In vivo visualization of the origination of skin graft vasculature in a wild-type/GFP crossover model

Calcagni, Maurizio; Althaus, Martina; Knapik, Alicia; Hegland, Niels; Contaldo, Claudio; Giovanoli, Pietro; Lindenblatt, Nicole

doi:10.1016/j.mvr.2011.07.003

Cited by 33 publications

(26 citation statements)

References 26 publications

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“…34 Assuming similarities between skin and conjunctival grafts, excessively thin CAG´s with little and/or damaged vasculature consequently might incur higher complication rates, such as graft necrosis or scarring. In our ultra-thin 60 µm CAGs, we were able to demonstrate the persistence of small and midsize stromal vessels by immunohistochemistry ( Figure 5).…”

Section: A N U S C R I P Tmentioning

confidence: 99%

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

et al. 2017

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Section: A N U S C R I P Tmentioning

confidence: 99%

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

et al. 2017

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“…Revascularization is an invasive process which requires proteolytic activity of the migrating cells. MMP-1, -2, -7, and -9 are involved in initiation of angiogenesis and vascular regression [44] [45]. Quiescent endothelial cells produce little or no MMP's, while active and invasive endothelium requires MMP activity [46].…”

Section: Discussionmentioning

confidence: 99%

Investigation of Open Abdomen Visceral Skin Graft Revascularization and Separation from Peritoneal Contents

Clark¹,

Coffman²,

Brandenburg³

et al. 2018

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Background: Despite increasing survival following damage control laparotomy and open abdomen technique, little is known about the biology of visceral skin graft revascularization and separation from peritoneal contents. Methods: Following laparotomy for trauma, patients with visceral edema preventing fascial closure underwent Vicryl mesh closure followed by visceral split-thickness skin grafting and readmission graft excision and abdominal wall reconstruction. Utilizing laser speckle contrast imaging, immunochemical staining of histologic sections, and RT-PCR array technology, we examined the revascularization, microvascular anatomy, morphology, and change in gene expression of visceral skin grafts. Results: Ten patients ranging in age from 25 to 46 years underwent visceral grafting for cutaneous coverage of an open abdomen. Skin graft perfusion peaked at a mean of 350 PU by post-operative day 14 synchronous with closure of meshed interstices, and remained constant until excision. Time to graft excision ranged from 6 to 18 months. CD-31 immunostaining documented a significant (p = 0.04) increase in vascular surface area in excised grafts compared to control skin. Trichrome staining revealed an 8-fold increase in excised graft thickness. Mesothelial cells were identified within the dermal matrix of excised grafts. RT-PCR demonstrated significant up-regulation of genes involved in matrix structure and remodeling, cytoskeleton regulation, and WNT signaling; and down-regulation of genes involved in inflammation and matrix proteolysis in excised grafts compared to control skin. Conclusion: Our data document early visceral skin graft perfusion and a plateau in revascularization. Histology reveals a robust dermal matrix populated by fibroblasts and mesothelial cells within a complex supporting vascular network. Genetic analysis of excised grafts reveals growth factor, collagen, and matrix remodeling gene expression.

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“…In summary, skin graft revascularization is a dynamic combination of internal inosculation, angiogenesis, and vasculogenesis. The majority of the graft's microvasculature regresses and is replaced by ingrowing microvessels from the wound bed [29,35]. After internal inosculation within 48-72 h, the graft is re-oxygenated, which triggers the angiogenic transformation of the preserved central graft microvessels.…”

Section: Revascularization Of Skin Graftsmentioning

confidence: 99%

The Crucial Role of Vascularization and Lymphangiogenesis in Skin Reconstruction

et al. 2018

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Background: The treatment of extensive skin defects and bradytrophic wounds remains a challenge in clinical practice. Despite emerging tissue engineering approaches, skin grafts and dermal substitutes are still the routine procedure for the majority of skin defects. Here, we review the role of vascularization and lymphangiogenesis for skin grafting and dermal substitutes from the clinician’s perspective. Summary: Graft revascularization is a dynamic combination of inosculation, angiogenesis, and vasculogenesis. The majority of a graft’s microvasculature regresses and is replaced by ingrowing microvessels from the wound bed, finally resulting in a chimeric microvascular network. After inosculation within 48–72 h, the graft is re-oxygenated. In contrast to skin grafts, the vascularization of dermal substitutes is slow and dependent on the ingrowth of vessel-forming angiogenic cells. Preclinical angiogenic strategies with adipose tissue-derived isolates are appealing for the treatment of difficult wounds and may markedly accelerate skin reconstruction in the future. However, their translation from bench to bedside is still restricted by major regulatory restrictions. Finally, the lymphatic system contributes to edema reduction and the removal of local wound debris. Therapeutic lymphangiogenesis is an emerging field of research in skin reconstruction. Key Messages: For the successful engraftment of skin grafts and dermal substitutes, the rapid formation of a microvascular network is of pivotal importance. Hence, to understand the biological processes behind revascularization of skin substitutes and to implement this knowledge into clinical practice is a prerequisite when treating skin defects. Furthermore, a functional lymphatic drainage crucially contributes to the engraftment of skin substitutes.

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In vivo visualization of the origination of skin graft vasculature in a wild-type/GFP crossover model

Cited by 33 publications

References 26 publications

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

Femtosecond laser-assisted conjunctival autograft preparation for pterygium surgery

Investigation of Open Abdomen Visceral Skin Graft Revascularization and Separation from Peritoneal Contents

The Crucial Role of Vascularization and Lymphangiogenesis in Skin Reconstruction

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