Current Challenges and Advances in Skin Repair and Regeneration

Topic Information

Dear Colleagues,

The skin is the human body's first barrier, and acts as a defense against external stimuli, protecting against damage and injury. The structure of the skin is complex: it is composed of the epidermis, dermis, and subcutaneous fat, acting as a barrier against the penetration of damaging UV rays from the sun, the invasion of harmful pathogens, and the evaporation of water, thereby protecting the underlying organs.

In clinical practice, the interruption of skin integrity can be caused by different external factors which range from an iatrogenic or post-traumatic excision to a severe loss of tissue, such as in relation to an ulcer, or even to an alteration of the skin structure by chemicals or heat.

Since skin represent the most extended and most visible organ of the human body, growing attention is given to its healing and its reconstruction. In the last few years, we have observed an increased interest in skin repair and regeneration to improve the positive results achievable with autologous grafts, either with full or partial thickness. Today, we observe a rising focus on dermal substitutes. They represent a valid option in the reconstruction of wound with large amount of dermal loss or with great scar retraction. Larger defects can be approached by the adoption of microsurgery and the harvesting of free flaps. Recently, innovative research studies have proposed the application of mesenchymal stem-cell-derived exosomes and nano-sized vesicles able to induce strong anti-inflammatory, anti-aging, and wound-healing effects, thereby easing the regenerative process.

One of the most complex skin districts to reconstruct is the facial region: here the skin has very varied characteristics changing thickness and elasticity, encountering very important vascular-nervous structures.

Dr. Giovanni Salzano
Dr. Chiara Copelli
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biomedicines biomedicines	3.9	5.2	2013	15.3 Days	CHF 2600	Submit
Journal of Clinical Medicine jcm	3.0	5.7	2012	17.3 Days	CHF 2600	Submit
Journal of Personalized Medicine jpm	3.0	4.1	2011	16.7 Days	CHF 2600	Submit

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Published Papers (6 papers)

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16 pages, 2176 KiB  

Open AccessArticle

Therapeutic Potential of a Biodynamic Supplement on Skin Pressure Ulcers: A Randomized Clinical Study

by Pasquale Ferorelli, Manfred Doepp, Stefano Lenzi, Roberto Rovelli, Gennaro Gisonna, Giuseppe Maierà, Francesco Antonelli, Massimo Radaelli, Anna Shevchenko, Giordana Feriotto, Carlo Mischiati, Ilaria Borromeo and Simone Beninati

Biomedicines 2024, 12(8), 1918; https://doi.org/10.3390/biomedicines12081918 - 22 Aug 2024

Viewed by 545

Abstract

Pressure ulcers (PUs) are a debilitating and often painful condition. They are localized lesions on the skin and/or underlying tissues and are common in the elderly, people with mobility difficulties, diabetics, and vascular disease or malnutrition, as well as in those requiring intensive [...] Read more.

Pressure ulcers (PUs) are a debilitating and often painful condition. They are localized lesions on the skin and/or underlying tissues and are common in the elderly, people with mobility difficulties, diabetics, and vascular disease or malnutrition, as well as in those requiring intensive or palliative care. The prevention and treatment of PUs involve strategies to optimize hydration, circulation, and nutrition. Nutrition plays a key role in pressure ulcer care because wounds require macronutrients and micronutrients to heal. Reports relating to the effectiveness of “Complementary Enzyme Therapy” also in the vulnological field led us to this study, the aim of which was to test the activity of a biodynamic food supplement (Citozym^®) rich in carbohydrates, vitamins, and amylase and lactase and characterized by marked antioxidant activity. Citozym^® administered topically and/or systemically, and in particular in both administrations, in patients suffering from Pus, has shown a marked reduction in bedsores and, in many cases, complete healing. Furthermore, it was possible to observe a lower incidence of side effects compared to conventional therapies. The results obtained, confirmed by various tests and recognized by the scientific community, allow us to conclude that treatment with Citozym^® could represent a new and effective strategy for the treatment of PUs. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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25 pages, 2351 KiB  

Open AccessArticle

Severity and Clinical Outcomes of Pediatric Burns—A Comprehensive Analysis of Influencing Factors

by Alexandra Toma, Dragoș Voicu, Constantin Popazu, Daniela Mihalache, Oana Duca, Dumitru Marius Dănilă and Dan Mircea Enescu

J. Pers. Med. 2024, 14(8), 788; https://doi.org/10.3390/jpm14080788 - 25 Jul 2024

Viewed by 564

Abstract

(1) Background: Burn injuries in children present a significant public health concern due to their potential for severe physical and psychological impact. (2) Methods: This study investigates the determinants of pediatric burn severity by analyzing the interplay of demographic and environmental factors. Through [...] Read more.

