title: Skin substitutes based on allogenic fibroblasts or keratinocytes for chronic wounds not responding to conventional therapy: a retrospective observational study.
abstract: Chronic wounds are an expression of underlying complex pathologies and have a high incidence. Skin substitutes may represent an alternative approach to treat chronic ulcers. The aim of this retrospective observational study was to evaluate the wound reduction using skin substitutes based on allogenic fibroblasts or keratinocytes in 30 patients not responding to conventional therapy. Wound bed was prepared, then keratinocytes on Laserskin(®) to treat superficial wounds or fibroblasts on Hyalograft 3D(R) to treat deep leg ulcers were applied, and finally wounds were treated with a secondary dressing composed of nanocrystalline silver. Once a week constructs were removed and new bioengineered products were applied, as well as nanocrystalline silver medication. In none of the cases under examination did any complications arise relating to the treatment. We also achieved a reduction in wound dimension and exudates, and an increase in wound bed score. Postoperative assessment shows a degree of healing that is statistically higher in the group treated with keratinocytes as compared with the fibroblast group. This retrospective study improves our understanding and defines the clinical indications for the various uses of the two types of skin substitutes.
authors: Unità Operativa Complessa di Chirurgia della Mano, Università degli Studi di Milano, Ospedale San Giuseppe Milan /IRCCS MultiMedica, Milano, Italy.
authors: Giorgio
authors: G
authors: Pajardi
authors: Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy.
authors: Vicenzo
authors: V
authors: Rapisarda
authors: Alphasearch sas, Monza, Italy.
authors: Francesco
authors: F
authors: Somalvico
authors: Struttura Complessa di Chirurgia Plastica e Centro Grandi Ustionati, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy.
authors: Andrea
authors: A
authors: Scotti
authors: Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy.
authors: Giulia Lo
authors: GL
authors: Russo
authors: Istituto di Chirurgia Plastica, Università degli Studi di Firenze, Milano, Italy.
authors: Francesco
authors: F
authors: Ciancio
authors: Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy.
authors: Arturo
authors: A
authors: Sgrò
authors: Struttura Complessa di Anatomia Patologica, Polo Universitario "A.O. Ospedale Luigi Sacco", Milano, Italy.
authors: Manuela
authors: M
authors: Nebuloni
authors: Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy.
authors: Raffaele
authors: R
authors: Allevi
authors: Dipartimento di Scienze del Farmaco, Università degli Studi di Pavia, Pavia, Italy.
authors: Maria L
authors: ML
authors: Torre
authors: Dipartimento di Scienze Biomediche, Università degli Studi di Milano, Milano, Italy.
authors: Emilio
authors: E
authors: Trabucchi
authors: Struttura Semplice Terapia Tissutale, Centro di Riferimento Regionale per la coltura di epidermide umana in vitro e banca per la crioconservazione dei tessuti, A.O. Ospedale Niguarda Ca' Granda, Milano, Italy.
authors: Mario
authors: M
authors: Marazzi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D003646:Debridement; D005260:Female; D005347:Fibroblasts / Q000637:transplantation*; D006801:Humans; D015603:Keratinocytes / Q000637:transplantation*; D007871:Leg Ulcer / Q000628:therapy*; D008297:Male; D053768:Metal Nanoparticles / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D018030:Silver Compounds / Q000627:therapeutic use; D017768:Skin, Artificial; D054457:Tissue Scaffolds; D014184:Transplantation, Homologous; D014945:Wound Healing
chemical_list: D018030:Silver Compounds
keywords: Hyaluronic acid; Nanocrystalline silver; Tissue-engineered skin substitute; Wound healing