Application of negative pressure wound therapy after skin grafting in the treatment of skin cancer:A case report

BACKGROUND Skin cancer is a common malignant tumor in dermatology.A large area must be excised to ensure a negative incisal margin on huge frontotemporal skin cancer,and it is difficult to treat the wound.In the past,treatment with skin grafting and pressure dressing was easy to cause complications such as wound infections,subcutaneous effusion,skin necrosis,and contracture.Negative pressure wound therapy(NPWT)has been applied to treat huge frontotemporal skin cancer.CASE SUMMARY Herein,we report the case of a 92-year-old woman with huge frontotemporal skin cancer.The patient presented to the surgery department complaining of ruptured bleeding and pain in a right frontal mass.The tumor was pathologically diagnosed as highly differentiated squamous cell carcinoma.The patient underwent skin cancer surgery and skin grafting,after which NPWT was used.She did not experience a relapse during the three-year follow-up period.CONCLUSION NPWT is of great clinical value in the postoperative treatment of skin cancer.It is not only inexpensive but also can effectively reduce the risk of surgical effusion,infection,and flap necrosis.

Artificial dermis combined with skin grafting for the treatment of hand skin and soft tissue defects and exposure of bone and tendon

BACKGROUND The recovery time of hand wounds is long,which can easily result in chronic and refractory wounds,making the wounds unable to be properly repaired.The treatment cycle is long,the cost is high,and it is prone to recurrence and disability.Double layer artificial dermis combined with autologous skin transplantation has been used to repair hypertrophic scars,deep burn wounds,exposed bone and tendon wounds,and post tumor wounds.AIM To investigate the therapeutic efficacy of autologous skin graft transplantation in conjunction with double-layer artificial dermis in treating finger skin wounds that are chronically refractory and soft tissue defects that expose bone and tendon.METHODS Sixty-eight chronic refractory patients with finger skin and soft tissue defects accompanied by bone and tendon exposure who were admitted from July 2021 to June 2022 were included in this study.The observation group was treated with double layer artificial dermis combined with autologous skin graft transplantation(n=49),while the control group was treated with pedicle skin flap transplantation(n=17).The treatment status of the two groups of patients was compared,including the time between surgeries and hospital stay.The survival rate of skin grafts/flaps and postoperative wound infections were evaluated using the Vancouver Scar Scale(VSS)for scar scoring at 6 mo after surgery,as well as the sensory injury grading method and two-point resolution test to assess the recovery of skin sensation at 6 mo.The satisfaction of the two groups of patients was also compared.RESULTS Wound healing time in the observation group was significantly longer than that in the control group(P<0.05,27.92±3.25 d vs 19.68±6.91 d);there was no significant difference in the survival rate of skin grafts/flaps between the two patient groups(P>0.05,95.1±5.0 vs 96.3±5.6).The interval between two surgeries(20.0±4.3 d)and hospital stay(21.0±10.1 d)in the observation group were both significantly shorter than those in the control group(27.5±9.3 d)and(28.4±17.7 d),respectively(P<0.05).In comparison to postoperative infection(23.5%)and subcutaneous hematoma(11.8%)in the control group,these were considerably lower at(10.2%)and(6.1%)in the observation group.When comparing the two patient groups at six months post-surgery,the excellent and good rate of sensory recovery(91.8%)was significantly higher in the observation group than in the control group(76.5%)(P<0.05).There was also no statistically significant difference in two point resolution(P>0.05).The VSS score in the observation group(2.91±1.36)was significantly lower than that in the control group(5.96±1.51),and group satisfaction was significantly higher(P<0.05,90.1±6.3 vs 76.3±5.2).CONCLUSION The combination of artificial dermis and autologous skin grafting for the treatment of hand tendon exposure wounds has a satisfactory therapeutic effect.It is a safe,effective,and easy to operate treatment method,which is worthy of clinical promotion.

