文献精选
Shaobin Huang1,2† , Zhicheng Hu1† , Peng Wang1 , Yi Zhang3 , Xiaoling Cao1 , Yunxian Dong1 , Pu Cheng1 , Hailin Xu1, Wenkai Zhu4 , Bing Tang1* and Jiayuan Zhu1*
* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 † Shaobin Huang and Zhicheng Hu contributed equally to this work.
1 Department of Burn, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, People’s Republic of China Full list of author information is available at the end of the article
Abstract
Background: Full-thickness wounds severely affect patients’ life quality and become challenging problems for clinicians. Stem cells have great prospects in the treatment of wounds. Our previous study confirmed that autologous basal cell suspension could promote wound healing, and epidermal stem cells (ESCs) were detected in the basal cell suspension. Herein, this study aimed to explore the effect of ESCs on full-thickness wounds.
Methods: Rat ESCs were isolated and expanded and then were transfected with lentivirus to stably express enhanced green fluorescent protein. The experimental rats were randomly divided into 2 groups: in the ESC group, the rat ESCs were sprayed on the full-thickness wounds of rats; in the control group, phosphate-buffered saline was sprayed the on the wounds. Next, wound healing and neovascularization were evaluated. Colonization, division, and differentiation of ESCs on the wound were analyzed by immunofluorescence.
Results: The rat ESCs colonized, divided, and proliferated in the wound. Additionally, rat ESCs around blood vessels differentiated into vascular endothelial cells and formed a lumen-like structure. Compared with the control group, the ESC group showed enhanced angiogenesis and accelerated wound healing.
Conclusions: Our study confirmed that rat ESCs are safe and effective for treating full-thickness wounds. Additionally, under certain conditions, ESCs can differentiate into vascular endothelial cells to promote angiogenesis and wound healing.
Keywords: ESCs, Cell differentiation, Angiogenesis, Full-thickness wounds
Z .-C. Hu1, D. Chen2, D. Guo3, Y.-Y. Liang1, J. Zhang1, J.-Y. Zhu1 and B. Tang1
Departments of 1Burn Surgery and 2Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, and 3Department of Plastic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Correspondence to: Dr B. Tang, Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China (e-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)
Background: Treatment of chronic wounds using traditional surgical procedures is challenging because of the low graft take rates. This study investigated the combination approach of split-thickness autografts with harvested skin cell suspension for chronic wound treatment.
Methods: This randomized clinical trial enrolled patients with chronic wounds between March 2012 and December 2013. Patients who were assigned randomly to the active treatment received a split-thickness autograft combined with harvested skin cell suspension. Control patients received the split-thickness autograft alone. The primary outcome was the rate of complete wound closure by postoperative day 28. Analysis was by intention to treat. Patients who achieved wound closure were followed up for a minimum of 6 months to evaluate the quality of healing.
Results: A total of 88 patients were included, 44 in each group. More patients achieved complete wound closure in the skin cell group than in the control group (41 versus 34 patients; P = 0⋅035). Complete wound closure was observed at a median of 14 (95 per cent c.i. 12⋅0 to 16⋅0) days in the skin cell group and 20 (15⋅7 to 24⋅3) days in the control group (P = 0⋅001). The skin cell group had significantly fewer complications (4 versus 11 patients; P = 0⋅047). The autografted sites displayed better physical attributes and a reduced tendency for wound recurrence in the skin cell group.
Conclusion: Complementary split-thickness autologous skin grafting with autologous skin cells harvested using ReCell® (Avita Medical, Cambridge, UK) technology improved the healing rate of chronic wounds. Registration number: UMIN000011966 (http://www.umin.ac.jp/ctr).
Z. Hu1, D. Guo3, P. Liu1, X. Cao1, S. Li2, J. Zhu1 and B. Tang1
Departments of 1 Burn Surgery and 2Plastic Surgery, First Affiliated Hospital of Sun Yat-sen University, and 3Department of Plastic Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
Correspondence to: Dr B. Tang, Department of Burn Surgery, First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China (e-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)">该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)
Background: Split-thickness skin graft (STSG) is used frequently, but may result in complications at the donor site. Rapid healing of donor-site wounds is critical to relieving morbidity. This study investigated whether autologous skin cell suspension could improve healing of STSG donor-site wounds.
Methods: Between September 2014 and February 2016, patients requiring STSGs were randomized to receive autologous skin cell suspension plus hydrocolloid dressings (experimental group) or hydrocolloid dressings alone (control group) for the donor site. The primary outcome was time to complete re-epithelialization. Secondary outcomes included pain and itching scores measured on a visual analogue scale, and adverse events. Patients were followed for 12 weeks to evaluate quality of healing. Analysis was by intention to treat.
Results: Some 106 patients were included, 53 in each group. Median time to complete re-epithelialization was 9⋅0 (95 per cent c.i. 8⋅3 to 9⋅7) days in the experimental group, compared with 13⋅0 (12⋅4 to 13⋅6) days in the control group (P < 0⋅001). Overall postoperative pain and itching scores were similar in both groups. No between-group differences in treatment-related complications were observed. Both patients and observers were more satisfied with healing quality after autologous skin cell suspension had been used.
Conclusion: The use of autologous skin cell suspension with hydrocolloid dressings accelerated epithelialization and improved healing quality of the donor site compared with hydrocolloid dressings alone. Registration number: UMIN000015000 (http://www.umin.ac.jp/ctr).
Paper accepted 11 January 2017
Published online 5 April 2017 in Wiley Online Library (www.bjs.co.uk). DOI: 10.1002/bjs.10508
Background: Parafricta bootees are made of low friction material intended to prevent heel pressure ulcers (PU).
Aims: To compare, in hospitalised patients, whether the bootees, added to standard care (SC), prevent heel PU compared with SC alone.
Methods: Patients with Waterlow score ≥20 and no heel PUs at baseline were randomly allocated to either bootees plus SC, or SC alone. Target sample size was 450 patients. Patients’ heels were clinically assessed for heel PUs at day 3 and day 14.
Results: Slow recruitment stopped the study early. In 31 recruited patients there were zero incident heel PUs (intervention group, 0%) versus 1 (SC group, 6%) at day 3 and no new heel pressure ulcers at Day 14.
Conclusion: This study failed to reach sufficient statistical power to assess the efficacy of the bootees in preventing heel PUs. No adverse events were related to the bootees. Only 1 patient in the SC group developed a heel PU.
KEY WORDS Pressure ulcer Bootees Friction Medical device-related pressure ulcers Shear
ANDREW CLEVES, Researcher, Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, University Hospital of Wales, Cardiff
NICOLA IVINS, Clinical Research Director, Welsh Wound Innovation Centre, Rhodfa Marics, Ynysmaerdy, Pontyclun
MICHAEL CLARK, Commercial Director, Welsh Wound Innovation Centre, Rhodfa Marics, Ynysmaerdy, Pontyclun
GRACE CAROLAN-REES, Cedar Director (Retired), Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, University Hospital of Wales, Cardiff
NIA JONES, Advanced Clinical Podiatrist, seconded to the Welsh Would Innovation Centre, Rhodfa Marics, Ynysmaerdy, Pontyclun.
JUDITH WHITE, Researcher, Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, University Hospital of Wales, Cardiff.
RHYS MORRIS,Cedar Director, Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, University Hospital of Wales, Cardiff
