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Flynn LE, Woodhouse KA. Burn Dressing Biomaterials and Tissue Engineering. Biomed Mater 2021. [DOI: 10.1007/978-3-030-49206-9_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mostafa D, Aboushelib M. Bioactive-hybrid-zirconia implant surface for enhancing osseointegration: an in vivo study. Int J Implant Dent 2018; 4:20. [PMID: 29900480 PMCID: PMC5999599 DOI: 10.1186/s40729-018-0129-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/23/2018] [Indexed: 11/12/2022] Open
Abstract
Background Zirconia is characterized by a hard, dense, and chemically inert surface which requires additional surface treatments in order to enhance osseointegration. The proposed hypothesis of the study was that combination of a nano-porous surface infiltrated with a bioactive material may enhance osseointegration of zirconia implants. Methods Custom-made zirconia implants (3.7 mm × 8 mm) were designed, milled, and sintered according to manufacturer recommendations. All implants received selective infiltration etching (SIE) technique to produce a nano-porous surface. Surface porosities were either filled with nano-hydroxy apatite particle- or platelet-rich plasma while uncoated surface served as a control (n = 12, α = 0.05). New surface properties were characterized with mercury porosimetry, XRD analysis, SEM, and EDX analysis. Implants were inserted in femur head of rabbits, and histomorphometric analysis was conducted after healing time to evaluate bone–implant contact percentage (BIC%). Results Selective infiltration etching produced a nano-porous surface with interconnected surface porosities. Mercury porosimetry revealed a significant reduction in total porosity percent after application of the two coating materials. XRD patterns detected hexagonal crystal structure of HA superimposed on the tetragonal crystal phase of zirconia. Histomorphometric analysis indicated a significantly higher (F = 14.6, P < 0.001) BIC% around HA–bioactive–hybrid surface (79.8 ± 3%) and PRP-coated surface (71 ± 6 %) compared to the control (49 ± 8%). Conclusions Bioactive–hybrid–zirconia implant surface enhanced osseointegration of zirconia implants.
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Affiliation(s)
- Dawlat Mostafa
- Dental Biomaterials, Faculty of Dentistry, Alexandria University, Champolion St., Azarita, Alexandria, Egypt
| | - Moustafa Aboushelib
- Dental Biomaterials, Faculty of Dentistry, Alexandria University, Champolion St., Azarita, Alexandria, Egypt.
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Growth Differentiation Factor 5 Accelerates Wound Closure and Improves Skin Quality During Repair of Full-Thickness Skin Defects. Adv Skin Wound Care 2017; 30:223-229. [DOI: 10.1097/01.asw.0000515078.69041.3c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Commercially available topical platelet-derived growth factor as a novel agent to accelerate burn-related wound healing. J Burn Care Res 2015; 35:e321-9. [PMID: 24476989 DOI: 10.1097/bcr.0000000000000013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The authors investigated whether the application of platelet-derived growth factor (PDGF) to donor site wounds would speed healing in a porcine model. In a red duroc pig model, three wounds that were 3 inches × 3 inches were created with a dermatome (0.06-inch depth) on one side of two different animals. These wounds were digitally and laser Doppler (LDI) imaged and biopsied immediately pre- and postwound creation and every 2 days for 2 weeks. A set of identical wounds were subsequently created on the opposite side of the same animals and treated with topical PDGF (becaplermin gel 0.01%, 4 g/wound) immediately on wounding. PDGF-treated wounds were imaged and biopsied as above. Digital images of wounds were assessed for epithelialization by clinicians using an ordinal scale. Perfusion units (PU) were evaluated by LDI. Wound healing was evaluated by hematoxylin and eosin histological visualization of an epithelium and intact basement membrane. First evidence of partial epithelialization was seen in control and PDGF-treated wounds within 7.7 ± 1.4 and 6.4 ± 1.1 days postwounding, respectively (P=.03). Completely epithelialized biopsies were seen in control and PDGF-treated wounds at 11.7 ± 2.6 and 9.6 ± 1.5 days, respectively (P=.02). Clinician evaluation of digital images showed that on day 9, control wounds were, on average, 48.3 ± 18.5% epithelialized vs 57.2 ± 20.2% epithelialized for PDGF-treated wounds. At day 16, control wounds showed an average of 72.9 ± 14.6% epithelialization and PDGF-treated wounds showed an average of 90 ± 11.8%epithelialization. Overall, PDGF-treated wounds had statistically significantly higher scores across all timepoints (P=.02). Average perfusion units as measured by LDI were similar for control and PDGF-treated wounds at time of excision (225 ± 81and 257 ± 100, respectively). On day 2 postwounding, average PU for control wounds were 803 and were 764 for PDGF-treated wounds. Control wounds maintained higher PU values compared with PDGF-treated wounds at all time points and returned to excision PU values by day 12.2 ± 1.1 postwounding. PDGF-treated wounds reached the same values by day 9.7 ± 2.3 (P=.03). The authors conclude that topical PDGF speeds time to epithelialization of partial-thickness wounds in a porcine model as evidenced by histology, clinical appearance, and time to return to prewounding vascularity.