Autologous scalp skin grafting to treat toxic epidermal necrolysis in a patient with a large skin injury:A case report

BACKGROUND Toxic epidermal necrolysis(TEN)is often associated with skin wounds affecting large areas.Healing of this type of wound is difficult because of pressure,infection and other factors.It can increase the length of hospital stay and result in wound sepsis and even death.CASE SUMMARY A 49-year-old woman developed a skin lesion covering 80%of the total body surface area after using a kind of Chinese medicinal ointment on a burn wound on her back;she developed life-threatening wound sepsis and septic shock.Methicillin-resistant Staphylococcus aureus,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa and other bacteria were cultured from wound tissue,deep venous catheter and blood samples.Imipenem cilastatin sodium,tigecycline and teicoplanin were used for anti-infection therapy.Finally,the patient was transferred to the burn department because of severe wound sepsis.In the burn intensive care unit,pain-free dressing changes and autologous scalp skin grafting were performed to heal the wound in addition to reasonable and effective antibacterial treatment according to microbial susceptibility test results.After three operations within 2 wk,the wound healed and sepsis resolved.CONCLUSION TEN patients with large areas of skin injury may develop wound infection and life-threatening wound sepsis.Autologous scalp skin grafting may be beneficial for rapid wound healing and reducing the risk of sepsis in TEN patients,and it leaves no scar at the donor site.

Clinical Application of Direct Skin Grafting Repair in Popliteal Scar Contracture after Burn in Children

Objective To observe the clinical application of direct skin grafting in repairing popliteal scar contracture after burn in children.Methods From April 2017 to January 2019,30 children with popliteal scar contracture after burn were selected as the research objects.The scar status,knee joint function and quality of life of the patients before and after the operation were compared by direct skin grafting after medium thickness skin removal.Results 30 patients were treated with skin grafting to repair popliteal scar contracture,27 patients healed well,and the survival rate of skin grafting reached 90.00%.The scores of postoperative scar and knee joint function scale(WOMAC)were lower than those before the operation,and the scores of concise health status scale(SF-36)were higher than those before the operation,with statistical significance(P<0.05).Conclusion Scar contracture of popliteal fossa after burn in children can be repaired by direct skin grafting in the skin extraction area after medium thickness skin cutting,which can effectively improve scar condition,restore knee joint function and significantly improve quality of life.

Porocarcinoma in a palm reconstructed with a full thickness skin graft: A case report

BACKGROUND Porocarcinoma is a rare type of skin cancer that originates from sweat gland tumors.It is an aggressive malignant skin cancer that is difficult to diagnose clinically owing to its rarity and similarity to squamous cell carcinoma(SCC).CASE SUMMARY This case involved a 92-year-old woman,a farmer by profession,presented with an exophytic and verrucous mass on her left palm that had formed 2 years prior and caused chronic pain and frequent bleeding.Initially,the patient was diagnosed with SCC using a punch biopsy;however,a repeat biopsy with addi-tional immunohistochemical tests was performed for porocarcinoma.Ultimately,the patient was diagnosed with porocarcinoma and reconstruction was planned using a full-thickness skin graft.After treatment,the range of motion of the palm was preserved,and the aesthetic outcome was favorable.At 6 mo of follow-up,the patient was satisfied with the outcome.CONCLUSION Porocarcinoma is commonly misdiagnosed as SCC;therefore,clinicians should consider porocarcinomas when evaluating mass-like lesions on the hands.

Skin grafting the vascular pedicle: a useful technique to avoid microvascular collapse in free tissue transfer for limb salvage

Aim:Free tissue transfer is essential for extremity reconstruction following traumatic injuries,oncologic resection,and diabetic complications.However,given the circumferential shape of the arm and leg,a small amount of ongoing edema can prevent a tension-free closure.Additionally,intraoperative thrombosis,vascular disease can lead to proximal exposure of the pedicle or vein grafts.This study evaluates the outcomes of microvascular transfers that utilized a skin graft for closure over the pedicle,in comparison with a matched cohort with a tension-free primary closure.Methods:A retrospective review was completed of all patients that underwent free flap reconstruction of an extremity defect from January 2014 to December 2017 at a single academic institution.Flaps that utilized skin grafting for closure were compared to those closed primarily.Adjunct operative procedures,demographics,and complications were evaluated.Results:A total of 71 patients fulfilled the inclusion criteria.The 11 flaps in 10 patients underwent skin grafting over the pedicle.The two cohorts were comparable in age,gender,BMI,and co-morbidities,excluding renal disease which was present in 40%(n=4)of skin grafted group compared to 6.5%(n=4)in the primary closure group.Flap area,operative time,and anastomosis technique were comparable between the two groups.There was no significant difference in the rates of post-operative complications including partial flap loss,complete flap loss,infection.Mean follow up time in the skin grafting group was 14.2 months and 20.2 months for the primary closure group. ;Conclusion:As per the principal,a tension-free closure is paramount to preventing tissue complications including direct compression of a microvascular pedicle.However,with ongoing tissue edema skin grafting should be considered as a reliable technique to ensure both protection of the pedicle as well as prevention of direct compression without additional complications and comparable post-operative outcomes.

