title: A Regenerative Approach with Dermal Micrografts in the Treatment of Chronic Ulcers.
abstract: The etiology of non-healing ulcers depends on both systemic and local factors. The introduction of advanced dressing, negative wound therapy and compression therapy have undoubtedly improved clinical outcomes. The principal aim of study was to demonstrate the efficacy of dermal micrografts in the treatment of ulcers with different etiologies. The second aim was to investigate in vitro the action of micrografts in the regenerative process.
  
  
  
  The dermal micro-grafts were obtained from mechanical disaggregation of small pieces of skin tissue through a medical device called Rigeneracons.
  
  
  
  We observed in vivo the ability of dermal autologous micrografts to improve the healing of venous, diabetic, pressure and post-traumatic ulcers after few week of treatment accomplished in general with a better quality of life for the patients. In vitro results showed that these micrografts express mesenchymal stem cells (MSCS) marker such as CD34, CD73, CD90 and CD105, and are able to form a viable and proliferative biocomplex with collagen sponge. Finally, the site of ulcers displayed a different expression of epidermal growth factors, insulin-like growth factors, platelet-derived growth factors and their receptors and tumor necrosis factor-β with respect to healthy skin samples.
  
  
  
  We reported a good outcome for the treatment of chronic ulcers using dermal autologous micrografts. Finally, we suggest that the positivity to MSCs markers and the ability to interact with a scaffold can play a key role in their regenerative properties.
authors.affiliation: Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Miraglia Square, 80122, Naples, Italy. fran.defr@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Francesco
authors.affiliation: Human Brain Wave srl, Corso Galileo Ferraris 63, 10128, Torino, Italy.|SHRO - Temple University of Philadelphia, Philadelphia, PA, USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Graziano
authors.affiliation: Human Brain Wave srl, Corso Galileo Ferraris 63, 10128, Torino, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Trovato
authors.affiliation: Department of Public Health, Experimental Medicine and Forensics, University of Pavia, Pavia, Italy.|C.I.T., Tissue Engineering Centre, University of Pavia, Pavia, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Ceccarelli
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Romano
authors.affiliation: Moncalieri Hospital, ASL To5 - U.C.S. Orthopedics and Traumatology, Piazza A. Ferdinando, 3, 10024, Moncalieri TO, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Marcarelli
authors.affiliation: Department of Public Health, Experimental Medicine and Forensics, University of Pavia, Pavia, Italy.|C.I.T., Tissue Engineering Centre, University of Pavia, Pavia, Italy.
authors.forename: Gabriella Maria
authors.initials: GM
authors.lastname: Cusella De Angelis
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation, Padua University Hospital, Padua, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Cillo
authors.affiliation: Department of Reconstructive Plastic Surgery-Hand Surgery, AOU "Ospedali Riuniti", Ancona, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Riccio
authors.affiliation: Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Miraglia Square, 80122, Naples, Italy.
authors.forename: Giuseppe Andrea
authors.initials: GA
authors.lastname: Ferraro
mesh_terms: D015720:5'-Nucleotidase / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000378:metabolism; D064592:Autografts; D015415:Biomarkers / Q000378:metabolism; D002908:Chronic Disease; D020405:Dermis / Q000637:transplantation*; D004815:Epidermal Growth Factor / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D059630:Mesenchymal Stem Cells / Q000378:metabolism; D008875:Middle Aged; D010982:Platelet-Derived Growth Factor / Q000235:genetics; D017479:Receptors, Platelet-Derived Growth Factor / Q000235:genetics; D012038:Regeneration; D044968:Regenerative Medicine / Q000379:methods; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016038:Skin Transplantation / Q000379:methods; D012883:Skin Ulcer / Q000235:genetics / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; D010982:Platelet-Derived Growth Factor; D004815:Epidermal Growth Factor; D066246:ErbB Receptors; D017479:Receptors, Platelet-Derived Growth Factor; D015720:5'-Nucleotidase
keywords: Growth factors; Mesenchymal stem cells; Micrograft; Ulcers; Wound healing