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Pajardi G, Rapisarda V, Somalvico F, Scotti A, Russo GL, Ciancio F, Sgrò A, Nebuloni M, Allevi R, Torre ML, Trabucchi E, Marazzi M. Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study. Int Wound J 2016; 13:44-52. [PMID: 24517418 PMCID: PMC7950180 DOI: 10.1111/iwj.12223] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/20/2013] [Accepted: 01/02/2014] [Indexed: 01/01/2023] Open
Abstract
Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.
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Affiliation(s)
- Giorgio Pajardi
- Unità Operativa Complessa di Chirurgia della Mano, Università degli Studi di Milano, Ospedale San Giuseppe Milan /IRCCS MultiMedica, Milano, Italy
| | - Vicenzo Rapisarda
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | | | - Andrea Scotti
- Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Giulia Lo Russo
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Francesco Ciancio
- Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy
| | - Arturo Sgrò
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
| | - Manuela Nebuloni
- Struttura Complessa di Anatomia Patologica, Polo Universitario "A.O. Ospedale Luigi Sacco", Milano, Italy
| | - Raffaele Allevi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Maria L Torre
- Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy
| | - Emilio Trabucchi
- Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy
| | - Mario Marazzi
- Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy
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