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Asami T, Soejima K, Kashimura T, Kazama T, Matsumoto T, Morioka K, Nakazawa H. Effects of combination therapy using basic fibroblast growth factor and mature adipocyte-derived dedifferentiated fat (DFAT) cells on skin graft revascularisation. J Plast Surg Hand Surg 2015; 49:229-33. [DOI: 10.3109/2000656x.2015.1020315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Soejima K, Shimoda K, Kashimura T, Yamaki T, Kono T, Sakurai H, Nakazawa H. One-step grafting procedure using artificial dermis and split-thickness skin in burn patients. EUROPEAN JOURNAL OF PLASTIC SURGERY 2013. [DOI: 10.1007/s00238-012-0785-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Mittermayr R, Branski L, Moritz M, Jeschke MG, Herndon DN, Traber D, Schense J, Gampfer J, Goppelt A, Redl H. Fibrin biomatrix-conjugated platelet-derived growth factor AB accelerates wound healing in severe thermal injury. J Tissue Eng Regen Med 2013; 10:E275-85. [DOI: 10.1002/term.1749] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 02/16/2013] [Accepted: 03/19/2013] [Indexed: 01/01/2023]
Affiliation(s)
- Rainer Mittermayr
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Ludwik Branski
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | - Martina Moritz
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
| | - Marc G. Jeschke
- Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Department of Surgery, Division of Plastic Surgery; University of Toronto; Canada
| | - David N. Herndon
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | - Daniel Traber
- Shriner's Hospital for Children; University of Texas Medical Branch; Galveston TX USA
| | | | - Jörg Gampfer
- Baxter Innovations GmbH, Division of Biosurgery; Vienna Austria
| | - Andreas Goppelt
- Baxter Innovations GmbH, Division of Biosurgery; Vienna Austria
| | - Heinz Redl
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology; Austrian Cluster for Tissue Regeneration; Vienna Austria
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Gau CH, Shen EC, Tu HP, Chiu HC, Fu E, Wang WN, Chiang CY. Freezing procedure without thrombin activation to retain and store growth factors from platelet concentrates. J Dent Sci 2011. [DOI: 10.1016/j.jds.2011.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Rhim JH, Jang IS, Kwon ST, Song KY, Yeo EJ, Park SC. Activation of Wound Healing in Aged Rats by Altering the Cellular Mitogenic Potential. J Gerontol A Biol Sci Med Sci 2010; 65:704-11. [DOI: 10.1093/gerona/glq065] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Effect of bovine pituitary extract on the formation of neocartilage in chitosan/gelatin scaffolds. J Taiwan Inst Chem Eng 2010. [DOI: 10.1016/j.jtice.2009.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Peerbooms JC, de Wolf GS, Colaris JW, Bruijn DJ, Verhaar JAN. No positive effect of autologous platelet gel after total knee arthroplasty. Acta Orthop 2009; 80:557-62. [PMID: 19916689 PMCID: PMC2823335 DOI: 10.3109/17453670903350081] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Activated platelets release a cocktail of growth factors, some of which are thought to stimulate repair. We investigated whether the use of autologous platelet gel (PG) in total knee arthroplasty (TKA) would improve wound healing and knee function, and reduce blood loss and the use of analgesics. PATIENTS AND METHODS 102 patients undergoing TKA were randomly assigned to a PG group (n = 50) or to a control (C) group (n = 52). The primary analysis was based on 73 participants (PG: 32; C: 41) with comparison of postoperative wound scores, VAS, WOMAC, knee function, use of analgesics, and the pre- and postoperative hemoglobin values after a follow-up of 3 months. 29 participants were excluded due to insufficient data. RESULTS The characteristics of the protocol-compliant patients were similar to those of the patients who were excluded. Analysis was per protocol and focused on the remaining 73 patients. At baseline and after 3 months of follow-up, there were no statistically significant differences between both groups regarding age, height, weight, sex, side of operation, platelet count, hemoglobin values, severity of complaints (WOMAC), and level of pain. INTERPRETATION In our patients undergoing TKA, application of PG to the wound site did not promote wound healing. Also, we found that PG had no effect on pain, knee function, or hemoglobin values.
