting physiology. Grafting also has significant pathogenic projections. On one hand, stock to scion mechanical contact enables the spread of diseases, even without a complete graft union. But, on the other hand, grafting onto resistant rootstocks serves as a principal tool in the management of fruit tree plagues and vegetable soil-borne diseases. The ‘graft hybrid’ historic controversy has not yet been resolved. Recent evidence suggests that epigenetic modification of DNA-methylation patterns may account for certain graft-transformation phenomena. Root grafting is a wide spread natural phenomenon; both intraspecific and interspecific root grafts have been recorded. Root grafts have an evolutionary role in the survival of storm-hit forest stands as well as in the spread of devastating diseases. A more fundamental evolutionary role is hinted by recent findings that demonstrate plastid and nuclear genome transfer between distinct Nicotiana species in the graft union zone, within a tissue culture system. This has led to the formation of alloploid cells that, under laboratory conditions, gave rise to a novel, alloploid Nicotiana species

  18. Development and Testing of Living Skin Equivalent.

    DTIC Science & Technology

    1988-05-01

    Model a) The use of Isografts in an inbred strain of rats. In a preliminary series of experiments the potential use of Fischer strain rats has been...tested by preparing a series of isografts made by grafting skin equivalents with cells from female donors to male hosts. On the average, wound...Autograft--rat 4 1 4 3 5 17 Autograft--rabbit 6 3 1 1 11 Isograft --rat 37 13 13 1 64 Allo fib., iso ker--rat 15 12 3 30 Allo fib, iso ker--rab 8 6 14 Iso

  19. Application of radiation grafted media for lectin affinity separation and urease immobilization: A novel approach to tumor therapy and renal disease diagnosis

    NASA Astrophysics Data System (ADS)

    Müller-Schulte, D.; Daschek, W.

    1995-09-01

    Carriers modified by synergistic radiation grafting are used as affinity media for the separation of a lectin from a mistletoe extract. The grafted supports show distinctly superior properties when compared to conventional affinity media. The application of these carriers as urease immobilization support incorporated in a conductimetric bioreactor for urea analysis as potential diagnostic device in renal diseases is also described.

  20. Comparative assessment of cultured skin substitutes and native skin autograft for treatment of full-thickness burns.

    PubMed Central

    Boyce, S T; Goretsky, M J; Greenhalgh, D G; Kagan, R J; Rieman, M T; Warden, G D

    1995-01-01

    OBJECTIVE: Comparison of cultured skin substitutes (CSSs) and split-thickness autograft (STAG) was performed to assess whether the requirement for autologous skin grafts may be reduced in the treatment of massive burns. SUMMARY BACKGROUND DATA: Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been demonstrated to close full-thickness skin wounds in athymic mice and to express normal skin antigens after closure of excised wounds in burn patients. METHODS: Data were collected from 17 patients between days 2 and 14 to determine incidence of exudate, incidence of regrafting, coloration, keratinization, and percentage of site covered by graft (n = 17). Outcome was evaluated on an ordinal scale (0 = worst; 10 = best) beginning at day 14, with primary analyses at 28 days (n = 10) and 1 year (n = 4) for erythema, pigmentation, epithelial blistering, surface roughness, skin suppleness, and raised scar. RESULTS: Sites treated with CSSs had increased incidence of exudate (p = 0.06) and decreased percentage of engraftment (p < 0.05) compared with STAG. Outcome parameters during the first year showed no differences in erythema, blistering, or suppleness. Pigmentation was greater, scar was less raised, but regrafting was more frequent in CSS sites than STAG. No differences in qualitative outcomes were found after 1 year, and antibodies to bovine collagen were not detected in patient sera. CONCLUSIONS: These results suggest that outcome of engrafted CSSs is not different from STAG and that increased incidence of regrafting is related to decreased percentage of initial engraftment. Increased rates of engraftment of CSSs may lead to improved outcome for closure of burn wounds, allow greater availability of materials for grafting, and reduce requirements for donor skin autograft. Images Figure 1. Figure 2. PMID:8526581

  1. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt.

    PubMed

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-08-13

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome.

  2. Skin resurfacing in a circumferential full thickness burn to the penis: lessons learnt

    PubMed Central

    Jabir, Shehab; Frew, Quentin; Thompson, Richard; Dziewulski, Peter

    2013-01-01

    A circumferential full-thickness burn to the penis is a rarely encountered injury. However, when it does occur, it proves a management challenge to the plastic and burns surgeon in terms of reconstruction. This is due to the need of not only regaining adequate function of the organ, but also because of the need for a pleasing aesthetic outcome. Split-skin grafts have been utilised successfully to resurface full thickness burns of the penis and have given good results. Yet the success of split-skin grafts, especially those applied to an anatomically challenging region of the body such as the penis, depends on a number of carefully thought-out steps. We discuss the case of a circumferential full-thickness burn to the penis which was treated with split-skin grafting and highlight important pitfalls that the plastic and burns surgeon need to be aware of to ensure a successful outcome. PMID:23946511

  3. The Use of Flaps and Grafts in the Treatment of Urethral Stricture Disease

    PubMed Central

    Wisenbaugh, Eric S.; Gelman, Joel

    2015-01-01

    The use of various grafts and flaps plays a critical role in the successful surgical management of urethral stricture disease. A thorough comprehension of relevant anatomy and principles of tissue transfer techniques are essential to understanding the appropriate use of grafts or flaps to optimize outcomes. We briefly review these principles and discuss which technique may be best suited for a given anterior urethral stricture, depending on the location and length of the stricture, the presence or absence of an intact corpus spongiosum, and the availability of adequate and healthy penile skin. PMID:26664357

  4. Conventional Strategic Deterrence

    SciTech Connect

    Latter, A.L.; Martinelli, E.A.; Speed, R.D.

    1992-08-01

    The Bush Administration argues that the US, as the world's only remaining superpower, must be prepared to intervene militarily in regional conflicts. However, the traditional American way of fighting-relying on ground forces with heavy equipment, supported by naval and air forces--could prove too expensive, both monetarily and in terms of expected American casualties, to garner the support of the American public or Congress. This paper argues that the revolution in conventional weaponry demonstrated in the Persian Gulf War opens up the possibility of a new strategy--called Conventional Strategic Deterrence--that could reduce both financial costs and casualties (if it were necessary to implement the strategy) while still being a strong and credible deterrent to regional conflict.

  5. Rapid, facile microwave-assisted synthesis of xanthan gum grafted polyaniline for chemical sensor.

    PubMed

    Pandey, Sadanand; Ramontja, James

    2016-08-01

    Grafting method, through microwave radiation procedure is extremely productive in terms of time consumption, cost effectiveness and environmental friendliness. In this study, conductive and thermally stable composite (mwXG-g-PANi) was synthesized by grafting of aniline (ANi) on to xanthan gum (XG) using catalytic weight of initiator, ammonium peroxydisulfate in the process of microwave irradiation in an aqueous medium. The synthesis of mwXG-g-PANi were confirm by FTIR, XRD, TGA, and SEM. The influence of altering the microwave power, exposure time of microwave, concentration of monomer and the amount of initiator of graft polymerization were studied over the grafting parameters, for example, grafting percentage (%G) and grafting efficiency (%E). The maximum %G and %E achieved was 172 and 74.13 respectively. The outcome demonstrates that the microwave irradiation strategy can increase the reaction rate by 72 times over the conventional method. Electrical conductivity of XG and mwXG-g-PANi composite film was performed. The fabricated grafted sample film were then examined for the chemical sensor. The mwXG-g-PANi, effectively integrated and handled, are NH3 sensitive and exhibit a rapid sensing in presence of NH3 vapor. Chemiresistive NH3 sensors with superior room temperature sensing performance were produced with sensor response of 905 at 1ppb and 90% recovery within few second.

  6. Laparoscopic versus conventional appendectomy.

    PubMed Central

    Vallina, V L; Velasco, J M; McCulloch, C S

    1993-01-01

    OBJECTIVE: The goal of this study was to prospectively define the impact of laparoscopy on the management of patients with a presumed diagnosis of appendicitis. SUMMARY BACKGROUND DATA: While the role of laparoscopy in the management of cholelithiasis is well established, its impact on the management of acute appendicitis needs to be objectively defined and compared to that of conventional management. Several authors have predicted that laparoscopic appendectomy will become the preferred treatment for appendicitis. METHODS: Two groups of consecutive patients with similar clinical characteristics of acute appendicitis were compared. Data on the laparoscopic group were compiled prospectively on standardized forms; data on the conventional group were collected retrospectively. Operative time, hospital stay, analgesia, cost, and return to normal activities were noted. RESULTS: Seventeen consecutive patients who underwent appendectomy were compared to 18 consecutive patients who underwent laparoscopy (16 of these 18 had laparoscopic appendectomy). There was no significant difference between the two groups in terms of clinical characteristics and appendiceal histopathology. The mean operative times were 61 +/- 4.1 minutes and 46 +/- 2.9 minutes for the laparoscopy and conventional groups, respectively (p < 0.01). Hospital stay was significantly shorter in the laparoscopic appendectomy group, with 81% of patients being discharged on their first postoperative day (p < 0.001). The laparoscopic appendectomy patients required significantly less narcotic analgesia (p < 0.02). Return to normal activity was not significantly different between the two groups. The average total cost of laparoscopic appendectomy was 30% greater than that of conventional appendectomy. CONCLUSIONS: Laparoscopy is a useful adjunct to the management of patients with a presumed clinical diagnosis of acute appendicitis. PMID:8239785

  7. IERS Conventions (2003)

    DTIC Science & Technology

    2004-01-01

    3), are the respective resonance frequencies associated with the Chandler wobble (CW), the retrograde free core nutation (FCN), and the pro- grade...Soc., 64, pp. 747–765. Zschau, J., 1983, “Rheology of the Earth’s mantle at tidal and Chandler Wobble periods,” Proc. Ninth Int. Symp. Earth Tides, New...Reference Frame CTRS Conventional Terrestrial Reference System CW Chandler Wobble DOMES Directory Of MERIT Sites DORIS Doppler Orbit determination

  8. Convention, Confirmation, and Credibility

    DTIC Science & Technology

    1989-01-01

    4 It was Pierre Duhem , a physicist, who made the strongest claim regarding the conventionality of what most people think of as empirical theory near...Mach, op. cit. p. 306. 5. Pierre Duhem , The Aim and Structure of Physical Theory Princeton University Press, Princeton, 1954. In French, it appeared as...examine in detail the ideas of Mach, Poincare, and Duhem . That they had the idea that it could be philosophically respectable to regard scientific

  9. [Neonatal conventional ventilation guidelines].

    PubMed

    2001-09-01

    Respiratory pathology is a frequent problem in Neonatal Intensive Care Units; the last few years, our knowledge about its management has improved enormously. Conventional Ventilatory support is a high-specialized technique that maintains a correct alveolar gas exchange while the primary aetiology is to present some clinical guidelines for every professional working with newborns who have respiratory failure improves. The aim of this document is to present some clinical guidelines for every professional working with newborns who have respiratory pathology

  10. Types of Coronary Artery Bypass Grafting

    MedlinePlus

    ... from the NHLBI on Twitter. Types of Coronary Artery Bypass Grafting There are several types of coronary ... for you based on your needs. Traditional Coronary Artery Bypass Grafting Traditional CABG is used when at ...

  11. Who Needs Coronary Artery Bypass Grafting?

    MedlinePlus

    ... from the NHLBI on Twitter. Who Needs Coronary Artery Bypass Grafting? Coronary artery bypass grafting (CABG) is used to treat people ... or after a heart attack to treat blocked arteries. Your doctor may recommend CABG if other treatments, ...

  12. Costal Cartilage Grafts in Rhinoplasty.

    PubMed

    Fedok, Fred G

    2016-01-01

    Cartilage grafts are regularly used in rhinoplasty. Septal and auricular donor sites are commonly used. Many situations compel the surgeon to use other alternative donor sites, including revision rhinoplasty and trauma. Many patients have a small amount of native septal cartilage and are unable to provide adequate septal cartilage to be used for frequently performed rhinoplasty maneuvers. The rib cage provides an enormous reserve of costal cartilage that can be carved into a variety of necessary grafts. A description of the technique of harvesting costal cartilage, a review of complications and management, and illustrative cases examples are included.

  13. Assessment of coronary bypass graft patency by electron-beam computed tomography.

    PubMed

    Abdel Aziz, Tarek A; Kumar, Pramod; Bazargani, Nooshin; Al-Hato, Eman; Al Khaja, Najib

    2003-06-01

    Twenty-one patients undergoing coronary artery bypass grafting were prospectively evaluated by conventional selective coronary angiography and electron-beam computed tomography. Eighty bypass grafts (60 saphenous vein and 20 left or right internal mammary artery) were evaluated for patency. The sensitivity and specificity of electron-beam computed tomography were 72% and 100%, respectively; positive and negative predictive values were 100% and 92.5%, respectively. Sensitivity and specificity according to coronary region were: left anterior descending artery, 33% and 100%; diagonal artery, 67% and 100%; circumflex artery, 75% and 100%; right coronary artery, 100% and 100%. Electron-beam computed tomography is relatively accurate and a promising tool for noninvasive evaluation of graft patency after coronary artery bypass graft surgery.

  14. Le Fort I Osteotomy with Bone Grafts in Preprosthetic Surgery: Technical Note

    PubMed Central

    Pingarron-Martin, Lorena; Arias-Gallo, Javier; Ong, Hui Shan; Pons, Manuel Chamorro

    2013-01-01

    Background Being edentulous causes progressive bony resorption in maxillae, which can lead to altered maxillomandibular relationships. Discussion should consider Le Fort I osteotomy with inlay grafts for a better success rate. Thus, this article introduces a technical note in improving the success rate. Case Report The presented technical note permits transformation of the surgery in a conventional Le Fort I with a simple fixation not only of the grafts but also of the osteotomy. The surgical steps are explained as well as the follow-up results. Discussion Adding additional wire anchorage around bone grafts greatly improved our success rate and reduced our operative time. Bone grafting concurrently with Le Fort I osteotomy immediately improved the facial skeletal profile. Several in vitro studies have shown that galvanic corrosion does not play a significant role when combining stainless steel and titanium. Our novel technique is relatively simple and can be easily picked up by young surgeons. PMID:24436751

  15. Graft-versus-host disease affecting oral cavity. A review.

    PubMed

    Margaix-Muñoz, Maria; Bagán, José V; Jiménez, Yolanda; Sarrión, María-Gracia; Poveda-Roda, Rafael

    2015-02-01

    Graft versus host disease (GVHD) is one of the most frequent and serious complications of hematopoietic stem cell transplantation, and is regarded as the leading cause of late mortality unrelated to the underlying malignant disease. GVHD is an autoimmune and alloimmune disorder that usually affects multiple organs and tissues, and exhibits a variable clinical course. It can manifest in either acute or chronic form. The acute presentation of GVHD is potentially fatal and typically affects the skin, gastrointestinal tract and liver. The chronic form is characterized by the involvement of a number of organs, including the oral cavity. Indeed, the oral cavity may be the only affected location in chronic GVHD. The clinical manifestations of chronic oral GVHD comprise lichenoid lesions, hyperkeratotic plaques and limited oral aperture secondary to sclerosis. The oral condition is usually mild, though moderate to severe erosive and ulcerated lesions may also be seen. The diagnosis is established from the clinical characteristics, though confirmation through biopsy study is sometimes needed. Local corticosteroids are the treatment of choice, offering overall response rates of close to 50%. Extracorporeal photopheresis and systemic corticosteroids in turn constitute second line treatment. Oral chronic GVHD is not considered a determinant factor for patient survival, which is close to 52% five years after diagnosis of the condition. Key words:Chronic graft-versus-host disease, oral chronic graft-versus-host disease, pathogenics, management, survival.

