Abstract: A novel recombinant protein (rSVEP), originally discovered in insect saliva and known to increase blood flow, was tested with the hypothesis it would improve healing of surgically created wounds in the skin of beagle dogs. This hypothesis was tested in an experimental protocol that included: 1) use of laser Doppler perfusion imaging (LDPI) to determine dose-response and duration of blood flow increase to rSVEP injected intradermally; 2) creation of sutured and open wounds in skin of six dogs and treatment of “matched pair” wounds in each dog with rSVEP or physiologically buffered saline (PBS-Control) injected intradermally or subcutaneously; 3) objective determination of effects of treatment. Objective parameters that yielded significant data were: a) measurement of breaking strength of sutured wounds using tensiometry and b) rate of open wound healing calculated by sequential digitization of open wound area. Blood flow increased eight fold and lasted up to 72 hours in respon

Abstract: The authors describe three years of clinical experience in chronic wound management. The authors treated 315 patients (age 65–75 years) with chronic recurrent leg ulcers by allograft of cryopreserved dermis. Patients were divided into two groups (A and B) on the basis of patient preference and underwent two different reepithelization techniques. Patients in group A received autologous thin mesh grafts. Patients in group B received cultured autologous epidermal grafts. Proportions were compared by univariate analysis (c2 test with the Yates correction; EpiInfo version 5). P values <0.05 were considered significant. The cultured autologous epidermal graft (group B) was significantly more effective at one-month follow up (p=0.023, odd ratio=1.85), but no differences were seen at 6 and 12 months. Dermal allografts were obtained from Siena skin bank (Tuscan Region Tissue Bank). Autologous keratinocytes were obtained by skin biopsy from the buttocks of patients. Patients were tre

Abstract: Leg ulceration typically is a chronic recurring condition with costs both to patients and to society. The first line of treatment is to correct the underlying etiology of the ulcer. This is not always possible, and for these hard-to-heal ulcers there are new treatment options, such as growth factors and biological skin substitutes. The objective of this study was to assess the effectiveness of a tissue-engineered human fibroblast-derived dermal substitute (HDS) (Dermagraft®, Smith & Nephew Inc., Largo, Florida) in the treatment of leg ulcers of varying etiologies. The data presented in this case series represent the results from the treatment of 114 patients with 151 chronic leg ulcers treated with HDS. This study showed that HDS was effective, well tolerated, and can be used in the treatment of hard-to-heal chronic ulcers of various origins. The overall reduction in size of all the ulcers was 63 percent. Especially good results were obtained in patients with rheumatic ulcers

Abstract: The authors reviewed 22 patients who received living skin equivalent (LSE) (Apligraf®, Organogenesis, Inc., Canton, Massachusetts) over 20 months in whom conventional therapy had failed. Ten patients had chronic venous insufficiency, and six patients had ulcers caused by venous stasis, diabetes mellitus, and arterial insufficiency. The remaining ulcers were attributed to connective tissue disease, trauma, radiation, cryoglobulinemia, and necrobiotic xanthogranuloma. Eight patients were diabetic. The mean duration of ulceration before LSE placement was 15 months. The mean ulcer size was 48mm. Patients were followed up weekly for eight weeks and then monthly for at least 22 months. Fourteen patients healed completely; treatment failed in eight.