(1) Background: Burn injuries in children present a significant public health concern due to their potential for severe physical and psychological impact. (2) Methods: This study investigates the determinants of pediatric burn severity by analyzing the interplay of demographic and environmental factors. Through a retrospective analysis of pediatric burn cases over five years, encompassing patient demographics, burn causative agents, and clinical outcomes, this research aims to identify significant predictors of burn severity. (3) Results: This study presents a comprehensive analysis of pediatric burn injuries, focusing on the severity, clinical outcomes, and multifactorial aspects influencing recovery. We reviewed 1498 pediatric burn cases from January 2015 to December 2020. The mean age of patients was 5.8 years, with a slight male predominance (54%). Scalds (45%), flame burns (30%), and contact burns (15%) were the most common burn types. Our findings indicate significant differences in burn severity based on TBSA, with 32.5% of cases having TBSA greater than 20%. Multivariate logistic regression identified rural residence, male gender, flame burns, and lower socioeconomic status as significant predictors of severe burn outcomes. The overall mortality rate was 2.5%, with higher rates among patients with TBSA greater than 40%. These results highlight the need for targeted prevention strategies and improved access to specialized burn care. (4) Conclusions: Understanding these factors can inform targeted prevention strategies and improve treatment protocols. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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6 pages, 5228 KiB  

Open AccessReview

Chemical Scalp Burn after Hair Coloring—Case Report with Literature Review

by Natalia Welc, Sandra Ważniewicz, Aleksandra Anioła, Paulina Ratajska, Małgorzata Wilawer, Magdalena Jałowska and Ryszard Żaba

J. Clin. Med. 2024, 13(12), 3542; https://doi.org/10.3390/jcm13123542 - 17 Jun 2024

Viewed by 854

Abstract

Hair dyeing is widely performed around the world. Chemical and thermal burns can result from the components present in brightening and coloring products, as well as the application process. We present a case of a chemical burn after applying hair dye and review [...] Read more.

Hair dyeing is widely performed around the world. Chemical and thermal burns can result from the components present in brightening and coloring products, as well as the application process. We present a case of a chemical burn after applying hair dye and review the literature on similar cases, the composition of hair dyes, their mechanism of action, and the process of burns. The patient was a 17-year-old girl, who presented to the Dermatology Clinic with a 13 × 10 cm ulcer on the scalp after hair dyeing in a hairdressing salon. General and local treatment was applied, with particular emphasis on specialized dressings. The ulcer site was replaced by an area of scarring after 11 months of treatment. Based on the presented case and the review of the literature, we conclude that hair dye treatments warrant careful attention for potential scalp complications. The diagnostic and therapeutic approach demands a multidisciplinary effort, with ongoing patient–doctor cooperation throughout the treatment, which may complicate and span several months. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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Supplementary File 1 (ZIP, 393 KiB)

16 pages, 3400 KiB  

Open AccessArticle

Comparison of Intact Fish Skin Graft and Allograft as Temporary Coverage for Full-Thickness Burns: A Non-Inferiority Study

by Randolph Stone II, Emily C. Saathoff, David A. Larson, John T. Wall, Nathan A. Wienandt, Skuli Magnusson, Hilmar Kjartansson, Robert J. Christy and Shanmugasundaram Natesan

Biomedicines 2024, 12(3), 680; https://doi.org/10.3390/biomedicines12030680 - 18 Mar 2024

Viewed by 1375

Abstract

The extent and depth of burn injury may mandate temporary use of cadaver skin (allograft) to protect the wound and allow the formation of granulation tissue while split-thickness skin grafts (STSGs) are serially harvested from the same donor areas. However, allografts are not [...] Read more.

The extent and depth of burn injury may mandate temporary use of cadaver skin (allograft) to protect the wound and allow the formation of granulation tissue while split-thickness skin grafts (STSGs) are serially harvested from the same donor areas. However, allografts are not always available and have a high cost, hence the interest in identifying more economical, readily available products that serve the same function. This study evaluated intact fish skin graft (IFSG) as a temporary cover to prepare the wound bed for STSG application. Thirty-six full-thickness (FT) 5 × 5 cm burn wounds were created on the dorsum of six anesthetized Yorkshire pigs on day −1. To mimic the two-stage clinical situation, on day 0, wounds were excised down to a bleeding wound bed and a temporary cover (either IFSG or cadaver porcine skin) was applied; then, on day 7, wounds were debrided to a viable wound bed prior to the application of autologous 1.5:1 meshed STSG (mSTSG). Rechecks were performed on days 14, 21, 28, 45, and 60 with digital images, non-invasive measurements, and punch biopsies. The IFSG created a granulated wound bed receptive to the application of an mSTSG. FT burn wounds treated with an IFSG had similar outcome measures, including contraction rates, trans-epidermal water loss (TEWL) measurements, hydration, and blood perfusion levels, compared to cadaver skin-treated burn wounds. Pathology scoring indicated significant differences between the allograft- and IFSG-treated wounds on day 7, with the IFSG having increased angiogenesis, granulation tissue formation, and immune cells. Pathology scoring indicated no significant differences once mSTSGs were applied to wounds. The IFSG performed as well as cadaver skin as a temporary cover and was not inferior to the standard of care, suggesting the potential to transition IFSGs into clinical use for burns. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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10 pages, 406 KiB  