  16. Radial bone graft usage for nasal septal reconstruction

    PubMed Central

    Cil, Yakup; Kocman, Atacan Emre; Yapici, Abdul Kerim; Ozturk, Serdar

    2011-01-01

    Background: Although various techniques have been described for correction of crooked and saddle nose deformities, these problems are challenging with high recurrence and revision rates. Conventional septal surgery may not be adequate for nose reconstruction in crooked and saddle nose deformities. Materials and Methods: Between December 2005 and October 2009, six patients with crooked nose and five patients with saddle nose deformities underwent corrective surgery in our clinic. All patients were male, and the mean age was 21 years (range, 19-23 years). We used rigid radial bone graft to prevent redeviation and recurrence following corrective nasal septal surgery. Results: The mean follow-up period was 28 months, ranging from 18 to 46 months. Mean operation time was 4 hours (3-4.5). All patients healed uneventfully. None of the patients required secondary surgery. Conclusions: We believe that radial bone grafts offer a long lasting support in treatment of challenging cases with crooked and saddle nose deformities. PMID:21713215

  17. Organosiloxane-grafted natural polymer coatings

    DOEpatents

    Sugama, Toshifumi

    1998-01-01

    A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation.

  18. Estrogens and aging skin

    PubMed Central

    Thornton, M. Julie

    2013-01-01

    Estrogen deficiency following menopause results in atrophic skin changes and acceleration of skin aging. Estrogens significantly modulate skin physiology, targeting keratinocytes, fibroblasts, melanocytes, hair follicles and sebaceous glands, and improve angiogenesis, wound healing and immune responses. Estrogen insufficiency decreases defense against oxidative stress; skin becomes thinner with less collagen, decreased elasticity, increased wrinkling, increased dryness and reduced vascularity. Its protective function becomes compromised and aging is associated with impaired wound healing, hair loss, pigmentary changes and skin cancer.   Skin aging can be significantly delayed by the administration of estrogen. This paper reviews estrogen effects on human skin and the mechanisms by which estrogens can alleviate the changes due to aging. The relevance of estrogen replacement, selective estrogen receptor modulators (SERMs) and phytoestrogens as therapies for diminishing skin aging is highlighted. Understanding estrogen signaling in skin will provide a basis for interventions in aging pathologies. PMID:24194966

  19. Grafting efficiency of synthetic polymers onto biomaterials: a comparative study of grafting-from versus grafting-to.

    PubMed

    Hansson, Susanne; Trouillet, Vanessa; Tischer, Thomas; Goldmann, Anja S; Carlmark, Anna; Barner-Kowollik, Christopher; Malmström, Eva

    2013-01-14

    In the present study, the two grafting techniques grafting-from - by activators regenerated by electron transfer atom transfer radical polymerization (ARGET ATRP) - and grafting-to - by copper(I)-catalyzed azide-alkyne cycloaddition (CuAAC) - were systematically compared, employing cellulose as a substrate. In order to obtain a meaningful comparison, it is crucial that the graft lengths of the polymers that are grafted from and to the substrates are essentially identical. Herein, this was achieved by utilizing the free polymer formed in parallel to the grafting-from reaction as the polymer for the grafting-to reaction. Four graft lengths were investigated, and the molar masses of the four free polymers (21 ≤ M(n) ≤ 100 kDa; 1.07 ≤ Đ(M) ≤ 1.26), i.e. the polymers subsequently employed in the grafting-to reaction, were shown to be in the same range as the molar masses of the polymers grafted from the surface (23 ≤ M(n) ≤ 87 kDa; 1.08 ≤ Đ(M) ≤ 1.31). The molecular weights of the chains grafted from the surface were established after cleavage from the cellulose substrates via size exclusion chromatography (SEC). High-resolution Fourier transform infrared microscopy (FT-IRM) was employed as an efficient tool to study the spatial distribution of the polymer content on the grafted substrates. In addition, the functionalized substrates were analyzed by X-ray photoelectron spectroscopy (XPS), contact angle (CA) measurements, and field-emission scanning electron microscopy (FE-SEM). For cellulose substrates modified via the grafting-from approach, the content of polymer on the surfaces increased with increasing graft length, confirming the possibility to tailor not only the length of the polymer grafts but also the polymeric content on the surface. In comparison, for the grafting-to reaction, the grafted content could not be controlled by varying the length of the preformed polymer: the polymer content was essentially the same for the four graft lengths

  20. Decellularized bone matrix grafts for calvaria regeneration

    PubMed Central

    Lee, Dong Joon; Diachina, Shannon; Lee, Yan Ting; Zhao, Lixing; Zou, Rui; Tang, Na; Han, Han; Chen, Xin; Ko, Ching-Chang

    2016-01-01

    Decellularization is a promising new method to prepare natural matrices for tissue regeneration. Successful decellularization has been reported using various tissues including skin, tendon, and cartilage, though studies using hard tissue such as bone are lacking. In this study, we aimed to define the optimal experimental parameters to decellularize natural bone matrix using 0.5% sodium dodecyl sulfate and 0.1% NH4OH. Then, the effects of decellularized bone matrix on rat mesenchymal stem cell proliferation, osteogenic gene expression, and osteogenic differentiations in a two-dimensional culture system were investigated. Decellularized bone was also evaluated with regard to cytotoxicity, biochemical, and mechanical characteristics in vitro. Evidence of complete decellularization was shown through hematoxylin and eosin staining and DNA measurements. Decellularized bone matrix displayed a cytocompatible property, conserved structure, mechanical strength, and mineral content comparable to natural bone. To study new bone formation, implantation of decellularized bone matrix particles seeded with rat mesenchymal stem cells was conducted using an orthotopic in vivo model. After 3 months post-implantation into a critical-sized defect in rat calvaria, new bone was formed around decellularized bone matrix particles and also merged with new bone between decellularized bone matrix particles. New bone formation was analyzed with micro computed tomography, mineral apposition rate, and histomorphometry. Decellularized bone matrix stimulated mesenchymal stem cell proliferation and osteogenic differentiation in vitro and in vivo, achieving effective bone regeneration and thereby serving as a promising biological bone graft. PMID:28228929

  1. Endovascular Stent Grafting for Aortic Arch Aneurysm in Aortoiliac Occlusive Disease following Aortic Arch Debranching and Aortobifemoral Reconstruction

    PubMed Central

    Canbay, Cagla; Onal, Yilmaz; Beyaz, Metin Onur; Sayin, Omer Ali; Barburoglu, Mehmet; Yornuk, Mesut; Acunas, Bulent; Alpagut, Ufuk; Dayioglu, Enver

    2017-01-01

    Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient. In these situations stent grafting may even be more complicated. In this report, we present the treatment of a 92-year-old patient with aortic arch aneurysm and proximal descending aortic aneurysm. For successful thoracic endovascular stent grafting, the patient needed an alternative route other than the native femoral and iliac arteries for the deployment of the stent graft. In addition, debranching of left carotid and subclavian arteries from the aortic arch was also required for successful exclusion of the thoracic aneurysm.

  2. Polyether-polyester graft copolymer

    NASA Technical Reports Server (NTRS)

    Bell, Vernon L. (Inventor)

    1987-01-01

    Described is a polyether graft polymer having improved solvent resistance and crystalline thermally reversible crosslinks. The copolymer is prepared by a novel process of anionic copolymerization. These polymers exhibit good solvent resistance and are well suited for aircraft parts. Previous aromatic polyethers, also known as polyphenylene oxides, have certain deficiencies which detract from their usefulness. These commercial polymers are often soluble in common solvents including the halocarbon and aromatic hydrocarbon types of paint thinners and removers. This limitation prevents the use of these polyethers in structural articles requiring frequent painting. In addition, the most popular commercially available polyether is a very high melting plastic. This makes it considerably more difficult to fabricate finished parts from this material. These problems are solved by providing an aromatic polyether graft copolymer with improved solvent resistance and crystalline thermally reversible crosslinks. The graft copolymer is formed by converting the carboxyl groups of a carboxylated polyphenylene oxide polymer to ionic carbonyl groups in a suitable solvent, reacting pivalolactone with the dissolved polymer, and adding acid to the solution to produce the graft copolymer.

  3. Microwave assisted synthesis of guar gum grafted sodium acrylate/cloisite superabsorbent nanocomposites: reaction parameters and swelling characteristics.

    PubMed

    Likhitha, M; Sailaja, R R N; Priyambika, V S; Ravibabu, M V

    2014-04-01

    In this study, superabsorbent nanocomposites of guar gum grafted sodium acrylate have been synthesized via both microwave and conventional techniques. The reaction parameters of both techniques were optimized and the microwave assisted method was proved to have higher grafting yield with lesser time of reaction as compared to the conventional method. X-ray diffraction and scanning electron microscopy analyses revealed that cloisite was exfoliated and uniformly dispersed in guar gum grafted sodium acrylate matrix. The results show that introducing cloisite into the guar gum grafted sodium acrylate network improved the swelling capability and the swelling rate of the superabsorbent nanocomposite was found to be enhanced at an optimal loading of 10% cloisite. The nanocomposites showed high water absorbency within a wide pH range. Preliminary studies on crystal violet dye removal showed promising results.

  4. Nonmelanoma skin cancer in India: current scenario.

    PubMed

    Panda, Saumya

    2010-10-01

    Incidence of skin cancers has been increasing since the last few decades worldwide. Nonmelanoma skin cancer (NMSC) is the commonest variety of cutaneous malignancy. Conventional wisdom has it that the incidence of all varieties of skin cancers is lower among Indians due to the protective effects of melanin. Though national surveys and cross-country data in India are unavailable, there are indirect indications from several smaller reports that NMSCs may be on the rise in India. Reports of quite a few atypical cases lead us to hypothesize that factors other than ultraviolet radiation may be important in the occurrences of these cancers, particularly in the skin types prevalent in India. The descriptive epidemiology and clinical characteristics of squamous and basal cell carcinoma in India, including their variants, are discussed here along with hypotheses on their etiopathogenesis. Novel management techniques currently available in India are also highlighted.

  5. NONMELANOMA SKIN CANCER IN INDIA: CURRENT SCENARIO

    PubMed Central

    Panda, Saumya

    2010-01-01

    Incidence of skin cancers has been increasing since the last few decades worldwide. Nonmelanoma skin cancer (NMSC) is the commonest variety of cutaneous malignancy. Conventional wisdom has it that the incidence of all varieties of skin cancers is lower among Indians due to the protective effects of melanin. Though national surveys and cross-country data in India are unavailable, there are indirect indications from several smaller reports that NMSCs may be on the rise in India. Reports of quite a few atypical cases lead us to hypothesize that factors other than ultraviolet radiation may be important in the occurrences of these cancers, particularly in the skin types prevalent in India. The descriptive epidemiology and clinical characteristics of squamous and basal cell carcinoma in India, including their variants, are discussed here along with hypotheses on their etiopathogenesis. Novel management techniques currently available in India are also highlighted. PMID:21430894

  6. Ovarian Grafts 10 Days after Xenotransplantation: Folliculogenesis and Recovery of Viable Oocytes

    PubMed Central

    Campos-Junior, Paulo Henrique Almeida; Alves, Thalys Jair Melo; Dias, Marco Tulio; Assunçao, Carolina Marinho; Munk, Michele; Mattos, Matheus Silvério; Kraemer, Lucas Rocha; Almeida, Brígida Gomes; Russo, Remo Castro; Barcelos, Lucíola; Camargo, Luiz Sérgio Almeida; Viana, Joao Henrique Moreira

    2016-01-01

    Ovarian xenotransplantation is a promising alternative to preserve fertility of oncologic patients. However, several functional aspects of this procedure remained to be addressed. The aim of this study was evaluate the feasibility of xenotransplantation as a strategy to maintain bovine ovarian grafts and produce oocytes. Adult ovarian cortical pieces were xenotransplanted to the dorsal subcutaneous of female NOD-SCID mice (n = 62). Grafts were recovered ten days after xenotransplantation. Host and graft weights; folliculogenesis progression; blood perfusion, relative gene expression and number of macrophage and neutrophil of xenografts; in vitro developmental competence of graft-derived oocytes were evaluated. Folliculogenesis was supported in the grafts, as indicated by the presence of primordial, primary, secondary, antral, and atretic follicles. The xenografts showed a greater volumetric density of atretic follicles and higher hyperemia and number of host-derived macrophage and neutrophil (P<0.05), when compared to non-grafted fragments. There was a higher blood perfusion under the back skin in the transplantation sites of host animals than in control and non-grafted (P<0.01). BAX and PRDX1 genes were up-regulated, while BCL2, FSHR, IGF1R and IGF2R were down-regulated, when compared to the control (P<0.01). Twenty seven oocytes were successfully harvested from grafts, and some of these oocytes were able to give rise to blastocysts after in vitro fertilization. However, cleavage and blastocyst rates of xenograft derived oocytes were lower than in control (P<0.01). Despite showing some functional modifications, the ovarian xenografts were able to support folliculogenesis and produce functional oocytes. PMID:27362486

  7. Endovascular Therapy is Effective Treatment for Focal Stenoses in Failing Infrapopliteal Vein Grafts

    PubMed Central

    Westin, Gregory G.; Armstrong, Ehrin J.; Javed, Usman; Balwanz, Christopher R.; Saeed, Haseeb; Pevec, William C.; Laird, John R.; Dawson, David L.

