-
Facial Plastic Surgery Clinics of North... May 2020Most complications associated with hair transplant surgery are usually preventable and most often arise as a consequence of poor planning or faulty surgical technique.... (Review)
Review
Most complications associated with hair transplant surgery are usually preventable and most often arise as a consequence of poor planning or faulty surgical technique. Patients should be evaluated for having realistic goals and a pattern that is amenable to aesthetic restoration. A good treatment plan must consider the potential for future hair loss. Well-informed patients who carefully follow instructions and take an active role in the postoperative recovery process minimize the chance of patient-controlled complications. This article discusses potential complications associated with hair restoration surgery, and the roles of the patient and physician in decreasing the risk of complications.
Topics: Alopecia; Hair; Humans; Postoperative Complications; Skin Transplantation; Tissue and Organ Harvesting; Transplant Donor Site; Transplantation, Autologous
PubMed: 32312509
DOI: 10.1016/j.fsc.2020.01.003 -
Journal of Visualized Experiments : JoVE Jan 2017Murine full-thickness skin transplantation is a well-established in vivo model to study alloimmune response and graft rejection. Despite its limited application to...
Murine full-thickness skin transplantation is a well-established in vivo model to study alloimmune response and graft rejection. Despite its limited application to humans, skin transplantation in mice has been widely employed for transplantation research. The procedure is easy to learn and perform, and it does not require delicate microsurgical techniques nor extensive training. Moreover, graft rejection in this model occurs in a very reproducible immunological reaction and is easily monitored by direct inspection and palpation. In addition, secondary skin transplantation with donor-matched or third-party skin grafts can be performed on more complex transplant models as an alternative and uncomplicated method to assess donor-specific tolerance. The complications are low and are in general limited to anesthesia overdose or respiratory distress after the procedure. Graft failure, on the other hand, occurs commonly as a result of poor preparation of the graft, incorrect positioning in the graft bed, or inappropriate placement of the bandage. In this article, we present a protocol for full-thickness skin transplantation in mice and describe the important steps necessary for a successful procedure.
Topics: Animals; Cyclosporine; Graft Rejection; Immunosuppressive Agents; Mice, Inbred BALB C; Mice, Inbred C57BL; Sirolimus; Skin Transplantation; Transplantation, Homologous
PubMed: 28117792
DOI: 10.3791/55105 -
Current Opinion in Organ Transplantation Oct 2020To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as... (Review)
Review
PURPOSE OF REVIEW
To summarize the evolution of skin xenotransplantation and contextualize technological advances and the status of clinically applicable large animal research as well as prospects for translation of this work as a viable future treatment option.
RECENT FINDINGS
Porcine xenografts at the start of the millennium were merely biologic dressings subject to rapid rejection. Since then, numerous important advances in swine to nonhuman primate models have yielded xenotransplant products at the point of clinical translation. Critical genetic modifications in swine from a designated pathogen-free donor herd have allowed xenograft survival reaching 30 days without preconditioning or maintenance immunosuppression. Further, xenograft coverage appears not to sensitize the recipient to subsequent allograft placement and vice versa, allowing for temporary coverage times to be doubled using both xeno and allografts.
SUMMARY
Studies in large animal models have led to significant progress in the creation of living, functional skin xenotransplants with clinically relevant shelf-lives to improve the management of patients with extensive burns.
Topics: Animals; Models, Animal; Skin Transplantation; Swine; Transplantation, Heterologous
PubMed: 32773504
DOI: 10.1097/MOT.0000000000000798 -
Current Pharmaceutical Design 2017The global volume of skin damage or injuries has major healthcare implications and, accounts for about half of the world's annual expenditure in the healthcare sector.... (Review)
Review
The global volume of skin damage or injuries has major healthcare implications and, accounts for about half of the world's annual expenditure in the healthcare sector. In the last two decades, tissue-engineered skin constructs have shown great promise in the treatment of various skin-related disorders such as deep burns and wounds. The treatment methods for skin replacement and repair have evolved from utilization of autologous epidermal sheets to more complex bilayered cutaneous tissue engineered skin substitutes. However, inadequate vascularization, lack of flexibility in drug/growth factors loading and inability to reconstitute skin appendages such as hair follicles limits their utilization for restoration of normal skin anatomy on a routine basis. Recent advancements in cutting-edge technology from stem cell biology, nanotechnology, and various vascularization strategies have provided a tremendous springboard for researchers in developing and manipulating tissue engineered skin substitutes for improved skin regeneration and wound healing. This review summarizes the overview of skin tissue engineering and wound healing. Herein, developments and challenges of various available biomaterials, cell sources and in vitro skin models (full thickness and wound healing models) in tissue-engineered skin research are discussed. Furthermore, central to the discussion is the inclusion of various innovative strategies starting from stem cells, nanotechnology, vascularization strategies, microfluidics to three dimensional (3D) bioprinting based strategies for generation of complex skin mimics. The review then moves on to highlight the future prospects of advanced construction strategies of these bioengineered skin constructs and their contribution to wound healing and skin regeneration on current practice.
