Hyaluronic acid three-dimensional scaffold for surgical revision of retracting scars: a human experimental study.
An observational study was carried out at the Plastic and Reconstructive Surgery Unit of the University of Pavia - Salvatore Maugeri Research and Care Institute, Pavia, Italy, to assess the clinical and histological long-term outcomes of autologous skin grafting of fresh surgical wounds following previous repair with a hyaluronic acid three-dimensional scaffold (Hyalomatrix®). Eleven fresh wounds from surgical release of retracted scars were enrolled in this study. A stable skin-like tissue cover was observed in all of the treated wounds in an average 1 month's time; at the end of this study, after an average of 12 months' time, all of the reconstructed areas were pliable and stable, although an average retraction rate of 51·62% was showed. Histological observation and immunohistochemical analysis displayed integration of the graft within the surrounding tissues. A regenerated dermis with an extracellular matrix rich in type I collagen and elastic fibres and with reduced type III collagen rate was observed. The epidermis and dermoepidermal junction featured a normal appearance with well-structured dermal papillae, too. Although the histological features would suggest regeneration of a skin-like tissue, with a good dermis and no signs of scarring, the clinical problem of secondary contracture is still unsolved.
Plastic and Reconstructive Surgery Unit, Salvatore Maugeri Research and Care Institute, University of Pavia, Pavia, Italy.
Angela
A
Faga
Giovanni
G
Nicoletti
Federica
F
Brenta
Silvia
S
Scevola
Giovanni
G
Abatangelo
Paola
P
Brun
D000293:Adolescent; D000328:Adult; D002648:Child; D002921:Cicatrix / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012867:Skin / Q000293:injuries*; D016038:Skin Transplantation / Q000379:methods*; D013997:Time Factors; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
D006820:Hyaluronic Acid