    2014-01-01

    Objective To evaluate the efficacy of endovascular therapy for maintaining patency and preserving limbs among patients with failing infrapopliteal bypass grafts. Methods We gathered data from a registry of catheter-based procedures for peripheral artery disease. Of 1554 arteriograms performed from 2006 to 2012, 30 patients had interventions for failing bypass vein grafts to infrapopliteal target vessels. The first intervention for each patient was used in this analysis. Duplex ultrasonography was used within 30 days after intervention and subsequently at 3-6 month intervals for graft surveillance. Results Interventions were performed for duplex ultrasonography surveillance findings in 21 patients and for symptoms of persistent or recurrent critical limb ischemia in 9 patients. Procedural techniques included cutting balloon angioplasty (83%), conventional balloon angioplasty (7%), and stent placement (10%). Procedural success was achieved in all cases. There were no procedure-related complications, amputations, or deaths within 30 days. By Kaplan-Meier analysis, 37% were free from graft restenosis at 12 months and 31% were at 24 months. Receiver operating characteristic analysis indicated that a lesion length of 1.75 cm best predicted freedom from restenosis (C statistic: 0.74). Residual stenosis (P=0.03), patency without reintervention (P=0.01), and assisted patency with secondary intervention (P=0.02) rates were superior for short lesions compared to long lesions. The cohort had acceptable rates of adverse clinical outcomes, with 96% of patients free from amputation at both 12 and 24 months; clinical outcomes were also better in patients with short lesions. Conclusions In this single-center experience with endovascular therapies to treat failing infrapopliteal bypass grafts, rates of limb preservation were high, but the majority of patients developed graft restenosis within 12 months. Grafts with longer stenoses fared poorly by comparison. These data suggest that

  8. Comparison of different skin preservation methods with gamma irradiation.

    PubMed

    Guerrero, Linda; Camacho, Bernardo

    2017-02-11

    Allografts are in constant demand, not only for burn victims, but also for all open wounds as "biological dressings". Tissue quality and security are two of the major concerns of Tissue Banks. There are limited studies published. There has been extensive discussion on the subject of preservation methods for cadaver skin. Most literature available comes from clinical reports. In this research, the authors compared 85% glycerolized non irradiated skin allografts with three glycerolized irradiated skin allografts (using different glycerol concentrations 50%, 70% and 85%). The evaluation of allograft quality was done by measuring physical and biological properties of such prepared human tissue grafts. In the histological structure evaluation changes were minimal and did not alter the skin structure. The clinical function of their behavior as temporal dressings was tested. They proved to have similar capabilities for improving granulating tissue and contributing to wound beds closure (Hickerson et al. (1994) [1]).

  9. Conventional magnetic superconductors

    SciTech Connect

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led to the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.

  10. Conventional magnetic superconductors

    DOE PAGES

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led tomore » the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.« less

  11. Simple Correction of Alar Retraction by Conchal Cartilage Extension Grafts

    PubMed Central

    Jang, Yong Jun; Kim, Sung Min; Lew, Dae Hyun

    2016-01-01

    Background Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. Methods Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction. Conchal cartilage extension grafts were fixed to the caudal margins of the lateral crura and covered with vestibular skin advancement flaps. Preoperative and postoperative photographs were reviewed and analyzed. Patient satisfaction was surveyed and categorized into 4 groups (very satisfied, satisfied, moderate, or unsatisfied). Results According to the survey, 8 patients were very satisfied, 9 were satisfied, and 1 considered the outcome moderate, resulting in satisfaction for most patients. The average distance from the alar rim to the long axis of the nostril was reduced by 1.4 mm (3.6 to 2.2 mm). There were no complications, except in 2 cases with palpable cartilage step-off that resolved without any aesthetic problems. Conclusions Conchal cartilage alar extension graft is a simple, effective method of correcting alar retraction that can be combined with aesthetic rhinoplasty conveniently, utilizing conchal cartilage, which is the most similar cartilage to alar cartilage, and requiring a lesser volume of cartilage harvest compared to previously devised methods. However, the current procedure lacks efficacy for severe alar retraction and a longer follow-up period may be required to substantiate the enduring efficacy of the current procedure. PMID:27896189

  12. Robust Lentiviral Gene Delivery But Limited Transduction Capacity of Commonly Used Adeno-Associated Viral Serotypes in Xenotransplanted Human Skin.

    PubMed

    Jakobsen, Maria; Askou, Anne Louise; Stenderup, Karin; Rosada, Cecilia; Dagnæs-Hansen, Frederik; Jensen, Thomas G; Corydon, Thomas J; Mikkelsen, Jacob Giehm; Aagaard, Lars

    2015-08-01

    Skin is an easily accessible organ, and therapeutic gene transfer to skin remains an attractive alternative for the treatment of skin diseases. Although we have previously documented potent lentiviral gene delivery to human skin, vectors based on adeno-associated virus (AAV) rank among the most promising gene delivery tools for in vivo purposes. Thus, we compared the potential usefulness of various serotypes of recombinant AAV vectors and lentiviral vectors for gene transfer to human skin in a xenotransplanted mouse model. Vector constructs encoding firefly luciferase were packaged in AAV capsids of serotype 1, 2, 5, 6, 8, and 9 and separately administered by intradermal injection in human skin transplants. For all serotypes, live bioimaging demonstrated low levels of transgene expression in the human skin graft, and firefly luciferase expression was observed primarily in neighboring tissue outside of the graft. In contrast, gene delivery by intradermally injected lentiviral vectors was efficient and led to extensive and persistent firefly luciferase expression within the human skin graft only. The study demonstrates the limited capacity of single-stranded AAV vectors of six commonly used serotypes for gene delivery to human skin in vivo.

  13. Robust Lentiviral Gene Delivery But Limited Transduction Capacity of Commonly Used Adeno-Associated Viral Serotypes in Xenotransplanted Human Skin

    PubMed Central

    Jakobsen, Maria; Askou, Anne Louise; Stenderup, Karin; Rosada, Cecilia; Dagnæs-Hansen, Frederik; Jensen, Thomas G.; Corydon, Thomas J.; Mikkelsen, Jacob Giehm; Aagaard, Lars

    2015-01-01

    Skin is an easily accessible organ, and therapeutic gene transfer to skin remains an attractive alternative for the treatment of skin diseases. Although we have previously documented potent lentiviral gene delivery to human skin, vectors based on adeno-associated virus (AAV) rank among the most promising gene delivery tools for in vivo purposes. Thus, we compared the potential usefulness of various serotypes of recombinant AAV vectors and lentiviral vectors for gene transfer to human skin in a xenotransplanted mouse model. Vector constructs encoding firefly luciferase were packaged in AAV capsids of serotype 1, 2, 5, 6, 8, and 9 and separately administered by intradermal injection in human skin transplants. For all serotypes, live bioimaging demonstrated low levels of transgene expression in the human skin graft, and firefly luciferase expression was observed primarily in neighboring tissue outside of the graft. In contrast, gene delivery by intradermally injected lentiviral vectors was efficient and led to extensive and persistent firefly luciferase expression within the human skin graft only. The study demonstrates the limited capacity of single-stranded AAV vectors of six commonly used serotypes for gene delivery to human skin in vivo. PMID:26204415

  14. Scarring, stem cells, scaffolds and skin repair.

    PubMed

    Markeson, Daniel; Pleat, Jonathon M; Sharpe, Justin R; Harris, Adrian L; Seifalian, Alexander M; Watt, Suzanne M

    2015-06-01

    The treatment of full thickness skin loss, which can be extensive in the case of large burns, continues to represent a challenging clinical entity. This is due to an on-going inability to produce a suitable tissue engineered substrate that can satisfactorily replicate the epidermal and dermal in vivo niches to fulfil both aesthetic and functional demands. The current gold standard treatment of autologous skin grafting is inadequate because of poor textural durability, scarring and associated contracture, and because of a paucity of donor sites in larger burns. Tissue engineering has seen exponential growth in recent years with a number of 'off-the-shelf' dermal and epidermal substitutes now available. Each has its own limitations. In this review, we examine normal wound repair in relation to stem/progenitor cells that are intimately involved in this process within the dermal niche. Endothelial precursors, in particular, are examined closely and their phenotype, morphology and enrichment from multiple sources are described in an attempt to provide some clarity regarding the controversy surrounding their classification and role in vasculogenesis. We also review the role of the next generation of cellularized scaffolds and smart biomaterials that attempt to improve the revascularisation of artificial grafts, the rate of wound healing and the final cosmetic and functional outcome.

  15. Severe combined immunodeficiency mouse and human psoriatic skin chimeras. Validation of a new animal model.

    PubMed

    Nickoloff, B J; Kunkel, S L; Burdick, M; Strieter, R M

    1995-03-01

    Research into the cause and pathophysiological mechanisms underlying expression of psoriatric skin lesions has been hampered by lack of an appropriate animal model for this common and enigmatic cutaneous disease. These studies characterize normal skin, pre-psoriatic skin, and psoriatic plaque skin samples transplanted onto severe combined immunodeficiency mice. In this report we document that 1), normal, prepsoriatic, and psoriatic plaque keratome skin samples can be transplanted onto severe combined immunodeficiency mice reliably with high rates of graft survival (> 85%) and with reproducible changes consistently observed over prolonged periods of engraftment; 2), after transplantation, by clinical assessment and routine light microscopy, normal skin remained essentially normal whereas pre-psoriatic skin became thicker, and psoriatic plaque skin retained its characteristic plaque-type elevation and scale; 3), by using a panel of antibodies and immunohistochemical analysis, the overall phenotype of human cell types (including immunocytes) that persisted in the transplanted skin was remarkably similar to the immunophenotype of pretransplanted skin samples; 4), clearly recognized interface zones between human and murine skin within the epidermal and dermal compartments could be identified by routine microscopy and immunostaining, with focal areas of chimerism; and 5), elevated interleukin 8 cytokine levels were present in transplanted pre-psoriatic and psoriatic plaque skin samples. We conclude that there are many similarities between pre- and post-transplanted human samples of normal and psoriatic skin that are grafted onto severe combined immunodeficiency mice. Thus, we propose that this new animal model is appropriate for additional mechanistic-type studies designed to reveal the underlying genetic/etiological abnormality, as well as better illuminate the pathophysiological basis, for this important skin disease.

  16. Radiation therapy - skin care

    MedlinePlus

    ... numbness Skin sores Most of these symptoms will go away after your treatments have stopped. However, your skin may remain darker, drier, and more sensitive to the sun. When your hair grows back, it may be different than before.

  17. Squamous cell skin cancer

    MedlinePlus

    ... occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. The earliest form of ... skin cancer is to reduce your exposure to sunlight . Always use sunscreen: Apply sunscreen with sun protection ...

  18. Components of skin

    MedlinePlus Videos and Cool Tools

    ... skin layers from the outside environment and contains cells that make keratin, a substance that waterproofs and strengthens the skin. The epidermis also has cells that contain melanin, the dark pigment that gives ...

  19. Skin, Hair, and Nails

    MedlinePlus

    ... thousands of cells and hundreds of sweat glands, oil glands, nerve endings, and blood vessels. Skin is ... empty into hair follicles and pores, produce the oil sebum that lubricates the skin and hair. Sebaceous ...

  20. Bleeding into the skin

    MedlinePlus

    Protect aging skin. Avoid trauma such as bumping or pulling on skin areas. For a cut or scrape, use direct pressure to stop the bleeding. If you have a drug reaction, ask your provider about stopping the drug. Otherwise, follow ...

  1. Bacterial Skin Infections

    MedlinePlus

    ... Diseases Take Big Slice Out of America's Health, Economy (News) Health Tip: Use Caution When Applying Hair Dye Additional ... Skin Diseases Take Big Slice Out of America's Health, Economy THURSDAY, March 2, 2017 (HealthDay News) -- Skin diseases ...

  2. Necrotizing Skin Infections

    MedlinePlus

    ... Diseases Take Big Slice Out of America's Health, Economy (News) Health Tip: Use Caution When Applying Hair Dye Additional ... Skin Diseases Take Big Slice Out of America's Health, Economy THURSDAY, March 2, 2017 (HealthDay News) -- Skin diseases ...

  3. Neuromodulators for Aging Skin

    MedlinePlus

    ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ...

  4. PPD skin test

    MedlinePlus

    ... is a method used to diagnose silent (latent) tuberculosis (TB) infection. PPD stands for purified protein derivative. ... skin test; Tuberculin skin test; Mantoux test Images Tuberculosis in the kidney Tuberculosis in the lung Positive ...

  5. Examine Your Skin

    MedlinePlus Videos and Cool Tools

    ... Store In Memory Melanoma Info Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding ... video. UPDATED: November 23, 2016 Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding ...

  6. Microwave assisted synthesis of polyacrylamide grafted starch (St-g-PAM) and its applicability as flocculant for water treatment.

    PubMed

    Mishra, Sumit; Mukul, Ankita; Sen, Gautam; Jha, Usha

    2011-01-01

    Polyacrylamide grafted starch (St-g-PAM) was made by a novel method of synthesis, involving combination of microwave radiation and a chemical free radical initiator (ceric ammonium nitrate) to initiate grafting reaction. This method (microwave assisted synthesis) is quick, highly reliable, reproducible and yields high quality product as compared to the conventional method (which uses a chemical free radical initiator alone to initiate the grafting reaction).The St-g-PAM grades synthesized were characterized by various physicochemical techniques. Further, its application as flocculant for wastewater treatment was investigated.

  7. Biodiesel from conventional feedstocks.

    PubMed

    Du, Wei; Liu, De-Hua

    2012-01-01

    At present, traditional fossil fuels are used predominantly in China, presenting the country with challenges that include sustainable energy supply, energy efficiency improvement, and reduction of greenhouse gas emissions. In 2007, China issued The Strategic Plan of the Mid-and-Long Term Development of Renewable Energy, which aims to increase the share of clean energy in the country's energy consumption to 15% by 2020 from only 7.5% in 2005. Biodiesel, an important renewable fuel with significant advantages over fossil diesel, has attracted great attention in the USA and European countries. However, biodiesel is still in its infancy in China, although its future is promising. This chapter reviews biodiesel production from conventional feedstocks in the country, including feedstock supply and state of the art technologies for the transesterification reaction through which biodiesel is made, particularly the enzymatic catalytic process developed by Chinese scientists. Finally, the constraints and perspectives for China's biodiesel development are highlighted.

