Current Challenges and Advances in Skin Repair and Regeneration

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biomedicines biomedicines	3.9	5.2	2013	14.6 Days	CHF 2600	Submit
Journal of Clinical Medicine jcm	3.0	5.7	2012	16 Days	CHF 2600	Submit
Journal of Personalized Medicine jpm	-	4.1	2011	17.4 Days	CHF 2600	Submit

9 pages, 2345 KiB

Open AccessTechnical Note

Oral Tongue Reconstruction with a Bozola Flap According to the Ansarin Glossectomies Classification

by Giovanni Salzano, Francesco Ferragina, Stefan Cocis, Fabio Maglitto, Alfonso Manfuso and Chiara Copelli

J. Clin. Med. 2025, 14(6), 1965; https://doi.org/10.3390/jcm14061965 - 14 Mar 2025

Viewed by 221

Abstract

Background: Myomucosal cheek flaps are currently considered the main reconstructive option for small to moderate oral cavity defects. Many reconstructive techniques following the resectioning of oral tongue squamous cell carcinoma (OTSCC) have been proposed over the years. Methods: We report a case of [...] Read more.

Background: Myomucosal cheek flaps are currently considered the main reconstructive option for small to moderate oral cavity defects. Many reconstructive techniques following the resectioning of oral tongue squamous cell carcinoma (OTSCC) have been proposed over the years. Methods: We report a case of OTSCC treated surgically and reconstructed with Bozola flap, analyzing the advantages and disadvantages of this surgical technique. The defect was classified according to the glossectomy classification proposed by Ansarin. Results: We believe that the Bozola buccinator myomucosal flap is a viable alternative to free flaps for the reconstruction of certain oral tongue defects. Conclusions: Based on our experience, the Bozola flap is an appropriate primary option for T1–T2 and certain T3 OTSCC defects (excluding the tip) for I–II and IIIa glossectomies, as recorded in the Ansarin classification. Full article

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

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14 pages, 1819 KiB

Open AccessArticle

Ultraviolet B Exposure Does Not Influence the Expression of YAP mRNA in Human Epidermal Keratinocytes—Preliminary Study

by Igor Aleksander Bednarski, Izabela Dróżdż, Magdalena Ciążyńska, Karolina Wódz, Joanna Narbutt and Aleksandra Lesiak

Biomedicines 2025, 13(3), 596; https://doi.org/10.3390/biomedicines13030596 - 1 Mar 2025

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Abstract

Background: The causal relationship between exposure to ultraviolet radiation and the development of skin cancers requires constant research for possible orchestrating mechanisms. In recent years, the Hippo pathway, along with its effector protein YAP, became implicated in cutaneous carcinogenesis; however, Hippo pathway regulation [...] Read more.

Background: The causal relationship between exposure to ultraviolet radiation and the development of skin cancers requires constant research for possible orchestrating mechanisms. In recent years, the Hippo pathway, along with its effector protein YAP, became implicated in cutaneous carcinogenesis; however, Hippo pathway regulation by ultraviolet radiation has not been described thoroughly. In order to address this issue, we focused on how different doses of ultraviolet B affect Hippo signaling pathway components and its upstream regulators, JNK1/2 and ABL1, in human keratinocytes. Additionally, we decided to determine how silencing of YAP influences Hippo pathway component expression. Methods: Primary epidermal keratinocytes were irradiated using UVB lamps with increasing doses of ultraviolet B radiation (including 311 nm UVB). Real-time PCR was used to determine the mRNA levels of each investigated gene. The experiment was then performed after YAP silencing using siRNA transfection. Additionally, we determined the mRNA expression of Hippo pathway components in an A431 cSCC cell line. Results: We observed that YAP mRNA expression in the A431 cell line was insignificant in comparison to control, while in the case of LATS1/2, a significant increase was noted. UVB irradiation did not change the levels of YAP mRNA expression in human epidermal keratinocytes. LATS1, LATS2, ABL1 and MAP4K4 mRNA expression was significantly upregulated after UVB irradiation in non-YAP-silenced keratinocytes in a dose-dependent manner, while after YAP silencing, only LATS2 and ABL1 showed significant mRNA upregulation. The 311 nm UVB irradiation resulted in significant, dose-dependent mRNA upregulation in non-YAP-silenced keratinocytes for LATS1, ABL1 and MAP4K4. After YAP silencing, a significant change in mRNA expression was present only in the case of ABL1. Conclusions: YAP mRNA expression does not significantly increase after exposure to UVB; however, it upregulates the expression of its proven (LATS1/2, JNK1/2) regulators, suggesting that in real-life settings, UV-induced dysregulation of the Hippo pathway may not be limited to YAP. Full article

