The outer root sheath of hair follicles plays an important role in epidermal regeneration in vivo. Keratinocytes isolated by explantation of outer root sheath tissue have extensive proliferative capacity irrespective of donor age, which probably depends on pluripotent epithelial stem cells residing in the outer root sheath. These keratinocytes can be organotypically grown to epidermal equivalents in vitro. We report here that in a multicenter, randomized phase II study, EpiDex trade mark, a tissue-engineered, fully differentiated autologous epidermal equivalent derived from keratinocytes of the outer root sheath of plucked anagen hair follicles, is as effective as split-thickness skin autografting in the promotion of healing and complete closure of recalcitrant vascular leg ulcers.

2 Farrar MD, Ingham E. Acne: inflammation. Clin Dermatol 2004; 22: 380-384. 3 Shalita AR, Myers JA, Krochmal L, Yaroshinsky A. The safety and efficacy of clindamycin phosphate foam 1% versus clindamycin phosphate topical gel 1% for the treatment of acne vulgaris. J Drugs Dermatol 2005; 4: 48-56. 4 Lawson EE, Edwards HG, Barry BW, Williams AC. Interaction of salicylic acid with verrucae assessed by FT-Raman spectroscopy. J Drug Target 1998; 5: 343-351. 5 Shalita AR. Comparison of a salicylic acid cleanser and a benzoyl peroxide wash in the treatment of acne vulgaris. Clin Ther 1989; 11: 264 -267. 6 Touitou E, Dayan N, Bergelson L, Godin B, Eliaz M. Ethosomes -novel vesicular carriers for enhanced delivery: characterization and skin penetration properties. J Contr Rel 2000; 65: 403-418. 7 Touitou E, Godin B. Enhanced skin permeation using ethosomes. In: Smith E, Maibach HI, eds. Percutaneous Penetration Enhancers, 2nd edn. CRC Press, New York, 2005: 95-108. 8 Paolino D, Lucania G, Mardente D, Alhaique F, Fresta M.Ethosomes for skin delivery of ammonium glycyrrhizinate: in vitro percutaneous permeation through human skin and in vivo anti-inflammatory activity on human volunteers.

Modern wound therapy is developing continuously. Vacuum therapy is an established procedure to treat wounds. Available on the market is, among others, the V.A.C. (Vacuum Assisted Closure) therapy system. Here, we report the various effects of the vacuum therapy on wounds such as reducing the bacterial contamination, improving granulation and microcirculation and focus on the practical use of the V.A.C., possible complications, contraindications and the economic aspects of the therapy. Since V.A.C. therapy allows rapid mobilization of patients especially with postoperative or posttraumatic wounds, infrequent dressing changes and relative analgesia, this treatment modality is well-accepted by patients with acute or chronic wounds. One explanation for the high acceptance on part of the therapists and the widespread use of the method are the excellent clinical results.

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