  8. Radiation-induced grafting of diallyldimethylammonium chloride onto acrylic acid grafted polyethylene

    NASA Astrophysics Data System (ADS)

    Francis, Sanju; Dhanawade, B. R.; Mitra, D.; Varshney, Lalit; Sabharwal, Sunil

    2009-01-01

    Diallyldimethylammonium chloride (DADMAC) was grafted onto polyethylene (PE) films by a double grafting procedure. The PE film was initially modified by grafting acrylic acid (AA), through a mutual irradiation method. AA-g-PE film, thus obtained was subjected to subsequent radiation grafting reaction of DADMAC, to give a DADMAC-g-AA-g-PE film having a comb-type structure. The influence of different conditions, such as the extent of AA grafting, DADMAC concentration, absorbed dose and dose rate, on the grafting yield of DADMAC was investigated. A maximum DADMAC grafting of 30% was achieved. The equilibrium degree of swelling (EDS) of the grafted films were gravimetrically determined. TGA and FT-IR techniques were employed to characterize the grafted PE films.

  9. Improved Methods to Produce Tissue-Engineered Skin Substitutes Suitable for the Permanent Closure of Full-Thickness Skin Injuries

    PubMed Central

    Larouche, Danielle; Cantin-Warren, Laurence; Desgagné, Maxime; Guignard, Rina; Martel, Israël; Ayoub, Akram; Lavoie, Amélie; Gauvin, Robert; Auger, François A.; Moulin, Véronique J.; Germain, Lucie

    2016-01-01

    Abstract There is a clinical need for skin substitutes to replace full-thickness skin loss. Our group has developed a bilayered skin substitute produced from the patient's own fibroblasts and keratinocytes referred to as Self-Assembled Skin Substitute (SASS). After cell isolation and expansion, the current time required to produce SASS is 45 days. We aimed to optimize the manufacturing process to standardize the production of SASS and to reduce production time. The new approach consisted in seeding keratinocytes on a fibroblast-derived tissue sheet before its detachment from the culture plate. Four days following keratinocyte seeding, the resulting tissue was stacked on two fibroblast-derived tissue sheets and cultured at the air–liquid interface for 10 days. The resulting total production time was 31 days. An alternative method adapted to more contractile fibroblasts was also developed. It consisted in adding a peripheral frame before seeding fibroblasts in the culture plate. SASSs produced by both new methods shared similar histology, contractile behavior in vitro and in vivo evolution after grafting onto mice when compared with SASSs produced by the 45-day standard method. In conclusion, the new approach for the production of high-quality human skin substitutes should allow an earlier autologous grafting for the treatment of severely burned patients. PMID:27872793

  10. Application of a high-level peracetic acid disinfection protocol to re-process antibiotic disinfected skin allografts.

    PubMed

    Lomas, R J; Huang, Q; Pegg, D E; Kearney, J N

    2004-01-01

    Skin allografts, derived from cadaveric donors, are widely used for the treatment of burns and ulcers. Prior to use in clinical situations, these allografts are disinfected using a cocktail of antibiotics and then cryopreserved. Unfortunately, this antibiotic disinfection procedure fails to decontaminate a significant proportion and these contaminated grafts can not be used clinically. We have investigated whether it is possible to apply a second, more potent disinfection procedure to these contaminated grafts and effectively to re-process them for clinical use. Cadaveric skin grafts, treated with antibiotics and cryopreserved, were thawed and a peracetic acid (PAA) disinfection protocol applied. The grafts were then preserved in a high concentration of glycerol or propylene glycol, and properties thought to be essential for successful clinical performance assessed. The cytotoxicity of the grafts was assessed using both extract and contact assays; damage to the skin collagen was assessed using a collagenase susceptibility assay and the capacity of the grafts to elicit an inflammatory response in vitro was assessed by quantifying the production of the pro-inflammatory cytokine TNF-alpha by human peripheral blood mononuclear phagocytes. PAA disinfection, in conjunction with either glycerol or propylene glycol preservation, did not render the grafts cytotoxic, pro-inflammatory, or increase their susceptibility to collagenase digestion. The rates of penetration of glycerol and propylene glycol into the re-processed skin were comparable to those of fresh skin. This study has demonstrated that PAA disinfection combined with immersion in high concentrations of either glycerol or propylene glycol was an effective method for re-processing contaminated skin allografts, and may justify their clinical use.

  11. Surgical Outcomes of Porcine Acellular Dermis Graft in Anophthalmic Socket: Comparison with Oral Mucosa Graft

    PubMed Central

    Teo, Livia; Woo, Young Jun; Kim, Dong Kyu; Kim, Chang Yeom

    2017-01-01

    Purpose We describe our experience with the Permacol graft in anophthalmic socket reconstruction, and compare it to the autologous buccal mucosal graft, emphasizing the postoperative vascularization and contraction of each graft. Methods This was a retrospective comparative study. We measured the time necessary for the graft surface to be completely vascularized, as well as the fornix depth of the conjunctival sac in anophthalmic patients. Results Ten patients underwent Permacol graft reconstruction, with 44 undergoing buccal mucosal graft reconstruction. Seven eyelids (70%) in the Permacol group had a good outcome, with improvement in lower eyelid position and prosthesis retention. Nine out of 10 eyelids (90%) in this group showed complete vascularization of the graft at 2.6 ± 1.9 months postoperatively, while the grafted buccal mucosa was fully vascularized at 1.1 ± 0.3 months postoperatively (p < 0.01). Postoperative fornix depth in the Permacol group was 9.1 ± 2.2 mm, compared to 14.9 ± 4.5 mm in the buccal mucosal graft group (p < 0.01). Mean increases in fornix depth were 33.1% and 67.9% of the mean vertical length of the implanted graft. Conclusions The Permacol graft can be useful as spacer graft material in anophthalmic socket patients. It takes longer to vascularize, and undergoes greater graft shrinkage with time, compared to the buccal mucosal graft. PMID:28243018

  12. Utility of Covered Stents for Revision of Aging Failing Synthetic Hemodialysis Grafts: A Report of Three Cases

    SciTech Connect

    Silas, Anne M. Bettmann, Michael A.

    2003-11-15

    Three aging failing hemodialysis polytetrafluoroethylene bypass shunts, average age 44 months, previously percutaneously revised with balloon angioplasty, presented with pseudoaneurysms and recurrent thrombosis. All were treated with percutaneous covered stent placement within their affected limbs. One graft was ligated 1 month after treatment for infected overlying skin ulcer, though this graft was subsequently surgically revised with interposition graft and the covered stent portion remains functional at 19 month follow-up. The 18- and 13- month follow- up of the remaining 2 patients shows that the covered stents remained patent and they are functional and being successfully and routinely punctured for dialysis. In this elderly population, the use of covered stents may prolong the functional life of failing hemodialysis bypass grafts, reducing the number of percutaneous and surgical interventions and further sparing other vascular access sites.

  13. Ultrasound skin imaging.

    PubMed

    Alfageme Roldán, F

    2014-12-01

    The interaction of high-frequency ultrasound waves with the skin provides the basis for noninvasive, fast, and accessible diagnostic imaging. This tool is increasingly used in skin cancer and inflammatory conditions as well as in cosmetic dermatology. This article reviews the basic principles of skin ultrasound and its applications in the different areas of dermatology.

  14. Skin self-exam

    MedlinePlus

    Skin cancer - self-exam; Melanoma - self-exam; Basal cell cancer - self-exam; Squamous cell - self-exam; Skin mole - self-exam ... Cancer Institute. What You Need To Know About Melanoma and Other Skin Cancers: How To Check Your ...

  15. Psychoneuroimmunology and the Skin.

    PubMed

    Honeyman, Juan F

    2016-08-23

    The nervous, immune, endocrine and integumentary systems are closely related and interact in a number of normal and pathological conditions. Nervous system mediators may bring about direct changes to the skin or may induce the release of immunological or hormonal mediators that cause pathological changes to the skin. This article reviews the psychological mechanisms involved in the development of skin diseases.

  16. Biology of Skin Color.

    ERIC Educational Resources Information Center

    Corcos, Alain

    1983-01-01

    Information from scientific journals on the biology of skin color is discussed. Major areas addressed include: (1) biology of melanin, melanocytes, and melanosomes; (2) melanosome and human diversity; (3) genetics of skin color; and (4) skin color, geography, and natural selection. (JN)

  17. Subacute radiation dermatitis: a histologic imitator of acute cutaneous graft-versus-host disease

    SciTech Connect

    LeBoit, P.E.

    1989-02-01

    The histopathologic changes of radiation dermatitis have been classified either as early effects (necrotic keratinocytes, fibrin thrombi, and hemorrhage) or as late effects (vacuolar changes at the dermal-epidermal junction, atypical radiation fibroblasts, and fibrosis). Two patients, one exposed to radiation therapeutically and one accidentally, are described. Skin biopsy specimens showed an interface dermatitis characterized by numerous dyskeratotic epidermal cells with lymphocytes in close apposition (satellite cell necrosis); that is, the epidermal changes were similar to those in acute graft-versus-host disease. Because recipients of bone marrow transplants frequently receive total body irradiation as part of their preparatory regimen, the ability of radiation to cause persistent epidermal changes similar to those in acute graft-versus-host disease could complicate the interpretation of posttransplant skin biopsy specimens.

  18. Minimizing superficial thermal injury using bilateral cryogen spray cooling during laser reshaping of composite cartilage grafts.

    PubMed

    Chang, Cheng-Jen; Cheng, Sally M H; Chiu, Lynn L; Wong, Brian J F; Ting, Keen

    2008-09-01

    Composite cartilage grafts were excised from New Zealand rabbit ears. Flat composite grafts (of cartilage and overlying skin graft on both surfaces) were obtained from each ear and cut into a rectangle measuring 50 mm by 25 mm (x by y) with an average thickness of approximately 1.3 mm (z), skin included. Specimens were manually deformed with a jig and maintained in this new position during laser illumination. The composite cartilage grafts were illuminated on the concave surface with an Nd:YAG laser (1,064 nm, 3 mm spot) at 10 W, 20 W, 30 W, 40 W, 50 W. Cryogen spray cooling (CSC) was applied to both exterior (convex) and interior (concave) surfaces of the tissue to reduce thermal injury to the grafts. CSC was delivered: (1) in controlled applications (cryogen released when surface reached 40 degrees C, and (2) receiving only laser at above wattage, no CSC [representing the control group]. The specimens were maintained in a deformation for 15 minutes after illumination and serially examined for 14 days. The control group with no CSC caused injury to all specimens, ranging from minor to full thickness epidermal thermal injury. Although most levels of laser and CSC yielded a high degree of reshaping over an acute time period, after 14 days specimens exposed to 30 W, 40 W, 50 W retained shape better than those treated at 10 W and 20 W. The specimens exposed to 50 W with controlled CSC retained its new shape to the highest degree over all others, and thermal injury was minimal. In conclusion, combinations of laser and CSC parameters were effective and practical for the reshaping of composite cartilage grafts.

  19. Transcutaneous Raman spectroscopy for assessing progress of bone-graft incorporation in bone reconstruction and repair

    NASA Astrophysics Data System (ADS)

    Okagbare, Paul I.; Esmonde-White, Francis W. L.; Goldstein, Steven A.; Morris, Michael D.

    2011-03-01

    Allografts and other bone-grafts are frequently used for a variety of reconstructive approaches in orthopaedic surgery. However, successful allograft incorporation remains uncertain. Consequently, there is significant need for methods to monitor the fate of these constructs. Only few noninvasive methods can fully assess the progress of graft incorporation and to provide information on the metabolic status of the graft, such as the mineral and matrix composition of the regenerated-tissue that may provide early indications of graft success or failure. For example, Computed-tomography and MRI provide information on the morphology of the graft/host interface. Limited information is also available from DXA. To address this challenge, we present here the implementation of a noninvasive Raman spectroscopy technique for in-vivo assessment of allograft incorporation in animal-model. In an animal use committee approved osseointegration experiment, a 3mm defect is created in rat's tibia. The defect is reconstructed using auto or allograft and Raman spectra are collected at several time-points during healing using an array of optical-fibers in contact with the skin of the rat over the tibia while the rat is anaesthetized. The array allows excitation and collection of Raman spectra through the skin at various positions around the tibia. Raman parameters such as mineral/matrix, carbonate/phosphate and cross-linking are recovered and monitored. The system is calibrated against locally-constructed phantoms that mimic the morphology, optics and spectroscopy of the rat. This new technology provides a non-invasive method for in-vivo assessment of bone-graft incorporation in animal-models and can be adapted for similar study in human subjects.

  20. In vivo regulation of murine hair growth: insights from grafting defined cell populations onto nude mice.

    PubMed

    Lichti, U; Weinberg, W C; Goodman, L; Ledbetter, S; Dooley, T; Morgan, D; Yuspa, S H

    1993-07-01

    The nude mouse graft model for testing the hair-forming ability of selected cell populations has considerable potential for providing insights into factors that are important for hair follicle development and proper hair formation. We have developed a minimal component system consisting of immature hair follicle buds from newborn pigmented C57BL/6 mice and adenovirus E1A-immortalized rat vibrissa dermal papilla cells. Hair follicle buds contribute to formation of hairless skin when grafted alone or with Swiss 3T3 cells, but produce densely haired skin when grafted with a fresh dermal cell preparation. The fresh dermal cell preparation represents the single cell fraction after hair follicles have been removed from a collagenase digest of newborn mouse dermis. It provides dermal papilla cells, fibroblasts, and possibly other important growth factor-producing cell types. Rat vibrissa dermal papilla cells supported dense hair growth at early passage in culture but progressively lost this potential during repeated passage in culture. Of 19 E1A-immortalized, clonally derived rat vibrissa dermal papilla cell lines, the four most positive clones supported hair growth to the extent of approximately 200 to 300 hairs per 1-2 cm2 graft area. The remaining clones were moderately positive (five clones), weakly positive (three clones), or negative (seven clones). Swiss 3T3 cells prevented contraction of the graft area but did not appear to affect the number of hairs in the graft site produced by dermal papilla cells plus hair follicle buds alone. The relatively low hair density (estimated 1-5% of normal) resulting from grafts of hair follicle buds with the most positive of the immortalized dermal papilla cell clones compared to fresh dermal cells suggests that optimal reconstitution of hair growth requires some function of dermal papilla cells partially lost during the immortalization process and possibly the contribution of other cell types present in the fresh dermal cell

  1. Anyone Can Get Skin Cancer

    Cancer.gov

    No matter if your skin is light, dark, or somewhere in between, everyone is at risk for skin cancer. Learn what skin cancer looks like, how to find it early, and how to lower the chance of skin cancer.