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Affiliation(s)
- Joost C Peerbooms
- Department of Orthopaedic Surgery, HAGA Hospital, The Haguethe Netherlands
| | - Gideon S de Wolf
- Department of Clinical Epidemiology and Biostatistics, Academic Medical CentreAmsterdamthe Netherlands
| | - Joost W Colaris
- Department of Orthopaedic Surgery, HAGA Hospital, The Haguethe Netherlands
| | - Daniël J Bruijn
- Department of Orthopaedic Surgery, HAGA Hospital, The Haguethe Netherlands
| | - Jan A N Verhaar
- Department of Orthopaedic Surgery, Erasmus Medical CentreRotterdamthe Netherlands
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Burn Dressing Biomaterials and Tissue Engineering. Biomed Mater 2009. [DOI: 10.1007/978-0-387-84872-3_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Improvement of Full-Thickness Skin Graft Survival by Application of Vascular Endothelial Growth Factor in Rats. Ann Plast Surg 2008; 60:589-93. [DOI: 10.1097/sap.0b013e31816d78fe] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dallari D, Savarino L, Stagni C, Cenni E, Cenacchi A, Fornasari PM, Albisinni U, Rimondi E, Baldini N, Giunti A. Enhanced Tibial Osteotomy Healing with Use of Bone Grafts Supplemented with Platelet Gel or Platelet Gel and Bone Marrow Stromal Cells. J Bone Joint Surg Am 2007. [DOI: 10.2106/00004623-200711000-00011] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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O'Ceallaigh S, Herrick SE, Bennett WR, Bluff JE, Ferguson MWJ, McGrouther DA. Perivascular cells in a skin graft are rapidly repopulated by host cells. J Plast Reconstr Aesthet Surg 2007; 60:864-75. [PMID: 17616363 DOI: 10.1016/j.bjps.2006.03.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Revised: 02/13/2006] [Accepted: 03/05/2006] [Indexed: 11/28/2022]
Abstract
Survival of grafted tissues is dependent upon revascularisation. This study investigated revascularisation in a murine skin graft model, using two methods. The first involved 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine (DiI) labelling of the wound bed, prior to replacing the skin graft, to allow tracking of host cells into the grafts. At time points between day 3 and day 14 post-surgery, DiI-labelled cells which had tracked into the grafts, were found to co-localise with CD31 positive endothelial cells and patent perfused vessels (fluorescein isothiocyanate (FITC)-dextran perfusion), to show possible association with the vasculature. To further differentiate between graft and host-derived cells, C57BL/6 wild-type grafts were placed on enhanced-green fluorescent protein (e-GFP) transgenic mouse hosts, and at set times post-grafting examined using confocal microscopy. Patent vessels were found at all depths of the graft by day 3. Host (DiI- or GFP-positive) cells were predominantly co-localised with graft vessels in grafts from day 3 onwards, with a similar morphology to control skin. Significantly more GFP labelled host cells were visualised in the superficial dermis at day 5 compared to day 3. Initial restoration of circulation appears to be due to linkage between existing graft and bed vessels, followed by an influx of host cells with a definite perivascular distribution. These findings have implications for skin autografts and tissue engineered skin substitutes.
