Comparison of five dermal substitutes in full-thickness skin wound healing in a porcine model

Philandrianos, C.; Andrac-Meyer, Lucile; Mordon, Serge; Feuerstein, Jean-Marc; Sabatier, Florence; Véran, Julie; Magalon, G.; Casanova, Dominique

doi:10.1016/j.burns.2012.02.008

Cited by 135 publications

(85 citation statements)

References 32 publications

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“…6,23,24 However, an ideal skin graft material has yet to be developed. 2 Allogeneic or xenograft materials can elicit clinical challenges such as rejection, contraction, bleeding and infection, scar formation, and poor tissue formation, 1,2 whereas synthetic skin substitutes often lack sufficient biologic information for effective scaffold integration.…”

Section: Discussionmentioning

confidence: 99%

Microporous Dermal-Like Electrospun Scaffolds Promote Accelerated Skin Regeneration

Bonvallet

Culpepper

Bain

et al. 2014

Tissue Engineering Part A

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The goal of this study was to synthesize skin substitutes that blend native extracellular matrix (ECM) molecules with synthetic polymers which have favorable mechanical properties. To this end, scaffolds were electrospun from collagen I (col) and poly(e-caprolactone) (PCL), and then pores were introduced mechanically to promote fibroblast infiltration, and subsequent filling of the pores with ECM. A 70:30 col/PCL ratio was determined to provide optimal support for dermal fibroblast growth, and a pore diameter, 160 mm, was identified that enabled fibroblasts to infiltrate and fill pores with native matrix molecules, including fibronectin and collagen I. Mechanical testing of 70:30 col/PCL scaffolds with 160 mm pores revealed a tensile strength of 1.4 MPa, and the scaffolds also exhibited a low rate of contraction ( < 19%). Upon implantation, scaffolds should support epidermal regeneration; we, therefore, evaluated keratinocyte growth on fibroblast-embedded scaffolds with matrix-filled pores. Keratinocytes formed a stratified layer on the surface of fibroblast-remodeled scaffolds, and staining for cytokeratin 10 revealed terminally differentiated keratinocytes at the apical surface. When implanted, 70:30 col/PCL scaffolds degraded within 3-4 weeks, an optimal time frame for degradation in vivo. Finally, 70:30 col/PCL scaffolds with or without 160 mm pores were implanted into full-thickness critical-sized skin defects. Relative to nonporous scaffolds or sham wounds, scaffolds with 160 mm pores induced accelerated wound closure, and stimulated regeneration of healthy dermal tissue, evidenced by a more normal-appearing matrix architecture, blood vessel in-growth, and hair follicle development. Collectively, these results suggest that microporous electrospun scaffolds are effective substrates for skin regeneration.

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Section: Discussionmentioning

confidence: 99%

Microporous Dermal-Like Electrospun Scaffolds Promote Accelerated Skin Regeneration

Bonvallet

Culpepper

Bain

et al. 2014

Tissue Engineering Part A

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“…12,[16][17][18] Another advantage of this model is that due to its size, larger wounds can be created than in the other models. 19 This mimics more closely the clinical situation of a large burn. However, the Yorkshire/Large White pig does not develop scar tissue akin to humans, 13 and longterm studies have not revealed significant effects on contraction.…”

Section: Wound Contraction In Animal Modelsmentioning

confidence: 99%

“…However, the Yorkshire/Large White pig does not develop scar tissue akin to humans, 13 and longterm studies have not revealed significant effects on contraction. 19 Although the advantages and drawbacks of the animal models used in this field are apparent, a wealth of information on the physiological and biological response to therapies can be gained from using these models in experimental settings closely mimicking the clinical situation. The limitations of in vitro studies mean that the complexity of vascularity, immune function, tissue durability, and host interaction cannot be adequately replicated experimentally.…”

Section: Wound Contraction In Animal Modelsmentioning

confidence: 99%

Strategies Demonstrating Efficacy in Reducing Wound ContractionIn Vivo

Sharpe

Martin

2013

Advances in Wound Care

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Significance: Scarring continues to present a significant clinical problem. Wound contraction leads to scarring and is mediated by myofibroblasts and contractile forces across the wound bed. Contracture formation can have a significant impact on the quality of life of the patient, particularly where function and appearance are affected. Recent Advances: Novel tissue-engineered matrices, cell-based therapies, and medicinal therapeutics have shown significant reduction in wound contraction in in-vivo models, particularly at early time points. These have been accompanied in many cases by reduced numbers of myofibroblasts, and in some by increased angiogenesis and improved neodermal architecture. Critical Issues: There are no animal models that replicate all aspects of wound healing as seen in patients. Therefore, information obtained from in vivo studies should be assessed critically. Additional studies, in particular those that seek to elucidate the mechanisms by which novel therapies reduce contraction, are needed to gain sufficient confidence to move into clinical testing. Future Directions: The use of knockout mouse models in particular has generated significant advances in knowledge of the mechanisms behind myofibroblast conversion and other factors involved in generating tension across the wound. Medicinal therapeutics and tissue-engineering approaches that seek to disrupt/alter these pathways hold much promise for future development and translation to clinical practice. SCOPEFull-thickness wounds heal with scarring, due to the abnormal arrangement of de novo collagen fibres in the neodermis and contractile forces exerted on the wound environment and surrounding tissue. Scar formation can have a negative impact on the patient and continues to present a significant clinical challenge. In vivo models take into account the physiological response to injury and the complex interactions that occur during wound repair that cannot be replicated in vitro. This review summarizes recent in vivo studies that have demonstrated efficacy in reducing wound contraction in model organisms. TRANSLATIONAL RELEVANCEThe demonstration of efficacy in vivo of a potential therapy to reduce wound contraction provides strong evidence of potential clinical efficacy. Further investigation and investment can then be undertaken to translate the novel therapy to early-stage clinical studies. In some cases, the manipulation, through the application of novel wound therapies, of the complex cascade of events leading to wound repair may have

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“…In fact, BM group is an innovative association showed in this study, and its results are promising. MDM offer a structure that allows for both cell migration and neovascularization 42,43 .…”

Section: Discussionmentioning

confidence: 99%

Cranial vault reconstruction with bone morphogenetic protein, calcium phosphate, acellular dermal matrix, and calcium alginate in mice

et al. 2014

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Comparison of five dermal substitutes in full-thickness skin wound healing in a porcine model

Cited by 135 publications

References 32 publications

Microporous Dermal-Like Electrospun Scaffolds Promote Accelerated Skin Regeneration

Microporous Dermal-Like Electrospun Scaffolds Promote Accelerated Skin Regeneration

Strategies Demonstrating Efficacy in Reducing Wound ContractionIn Vivo

Cranial vault reconstruction with bone morphogenetic protein, calcium phosphate, acellular dermal matrix, and calcium alginate in mice

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