Erosive Pustular Dermatosis of the Scalp After Excision and Skin Grafting of Scalp Squamous Cell Carcinoma

Introduction:Erosive pustular dermatosis of the scalp(EPDS)is an uncommon condition with unknown etiology.The clinical exclusive diagnosis needs to be differentiated from similar diseases.Case presentation:A 68-year-old woman presented with an eight-month history of a chronic scalp eruption.She had been diagnosed as squamous cell carcinoma by biopsy nine months ago,and had been treated by surgical excision and skin grafting.One month later,she was referred for evaluation of the newly enlarged lesion which was observed at the skin grafting site.She was diagnosed of EPDS based on characteristics of lesions,clinicopathological findings and laboratory data.The condition had clinically improved with systemic steroid therapy and topical tacrolimus for two weeks.Relapses occurred after complete withdrawal of both treatments.After repeating the above therapy and applying topical tacrolimus as maintenance therapy,the condition was well controlled at the one-year follow-up.Discussion:EPDS is an uncommon inflammatory dermatosis with main incidence rate of elderly patients and female predominance.The diagnosis of EPDS cant be made only by histopathological examination,which is helpful for differential diagnosis.Microbiological investigations commonly remain negative.For the high risk of relapse,it is important for clinicians to be aware of maintenance treatment and a long-term management.Conclusion:It should be recognized by clinicians that EPDS is an uncommon and relapse disease,leading to serious cosmetic problems.The treatment lacks evidence-based medicine data,clinician should choose the appropriate therapy according to the condition of patients.

Oxygen Penetration Through Full-Thickness Skin by Oxygen-Releasing Sutures for Skin Graft Transplantation

The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full-thickness oxygen delivery is limited by the poor oxygen permeability of skin.Oxygen-releasing sutures(O_(2)sutures)were developed to facilitate oxygen penetration through full-thickness skin.The O_(2)sutures delivered 100 times more oxygen than topical gaseous oxygen therapy at a 15 mm depth in the skin model.Under extreme hypoxia(<0.5%O_(2),v/v),O_(2)sutures could also promote endothelial cell proliferation.After the transplantation of FTSGs in mice,O_(2)sutures accelerated blood re-perfusion and increased the survival area of the skin graft.It is expected that O_(2)sutures will be adopted in clinical applications to increase the success rate of full-thickness skin transplantation.

A Novel Composite Skin Graft Technique with Fat Derivatives

Skin grafting,although a relatively classic and well-known technique,still has multiple disadvantages such as secondary contracture of the skin graft,sunken depression,poor elasticity,and color mismatch.Adding adipose tissues significantly improved the graft appearance compared to traditional skin grafting methods.Herein,we report two cases of modified skin graft procedures,both showing positive outcomes.In case 1,a mechanically processed fat-derived product was injected into the lower half of the skin graft area.In case 2,left upper eyelid blepharoplasty was performed,and the orbital fat strip was transferred and placed under the recipient area on the right side.Hair growth was observed only in case 1,whereas the extent of sunken depression was significantly reduced in both cases.Compared to traditional skin grafting methods,adding fat components to the skin graft recipient area improved the appearance and blood supply,together with enhancing the regenerative rate.

Study on Different Types of Skin Flap Transplantation to Repair Forefoot Damaged Injury

Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their clinical data were retrospectively analyzed.All the selected patients received skin flap transplantation and repair,of which 26 patients received free myocutaneous flap transplantation and repair,and were treated as group A.The other 36 patients underwent retrograde foot flap transplantation and repair.They were taken as group B,and the clinical treatment methods and curative effects were summarized.Results Among the 26 patients in group A,the skin flaps of 21 patients survived completely,while those of the other 5 patients showed partial necrosis at the edge of the skin flaps.They were treated with free skin grafting and healed after regular dressing change.All the skin flaps survived.Follow-up for at least 6 months showed that 11 patients had mild claudication and skin flap sensation was slightly poor.Among the 36 patients in group B,only 2 cases suffered from distal partial necrosis after the operation,which was caused by large tension after dorsum pedis flap transplantation.After systematic treatment and regular dressing change by doctors,the flaps of 2 patients healed.In addition,venous reflux disorder occurred in 3 patients with medial saphenous nerve nutrient vessel flap of the foot,which was related to swelling factors.The flaps of other patients survived,healed well and did not show infection symptoms.Conclusion According to the actual condition of patients with forefoot damage,the flap repair method is formulated,which has good short-term and long-term therapeutic effects and plays an important role in repairing forefoot damage.