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Affiliation(s)
- S O'Ceallaigh
- UK Centre for Tissue Engineering, Faculty of Life Sciences, UK
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Borzini P, Mazzucco I. Platelet-rich plasma (PRP) and platelet derivatives for topical therapy. What is true from the biologic view point? ACTA ACUST UNITED AC 2007. [DOI: 10.1111/j.1751-2824.2007.00085.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Proksch E, Jensen JM, Crichton-Smith A, Fowler A, Clitherow J. Rationale Behandlung von Patienten mit Verbrennungen 1. Grades. Hautarzt 2007; 58:604-10. [PMID: 17565478 DOI: 10.1007/s00105-007-1364-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
First-degree burns are the most common type of burn, but are often inadequately treated. The methods of treatment and the course of healing are poorly documented owing to the fact that first-degree burns are generally not considered to be a serious injury. First-degree burns can be caused by thermal injury or UV irradiation (sunburn). The pathophysiology and the therapeutic approach are similar, although the damage follows a different time course for each injury--immediate damage after contact with hot objects, liquids or fire, delayed damage after sun exposure. After initial cooling with water, aqueous emulsions with small amounts of well-tolerated lipids (O/W emulsions) are best suited for treating first-degree burns or sunburn. Water evaporates producing cooling and reducing inflammation; the lipids accelerate the repair of the damaged skin barrier and reduce drying. Foam sprays and lotions are ideal because they are easy and painless to apply. The use of topical corticosteroids is not recommended, as superiority to the vehicle has not been shown.
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Affiliation(s)
- E Proksch
- Universitäts-Hautklinik, Schittenhelmstrasse 7, 24105 Kiel, Germany.
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Shen EC, Chou TC, Gau CH, Tu HP, Chen YT, Fu E. Releasing growth factors from activated human platelets after chitosan stimulation: a possible bio-material for platelet-rich plasma preparation. Clin Oral Implants Res 2006; 17:572-8. [PMID: 16958699 DOI: 10.1111/j.1600-0501.2004.01241.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Thrombin is commonly used for activating the platelets and releasing the growth factors on the application of platelet-rich plasma (PRP). We have previously reported that chitosan can enhance rabbit platelet aggregation. In this study, the effects of chitosan on the subsequent growth factors release after human platelets activation were examined to evaluate the possibility of chitosan being used as a substitute for thrombin during PRP preparation. MATERIAL AND METHODS Human platelet activation was determined by aggregation, adhesion and alpha-granule membrane glycoprotein expression. Platelet aggregation was measured by the turbidimetric method, the adhesion was directly examined on chitosan-coated glass plates under light microscope and scanning electron microscope (SEM), and the alpha-granule membrane glycoprotein was detected by fluorescent isothiocyanate (FITC)-conjugated anti-CD61 antibody through flow cytometry. The subsequent epidermal growth factor (EGF), platelet-derived growth factor (PDGF)-AB and transforming growth factor (TGF)-beta1 release from platelets were assayed by ELISA after mixing with chitosan. RESULTS The enhancing effects on the platelet adhesion and the aggregation from chitosan were observed. Under both microscopes, the adhesive platelets on the chitosan-coated plates were not only greater in number but also earlier in activation than those on the control plates. With flow cytometry, increased glycoprotein IIIa expression in platelets was detected after chitosan treatment. Greater concentrations of growth factors were measured from PRP after chitosan treatment than after the solvent treatment. CONCLUSION Because of the observations of growth factors releasing from activated human platelets after chitosan stimulation, we suggest that chitosan may be an appropriate substitute for thrombin in PRP preparation.
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Affiliation(s)
- E-Chin Shen
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
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Soejima K, Chen X, Nozaki M, Hori K, Sakurai H, Takeuchi M. Novel application method of artificial dermis: One-step grafting procedure of artificial dermis and skin, rat experimental study. Burns 2006; 32:312-8. [PMID: 16527418 DOI: 10.1016/j.burns.2005.10.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Indexed: 11/24/2022]
Abstract
BACKGROUND Currently, to treat skin defects with artificial dermis (AD), two surgical procedures where the artificial dermis grafting and another secondary skin grafting are required. The purpose of this study was to achieve simultaneous grafting of the artificial dermis and the split-skin. To enhance the wound angiogenesis, cultured endothelial cells, fibroblasts and PDWHF (platelet derived wound healing factor) were employed. METHODS The experiment consists of following two parts: (1) Investigation to obtain faster angiogenesis into the bilayer artificial dermis: full-thickness wounds created on the back of the rats were treated with the artificial dermis (Terudermis, with silicone sheet, TERUMO Co., Japan). Prior to the artificial dermis grafting, following four groups were established; control group (AD alone, n=6), PDWHF group (AD treated with PDWHF, n=6), cultured cells group (AD treated with cultured endothelial cells and fibroblasts, n=6), combination group (AD treated with PDWHF and cultured cells, n=6). (2) Trial of one-stage grafting of the AD and the skin: simultaneous grafting of the artificial dermis and skin was performed using the same rat model. Before making skin defects, split thickness skin were harvested. Then the skin grafting was carried out immediately after the AD grafting. To allow grafting of the skin onto the artificial dermis, the AD without silicone sheet (Terudermis without silicone sheet, TERUMO Co., Japan) were used. Two groups, control group (AD alone, n=3) and treatment group (AD with PDWF and cultures, n=3) were established. RESULTS (1) When the artificial dermis were treated with PDWHF, cultured endothelial cells and fibroblasts, vascular invasion into the artificial dermis was observed 5 days after the surgery. (2) In the treatment group, the skin grafted immediately after the artificial dermis grafting was completely taken. CONCLUSIONS The present study revealed that treatment with PDWHF, combined with cultured endothelial cells and fibroblasts, accelerated wound angiogenesis. By this method, one-step grafting procedure of the artificial dermis and the skin is possible.