  2. Resurfacing glabrous skin defects in the hand: the thenar base donor site.

    PubMed

    Milner, Chris S; Thirkannad, Sunil M

    2014-06-01

    Defects of the glabrous skin surfaces of the palm and fingers result from numerous causes including larger fingertip injuries, unhealed burns, and after surgery for diverse pathologies. The qualities of glabrous skin are specifically tailored to the functional requirements of high-shear strength and robustness. Despite these unique properties, graft reconstruction of defects in the glabrous regions of the hand is frequently achieved with skin from nonglabrous donor sites such as the medial forearm. Nonglabrous skin has a poor color and texture match for such applications and is frequently associated with tender and unsightly donor scars. We describe our experiences of harvesting full-thickness grafts from the glabrous skin centered over the proximal flexion crease at the level of the metacarpophalangeal joint of the thumb. We have utilized this site to harvest skin grafts of up to 2 cm in width for the resurfacing of small-sized to medium-sized defects on the palmar surfaces of the hands and fingers in 28 patients under both traumatic and elective circumstances. The skin has an excellent type-match to the defect and is quick and easy to harvest due to its adjacent location to the defect. The donor scar matures quickly, and as it lies along the thumb base crease, it runs along one of the least used contact surfaces, thereby limiting the potential discomfort associated with FTSG harvest sites from other areas. Patient satisfaction with the procedure has been high, and it represents a useful alternative to traditional nonglabrous skin graft donor sites for small-sized to medium-sized defects.

  3. Grafting of water turbines runner

    SciTech Connect

    Yang, I.T.

    1983-12-01

    It is possible to graft upon or hybridize two different types of water turbines' runner in order to attain more perfect performance to meeting engineering needs. The answer is positive and very interesting, as shown in the research experiment in the Hydromachines Laboratory of Gansu University of Technology. Grafting a group of propeller blades (Ns=440 N.KW) on a Francis turbine runner (Ns=200) with certain boundary conditions in the flow areas, a new hybrid multiplex runner performance has been achieved. Its efficiency curve has been improved at high speed and large flow rate operating conditions that could be able to meet the engineering requirements when the head of the hydropower station is lower than normal. Its unit rotation speed is increased about 25% over that of the Francis. The general performance curve of this hybrid runner will be provided in this paper.

  4. Case Report of Relay Liver Transplantation With Graft Infected With Hepatitis B Virus.

    PubMed

    Wong, T C L; She, W H; Cheung, T T; Chan, S C; Lo, C M

    2015-11-01

    Reuse of liver graft for transplantation is extremely uncommon. We report the 1st case of reuse of liver graft from a recipient who had hepatitis B virus (HBV) infection, 11 years after the 1st transplantation. Our relay liver transplantation challenged conventional thinking because of late reuse of graft in the presence of HBV infection. Moreover, both the 1st and the 2nd donors were of advanced age. The key questions were whether the liver graft could be reused safely, especially in the setting of HBV infection, and technical concerns during organ procurement and implantation. The absence of HBV replication was confirmed with negative hepatitis B surface antigen and undetectable serum HBV DNA in the 2nd donor. Based on our experience in managing HBV infection after liver transplantation, we were confident that the adequately suppressed HBV infection in the donor would not jeopardize graft function and that the graft would be able to withstand another ischemia-perfusion injury to continue to function well in our recipient.

  5. [Bone grafts using tissue engineering].

    PubMed

    Delloye, C

    2001-01-01

    An overview of bone grafts and, in particular, the allografts is presented. The availability of bone allografts, has promoted their use at the expense of the autograft. However, the loss of the cellular activity in an allograft, makes them less performant than an autograft. The use of an allograft in a small size defect can be advocated provided that the implantation technique is stringent. In case of a large segmental bone defect, an allograft can be considered whereas an autograft is not anymore possible. A massive bone allograft allows an anatomical reconstruction and the preservation of strong tendon insertions. In tumor surgery, a bone allograft has become one of the best options to reshape the skeleton. To offset the poor remodeling of the massive bone allografts, and to improve the take of small size bone allografts, researches are presently carried on, using tissue engineering in order to recover a cellular population. The aim is to combine an acellular bone graft with the cells of the recipient. Cells are procured from the bone marrow. Stromal cells are isolated, cultured, so that they will grow with an osteoblastic phenotype. They can be used alone or in association with a bone graft. It is believed that tomorrow such cellular therapy will become a routine procedure.

  6. Conventional mechanical ventilation

    PubMed Central

    Tobias, Joseph D.

    2010-01-01

    The provision of mechanical ventilation for the support of infants and children with respiratory failure or insufficiency is one of the most common techniques that are performed in the Pediatric Intensive Care Unit (PICU). Despite its widespread application in the PICUs of the 21st century, before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread use of endotracheal intubation thereby ushering in the era of positive pressure ventilation. Although there seems to be an ever increasing complexity in the techniques of mechanical ventilation, its successful use in the PICU should be guided by the basic principles of gas exchange and the physiology of respiratory function. With an understanding of these key concepts and the use of basic concepts of mechanical ventilation, this technique can be successfully applied in both the PICU and the operating room. This article reviews the basic physiology of gas exchange, principles of pulmonary physiology, and the concepts of mechanical ventilation to provide an overview of the knowledge required for the provision of conventional mechanical ventilation in various clinical arenas. PMID:20927268

  7. The use of cyclosporin A in clinical organ grafting.

    PubMed Central

    Calne, R Y; White, D J

    1982-01-01

    Experiments in animals with organ allografts showed that Cyclosporin A (CyA) was an extremely powerful immunosuppressant with a good therapeutic index. A pilot study of the drug in human recipients of renal allografts revealed an unexpected side effect, nephrotoxicity, which made care of patients difficult. Following a policy of deliberate hydration of patients in the perioperative phase and withholding CyA until diuresis was occurring in the graft, excellent results have been obtained in clinical practice. An 82% actuarial functional survival at both one and two years has been obtained in the 59 patients treated with this protocol. A multicenter trial is now in progress in eight centers in Europe, comparing CyA used in the manner described above with conventional azathioprine and steroids. CyA has also been used in 17 recipients of liver allografts, ten of whom are still alive and 11 recipients of segmental pancreatic allografts, one of whom remains off insulin after two and a quarter years. Sudden graft failure occurred between three months and two years in three patients whose pancreatic duct had been occluded. The authors' most recent segmental pancreas graft has been drained into a long roux loop without complications. The main objective in the use of this drug is to obtain consistent immunosuppression without nephrotoxicity. It is possible that maintaining blood level between defined limits would improve results. PMID:7051997

  8. Sensitive skin: an overview.

    PubMed

    Inamadar, Arun C; Palit, Aparna

    2013-01-01

    Sensitive skin is less tolerant to frequent and prolonged use of cosmetics and toiletries. It is self-diagnosed and typically unaccompanied by any obvious physical signs of irritation. With the change in lifestyle and also with increased opportunity to use many new brands of cosmetics and toiletries, there has been an increase in females complaining of unique sensation in their facial skin. Sensitive skin presents as smarting, burning, stinging, itching, and/or tight sensation in their facial skin. The condition is found in more than 50% of women and 40% of men, creating a sizable demand for products designed to minimize skin sensitivity. Good numbers of invasive and non-invasive tests are designed to evaluate and predict the sensitive skin. Management includes guidelines for selecting suitable cosmetics and toiletries in sensitive skin individuals.

  9. Pursuing prosthetic electronic skin

    NASA Astrophysics Data System (ADS)

    Chortos, Alex; Liu, Jia; Bao, Zhenan

    2016-09-01

    Skin plays an important role in mediating our interactions with the world. Recreating the properties of skin using electronic devices could have profound implications for prosthetics and medicine. The pursuit of artificial skin has inspired innovations in materials to imitate skin's unique characteristics, including mechanical durability and stretchability, biodegradability, and the ability to measure a diversity of complex sensations over large areas. New materials and fabrication strategies are being developed to make mechanically compliant and multifunctional skin-like electronics, and improve brain/machine interfaces that enable transmission of the skin's signals into the body. This Review will cover materials and devices designed for mimicking the skin's ability to sense and generate biomimetic signals.

  10. [Skin diseases and obesity].

    PubMed

    Guerra-Segovia, Carolina; Ocampo-Candiani, Jorge

    2015-01-01

    Obesity is a public health problem worldwide. It predominates in industrialized countries; however, it is prevalent in all nations. It is defined as a condition of excess adipose tissue and is the result of changes in lifestyle, excessive consumption of energy-dense foods with poor nutritional value, physical inactivity and the reduction of open space where one can practice a sport. Although obesity is associated with multiple diseases, it is important to stress that the metabolic changes caused by it affect skin physiology and play a predisposing factor for the development of skin diseases. Very little has been studied on the impact of obesity on the skin. The purpose of this article is to review the most frequently skin diseases in obesity. Some skin pathologies in obesity are caused by changes in skin physiology, others are related to insulin resistance or constitute an exacerbating factor for dermatitis. This article covers the clinical features of obesity related skin disease and its management.

  11. Oral disease profiles in chronic graft versus host disease.

    PubMed

    Bassim, C W; Fassil, H; Mays, J W; Edwards, D; Baird, K; Steinberg, S M; Cowen, E W; Naik, H; Datiles, M; Stratton, P; Gress, R E; Pavletic, S Z

    2015-04-01

    At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral c

  12. ESD and the Rio Conventions

    ERIC Educational Resources Information Center

    Sarabhai, Kartikeya V.; Ravindranath, Shailaja; Schwarz, Rixa; Vyas, Purvi

    2012-01-01

    Chapter 36 of Agenda 21, a key document of the 1992 Earth Summit, emphasised reorienting education towards sustainable development. While two of the Rio conventions, the Convention on Biological Diversity (CBD) and the United Nations Framework Convention on Climate Change (UNFCCC), developed communication, education and public awareness (CEPA)…

  13. Complications of fat grafts growth after weight gain: report of a severe diplopia.

    PubMed

    Duhoux, Alexandre; Chennoufi, Mehdi; Lantieri, Laurent; Hivelin, Mikael

    2013-07-01

    A 47 years old woman underwent autologous fat grafting to treat a 5×4 cm depression of the lower lid and the upper cheek secondary resection of squamous cell carcinoma and subsequent coverage by full thickness skin graft. 20 mL of autologous fat were harvested from lower abdomen, centrifuged and injected subcutaneously. The patient then gained a total of 15 kg over a period of 24 months. Eye dystopia developed while the grafted area became convex. MRI confirmed subcutaneous fat mass going to the orbital floor through the inferior septal defect. The fat excess was removed through a trans-conjonctival approach allowing for a progressive regression of diplopia after 2 months while the oedema reduced. The overall follow up from the resection-coverage and last examination was 5 years. In this case with a context of noticeable weight gain, the growth of a fat graft trapped between a sclerous plane and the eye, that penetrated the orbital cavity through a septal defect led have led to exophthalmos, ocular dystopia and diplopia. Systematic overcorrection in autologous fat grafting should be prevented, especially in functional areas and on low body mass index patient that might gain weight.

  14. Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model

    PubMed Central

    Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

    2016-01-01

    Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (SecPBMC), apoptotic PBMCs (Apo-SecPBMC), or controls. The wounds treated with Apo-SecPBMC had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-SecPBMC had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-SecPBMC significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting. PMID:27125302

  15. Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model.

    PubMed

    Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

    2016-04-29

    Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (Sec(PBMC)), apoptotic PBMCs (Apo-Sec(PBMC)), or controls. The wounds treated with Apo-Sec(PBMC) had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-Sec(PBMC) had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-Sec(PBMC) significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting.

  16. Conservative Pancreas Graft Preservation at the Extreme

    PubMed Central

    Laurence, Jerome Martin; Sapisochin, Gonzalo; Selzner, Markus; Norgate, Andrea; Kumar, Deepali; McGilvary, Ian D.; Preig, Paul D.; Schiff, Jeffrey; Cattral, Mark S.

    2016-01-01

    Because of the value some patients place in remaining insulin-independent after pancreas transplantation, they may be reluctant to undergo graft pancreatectomy, even in the face of extreme complications, such as graft thrombosis and duodenal segment leak. Partly, for this reason, a variety of complex salvage techniques have been described to save the graft in such circumstances. We report a case of a series of extreme complications related to a leak from the duodenal segment after a simultaneous pancreas and kidney transplant. These included infected thrombosis of the inferior vena cava associated with a graft venous thrombosis and a retroperitoneal fistula. The patient retained graft function with insulin independence and repeatedly declined graft pancreatectomy against the advice of the transplant team. Conservative treatment with percutaneous drainage, antibiotics, and anticoagulation was eventually successful. This outcome is unique in our experience and may be instructive to teams caring for pancreas transplant recipients. PMID:27500244

  17. Grafting chitosan and polyHEMA on carbon nanotubes surfaces: "grafting to" and "grafting from" methods.

    PubMed

    Mahmoodian, Hossein; Moradi, Omid; Shariatzadeh, Behnam

    2014-02-01

    We report a simple method for engineering chitosan (CS) functionalized multi-walled carbon nanotube (MWCNT) composites with a biomedically important polymer, poly-2-hydroxyethyl methacrylate (polyHEMA), by chemical grafting HEMA monomers via free radical polymerization. Functionalization of CS and polyHEMA occurred in three steps. First, using microwave irradiation, CS was grafted onto the surface and sidewall of the carbon nanotubes. Second, HEMA monomers were grafted onto the polymeric matrix surface. The final step involved free radical polymerization of HEMA monomers. Composite synthesis was confirmed by Fourier transform infrared (FTIR) spectroscopy. Moreover, the presence of polyHEMA on the surface of the CS functionalized carbon nanotubes was confirmed by field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM) and thermo gravimetric analysis (TGA) analyses. Furthermore, in the aqueous phase, our novel composites exhibited higher dispersibility compared with pristine MWCNTs. Considering the biomedical importance of polyHEMA and CS polymers, we expect these materials to be useful in the pharmaceutical industry as novel biomaterial composites with potential applications in drug delivery.