Reconstruction of massive skin avulsion of the scrota and penis by combined application of dermal regeneration template(Pelnac) and split-thickness skin graft with vacuum-assisted closure: A case report

BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.

Skin Graft in the Surgery Department “B” of the CHU du Point “G” about 50 Cases

Aim: To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. Patients and Methods: This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. Result: There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm2. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). Conclusion: They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.

Correction of Scar Contracture Deformity of Dorsal Hand by Invisible Full-thickness Mesh Skin Graft

Objective To investigate the effect of invisible full-thickness mesh skin graft in the treatment of scar contracture deformity of the dorsal hand.Methods From January 2016 to February 2019,25 patients with cicatricial contracture deformity of dorsal hand admitted to our hospital underwent full thickness skin graft.During the operation,the scar healed completely and the superficial fascia remained intact.The wound surface was transplanted with invisible mesh full thickness skin graft.The survival of the skin graft and the recovery of hand function and appearance in the later period were observed after the operation.Results The skin grafts of 20 patients survived with high quality,3 cases had partial epidermis exfoliation,and 2 cases had partial epidermis scattered in blisters.After intensive dressing change,all wounds healed and no complications occurred after the operation.The hand function and appearance of the patients were obviously improved.Conclusion The application of full thickness skin graft to correct scar deformity has the advantages of good functional and appearance recovery and difficult postoperative contracture.Invisible full-thickness mesh skin graft is one of the ideal methods to correct scar contracture deformity of the dorsal hand.

Histologic analysis and long-term effect of acellular dermal matrix combined with autologous thin split-thickness skin graft

Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined with autoiogous

The Utility of the Galea in Scalp Reconstruction

Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.

Strategies and challenges in the treatment of chronic venous leg ulcers

Evaluating patients with chronic venous leg ulcers(CVLUs)is essential to find the underlying etiology.The basic tenets in managing CVLUs are to remove the etiological causes,to address systemic and metabolic conditions,to examine the ulcers and artery pulses,and to control wound infection with debridement and eliminating excessive pressure on the wound.The first-line treatments of CVLUs remain wound care,debridement,bed rest with leg elevation,and compression.Evidence to support the efficacy of silver-based dressings in healing CVLUs is unavailable.Hydrogen peroxide is harmful to the growth of granulation tissue in the wound.Surgery options include a high ligation with or without stripping or ablation of the GSVs depending on venous reflux or insufficiency.Yet,not all CVLUs are candidates for surgical treatment because of comorbidities.When standard care of wound for 4 wk failed to heal CVLUs effectively,use of advanced wound care should be considered based on the available evidence.Negative pressure wound therapy facilitates granulation tissue development,thereby helping closure of CVLUs.Autologous split-thickness skin grafting is still the gold standard approach to close huge CVLUs.Hair punch graft appears to have a better result than traditional hairless punch graft for CVLUs.Application of adipose tissue or placenta-derived mesenchymal stem cells is a promising therapy for wound healing.Autologous platelet-rich plasma provides an alternative strategy for surgery for safe and natural healing of the ulcer.The confirmative efficacy of current advanced ulcer therapies needs more robust evidence.

Clinical features, surgical outcomes and genetic analysis of ectodermal dysplasia with ocular diseases

AIM: To report on the clinical features, surgical outcomes and gene mutation analysis of three ectodermal dysplasia probands with ocular diseases. METHODS: A case-note review of three unrelated probands diagnosing with ectodermal dysplasia with ocular diseases was undertaken. Patient clinical features and the outcomes of surgery were analysed. The suspected pathogenic genes were analysed by whole exome sequencing from patients with ectodermal dysplasia and Sanger sequencing from family members.RESULTS: The ocular clinical features of ectodermal dysplasia with ocular diseases mainly include eyelid ectropion, lagophthalmos and absence of lacrimal punctum. All the probands underwent surgeries of full-thickness free skin flap grafting to correct ectropion. They achieved good recovery, and there were no obvious complications during the follow-up. The gene sequencing results did not show any meaningful genetic mutations.CONCLUSION: Lid ectropion is one of the key clinical traits of ectodermal dysplasia with ocular diseases. Ectropion correction with full-thickness free skin flap grafting is an effective procedure to correct ectropion for ectodermal dysplasia patients with ichthyosis-like tissue. The suspected pathogenic genes of ectodermal dysplasia with ectropion should be further verified or confirmed by large samples of the family.