Open AccessReview

Fresh Frozen Homologous Rib Cartilage: A Narrative Review of a New Trend in Rhinoplasty

by Giovanni Salzano, Giovanni Audino, Giovanni Dell’Aversana Orabona, Umberto Committeri, Stefania Troise, Antonio Arena, Luigi Angelo Vaira, Pietro De Luca, Alfonso Scarpa, Andrea Elefante, Antonio Romano, Luigi Califano and Pasquale Piombino

J. Clin. Med. 2024, 13(6), 1715; https://doi.org/10.3390/jcm13061715 - 16 Mar 2024

Viewed by 1137

Abstract

Background: Revision rhinoplasty is a technically demanding surgical procedure that can put every surgeon in trouble. The main issue of these cases is often an altered osteocartilaginous framework following over-resection during the first intervention. Moreover, the available septal or auricular cartilage for [...] Read more.

Background: Revision rhinoplasty is a technically demanding surgical procedure that can put every surgeon in trouble. The main issue of these cases is often an altered osteocartilaginous framework following over-resection during the first intervention. Moreover, the available septal or auricular cartilage for grafting is usually not enough. This review aims to examine contemporary advances in applications of fresh frozen cartilage in rhinoplasty. Methods: A structured review of the current literature (up to December 2023) was performed on four bibliographic databases: PubMed, EMBASE, Cochrane and Medline. The search terms were combinations of “Rhinoplasty” and “Cartilage Graft”, “Allograft” or “Fresh Frozen Cartilage”. The citations of selected studies and review articles were also evaluated if present. Results: The research resulted in 152 articles, and only ten met the inclusion criteria: nine clinical articles and one in vitro study. One of the ten eligible articles was excluded. Conclusions: Fresh frozen rib cartilage proved to be a viable alternative to autologous rib grafts and irradiated homologous rib graft. Despite the higher costs, FFRG can provide a sufficient amount of tissue for grafting avoiding donor site complications and reducing the operative time and proved to have more chondrocytes and to be less prone to resorption compared to irradiated rib. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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11 pages, 1616 KiB  

Open AccessReview

Severe Acute Ischemia of Glans Penis after Achieving Treatment with Only Hyperbaric Oxygen Therapy: A Rare Case Report and Systematic Literature Review

by Adrian Hașegan, Ionela Mihai, Dan Bratu, Ciprian Bacilă, Mihai Dan Roman, Cosmin Ioan Mohor, Adrian Teodoru, Sabrina Birsan, Cosmin Mutu, Călin Chibelean, Maria Totan, Nicolae Grigore, Gabriela Iancu, Horatiu Dura and Adrian Boicean

J. Pers. Med. 2023, 13(9), 1370; https://doi.org/10.3390/jpm13091370 - 12 Sep 2023

Cited by 1 | Viewed by 2072

Abstract

Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and [...] Read more.

Acute ischemia of the glands is a severe complication after circumcision. We outline the challenging case of a seventeen-year-old boy with glandular ischemia (GI) that appeared shortly after circumcision. Methods: We present a case report and literature review related to glans ischemia, and the complications of circumcision are reviewed. We note that there are very few cases described in the literature. Our patient was successfully treated with hyperbaric oxygen therapy (HBOT) after four days of no positive effect after all medical and surgical treatments written in the literature: Subcutaneous enoxaparin, local application of a glyceryl trinitrate, continuous epidural perfusion, intravenous pentoxifylline, alprostadil, intraoperative drainage, and aspiration with saline solution and epinephrine. Clinical improvement was noted at the first session of HBOT. A number of days after the operation, the penis looked normal and was healing. Complete healing of the penile glans was successfully realized one month after surgery. Conclusion: Based on the review and the case presented, we conclude that HBOT is the treatment of choice for acute ischemia of the penile glans, especially when other treatments do not work. Full article

(This article belongs to the Topic Current Challenges and Advances in Skin Repair and Regeneration)

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