Topics: Animals; Biocompatible Materials; Forecasting; Humans; Regeneration; Skin Physiological Phenomena; Skin Transplantation; Skin, Artificial; Stem Cell Transplantation; Stem Cells; Tissue Engineering; Wound Healing
PubMed: 28552069
DOI: 10.2174/1381612823666170526094606 -
Plastic and Aesthetic Nursing
Topics: Skin Transplantation
PubMed: 36450050
DOI: 10.1097/PSN.0000000000000453 -
Wiener Klinische Wochenschrift Dec 2015The loss of tissue is still one of the most challenging problems in healthcare. Efficient laboratory expansion of skin tissue to reproduce the skins barrier function can... (Review)
Review
The loss of tissue is still one of the most challenging problems in healthcare. Efficient laboratory expansion of skin tissue to reproduce the skins barrier function can make the difference between life and death for patients with extensive full-thickness burns, chronic wounds, or genetic disorders such as bullous conditions. This engineering has been initiated based on the acute need in the 1980s and today, tissue-engineered skin is the reality. The human skin equivalents are available not only as models for permeation and toxicity screening, but are frequently applied in vivo as clinical skin substitutes. This review aims to introduce the most important recent development in the extensive field of tissue engineering and to describe already approved, commercially available skin substitutes in clinical use.
Topics: Bandages; Combined Modality Therapy; Humans; Lacerations; Negative-Pressure Wound Therapy; Skin; Skin Transplantation; Skin, Artificial
PubMed: 26404739
DOI: 10.1007/s00508-015-0859-7 -
The Journal of Hand Surgery Mar 2015There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small... (Review)
Review
There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.
Topics: Burns, Chemical; Combined Modality Therapy; Debridement; Education, Medical, Continuing; Female; Graft Survival; Hand Injuries; Humans; Injury Severity Score; Male; Postoperative Complications; Prognosis; Risk Assessment; Skin Transplantation; Surgical Flaps; Therapeutic Irrigation; Treatment Outcome; Wound Healing
PubMed: 25653184
DOI: 10.1016/j.jhsa.2014.07.056 -
The Journal of the American Academy of... Sep 2022Acute compartment syndrome is a surgical emergency in the extremities resulting from increased compartmental pressure, requiring immediate fasciotomy to resolve muscular... (Review)
Review
Acute compartment syndrome is a surgical emergency in the extremities resulting from increased compartmental pressure, requiring immediate fasciotomy to resolve muscular compromise. As the mainstay treatment, fasciotomies involve substantial skin incisions and are thus prone to complications such as skin necrosis, wound infection, and permanent disability. Multidisciplinary care instituted at the time of fasciotomy can facilitate timely closure and minimize the complication profile. Several approaches are available to enhance outcomes of fasciotomy wounds, and a comprehensive knowledge of these options affords the treating surgeon greater flexibility and confidence in optimal management. Common techniques include early primary closure, gradual approximation, skin grafting, and negative pressure therapy. There is currently no consensus on the best method of closure. The purpose of this study was to review fasciotomy wound management from the time of initial release to final closure. Highlights include preparation for closing these wounds; the various techniques for fasciotomy closure, including adjunct options; evaluation of timing and staging; and injury-specific features, such as fracture management, limited subcutaneous tissues, and hand fasciotomies. Combining the perspectives of orthopaedic and plastic surgery, this review evaluates the benefits of multiple closure methods and highlights the importance of planning closure at the time of release.
Topics: Compartment Syndromes; Extremities; Fasciotomy; Humans; Skin Transplantation; Suture Techniques
PubMed: 36001887
DOI: 10.5435/JAAOS-D-21-01046 -
Annals of Plastic Surgery Jul 2019There have been significant advances in the care of burns over the past decade. As a result of the improved survival of burn patients, attention has shifted to the... (Review)
Review
There have been significant advances in the care of burns over the past decade. As a result of the improved survival of burn patients, attention has shifted to the optimized management of their wounds. Traditionally, autografts have been described as the gold standard treatment in cases of deep second- and third-degree burn wounds; however, they are limited especially in large surface area burns. As such, advancements have been made in the development of biologic dressings, which attempt to mimic the function of the lost epidermis and/or dermis. The ideal biologic dressing is nontoxic, lacks antigenicity, is immunologically compatible, and is sterile. Additionally, easy storage conditions, long shelf lives, and reasonable costs are key determinants of whether biologic dressings may truly be widely used in the clinical setting. Biologic dressings serve an important role as skin substitutes in the setting of acute burn injury. This review aims to summarize the multitude of available biologic dressings and their applications. METHODS: The PubMed and Google Scholar databases were searched for the following terms either alone or in combination: "burn injury," "biologic membrane," "skin substitutes," "biosynthetic dressings," and "acellular membrane."
Topics: Biological Dressings; Biological Products; Burns; Female; Humans; Injury Severity Score; Male; Prognosis; Skin Transplantation; Skin, Artificial; Transplantation, Autologous; Wound Healing
PubMed: 31194708
DOI: 10.1097/SAP.0000000000001915 -
Journal of Orthopaedic Trauma Jul 2015
Topics: Humans; Negative-Pressure Wound Therapy; Skin Transplantation; Wounds and Injuries
PubMed: 26091529
DOI: 10.1097/01.bot.0000467183.34037.8c