  18. Autologous Smashed Dermal Graft with Epidermal Re-closure: Modified Technique for Acne Scars

    PubMed Central

    Nagaraju, Umashankar; Chikkaiah, Mahesh K; Raju, Belliappa P; Agarwal, Priyanka

    2016-01-01

    Conventional technique of dermal grafting for acne scars where the source of filler material used is the patient's own dermis requires longer surgical time, recovery period and can result in unsightly scars at the donor area. Hence, it is not suitable for treating a larger number of scars. Furthermore, these dermal grafts are firm and cannot be contoured to fit all types of acne scars. Occurrence of epidermal cyst and secondary infection is another complication if epidermis is not completely removed. Enzymatic techniques need trypsinisation which is expensive and requires laboratory facilities. PMID:28163459

  19. New strategies for preoperative skin antisepsis.

    PubMed

    Ulmer, Miriam; Lademann, Juergen; Patzelt, Alexa; Knorr, Fanny; Kramer, Axel; Koburger, Torsten; Assadian, Ojan; Daeschlein, Georg; Lange-Asschenfeldt, Bernhard

    2014-01-01

    During the past decades, encouraging progress has been made in the prevention of surgical site infections (SSI). However, as SSI still occur today, strategic prevention measures such as standardized skin antisepsis must be implemented and rigorously promoted. Recent discoveries in skin physiology necessitate the development of novel antiseptic agents and procedures in order to ameliorate their efficacy. In particular, alternate target structures in the skin need to be taken into consideration for the development of the next generation of antiseptics. Recent investigations have shown that a high number of microorganisms are located within and in the close vicinity of the hair follicles. This suggests that these structures are an important reservoir of bacterial growth and activity in human skin. To date, it has not been fully elucidated to what extent conventional liquid antiseptics sufficiently target the hair follicle-related microbial population. Modern technologies such as tissue-tolerable plasma (TTP) have been tested for their potential antiseptic efficiency by reducing the bacterial load in the skin and in the hair follicles. First experiments using liposomes to deliver antiseptics into the hair follicles have been evaluated for their potential clinical application. The present review evaluates these two innovative methods for their efficacy and applicability in preoperative skin antiseptics.

  20. Preoperative graft assessment in aortocoronary bypass surgery

    PubMed Central

    Tinica, Grigore; Vartic, Cristina Luca; Mocanu, Veronica; Baran, Dana; Butcovan, Doina

    2016-01-01

    Coronary artery bypass graft (CABG) is a surgical procedure able to improve the blood supply to the myocardium. In the present study, the distal segments of grafts taken from the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV) for use in aortocoronary bypass surgery were examined. The morphologies of the grafts were investigated in order to draw conclusions concerning their patency and viability. In addition, clinical and laboratory risk factors considered to be significant predictors of lesion severity in graft vessels used in CABGs were investigated. In total, 54 distal graft segments of ITAs, RAs and SVs from 20 men and 6 women aged between 42 and 78 years, were evaluated. Histological analyses were used to visualize graft lesions. Morphometrically, the intimal thickness index (ITI) and luminal narrowing were assessed as an indication of graft patency. The histological changes observed in the graft vessel walls included the presence of distinct atheromatous plaques (fatty streaks in 2 cases) or thickening of the intima (20 cases) and media (17 cases). Morphometric analysis showed that the mean ITI of the vessel conduits was 0.37 in the SVs, 0.95 in the RAs, and 1.66 in the ITAs. No patient had >50% conduit stenosis. By assessing the association between risk factors and graft lesions, it was found that all the patients showed risk factors for atherosclerosis, such as age (61.54%), arterial hypertension (65.38%), hyperlipidemia (65.38%), smoking (34.61%), diabetes mellitus (38.46%) and obesity (15.38%). The presence of pre-existing lesions in bypass grafts may contribute to a reduction in their viability, particularly in the case of venous grafts. Further long-term follow-ups are mandatory to evaluate the consequences of such lesions upon the patency of the grafts. PMID:27446279

  1. Organosiloxane-grafted natural polymer coatings

    DOEpatents

    Sugama, Toshifumi

    1998-12-01

    A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation. 17 figs.

  2. Interdigitating reticulum cells in human renal grafts.

    PubMed

    Wakabayashi, T; Onoda, H

    1991-01-01

    Seventeen human renal graft biopsies taken 1 h to 50 days after transplantation and 3 human renal non-graft biopsies (2 minimal change and 1 non-tumour portion of angiomyolipoma) were investigated with immunoelectron microscopy in order to identify interdigitating reticulum cells (IDC) or dendritic cells (DC) in renal tissues. The antibodies used consisted of a rabbit polyclonal antibody of antihuman S100 beta protein, mouse monoclonal antibodies of antihuman HLA-DR, anti-CD3, and anti-CD1a. IDC or DC were identified in 11 renal grafts. They were found both in the glomerular and interstitial (peritubular) capillary lumens but not in the interstitium of 1 case: both were present in the interstitial capillary lumens and interstitium of another case, and in the interstitium only of 9 cases. In the remaining 6 grafts and 3 non-grafts they were not detected. These 6 grafts and 3 non-grafts did not show any pathological change except for foot process fusion of the glomerular epithelia in 2 cases of minimal change. These findings suggest that IDC or DC are not normally present in human renal tissues. The presence of the cell in the glomerular and peritubular capillary lumens of a biopsy taken after 1 h and their presence in the interstitial capillary lumens of another graft biopsy, suggest that the IDC or DC in human renal grafts are derived from recipients, not donors, and that they migrate from the circulating blood toward the interstitium.

  3. Plant grafting: insights into tissue regeneration

    PubMed Central

    2016-01-01

    Abstract For millennia, people have cut and joined different plants together through a process known as grafting. The severed tissues adhere, the cells divide and the vasculature differentiates through a remarkable process of regeneration between two genetically distinct organisms as they become one. Grafting is becoming increasingly important in horticulture where it provides an efficient means for asexual propagation. Grafting also combines desirable roots and shoots to generate chimeras that are more vigorous, more pathogen resistant and more abiotic stress resistant. Thus, it presents an elegant and efficient way to improve plant productivity in vegetables and trees using traditional techniques. Despite this horticultural importance, we are only beginning to understand how plants regenerate tissues at the graft junction. By understanding grafting better, we can shed light on fundamental regeneration pathways and the basis for self/non‐self recognition. We can also better understand why many plants efficiently graft whereas others cannot, with the goal of improving grafting so as to broaden the range of grafted plants to create even more desirable chimeras. Here, I review the latest findings describing how plants graft and provide insight into future directions in this emerging field. PMID:28316790

  4. Late infection in Dacron arterial grafts.

    PubMed

    Harvey, D R; Bliss, B P

    1975-06-01

    We report a series of cases of late infection in Dacron arterial grafts. Late infection is defined as that presenting de novo 6 months or more after the patient's discharge from hospital with a clean healed wound. One hundred and ten patients were followed up and 6 cases of this type of infection occurred. The diagnosis was made on clinical grounds and usually pain, suppuration in the line of graft, or graft exposure were the presenting features. Secondary haemorrhage, common in early infection, did not occur. Conservative management failed in most cases and removal of the infected graft was necessary. The difficult problems associated with revascularization are discussed.

  5. Tunable Engineered Skin Mechanics via Coaxial Electrospun Fiber Core Diameter

    PubMed Central

    Blackstone, Britani Nicole; Drexler, Jason William

    2014-01-01

    Autologous engineered skin (ES) offers promise as a treatment for massive full thickness burns. Unfortunately, ES is orders of magnitude weaker than normal human skin causing it to be difficult to apply surgically and subject to damage by mechanical shear in the early phases of engraftment. In addition, no manufacturing strategy has been developed to tune ES biomechanics to approximate the native biomechanics at different anatomic locations. To enhance and tune ES biomechanics, a coaxial (CoA) electrospun scaffold platform was developed from polycaprolactone (PCL, core) and gelatin (shell). The ability of the coaxial fiber core diameter to control both scaffold and tissue mechanics was investigated along with the ability of the gelatin shell to facilitate cell adhesion and skin development compared to pure gelatin, pure PCL, and a gelatin-PCL blended fiber scaffold. CoA ES exhibited increased cellular adhesion and metabolism versus PCL alone or gelatin-PCL blend and promoted the development of well stratified skin with a dense dermal layer and a differentiated epidermal layer. Biomechanics of the scaffold and ES scaled linearly with core diameter suggesting that this scaffold platform could be utilized to tailor ES mechanics for their intended grafting site and reduce graft damage in vitro and in vivo. PMID:24712409

  6. The healing effect of unrestricted somatic stem cells loaded in collagen-modified nanofibrous PHBV scaffold on full-thickness skin defects.

    PubMed

    Keshel, Saeed Heidari; Biazar, Esmaeil; Rezaei Tavirani, Mostafa; Rahmati Roodsari, Mohammad; Ronaghi, Abdolaziz; Ebrahimi, Maryam; Rad, Hadi; Sahebalzamani, Ali; Rakhshan, Azadeh; Afsordeh, Kobra

    2014-06-01

    Unrestricted somatic stem cells (USSCs) loaded in nanofibrous PHBV scaffold can be used for skin regeneration when grafted into full-thickness skin defects of rats. Nanofibrous PHBV scaffolds were designed using electrospinning method and then, modified with the immobilized collagen via the plasma method. Afterward, the scaffolds were evaluated using scanning electron microscopy, physical and mechanical assays. In this study; nanofibrous PHBV scaffolds loaded with and without USSCs were grafted into the skin defects. The wounds were subsequently investigated at 21 days after grafting. Results of mechanical and physical analyses showed good resilience and compliance to movement as a skin graft. In animal models; all study groups excluding the control group exhibited the most pronounced effect on wound closure, with the statistically significant improvement in wound healing being seen on post-operative Day 21. Histological and immunostaining examinations of healed wounds from all groups, especially the groups treated with stem cells, showed a thin epidermis plus recovered skin appendages in the dermal layer. Thus, the graft of collagen-coated nanofibrous PHBV scaffold loaded with USSC showed better results during the healing process of skin defects in rat model.

  7. Studies on the conservation of epidermal specificies of skin and certain mucosas in adult mammals.

    PubMed

    Billingham, R E; Silvers, W K

    1967-03-01

    To determine whether the factor(s) responsible for the conservation of epidermal specificities in adult guinea pigs and hamsters resides in the germinal layer of the epidermis or in the dermis, thin grafts of skin, possessing qualitatively distinct regional characteristics, were separated into their superficial epidermal and dermal components with the aid of trypsin. Dermis of one type was combined with epidermis of another to produce "recombinant" grafts which were then transplanted to small, full thickness cutaneous sites on the thorax of geneticaily compatible hosts. A variant of this procedure involved transplanting sheets of superficial epidermis of various types to shallow split thickness recipient areas in the skin of the thorax. All grafts were maintained for 100 days before they were excised and examined histologically. The results indicate that, whereas the dermis determines the kind of epidermis produced in recombinant grafts involving the ear, the sole of the foot, and the trunk, this is not the case in recombinants which include tongue, esophageal, or cheek pouch epithelia. The one exception to this occurred when tongue or esophagus epithelia were transplanted to split thickness beds in trunk skin. Here they appeared to produce an epidermis characteristic of their new location. It is believed that this exception is probably due to the fact that the native follicular epidermis present in trunk dermis made such a substantial contribution to the new superficial epidermis that it behaved overtly as body skin epidermis. Taken together, these results suggest that basal layer cells of the superficial epidermis of sole of foot skin, ear skin, and the hair-bearing skin of the general integument behave as if they are equipotential, and that in adult life maintenance of these particular epidermal specificities is the outcome of persistent specific inductive stimuli from the underlying dermis. The results of subsidiary experiments are reported which indicate that

  8. Skin protection for hairdressers.

    PubMed

    Skudlik, Christoph; John, Swen Malte

    2007-01-01

    The application of protective creams in the hairdressing trade forms part of a complex concept for the prevention of occupational skin disorders. To date, no comparative controlled intervention studies have been carried out using different skin-protective creams. Previously published skin protection plans concerning barrier creams for the hairdressing trade are fairly general or rudimentary, reflecting our still limited knowledge on the subject. Bioengineering studies have even demonstrated a paradoxical effect of a certain skin-protective foam designed for hairdressers. Regarding other barrier creams, a certain protective effect could however be shown in studies concerning exposure to wetness and detergents. Pre-exposition skin protection seems to be of particular relevance. Thus, in principle, the regular application of adequate skin protection creams can be recommended in the hairdressing trade, although the protective effect should not be overvalued.

  9. Cell-Assisted Lipotransfer Improves Volume Retention in Irradiated Recipient Sites and Rescues Radiation-Induced Skin Changes

    PubMed Central

    Luan, Anna; Duscher, Dominik; Whittam, Alexander J.; Paik, Kevin J.; Zielins, Elizabeth R.; Brett, Elizabeth A.; Atashroo, David A.; Hu, Michael S.; Lee, Gordon K.; Gurtner, Geoffrey C.; Longaker, Michael T.; Wan, Derrick C.

    2016-01-01

    Radiation therapy is not only a mainstay in the treatment of many malignancies but also results in collateral obliteration of microvasculature and dermal/subcutaneous fibrosis. Soft tissue reconstruction of hypovascular, irradiated recipient sites through fat grafting remains challenging; however, a coincident improvement in surrounding skin quality has been noted. Cell-assisted lipotransfer (CAL), the enrichment of fat with additional adipose-derived stem cells (ASCs) from the stromal vascular fraction, has been shown to improve fat volume retention, and enhanced outcomes may also be achieved with CAL at irradiated sites. Supplementing fat grafts with additional ASCs may also augment the regenerative effect on radiation-damaged skin. In this study, we demonstrate the ability for CAL to enhance fat graft volume retention when placed beneath the irradiated scalps of immunocompromised mice. Histologic metrics of fat graft survival were also appreciated, with improved structural qualities and vascularity. Finally, rehabilitation of radiation-induced soft tissue changes were also noted, as enhanced amelioration of dermal thickness, collagen content, skin vascularity, and biomechanical measures were all observed with CAL compared to unsupplemented fat grafts. Supplementation of fat grafts with ASCs therefore shows promise for reconstruction of complex soft tissue defects following adjuvant radiotherapy. PMID:26661694

  10. Effects of thermal water on skin regeneration.

    PubMed

    Faga, Angela; Nicoletti, Giovanni; Gregotti, Cesarina; Finotti, Valentina; Nitto, Agnese; Gioglio, Luciana

    2012-05-01

    An experimental study was carried out in an animal (New Zealand white rabbit) wound model to evaluate any effects of a hypotonic, bicarbonate-calcium-magnesium mineral water (Comano thermal water) on skin regeneration, comparing the healing rate of split-thickness skin graft donor sites treated with the thermal water wet dressing versus a standard petrolatum gauze dressing versus a saline solution wet dressing. The study was performed in two steps; an overall of 22 animals were enrolled in the study. The wound healing progress was evaluated both by the surgeons and by the histologists. Sixty-four punch biopsies were examined in all. The histological samples were examined after staining with haematoxylin and eosin, Masson's and orcein staining and under a transmission electron microscope. The data were statistically analysed. The Comano thermal water proved to improve skin regeneration, not only by increasing keratinocyte proliferation and migration but also favourably modulating the regenerated collagen and elastic fibres in the dermis. We propose that the results of the topical treatment with the thermal water could be due to the favourable combination of a local wet environment with an anti-inflammatory action and that the regenerative properties of Comano thermal water observed in rabbits could also be applied for human use.

