Journal_1_2014_final_WEB

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* At smith&nephew we fully support healthcare professionals to address the true costs of wound care. Sponsored by Smith & Nephew Wound Management The Wound Care Iceberg Satellite Symposium at EWMA 2014, Thursday 15th May, 13:15-14:15, Room N104 It’s the hidden costs of wound care that affect healthcare resources the most. At Smith & Nephew we are passionate about reducing the human and economic cost of wounds. In the Smith & Nephew symposium, we will examine some of the real and hidden costs involved in wound care, how they affect you, and how we can help reduce them. We will demonstrate this with some exciting studies featuring ALLEVYN Life advanced wound dressing and PICO negative pressure wound therapy, which show how costs associated with nursing time and dressing changes may be decreased. We look forward to seeing you in Madrid! Visit us at the Smith & Nephew booth: 10D11 For patients. For budgets. For today. Wound Management Smith & Nephew, Medical Ltd, 101 Hessle Road, Hull, HU3 2BN, UK T +44 (0)1482 225181 - F +44 (0)1482 328326 - www.smith-nephew.com/wound Trademark of Smith & Nephew © Smith & Nephew March 2014 48467
Science, Practice and Education Regenerative medicine in burn wound healing: Aiming for the perfect skin Summary The healing of full thickness wounds such as burn wounds remains complicated by hypertrophic scar formation and contraction. The standard treatment is transplantation with autologous split thickness skin grafts. For extensive burns, these grafts are widely meshed due to limited donor sites, which often results in a poor functional and cosmetic outcome. The application of cultured autologous keratinocytes may enhance wound closure and improve scars. The first epidermal substitute, a confluent epithelial sheet, was developed in 1979. These cultured epidermal autografts (CEA) have been used in burn patients with variable success. Due to the variation in the efficacy of CEAs, however, new strategies have been employed. Currently, the application of preconfluent proliferating keratinocytes is considered a better strategy for burn wound treatment. In addition to improvements in epidermal grafts, the healing outcome may improve with the application of dermal substitutes. Over the past several decades, several scaffolds have been developed to mimic the dermis. These substitutes can be supplemented with growth factors and cells. In particular, the application of mesenchymal stem cells (MSCs) is thought to be a promising perspective for cell-based tissue engineering. Dermal substitution Although transplantation with a meshed split thickness autograft is the gold standard, healing of the transplanted burn wound is not optimal and results in scar formation, which is thought to be due to the lack of sufficient dermal material in the thin autograft and a delayed re-epithelialisation of the wound. The interstices of the meshed graft especially are prone to hypertrophic scarring. Several skin substitutes have been explored over the past several decades to improve the healing process. These substitutes comprise epidermal, dermal, or full skin constructs. Epidermal substitutes consist mainly of cultured keratinocytes, which can be supported by a carrier system. The main component of the dermis is the extracellular matrix (ECM), which provides support for different cell types and skin appendages such as hair, sebaceous glands, and sweat glands. The ECM plays an important role in the regulation of the different cells in the dermis. The lack of dermal ECM in full-thickness burn wounds is thought, therefore, to be an important cause of scar formation. Several scaffolds have been developed to create an environment that mimics the dermal ECM. Many of these constructs are based on the natural components of the dermal ECM, with collagen as the most abundant component of the skin as a base. One of the first skin substitutes used in burn patients was an acellular bilayered construct that consists of a collagen matrix with a silicon top layer to mimic the epidermis 1 . In addition to collagen, this scaffold also contains chondroitin 6-sulfate, a glycosaminoglycan (GAG), which provides more elasticity and better tensile strength to the scaffold and protects the scaffold against fast biodegradation. The porous structure of the collagen/GAG scaffold allows the migration of various cell types and structures such as blood vessels into the substitute. This construct, which is currently available as Integra ® , is used in a two-step procedure. During the first operation, the burn wound is excised and the skin substitute is applied. In a second operation Magda MW Ulrich MD, PhD Association of Dutch Burn Centres, Beverwijk, the Netherlands Correspondence: mulrich@burns.nl Conflict of interest: none EWMA Journal 2014 vol 14 no 1 25
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Cochrane Reviews studies were noted
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Cochrane Reviews infection status a
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EWMA English English Polish Lithuan
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EWMA MADRID A city where you will f
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Strong when wet 1,2 Gentle on the b
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Now available - DURAFIBER Ag with a
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EWMA n GNEAUPP 2014 Christina Lindh
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will be held at this year’s EWMA
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Submit your next paper to Phlebolog
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Nordic Diabetic Foot Symposium 2014
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Programme in Austria 25th Conferenc
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JOURNAL CITATION REPORTS 2013 SPECI
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Cooperating Organisations AEEVH Spa
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6 Editorial Science, Practice and E
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