Reliability of the Estimation of the Take of Split Thickness Graft by the Observation Method

Introduction: Split thickness skin grafts are frequently employed to provide biological cover for extensive wounds. The take of the skin graft is traditionally estimated by observation and recorded as a percentage. The intent of this study was to ascertain the reliability of the observation method in comparison with the Image J digital programme. Materials and Methods: The study was a longitudinal study conducted on the wards of the National Reconstructive Plastic Surgery and Burns Centre (NRPSBC) at the Korle Bu Teaching Hospital (KBTH) on patients who were admitted during the period of the study with wounds who received split skin grafts. Image J®, an image analysis program, was employed in the calculation of the take of the grafts. These were compared to values obtained by estimation by observation. Results: There was no statistically significant difference between the estimation of graft take, made by observation and using Image J® digital programme. Conclusion: The estimation of graft take by observation is an acceptable practice.

Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns

Background:Staged excision and grafting with viable cryopreserved alloskin or fresh pigskin at an early stage is a main strategy for wound management in massive burns.Alloskin is the gold standard of a biological temporary skin substitute,and the main drawback to its wider use is the limited number of donors.In this paper,we compare the use of fresh pigskins to cryopreserved alloskins as temporary skin substitutes on subcutaneous tissue wounds after tangential excision by observing the clinical performances of these grafts in cases of a massive burn.Methods:We selected six adult massive burn patients undergoing tangential excision and skin grafting on subcutaneous tissue wounds(TESGSTW)at our burn center from January 1,2003 to December 31,2013.The general clinical data and survival percentage of skins at postoperative weeks(POWs)1,2,and 3 were analyzed.In our clinical practice,we also observed the phenomenon that several viable cryopreserved alloskin or fresh pigskin grafts used as temporary coverage on subcutaneous tissue wounds had long-term survival after repeated desquamation.The macroscopic and histological results of one typical case were also analyzed.Results:In this study,the first three TESGSTW operations were performed at 2–3,5–8,and 11–16 days post-injury.The operation areas were 30.3±7.9%total body surface area(TBSA),19.0±6.0%TBSA,and 12.0±1.7%TBSA,respectively.The survival percentage of the cryopreserved alloskins or fresh pigskins at POWs 1,2,and 3 were 80.0±10.0%vs 75.7±5.3%(t=1.01,P=0.16),71.2±10.6%vs 66.4±6.2%(t=1.09,P=0.30),and 48.7±2.5%vs 35.0±7.0%(t=3.83,P=0.03),respectively.The microscopic observation of the survival of alloskins or pigskins in one typical case showed rete ridges and a basilar membrane at the joint of the epidermis and dermis at an early stage;these structures disappeared with extended time post-operation.Conclusions:From the clinical observations,fresh pigskin and cryopreserved alloskins could be used with equal effectiveness at an early stage(within 2 weeks post-operation)as temporary coverage on massive burns after TESGSTW.After engraftment,several cryopreserved alloskins or fresh pigskins could co-survive in a massive burn patient for an extended amount of time.The co-survival of alloskin and pigskin will provide clues for further research into skin transplantation.

One-step approach for full-thickness skin defect reconstruction in rats using minced split-thickness skin grafts with Pelnac overlay

Background:Split-thickness skin grafting is the current gold standard for the treatment of traumatic skin loss.However,for patients with extensive burns,split-thickness skin grafting is limited by donor skin availability.Grafting split-thickness skin minced into micrografts increases the expansion ratio but may reduce wound repair quality.Dermal substitutes such as Pelnac can enhance the healing of full-thickness skin wounds,but their application currently requires two surgeries.The present study investigated whether it is possible to repair full-thickness skin defects and improve wound healing quality in a single surgery using Pelnac as an overlay of minced split-thickness skin grafts in a rat model.Methods:A full-thickness skin defect model was established using male Sprague-Dawley rats of 10 weeks old.The animals were randomly divided into control and experimental groups in which Vaseline gauze and Pelnac,respectively,were overlaid on minced split-thickness skin grafts to repair the defects.Wound healing rate and quality were compared between the two groups.For better illustration of the quality of wound healing,some results were compared with those obtained for normal skin of rats.Results:We found that using Pelnac as an overlay for minced split-thickness skin grafts accelerated wound closure and stimulated cell proliferation and tissue angiogenesis.In addition,this approach enhanced collagen synthesis and increased the formation of basement membrane and dermis as well as the expression of growth factors related to wound healing while reducing scar formation.Conclusions:Using minced split-thickness skin grafts overlaid with Pelnac enables the reconstruction of fullthickness skin defects in a single step and can increase the healing rate while improving the quality of wound healing.