  11. What to Expect during Coronary Artery Bypass Grafting

    MedlinePlus

    ... NHLBI on Twitter. What To Expect During Coronary Artery Bypass Grafting Coronary artery bypass grafting (CABG) requires ... surgery to newer, less-invasive methods. Traditional Coronary Artery Bypass Grafting This type of surgery usually lasts ...

  12. Initiator Effects in Reactive Extrusion of Starch Graft Copolymers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Graft copolymers of starch with water-soluble polymers such as polyacrylamide have potential applications including hydrogels, superabsorbents, and thickening agents. Reactive extrusion is a rapid, continuous method for production of starch graft copolymers with high reaction and grafting efficienc...

  13. Epithelial and stromal developmental patterns in a novel substitute of the human skin generated with fibrin-agarose biomaterials.

    PubMed

    Carriel, Víctor; Garzón, Ingrid; Jiménez, Jose-María; Oliveira, Ana-Celeste-Ximenes; Arias-Santiago, Salvador; Campos, Antonio; Sánchez-Quevedo, Maria-Carmen; Alaminos, Miguel

    2012-01-01

    Development of human skin substitutes by tissue engineering may offer new therapeutic alternatives to the use of autologous tissue grafts. For that reason, it is necessary to investigate and develop new biocompatible biomaterials that support the generation of a proper human skin construct. In this study, we generated a novel model of bioengineered human skin substitute using human cells obtained from skin biopsies and fibrin-agarose biomaterials and we evaluated this model both at the ex vivo and the in vivo levels. Once the dermal fibroblasts and the epithelial keratinocytes were isolated and expanded in culture, we used fibrin-agarose scaffolds for the development of a full-thickness human skin construct, which was evaluated after 1, 2, 3 and 4 weeks of development ex vivo. The skin substitutes were then grafted onto immune-deficient nude mice and analyzed at days 10, 20, 30 and 40 postimplantation using transmission electron microscopy, histochemistry and immunofluorescence. The results demonstrated that the fibrin-agarose artificial skin had adequate biocompatibility and proper biomechanical properties. A proper development of both the bioengineered dermis and epidermis was found after 30 days in vivo, although the tissues kept ex vivo and those implanted in the animal model for 10 or 20 days showed lower levels of differentiation. In summary, our model of fibrin-agarose skin equivalent was able to reproduce the structure and histological architecture of the native human skin, especially after long-term in vivo implantation, suggesting that these tissues could reproduce the native skin.

  14. Mouse models for graft arteriosclerosis.

    PubMed

    Qin, Lingfeng; Yu, Luyang; Min, Wang

    2013-05-14

    Graft arteriosclerois (GA), also called allograft vasculopathy, is a pathologic lesion that develops over months to years in transplanted organs characterized by diffuse, circumferential stenosis of the entire graft vascular tree. The most critical component of GA pathogenesis is the proliferation of smooth muscle-like cells within the intima. When a human coronary artery segment is interposed into the infra-renal aortae of immunodeficient mice, the intimas could be expand in response to adoptively transferred human T cells allogeneic to the artery donor or exogenous human IFN-γ in the absence of human T cells. Interposition of a mouse aorta from one strain into another mouse strain recipient is limited as a model for chronic rejection in humans because the acute cell-mediated rejection response in this mouse model completely eliminates all donor-derived vascular cells from the graft within two-three weeks. We have recently developed two new mouse models to circumvent these problems. The first model involves interposition of a vessel segment from a male mouse into a female recipient of the same inbred strain (C57BL/6J). Graft rejection in this case is directed only against minor histocompatibility antigens encoded by the Y chromosome (present in the male but not the female) and the rejection response that ensues is sufficiently indolent to preserve donor-derived smooth muscle cells for several weeks. The second model involves interposing an artery segment from a wild type C57BL/6J mouse donor into a host mouse of the same strain and gender that lacks the receptor for IFN-γ followed by administration of mouse IFN-γ (delivered via infection of the mouse liver with an adenoviral vector. There is no rejection in this case as both donor and recipient mice are of the same strain and gender but donor smooth muscle cells proliferate in response to the cytokine while host-derived cells, lacking receptor for this cytokine, are unresponsive. By backcrossing additional

  15. Grafted methylenediphosphonate ion exchange resins

    DOEpatents

    Trochimcznk, A.W.; Gatrone, R.C.; Alexandratos, S.; Horwitz, E.P.

    1997-04-08

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorus. The pendent groups have the formula as shown in the patent wherein R is hydrogen, a cation or mixtures thereof; and R{sup 1} is hydrogen or an C{sub 1}-C{sub 2} alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange resin are also disclosed.

  16. Grafted methylenediphosphonate ion exchange resins

    DOEpatents

    Trochimcznk, Andrzej W.; Gatrone, Ralph C.; Alexandratos, Spiro; Horwitz, E. Philip

    1998-01-27

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorous. The pendent groups have the formula ##STR1## wherein R is hydrogen, a cation or mixtures thereof; and R.sup.1 is hydrogen or an C.sub.1 -C.sub.2 alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange-resin are also disclosed.

  17. Grafted methylenediphosphonate ion exchange resins

    DOEpatents

    Trochimcznk, Andrzej W.; Gatrone, Ralph C.; Alexandratos, Spiro; Horwitz, E. Philip

    1997-01-01

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorous. The pendent groups have the formula ##STR1## wherein R is hydrogen, a cation or mixtures thereof; and R.sup.1 is hydrogen or an C.sub.1 -C.sub.2 alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange resin are also disclosed.

  18. Neuroendocrinology of the skin

    PubMed Central

    Zmijewski, Michal A

    2011-01-01

    The concept on the skin neuro-endocrine has been formulated ten years ago, and recent advances in the field further strengthened this role. Thus, skin forms a bidirectional platform for a signal exchange with other peripheral organs, endocrine and immune systems or brain to enable rapid and selective responses to the environment in order to maintain local and systemic homeostasis. In this context, it is not surprising that the function of the skin is tightly regulated by systemic neuro-endocrine system. Skin cells and skin appendages not only respond to neuropeptides, steroids and other regulatory signals, but also actively synthesis variety of hormones. The stress responses within the skin are tightly regulated by locally synthesized factors and their receptor expression. There is growing evidence for alternative splicing playing an important role in stress signaling. Deregulation of the skin neuro-endocrine signaling can lead or/and be a marker of variety of skin diseases. The major problem in this area relates to their detailed mechanisms of crosstalk between skin and brain and between the local and global endocrine as well as immune systems. PMID:21519402

  19. Skin care and incontinence

    MedlinePlus

    Incontinence - skin care; Incontinence - pressure sore; Incontinence - pressure ulcer ... redness, peeling, irritation, and yeast infections likely. Bedsores ( pressure sores ) may also develop if the person: Has ...

  20. Design and development of multilayer vascular graft

    NASA Astrophysics Data System (ADS)

    Madhavan, Krishna

    2011-07-01

    Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture

  1. Radiation resistivity of polyacenaphthylene-grafted polyethylene

    NASA Astrophysics Data System (ADS)

    Hayakawa, Kiyoshi; Kawase, Kaoru; Yamakita, Hiromi

    Thin poly (ethylene-g-acenaphthylene) films prepared by the vapor-phase grafting method were subjected to the γ-irradiation in air, and various changes in tensile and structural properties of the film were investigated by comparing with those of the untreated or crosslinked polyethylene film. Polyethylene got to lose its inherent necking property by oxidative degradation and to be brittle-fractured by the irradiation dose less than 100 Mrad in air. The polyacenaphthylene-grafted polyethylenes (extent of grafting, ˜ 54 by {100( P-P°) }/{P°}), however, kept their ductility up to 200 Mrad or more, and the rate of increase in elastic modulus as well as yield strength with the increasing irradiation dose was considerably lower than that of untreated or crosslinked polyethylene. The effect of the grafting extent, and that of the irradiation dose-rate on the fracture energy were also examined. The weight increase of polyethylene due to the oxygen consumption and the resulting formation of carbonyl group which proceeded proportionally with the irradiation dose were remarkably suppressed by the grafting, whereas the double bond formation seemed to be unaffected by it. The grafted film held the original content of gel fraction unchanged during the irradiation in air, but the average molecular weight of the sol fraction decreased gradually. Meanwhile, the gel fraction of the crosslinked polyethylene was degenerated by a small dose of irradiation. The analysis of gaseous products revealed the formation of water, methanol, acetaldehyde and so forth from the irradiated grafted film. The grafting procedure and the subsequent irradiation of the grafted film did not affect the degree of crystallinity of the backbone polyethylene. The role played by the grafted polyacenaphthylene for endowing the radiation resistivity to polyethylene and its inherent limitation in effect were discussed from the structural point of view of the grafted film.

  2. [Skin cancer: from smearing to cutting].

    PubMed

    Kelleners-Smeets, Nicole W J; Bekkenk, Marcel W; de Haas, Ellen R M

    2013-01-01

    The most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Conventional excision is still the current treatment of choice for these malignant tumours. Given the many subtypes and high incidence, the treatment of these skin tumours is not only a matter of surgical procedures. There are many different therapeutic options, from smearing to cutting. Those treating patients with non-melanoma skin cancer should have knowledge of the advantages and disadvantages of these many options. Radical surgical treatment is desired, but large margins are preferably avoided. Mohs micrographic surgery is a treatment option available for BCC and SCC in the face. Superficial BCC can be effectively treated with optimal cosmetic outcome in various, non-invasive ways.

  3. Surface zwitterionization of expanded poly(tetrafluoroethylene) membranes via atmospheric plasma-induced polymerization for enhanced skin wound healing.

    PubMed

    Jhong, Jheng-Fong; Venault, Antoine; Hou, Chun-Chung; Chen, Sheng-Han; Wei, Ta-Chin; Zheng, Jie; Huang, James; Chang, Yung

    2013-07-24

    Development of bioinert membranes to prevent blood clotting, tissue adhesion, and bacterial attachment is important for the wound healing process. In this work, two wound-contacting membranes of expanded poly(tetrafluoroethylene) (ePTFE) grafted with zwitterionic poly(sulfobetaine methacrylate) (PSBMA) and hydrophilic poly(ethylene glycol) methacrylate (PEGMA) via atmospheric plasma-induced surface copolymerization were studied. The surface grafting chemical structure, hydrophilicity, and hydration capability of the membranes were determined to illustrate the correlations between bioadhesive properties and wound recovery of PEGylated and zwitterionic ePTFE membranes. Bioadhesive properties of the membranes were evaluated by the plasma protein adsorption, platelet activation, blood cell hemolysis, tissue cell adhesion, and bacterial attachment. It was found that the zwitterionic PSBMA-grafted ePTFE membrane presented high hydration capability and exhibited the best nonbioadhesive character in contact with protein solution, human blood, tissue cells, and bacterial medium. This work shows that zwitterionic membrane dressing provides a moist environment, essential for "deep" skin wound healing observed from the animal rat model in vivo and permits a complete recovery after 14 days, with histology of repaired skin similar to that of normal skin tissue. This work suggests that the bioinert nature of grafted PSBMA polymers obtained by controlling grafting structures gives them great potential in the molecular design of antibioadhesive membranes for use in skin tissue regeneration.

  4. Human skin transcriptome during superficial cutaneous wound healing.

    PubMed

    Nuutila, Kristo; Siltanen, Antti; Peura, Matti; Bizik, Jozef; Kaartinen, Ilkka; Kuokkanen, Hannu; Nieminen, Tapio; Harjula, Ari; Aarnio, Pertti; Vuola, Jyrki; Kankuri, Esko

    2012-01-01

    Healing of the epidermis is a crucial process for maintaining the skin's defense integrity and its resistance to environmental threats. Compromised wound healing renders the individual readily vulnerable to infections and loss of body homeostasis. To clarify the human response of reepithelialization, we biopsied split-thickness skin graft donor site wounds immediately before and after harvesting, as well as during the healing process 3 and 7 days thereafter. In all, 25 biopsies from eight patients qualified for the study. All samples were analyzed by genome-wide microarrays. Here, we identified the genes associated with normal skin reepithelialization over time and organized them by similarities according to their induction or suppression patterns during wound healing. Our results provide the first elaborate insight into the transcriptome during normal human epidermal wound healing. The data not only reveal novel genes associated with epidermal wound healing but also provide a fundamental basis for the translational interpretation of data acquired from experimental models.

  5. CT scanning of the breast using a conventional CT scanner.

    PubMed

    Doust, B D; Milbrath, J R; Doust, V L

    1981-09-01

    Using a conventional body CT scanner, computed tomography of the breast was performed on 32 patients known to have or suspected of having breast masses. Xeromammograms were available for comparison in all cases. All mass lesions were histologically proved. Seven patients were examined prone, 25 supine. The prone position yielded pictures that resembled craniocaudal mammograms. Breast asymmetry, skin thickening, stranding from a mass to the chest wall, calcification, and axillary lymphadenopathy could be demonstrated by means of CT. The portion of the breast adjacent to the chest wall was more readily examined by means of CT than by conventional mammography. Internal mammary nodes could not be demonstrated.

  6. The changing face of graft-versus-host disease.

    PubMed

    Schaffer, Julie V

    2006-12-01

    Despite advances in the procedure and posttransplantation immunosuppressive therapy, more than half of allogeneic hematopoietic stem cell transplant (HSCT) recipients develop graft-versus-host disease (GVHD), which remains a major cause of morbidity and mortality. Modern HSCT protocols have resulted in substantial alterations in the timing and relative incidences of acute and chronic GVHD, making traditional classification schemes obsolete. This article reviews major changes in HSCT during the past decade, evolving concepts of acute and chronic GVHD (including new diagnostic criteria) and the expanding spectrum of cutaneous GVHD. It focuses on observations that have led to a better delineation of the full constellation of skin findings in chronic cutaneous GVHD, including lichen sclerosus, morpheaform lesions, and eosinophilic fasciitis. Recent insights into pathogenesis of GVHD, lessons from GVHD arising in settings outside HSCT, and therapeutic advances also are highlighted.

  7. HISTOPATHOLOGIC DIAGNOSIS OF CHRONIC GRAFT VERSUS HOST DISEASE

    PubMed Central

    Shulman, Howard M.; Cardona, Diana M.; Greenson, Joel K.; Hingorani, Sangeeta; Horn, Thomas; Huber, Elisabeth; Kreft, Andreas; Longerich, Thomas; Morton, Thomas; Myerson, David; Prieto, Victor G.; Rosenberg, Avi; Treister, Nathaniel; Washington, Kay; Ziemer, Mirjana; Pavletic, Steven Z.; Lee, Stephanie J.; Flowers, Mary E.D.; Schultz, Kirk R.; Jagasia, Madan; Martin, Paul J.; Vogelsang, Georgia B.; Kleiner, David E.