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

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22 pages, 4928 KiB

Open AccessArticle

Honey, Gellan Gum, and Hyaluronic Acid as Therapeutic Approaches for Skin Regeneration

by Patrícia Sousa, Alicia Moreira, Bruna Lopes, Ana Catarina Sousa, André Coelho, Alexandra Rêma, Maria Balça, Luís Atayde, Carla Mendonça, Lucília P. da Silva, Cristiana Costa, Alexandra P. Marques, Irina Amorim, Rui Alvites, Filipa Batista, Filipa Mata, João Transmontano and Ana Colette Maurício

Biomedicines 2025, 13(2), 508; https://doi.org/10.3390/biomedicines13020508 - 18 Feb 2025

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Abstract

Background/Objectives: Chronic wounds pose a significant health concern, with their prevalence increasing due to various etiologies. The global aging population further contributes to this rise, placing a substantial burden on healthcare systems in developed countries. This work aimed to develop new therapeutic [...] Read more.

Background/Objectives: Chronic wounds pose a significant health concern, with their prevalence increasing due to various etiologies. The global aging population further contributes to this rise, placing a substantial burden on healthcare systems in developed countries. This work aimed to develop new therapeutic options in the form of creams and dressings based on honey, gellan gum, and hyaluronic acid for preventing and treating chronic wounds across all stages. Methods: To address this, after the formulations were developed, in vitro cytocompatibility was determined. To confirm biocompatibility, an ovine wound model was used: full-thickness excisional wounds were treated with three formulations, namely gellan gum and honey sponges (GG-HNY), gellan gum, honey and hyaluronic acid sponges (GG-HA-HNY) and a honey-based cream (cream FB002). Daily assessments, including visual evaluation and wound scoring, were conducted for 30 days. Following the study period, tissues were collected for histological analyses. Results: The macroscopic examination revealed that all therapeutic groups facilitated lesion closure. Lesion size reduction, granulation tissue disappearance, and scar tissue development were consistent across all groups, with the group receiving cream demonstrating an advanced stage of healing. All groups achieved substantial wound closure by day 30, with no significant differences. Histopathological analysis following ISO standards revealed that GG-HA-HNY had the lowest ISO score, indicating minimal reactivity and inflammation, which corroborated the cytocompatibility. Conclusions: Combining these insights with previous findings enhances our understanding of wound regeneration dynamics and contributes to refining therapeutic strategies for chronic wounds. The formulations were designed to balance therapeutic efficacy with cost-effectiveness, leveraging low-cost raw materials and straightforward production methods. Full article

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

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10 pages, 2684 KiB

Open AccessSystematic Review

Efficacy of Larval Therapy for Wounds: A Systematic Review and Meta-Analysis

by Thao Lam, Gabriela E. Beraja and Hadar Lev-Tov

J. Clin. Med. 2025, 14(2), 315; https://doi.org/10.3390/jcm14020315 - 7 Jan 2025

Viewed by 1023

Abstract

Background/Objective: Larval therapy (LT), an intervention using live fly larvae to remove necrotic tissue and promote healing, has regained attention in order to address the growing need for chronic wound management. LT was approved by the Food and Drug Administration (FDA) in [...] Read more.

