Two Cases of Traumatic Wounds in Patients with Ehlers-Danlos Syndrome Successfully Treated with a Bioengineered Skin Equivalent
Abstract: The authors present two cases in which traumatic wounds in patients with Ehlers-Danlos syndrome (EDS) were successfully treated with a bioengineered skin equivalent (BSE) (Apligraf®, Organogenesis, Canton, Massachusetts). Due to defects in collagen metabolism, it has been reported that patients with EDS have poor wound healing and unsightly scarring. Considering this, it is important to look into alternate ways to improve the healing process while avoiding donor site morbidity. The authors have demonstrated, in these two cases, the successful use of BSE as an option for use in the healing of wounds in patients with this syndrome.
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The Use of a Biologic Tissue Matrix (Integra? Bilayer Matrix Wound Dressing) in the Treatment of Recessive Dystrophic Epidermolysis Bullosa Pseudosyndactyly Deformity
Pseudosyndactyly, a mitten deformity of the hand, is a serious problem that can arise in children with recessive dystrophic epidermolysis bullosa (EB). The authors present 2 cases of patients who developed significant contractures of their hands with limited functional use secondary to pseudosyndactyly. At the time of both initial operations, digit separation and contracture releases were performed, which resulted in large areas of denuded skin on the palmar and volar aspect of the fingers and hand. A biologic tissue matrix (Integra? Bilayer Matrix Wound Dressing, Integra Lifesciences Corp., Plainsboro, NJ) was used initially to cover the wounds. Subsequently, a bioengineered skin equivalent (Apligraf?, Organogenesis Inc., Canton, Mass) was used for epidermal coverage. The biologic tissue matrix was selected because of its excellent tensile strength, flexible adherent covering, and success with decreasing the incidence of postoperative wound contracture, which the authors believed was necessary for the hands to heal successfully. Skin grafting was not an option in either case because the patients did not have any suitable harvest sites secondary to the generalized blistering as a result of the epidermolysis bullosa. The bioengineered skin equivalent was used to promote reepithelization of the neodermis created by the biologic tissue matrix by delivering multiple growth factors and cytokines.
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Editorial Message
Editorial Message Editor's Message: Editorial Message - David T. Rovee, PhD November, 2006Dear Readers, The use of silver nitrate and silver sulfadiazine (SSD) has been common in burns for many years. Yilmaz et al (Effect of low-energy gallium arsenide [GaAs, 904 nm] laser irradiation on wound healing in rat skin) report on the effects of laser irradiation on the healing of circular excisions in animals. &...
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Cutaneous Manifestations of Diabetes
Abstract: Diabetes mellitus is a chronic disease of metabolic dysregulation involving the abnormal metabolism of glucose. Diabetes has a significant impact on the healthcare costs of the Western world. Nearly all patients with diabetes eventually develop cutaneous manifestations of the disease. Cutaneous signs of the disease can heighten the suspicions of a physician regarding the diagnosis of diabetes. This article will focus on the clinical features, pathogenesis, and treatment modalities of the various dermatologic manifestations of the disease ranging from the more benign granuloma annulare to the more sinister diabetic ulcer.
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June 2003 Editor's Message
June 2003 Editor's Message Editor's Message: June 2003 Editor's Message - David Rovee, PhD Editor, WOUNDS Dear Readers: I welcome the addition of our new department editor, Dr. Sarah Cockbill, who heads the department on veterinary wounds. While wounds on the general body skin heal uneventfully, wounds on the lower limb of the horse often are complicated by exuberant granulation tissue (termed proud flesh), either failure to heal or slow healing, and little contraction. , (Apoptosis in skin...
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