    2015-01-01

    The 2005 National Institute of Health (NIH) Consensus Conference outlined histopathological diagnostic criteria for the major organ systems affected by both acute and chronic graft-versus-host disease (GVHD). The 2014 Consensus Conference led to this updated document with new information from histopathological studies of GVHD in the gut, liver, skin and oral mucosa and expanded discussion of GVHD in the lungs and kidneys. The recommendations for final histological diagnostic categories have been simplified from 4 categories to 3: no GVHD, possible, and likely GVHD based on better reproducibility achieved by combining the previous categories of consistent with and definite GVHD into the single category of likely GVHD. Issues remain in the histopathological characterization of GVHD, particularly with respect to the threshold of histological changes required for diagnostic certainty. Guidance is provided for the incorporation of biopsy information into prospective clinical studies of GVHD, particularly with respect to biomarker validation. PMID:25639770

  8. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    NASA Astrophysics Data System (ADS)

    Wada, Yuki; Seko, Noriaki; Nagasawa, Naotsugu; Tamada, Masao; Kasuya, Ken-ichi; Mitomo, Hiroshi

    2007-06-01

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  9. Fat Grafting in Burn Scar Alleviates Neuropathic Pain via Anti-Inflammation Effect in Scar and Spinal Cord

    PubMed Central

    Huang, Shu-Hung; Wu, Sheng-Hua; Lee, Su-Shin; Chang, Kao-Ping; Chai, Chee-Yin; Yeh, Jwu-Lai; Lin, Sin-Daw; Kwan, Aij-Lie; David Wang, Hui-Min; Lai, Chung-Sheng

    2015-01-01

    Burn-induced neuropathic pain is complex, and fat grafting has reportedly improved neuropathic pain. However, the mechanism of fat grafting in improving neuropathic pain is unclear. Previous investigations have found that neuroinflammation causes neuropathic pain, and anti-inflammatory targeting may provide potential therapeutic opportunities in neuropathic pain. We hypothesized that fat grafting in burn scars improves the neuropathic pain through anti-inflammation. Burn-induced scar pain was confirmed using a mechanical response test 4 weeks after burn injuries, and autologous fat grafting in the scar area was performed simultaneously. After 4 weeks, the animals were sacrificed, and specimens were collected for the inflammation test, including COX-2, iNOS, and nNOS in the injured skin and spinal cord dorsal horns through immunohistochemistry and Western assays. Furthermore, pro-inflammatory cytokines (IL-1 β and TNF-α) in the spinal cord were collected. Double immunofluorescent staining images for measuring p-IκB, p-NFκB, p-JNK, and TUNEL as well as Western blots of AKT, Bax/Bcl-2 for the inflammatory process, and apoptosis were analyzed. Fat grafting significantly reduced COX2, nNOS, and iNOS in the skin and spinal cord dorsal horns, as well as IL-1β and TNF-α, compared with the burn group. Moreover, regarding the anti-inflammatory effect, the apoptosis cells in the spinal cord significantly decreased after the fat grafting in the burn injury group. Fat grafting was effective in treating burn-induced neuropathic pain through the alleviation of neuroinflammation and ameliorated spinal neuronal apoptosis. PMID:26368011

  10. Tuning mechanical properties of polymer-grafted nanoparticle networks by using biomimetic catch bonds

    NASA Astrophysics Data System (ADS)

    Mbanga, Badel L.; Iyer, Balaji V. S.; Yashin, Victor V.; Balazs, Anna C.

    Cross-linked networks of polymer-grafted nanoparticles (PGNs) constitute a class of composites with tunable mechanical properties that exhibit a self-healing behavior. A PGN network consists of nanoparticles that are decorated with end-grafted polymer chains. Reactive groups on the free ends of these grafted chains can form bonds with the chain ends on the nearby particles. We study these materials using a 3D computational model that encompasses the particle-particle interactions, the kinetics of bond formation and rupture, and the external forces applied to the network. In our model, a fraction of cross-links is formed through biomimetic ``catch'' bonds. In contrast to conventional ``slip'' bonds, catch bonds can effectively become stronger under a deformation. We show that by varying the fraction of these catch bonds in the network, the toughness, ductility, and tensile strength of the material could be tuned to desired levels.

  11. Homopiperazine grafted mesoporous silicas from rice husk ash for CO2 adsorption.

    PubMed

    Vinodh, Rajangam; Bhagiyalakshmi, Margandan; Hemalatha, Pushparaj; Ganesh, Mani; Peng, Mei Mei; Palanichamy, Muthiahpillai; Cha, Wang Seog; Jang, Hyun Tae

    2014-06-01

    Chloro-functionalized mesoporous MCM-41, SBA-15, MCM-48 and KIT-6 were synthesized by co-condensation of 3-chloropropyl-trimethoxy-silane (CPTMS) and rice husk ash sodium silicate solution, which is subsequently grafted with a heterocyclic amine, homopiperazine (HPZ). X-ray powder diffraction and BET analysis of the chloro-functionalized mesoporous silicas confirmed the similarity between their structural properties and those obtained from conventional silica sources. CO2 adsorption studies of all HPZ-grafted mesoporous silicas exhibited 8-10 wt% of adsorption capacity and are found to be selective, recyclable and thermally stable. Here, the CO2 adsorption reaction is via the traditional carbamate mechanism. The presence of both secondary and tertiary amine in HPZ influences the high CO2 adsorption capacity. Hence, these HPZ-grafted mesoporous silicas could contribute to CO2 capture as a green, tunable, selective and efficient sorbent.

  12. Lymphoedema of the penis and scrotum as a sequela of chronic skin infection

    PubMed Central

    Nishimoto, Soh; Kinoshita, Masato; Miyazaki, Yuko; Kawai, Kenichiro; Kakibuchi, Masao

    2016-01-01

    A Japanese male patient presented with an enormously disfigured penis and scrotum. The penis was swollen and distorted rightward, and the skin was hard and lumpy. The patient had had a subdermal abscess for 6 years. The current condition was considered secondary lymphoedema of the penis and scrotum resulting from chronic skin infection. Wide excision of the affected area with bilateral inguinal lymph node dissection were performed. The degloved penile shaft and scrotum were covered with skin grafts, and a satisfactory result was obtained. PMID:27432903

  13. Physiology of skin.

    PubMed

    Greaves, M W

    1976-07-01

    One of Montagna's greatest contributions to study of the biology of the skin has been his demolition of the artificial walls that traditionally separated the histologist from the physiologist. He has shown that only by relating function with structure can we shed light on the workings of the skin. He has stressed the fallacy of studying a single structural or functional unit in isolation from others. The skin represents an organization of many different functional units, and physiology of skin is the study of this organization. My purpose is to make a personal commentary on the achievements, failures, and prospects of understanding some aspects of the organization of the functional units. Twenty-five years ago, the importance of relating skin to internal organs and systems received much attention. We have long been aware that skin sometimes reacts to internal disease, but only recently has the impact of skin disorders on the circulatory, renal, and gastrointestinal systems been recognized. As a result, our patients are now less likely to suffer from neglect of the whole which follows narrow over-specialized attention to the part. Increased interest in endocrine effects on the skin has revealed that several important physiologic activities of the skin are either partly or wholly regulated by hormones secreted by endocrine glands. Nevertheless, some physiologic activities in skin seems to be independent, their regulation being carried out by local mediating hormones. Other activities involve both central and local regulation. The nature and roles of these two control mechanisms and their interrelation constitute by far the most promising physiologic research in skin.

  14. Ethylene vinyl acetate based radiation grafted hydrophilic matrices: Process parameter standardization, grafting kinetics and characterization

    NASA Astrophysics Data System (ADS)

    Chaudhari, C. V.; Mondal, R. K.; Dubey, K. A.; Grover, V.; Panicker, L.; Bhardwaj, Y. K.; Varshney, L.

    2016-08-01

    A transparent, elastomeric, grafted matrix for several potential applications was synthesized by single-step simultaneous radiation grafting of methacrylic acid onto ethylene vinyl acetate (EVA). CuSO4 was found to be the most suitable homo-polymerization inhibitor among different inhibitors tried. The grafting kinetics was found to be a strong function of dose rate (D) and monomer content (M) and an equation relating grafting rate Rg=Kg [M]1.13D0.23 was deduced. Crystallinity of the grafted matrices as assessed from XRD and DSC measurements indicated decrease in crystalline content with increase in grafting yield, suggesting crystalline domain of EVA get disrupted on grafting. Elastic modulus increased linearly with the increase in grafting yield, though elongation at break decreased precipitously from 900% to 30% at even ~9% grafting. Thermo-gravimetric analysis showed three step weight loss of the grafted EVA matrix. The grafting of MAA resulted in increase in surface energy mainly due to enhanced polar component.

  15. Xenon treatment protects against cold ischemia associated delayed graft function and prolongs graft survival in rats.

    PubMed

    Zhao, H; Watts, H R; Chong, M; Huang, H; Tralau-Stewart, C; Maxwell, P H; Maze, M; George, A J T; Ma, D

    2013-08-01

    Prolonged hypothermic storage causes ischemia-reperfusion injury (IRI) in the renal graft, which is considered to contribute to the occurrence of the delayed graft function (DGF) and chronic graft failure. Strategies are required to protect the graft and to prolong renal graft survival. We demonstrated that xenon exposure to human proximal tubular cells (HK-2) led to activation of range of protective proteins. Xenon treatment prior to or after hypothermia-hypoxia challenge stabilized the HK-2 cellular structure, diminished cytoplasmic translocation of high-mobility group box (HMGB) 1 and suppressed NF-κB activation. In the syngeneic Lewis-to-Lewis rat model of kidney transplantation, xenon exposure to donors before graft retrieval or to recipients after engraftment decreased caspase-3 expression, localized HMGB-1 within nuclei and prevented TLR-4/NF-κB activation in tubular cells; serum pro-inflammatory cytokines IL-1β, IL-6 and TNF-α were reduced and renal function was preserved. Xenon treatment of graft donors or of recipients prolonged renal graft survival following IRI in both Lewis-to-Lewis isografts and Fischer-to-Lewis allografts. Xenon induced cell survival or graft functional recovery was abolished by HIF-1α siRNA. Our data suggest that xenon treatment attenuates DGF and enhances graft survival. This approach could be translated into clinical practice leading to a considerable improvement in long-term graft survival.

  16. About Skin: Your Body's Largest Organ

    MedlinePlus

    ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ...

  17. Thermal stability of grafted fibers. [Gamma radiation

    SciTech Connect

    Sundardi, F.; Kadariah; Marlianti, I.

    1983-10-01

    Presented the experimental results on the study of thermal stability of grafted fibers, i.e., polypropylene-, polyester-, and rayon-grafted fibers. These fibers were obtained by radiation grafting processes using hydrophylic monomers such as 1-vinyl 2-pyrolidone, acrylic acid, N-methylol acrylamide, and acrylonitrile. The thermal stability of the fibers was studied using a Shimadzu Thermal Analyzer DT-30. The thermal stability of the fibers, which can be indicated by the value of the activation energy for thermal degradation, was not improved by radiation grafting. The degree of improvement depends on the thermal stability of the monomers used for grafting. The thermal stability of a polypropylene fiber, either a grafted or an ungrafted one, was found to be inferior compared to the polyester of a rayon fiber, which may be due to the lack of C=O and C=C bonds in the polypropylene molecules. The thermal stability of a fiber grafted with acrylonitrile monomer was found to be better than that of an ungrafted one. However, no improvement was detected in the fibers grafted with 1-vinyl 2-pyrrolidone monomer, which may be due to the lower thermal stability of poly(1-vinyl-2-pyrrolidone), compared to the polypropylene or polyester fibers. 17 figures, 3 tables.

  18. Intraoperative anterior cruciate ligament graft contamination.

    PubMed

    Pasque, Charles B; Geib, Timothy M

    2007-03-01

    Intraoperative anterior cruciate ligament graft contamination is a rare but potentially devastating occurrence for any surgeon to encounter. Most instances in our experience have happened when a surgeon first enters practice or is operating in a new environment with new staff. Based on the currently available literature and the senior author's personal experience with 3 cases, intraoperative cleansing of the graft followed by implantation is a reasonable option. The protocol used successfully in these 3 cases includes getting the graft off of the floor immediately, removing any suture material in the graft, cleansing the graft for 15 to 30 minutes each in chlorohexidine and triple antibiotic solution, followed by a normal saline rinse. All graft sutures should then be replaced. The graft should then be resized and the tibial and femoral tunnels adjusted if needed. After implantation of the graft, additional intraoperative and postoperative intravenous antibiotic and/or oral antibiotic administration is also recommended for the first 1 to 2 weeks. Close clinical follow-up is also very important the first 6 weeks postoperatively and should include candid communication with the patient and family.

  19. Mycobacterium chelonei infection of a corneal graft.

    PubMed Central

    Aylward, G. W.; Stacey, A. R.; Marsh, R. J.

    1987-01-01

    We present a case of Mycobacterium chelonei infection in a corneal graft. The chronic ulceration and stromal infiltration followed a well defined course and eventually responded to topical amikacin, though a further graft was required. Previous cases of keratitis due to the M. fortuitum complex are reviewed. Images PMID:3311141

  20. Electrostrictive Graft Elastomers and Applications

    NASA Technical Reports Server (NTRS)

    Su, J.; Harrison, J. S.; St.Clair, T. L.; Bar-Cohen, Y.; Leary, S.

    1999-01-01

    Efficient actuators that are lightweight, high performance and compact are needed to support telerobotic requirements for future NASA missions. In this work, we present a new class of electromechanically active polymers that can potentially be used as actuators to meet many NASA needs. The materials are graft elastomers that offer high strain under an applied electric field. Due to its higher mechanical modulus, this elastomer also has a higher strain energy density as compared to previously reported electrostrictive polyurethane elastomers. The dielectric, mechanical and electromechanical properties of this new electrostrictive elastomer have been studied as a function of temperature and frequency. Combined with structural analysis using x-ray diffraction and differential scanning calorimetry on the new elastomer, structure-property interrelationship and mechanisms of the electric field induced strain in the graft elastomer have also been investigated. This electroactive polymer (EAP) has demonstrated high actuation strain and high mechanical energy density. The combination of these properties with its tailorable molecular composition and excellent processability makes it attractive for a variety of actuation tasks. The experimental results and applications will be presented.