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Affiliation(s)
- Kazutaka Soejima
- Department of Plastic Surgery, Tokyo Metropolitan General Hospital, and Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Japan.
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Savarino L, Cenni E, Tarabusi C, Dallari D, Stagni C, Cenacchi A, Fornasari PM, Giunti A, Baldini N. Evaluation of bone healing enhancement by lyophilized bone grafts supplemented with platelet gel: A standardized methodology in patients with tibial osteotomy for genu varus. J Biomed Mater Res B Appl Biomater 2006; 76:364-72. [PMID: 16161123 DOI: 10.1002/jbm.b.30375] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Orthopedic practice may be adversely affected by an inadequate bone repair that might compromise the success of surgery. In recent years, new approaches have been sought to improve bone healing by accelerating the rate of new bone formation and the maturation of the matrix. There is currently great interest in procedures involving the use of platelet gel (PG) to improve tissue healing, with satisfactory results both in vitro and in maxillofacial surgery. Otherwise, to our knowledge, only a preliminary clinical study was undertaken in the orthopedic field [Kitoh et al., Bone 2004;35:892-898] and the efficacy of PG is still controversial. Our paper focuses on the effect on bone regeneration by adding PG to lyophilized bone chips used for orthopedic applications. The clinical model and the laboratory methodology were standardized. As a clinical model, we employed the first series of patients of a randomized case-control study undergoing high tibial osteotomy (HTO) for genu varus. Ten subjects were enrolled: in 5 patients lyophilized bone chips supplemented with PG were inserted during tibial osteotomy (group A); 5 patients were used as a control (group B) and lyophilized bone chips without gel were applied. Forty-five days after surgery, computed tomography scan guided biopsies of grafted areas were obtained and the bone maturation was evaluated by a standardized methodology: the osteogenic and angiogenic processes were semi-quantitatively characterized by using histomorphometry, and the mineral component of the lyophilized and host bone was analyzed by using X-ray diffraction technique with sample microfocusing and microradiography. Lyophilized bone with PG seems to accelerate the healing process, as shown by new vessel formation and deposition of newly formed bone, with no evidence of inflammatory cell infiltrate, when compared with lyophilized bone without gel. On the contrary, lyophilized bone undergo a resorption process, and a fibrous tissue often fills the spaces between chips. A histiocytic/giant-cell reaction is sometimes present. Otherwise, no differences have been found concerning microstructure. Our findings show the reliability of the methodology used to monitor early bone repair. The completion of the study and the evaluation of the ultimate clinical outcome are necessary in order to verify PG in vivo effects in orthopedic surgery.
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Affiliation(s)
- L Savarino
- Laboratory for Pathophysiology of Orthopaedic Implants, Istituti Ortopedici Rizzoli, Via di Barbiano 1/10, 40136 Bologna, Italy.
