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  • 1
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Failure of re-epithelialization characterizes the pathophysiology of chronic wounds. However, the mechanism of this failure has not been fully clarified. During the re-epithelialization of acute wounds, migrating epidermal cells up-regulate integrins α5β1, αvβ5, αvβ6 and these integrins play an important role in the re-epithelialization process. Laminin-1 is a basement membrane component which appears during the late phase of the re-epithelialization process. In this study, with 6 specimens from burn patients (acute wounds, control) and 11 specimens from patients with pressure ulcers, we examined the expression of α5β1 in the migrating epidermis, laminin-1 at the dermal-epidermal junction and fibronectin in the dermis by an immunohistochemical method. We then compared the findings for α5β1 with histological, laminin-1 and fibronectin distribution findings. In 8 out of the 11 pressure ulcer specimens, the expression of α5β1 significantly decreased or was negative while it increased in the control. The degree of expression correlated well with histological findings of epidermal elongation over the wound bed. Moreover, fibronectin distribution in all the pressure ulcer specimens decreased considerably while it increased in three out of the six burn specimens. A statistically significant correlation was found between the distance at which the cells were positively stained for α5β1 and the distance at which they were negatively stained for laminin-1 in both the burn (control) and pressure ulcer specimens. Our data demonstrated that the decrease in α5β1 expression correlated with the failure in re-epithelialization of chronic wounds (pressure ulcers). It was also suggested that the decrease in fibronectin distribution was responsible for the failure of the re-epithelialization process.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1524-475X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: Multi-center clinical trials were performed using allogeneic cultured dermal substitutes (CDS) newly developed in the R & D Center for Artificial Skin of Kitasato University. Method: This study was designed to evaluate the efficacy of CDS for the treatment of burns in 5 cases and the treatment of skin ulcers in 4 cases. Complications with the skin ulcers were diabetes (1 case), varix (1 case), and collagen diseases (2 cases). The wound surface area was measured with picture analysis software during the wound healing process. Results: The clinical evaluation was made using a protocol that includes a standard for the development of new wound dressings. According to the comprehensive judgment, the results achieved were evaluated as excellent for 4 burn cases and good for one case. Regarding the skin ulcers, results were excellent in 3 cases and good for one case. No harmful complications were observed during this study. Conclusions: CDS were useful for burn and ulcer treatment but the wound surface must be checked rigorously for the occurrence of infection during the healing process.
    Type of Medium: Electronic Resource
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