Background/Objective: Larval therapy (LT), an intervention using live fly larvae to remove necrotic tissue and promote healing, has regained attention in order to address the growing need for chronic wound management. LT was approved by the Food and Drug Administration (FDA) in 2004 to treat difficult-to-heal wounds; however, LT remains an underutilized therapy. To evaluate efficacy of LT in a systematic review and meta-analysis of wound outcomes from randomized controlled trials (RCTs). Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to conduct a literature search across five databases for published and unpublished RCTs comparing LT to conventional therapy. A meta-analysis was performed to evaluate LT’s effect on debridement as the primary outcome. Wound healing, bioburden, and treatment-related pain were analyzed as secondary outcomes. Bias was assessed using Cochrane’s Risk-of-Bias 2 tool. Results: Eight RCTs were included in the review. The meta-analysis suggested that LT may be more effective for complete wound debridement (RR = 2.17), though this result was not significant (p = 0.09). The analysis is limited by the small number of studies and the high heterogeneity between studies (I² = 75%). There were no significant differences in the healing rate, antimicrobial effects, or pain compared to conventional therapy. There is a moderate risk for bias in the selection of reported outcomes. Conclusions: LT is as effective as conventional therapy for debridement and may be an alternative for patients who cannot tolerate traditional methods. LT patients may experience similar levels of pain, but LT does not worsen wound healing or infection compared to those receiving routine care. Full article

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

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15 pages, 1865 KiB

Open AccessArticle

Assessing the Influence of Hyaluronan Dressing on Wound Healing on Split-Thickness Skin Graft Donor Sites Using a Three-Dimensional Scanner

by Anna Bock, Florian Peters, Marius Heitzer, Philipp Winnand, Kristian Kniha, Marie Sophie Katz, Frank Hölzle and Ali Modabber

J. Clin. Med. 2024, 13(21), 6433; https://doi.org/10.3390/jcm13216433 - 27 Oct 2024

Viewed by 1047

Abstract

Objectives: The topical application of hyaluronic acid after injury may accelerate the wound healing process. We aimed to retrospectively investigate whether the topical application of hyaluronic acid on standardized wounds after split-thickness skin graft removal on the thigh would accelerate wound healing and [...] Read more.

Objectives: The topical application of hyaluronic acid after injury may accelerate the wound healing process. We aimed to retrospectively investigate whether the topical application of hyaluronic acid on standardized wounds after split-thickness skin graft removal on the thigh would accelerate wound healing and improve scarring outcomes. Additionally, we aimed to evaluate the usefulness of three-dimensional (3D) scanning to assess scars. Methods: The wound healing process of a hyaluronan group (n = 20) and a control (n = 21) were analyzed and evaluated using 3D scans at 7 and 14 days and 1, 3, and 6 months post-operatively. Scar evaluations by the patients were conducted 6 months post-operatively using the patient and observer scar assessment scale and the Manchester scar scale. Experts evaluated the scars after 6 months using a modified version of both scales. Results: On days 7 and 14, significantly larger areas of the wound surface were closed in the hyaluronan group compared to the control group (p < 0.05). After 1 month, significantly more crusted areas remained in the control group than in the hyaluronan group (p < 0.05). At the 6-month self-assessments, the hyaluronan group evaluated their scars as being significantly better compared to the control group. Conclusions: The topical application of hyaluronic acid in combination with polyurethane foam as a wound dressing after split skin removal accelerated the wound healing rate and positively influenced scar appearance after 6 months. Three-dimensional scanning is useful for evaluating and documenting the wound healing process. Full article

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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 1673

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

Cited by 1 | Viewed by 1637

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 2501

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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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 2436

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

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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

Cited by 5 | Viewed by 2120

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

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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 4 | Viewed by 2871

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

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