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Huang S, Jin Y, Deng T, Wu H. Wound dressings containing bFGF-impregnated microspheres: Preparation, characterization,in vitro andin vivo studies. J Appl Polym Sci 2006. [DOI: 10.1002/app.23319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Jensen TB, Rahbek O, Overgaard S, Søballe K. Platelet rich plasma and fresh frozen bone allograft as enhancement of implant fixation. An experimental study in dogs. J Orthop Res 2004; 22:653-8. [PMID: 15099648 DOI: 10.1016/j.orthres.2003.10.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2002] [Accepted: 10/08/2003] [Indexed: 02/04/2023]
Abstract
Platelet rich plasma (PRP) is an autologous source of growth factors. By application of PRP around cementless implants alone or in combination with bone allograft chips, early implant fixation and gap healing could be improved. We inserted two porous HA coated titanium implants extraarticularly in each proximal humerus of eight dogs. Each implant was surrounded by a 2.5 mm gap. Four treatments were block randomized to the four gaps in each dog: Treatment 1: empty gap, treatment 2: PRP, treatment 3: fresh frozen bone allograft, treatment 4: fresh frozen bone allograft+PRP. PRP was prepared from each dog prior to operation by isolating the buffycoat from centrifuged blood samples. Platelet count in PRP was increased 670% compared to baseline level. Calcium/thrombin was added to degranulate platelets and form a gel. Three weeks after surgery, push-out test and histomorphometri was performed. After three weeks, the non-allografted implants had poor mechanical properties. Bone grafting significantly increased implant fixation, bone formation in the gap and bone growth on the implant surface. We found no significant effect of PRP alone or mixed with bone allograft on implant fixation or bone formation. In conclusion, we showed the importance of bone allografting on early implant fixation and bone incorporation but we found no effect of PRP. More studies are needed to investigate the effect and possible clinical applications of platelet concentrates which are now being commercialised.
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Affiliation(s)
- T B Jensen
- Orthopaedic Research Group, Institute of Experimental Clinical Research, Aarhus University Hospital, Aarhus Kommunehospital, 8000 Aarhus C, Denmark.
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Trengove NJ, Bielefeldt-Ohmann H, Stacey MC. Mitogenic activity and cytokine levels in non-healing and healing chronic leg ulcers. Wound Repair Regen 2000; 8:13-25. [PMID: 10760211 DOI: 10.1046/j.1524-475x.2000.00013.x] [Citation(s) in RCA: 271] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The cause of impaired healing in chronic leg ulcers is not known. However, recent attempts to modify the healing process have focused on adding growth factors to stimulate healing and have failed to produce dramatic improvements in healing. This study used a unique model of chronic wound healing in humans to obtain wound fluid samples from chronic venous leg ulcers that had changed from a nonhealing to a healing phase. These samples were used to assess cytokine and growth factor levels, and mitogenic activity in these nonhealing and healing chronic wounds. The pro-inflammatory cytokines interleukin-1, interleukin-6 and tumor necrosis factor-alphawere found to be present in significantly higher concentrations in wound fluid from nonhealing compared to healing leg ulcers. There were detectable levels but, no significant change in the levels of platelet derived growth factor, epidermal growth factor, basic fibroblast growth factor or transforming growth factor-betaas ulcers healed. Wound fluid was added to fibroblasts in vitro to assess mitogenic activity. There was a significantly greater proliferative response to healing wound fluid samples compared to nonhealing samples. These results suggest that healing may be impaired by inflammatory mediators rather than inhibited by a deficiency of growth factors in these chronic wounds.
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Affiliation(s)
- N J Trengove
- Department of Surgerya, Fremantle Hospital, University of Western Australia, Fremantle, Australia
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Smith KJ. The prevention and treatment of cutaneous injury secondary to chemical warfare agents. Application of these finding to other dermatologic conditions and wound healing. Dermatol Clin 1999; 17:41-60, viii. [PMID: 9986995 DOI: 10.1016/s0733-8635(05)70069-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chemical warfare agents are easily and inexpensively produced and are therefore potentially accessible to even underdeveloped nations and are a threat to civilian populations as well as advancing troops. Sulfur mustard is by far the most significant chemical warfare agent that produces cutaneous injury. Significant advances over the past few years have been made in understanding the pathophysiology of the lesions produced by sulfur mustard, as well as development of barrier creams and pre and post exposure therapies to moderate the damage and accelerate healing. Not only have these advances improved our understanding of the sulfur mustard injury and the care of the patients, these are potentially numerous applications for these findings in other dermatologic conditions including the treatment of chronic wounds.
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Affiliation(s)
- K J Smith
- Department of Dermatology, National Naval Medical Center, Bethesda, Maryland, USA
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