title: Recovery course of full-thickness skin defects with exposed bone: an evaluation by a quantitative examination of new blood vessels.
abstract: BACKGROUND
  Full-thickness skin defects with exposed bone are often hard to heal. The lack or delayed re-vascularization is considered one of the major causes, and the periosteum is also suggested to have an important role in tissue regeneration.
  
  
  METHODS
  Full-thickness skin defect wounds with exposed bone were made in the parietal region of Wister rats. The periosteum of the exposed parietal bone was removed in the periosteum-lacking group, but maintained in the control group (periosteum-intact group). The wound was covered by an artificial dermis made of collagen. The wound healing process was histologically compared. Double immunostaining of alpha-smooth muscle actin (SMA) and von Willebrand factor (vWF) was used for re-vascularization examination, and the blood vessel density in the artificial dermis was quantified.
  
  
  RESULTS
  The density of the blood vessels in the uninjured parietal tissue was approximately 80 vessels/mm(2). To reach this density, 7 and 21 days were required for the control (periosteum-intact) and the periosteum-lacking groups, respectively. This coincided with complete revascularization, fibroblast migration and the reentry of blood vessels to the upper layer of the wound were observed.
  
  
  CONCLUSIONS
  The described results support the importance of the periosteum in the full-thickness skin defect healing process.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Hongo, Tokyo, Japan. koga@med.juntendo.ac.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Koga
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Komuro
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yamato
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Sueyoshi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kojima
authors.forename: Teruo
authors.initials: T
authors.lastname: Okano
authors.forename: Akira
authors.initials: A
authors.lastname: Yanai
mesh_terms: D000818:Animals; D002465:Cell Movement; D003094:Collagen; D004847:Epithelial Cells / Q000166:cytology / Q000502:physiology; D005347:Fibroblasts / Q000166:cytology / Q000502:physiology; D008297:Male; D018919:Neovascularization, Physiologic / Q000502:physiology; D010294:Parietal Bone; D010521:Periosteum / Q000502:physiology*; D051381:Rats; D017208:Rats, Wistar; D012867:Skin / Q000098:blood supply* / Q000166:cytology / Q000293:injuries*; D017768:Skin, Artificial; D014945:Wound Healing / Q000502:physiology*
chemical_list: D003094:Collagen