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Int. J. Mol. Sci. 2017, 18(5), 1054; doi:10.3390/ijms18051054

First Insights into Human Fingertip Regeneration by Echo-Doppler Imaging and Wound Microenvironment Assessment

Plastic and Hand Surgery Department, Lausanne University Hospital, 1011 Lausanne, Switzerland
These authors contributed equally to this work.
These authors contributed equally to this work.
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Academic Editor: Allison Cowin
Received: 9 April 2017 / Revised: 3 May 2017 / Accepted: 6 May 2017 / Published: 13 May 2017
(This article belongs to the Special Issue Wound Repair and Regeneration)
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Abstract

Fingertip response to trauma represents a fascinating example of tissue regeneration. Regeneration derives from proliferative mesenchymal cells (blastema) that subsequently differentiate into soft and skeletal tissues. Clinically, conservative treatment of the amputated fingertip under occlusive dressing can shift the response to tissue loss from a wound repair process towards regeneration. When analyzing by Immunoassay the wound exudate from occlusive dressings, the concentrations of brain-derived neurotrophic factor (BDNF) and leukemia inhibitory factor (LIF) were higher in fingertip exudates than in burn wounds (used as controls for wound repair versus regeneration). Vascular endothelial growth factor A (VEGF-A) and platelet-derived growth factor (PDGF) were highly expressed in both samples in comparable levels. In our study, pro-inflammatory cytokines were relatively higher expressed in regenerative fingertips than in the burn wound exudates while chemokines were present in lower levels. Functional, vascular and mechanical properties of the regenerated fingertips were analyzed three months after trauma and the data were compared to the corresponding fingertip on the collateral uninjured side. While sensory recovery and morphology (pulp thickness and texture) were similar to uninjured sides, mechanical parameters (elasticity, vascularization) were increased in the regenerated fingertips. Further studies should be done to clarify the importance of inflammatory cells, immunity and growth factors in determining the outcome of the regenerative process and its influence on the clinical outcome. View Full-Text
Keywords: fingertip regeneration; clinical assessment; Doppler imaging; angiogenesis fingertip regeneration; clinical assessment; Doppler imaging; angiogenesis
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MDPI and ACS Style

Jafari, P.; Muller, C.; Grognuz, A.; Applegate, L.A.; Raffoul, W.; di Summa, P.G.; Durand, S. First Insights into Human Fingertip Regeneration by Echo-Doppler Imaging and Wound Microenvironment Assessment. Int. J. Mol. Sci. 2017, 18, 1054.

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