記述言語：英語   出版者・発行元：TAYLOR & FRANCIS LTD  

This study aimed to develop a novel wound dressing composed of hyaluronic acid (HA) spongy sheet containing bioactive components. The wound dressing prepared by the freeze-drying method has a two-layered structure: an upper layer composed of cross-linked high-molecular-weight HA (HMW-HA) and a lower layer composed of low-molecular-weight HA (LMW-HA) containing arginine (Arg), magnesium ascorbyl phosphate (vitamin C derivative: VC), and epidermal growth factor (EGF) (referred to as EGF-dressing). A wound dressing containing only Arg and VC was prepared in a similar manner (referred to as EGF-free-dressing). The potential of each wound dressing was evaluated in animal tests using Sprague Dawley (SD) rats and diabetic mice. In the first experiment, each wound dressing was applied to a full-thickness skin defect in the abdominal region of SD rats. Wound conditions after 1week and 2weeks of treatment were evaluated based on macroscopic and histological appearance. A commercially available non-woven alginate wound dressing (Alg-dressing) was used in a control group. Both EGF-free-dressing and EGF-dressing decreased wound size and promoted granulation tissue formation associated with angiogenesis more effectively when compared with Alg-dressing. In particular, EGF-dressing promoted re-epithelialization. In the second experiment, each wound dressing was applied to a full-thickness skin defect in the dorsal region of diabetic mice. Wound conditions after 1week and 2weeks of treatment were evaluated based on macroscopic and histological appearance. A commercially available Alg-dressing was used in a control group. Both EGF-free-dressing and EGF-dressing decreased wound size and promoted granulation tissue formation associated with angiogenesis more effectively when compared with Alg-dressing. These findings indicate that EGF-free-dressing and EGF-dressing have the potential for more effective wound healing when compared with Alg-dressing. In particular, EGF-dressing has a higher potential for wound healing when compared with EGF-free-dressing.

DOI： 10.1080/09205063.2014.929427

Web of Science

PubMed

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記述言語：英語   出版者・発行元：TAYLOR & FRANCIS LTD  

Anti-adhesive products need to be designed while considering the concept of wound healing. Two main events must proceed simultaneously: facilitating wound healing in surgically excised tissue, as well as preventing injured tissue from adhering to the surrounding tissue. The present study aimed to develop an anti-adhesive spongy sheet composed of hyaluronic acid and collagen (Col) containing epidermal growth factor, and to investigate the potential of this spongy sheet using an in vitro wound surface model (placing a spongy sheet on a fibroblast-incorporating Col gel sheet) and an in vitro inter-tissue model (placing a spongy sheet between two fibroblast-incorporating Col gel sheets). These in vitro experiments demonstrated that this spongy sheet effectively stimulates fibroblasts to release an increased amount of vascular endothelial growth factor and hepatocyte growth factor, which are essential for wound healing to proceed succesfully. In addition, anti-adhesive performance of this spongy sheet was evaluated in animal experiments using Sprague Dawley rats. Under anesthesia, a 1cmx2cm segment of peritoneum was superficially excised from walls, and the cecum was then abraded by scraping with a scalpel blade over a 1cmx2cm area. A piece of spongy sheet was placed on the peritoneal defect. Both defects were placed in contact, and the incision was closed by suturing. Peritoneal condition was evaluated after one week. This spongy sheet was capable of facilitating the wound healing of surgically excised tissue and preventing surgically excised tissue from adhering to surrounding tissues.

DOI： 10.1080/09205063.2014.926579

Web of Science

PubMed

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記述言語：英語   出版者・発行元：TAYLOR & FRANCIS LTD  

The present study aimed to develop a two-layered cultured dermal substitute (CDS). The upper layer is a hyaluronic acid (HA) and collagen (Col) spongy sheet with or without epidermal growth factor (EGF). The lower layer is a HA spongy sheet and Col gel containing fibroblasts. The CDS is prepared in serum-free medium, followed by placing on the wound surface. Corresponding to clinical application, CDS was incubated in serum-free medium for a period of 1, 3 or 5days, followed by placing onto the air and culture medium interface (wound surface model), and culture for 6days using conventional culture medium supplemented with serum. Metabolic activity and cytokine production were considerably higher in EGF-incorporating CDS, as compared with EGF-free CDS. Metabolic activity of EGF-incorporating CDS was maintained for a period of 3days, but decreased slightly after 5days. EGF-incorporating CDS is able to effectively stimulate fibroblasts within CDS to release increased amounts of vascular endothelial growth factor and hepatocyte growth factor, which are essential for wound healing. CDS is promising for wound therapy, because there is no risk of cellular damage caused by cryopreservation, thawing and rinsing processes. The critical issue is how to reduce the cellular damage during a prolonged period of incubation in serum-free medium. EGF-incorporating CDS can be used after a period of 3-5days incubation in serum-free medium. This period is sufficient for transport of CDS from manufacturing facilities to hospitals.

DOI： 10.1080/09205063.2014.920171

Web of Science

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本形成外科学会  

40歳男性。4歳時の右肩BCG接種痕からケロイドが発生、これが徐々に拡大したためステロイド剤の塗布が行われたが軽快しなかった。11歳児に切除術と全層植皮術が施行され、右肩植皮部にステロイド剤および圧迫固定が行なわれるも、ケロイドは再発した。その後、海外に引っ越しため積極的な治療が行えず、30歳時に再診した際は右肩植皮部のケロイドは増悪していた。その他にも多発(右鼠径部、下顎部、腋窩、上肢、前胸部、上腹部ほか、後頸部、肩甲骨部、背部、臀部、大腿、下腿側面)しており、更に排便時に生じた裂創からもケロイドが発生していた。肛門は病変で完全に覆われており、排便時は便を用手的にかき出さなければならず、下腹部を中心にケロイド内に膿瘍形成がみられ、連日の排膿処置および創処置を要していた。以上、これらの経過を踏まえ、治療としてケロイドの減量と感染コントロールを目的としてケロイド内で病変の切除を行い、腋窩と肛門周囲は縫合閉鎖した。植皮術は切除したケロイドの表面より採皮し、再利用する形にし、後療法は電子線照射とトラニラスト内服を開始した。その結果、術後2ヵ月で完全に上皮化し、術後1年半経過した現在は下腹部にケロイドの再発は一部認めるも周囲への拡大や膿瘍形成はなく、通常の排便が可能となり、ADLも改善した。

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