The Epidermis in Wound Healing (Dermatology: Clinical & Basic Science)

Front cover......Page 1
Preface......Page 9
Editors......Page 11
Contributors......Page 13
Table of Contents......Page 17
Cellular and Biochemical Issues......Page 21
1.1 Introduction......Page 23
1.2 Morphologic Aspects of the Response of Wounded Skin Equivalents......Page 24
1.3 Proliferative Response to Skin-Equivalent Wounding......Page 25
1.4 Keratinocyte Migration in Response to Wounding of Skin Equivalents......Page 30
1.5 Growth Factor Responsiveness and Synthesis in Wounded Skin Equivalents......Page 31
1.6 Protease Activation in Wounded Skin Equivalents......Page 32
1.7 Patterns of Keratinocyte Differentiation in Wounded Skin Equivalents......Page 33
1.8 Summary......Page 34
1.9 Fabrication of Skin-Equivalent Wound Healing Model......Page 35
References......Page 42
Epidermal Repair and the Chronic Wound......Page 45
2.1 Introduction: Important Differences between Acute and Chronic Wounds......Page 46
2.2 Keratinocyte Function and Wound Healing......Page 49
2.4 Growth Factors/Cytokines as Regulators of Wound Healing......Page 51
2.4.2 Tumor Necrosis Factor a (TNFa)......Page 52
2.4.5 Epidermal Growth Factor (EGF/TGFa)......Page 53
2.4.7 Transforming Growth Factor b (TGFb)......Page 54
2.4.9 Growth Factors/Cytokines as Therapeutic Agents for Chronic Wounds......Page 55
2.5 Keratinocyte Adhesion and Reepithelialization......Page 56
2.6 Keratinocyte Behavior in Chronic Wounds......Page 57
2.7.2 Serine Proteinases......Page 58
2.7.4 Neutrophil Elastase......Page 60
2.7.5 Matrix Metalloproteinases (MMPs)......Page 61
2.8 Summary......Page 62
References......Page 64
The Biochemistry of Epidermal Healing......Page 79
3.1 Injury and the Onset of Biochemical Signaling......Page 80
3.1.1 Migration......Page 81
3.1.2 Mitosis......Page 83
3.1.4 Signal Transduction and Transcription Factors in Reepithelialization......Page 84
3.2.1 Epidermal-Dermal Communication......Page 86
3.2.2.2 Fibroblast Growth Factors, a Family of Epidermal Modulators......Page 87
3.2.2.3 Transforming Growth Factor Beta, a Master Growth Factor......Page 88
3.2.2.6 Nitric Oxide Expression in Wound Healing......Page 89
3.2.2.7 Temporal Sequence of Growth Factor Release......Page 90
3.2.2.8 Extracellular Matrix in Regulation of Epidermal Healing......Page 91
3.2.2.9 Matrix Metalloproteinases and Other Proteases......Page 92
3.2.3 Communication with Other Systems......Page 93
3.2.3.3 Innervation......Page 94
3.3 Keloid Keratinocytes (Do They Send Different Signals?)......Page 95
3.4 Fetal Wound Healing......Page 96
Abbreviations......Page 98
References......Page 99
Local Environment and Healing......Page 107
Perspective......Page 109
4.1 Historic Origins of Moist Wound Healing......Page 110
4.2 The Dawning Science of Moist Wound Healing......Page 111
4.3.1 Occlusion Babel......Page 112
4.3.2 Myths about Moist Wound Healing......Page 113
4.3.4 Improper Dressing Use......Page 114
References......Page 118
5.1 Introduction......Page 123
5.2 Effects of Occlusive and Semipermeable Membranes on Wound Healing......Page 124
5.3 Conclusions......Page 125
References......Page 127
Quantifying Repair in the Epidermis......Page 131
6.1 Introduction......Page 133
6.2 Occlusive Dressings......Page 135
6.3 Growth Factors......Page 137
6.4 Wound Infection, Biofilms, and Antimicrobials......Page 138
6.5 Summary......Page 140
References......Page 141
7.1 Introduction......Page 145
7.2 Video Image Analysis......Page 146
7.3 Shape Characterization......Page 147
7.5 High-Frequency Ultrasound......Page 148
7.6 Laser Doppler Systems......Page 150
7.7 Transcutaneous Oximetry......Page 152
7.8 pH Measurement......Page 153
7.9 Infrared Thermal Imaging Systems......Page 155
References......Page 157
8.2.1 Tape Stripping......Page 161
8.2.2 Lipid Solvent......Page 163
8.2.4 Allergic Contact Dermatitis......Page 164
8.2.5 Blisters......Page 165
8.3 Conclusions......Page 166
References......Page 170
Physical and Chemical Factors Affecting Repair......Page 173
9.1 Introduction......Page 175
9.2 Biofilms and Planktonic Bacteria......Page 176
9.3 The Importance of Bacteria within Wounds......Page 177
9.4 Microbiology of Wounds......Page 178
9.5 Sampling Techniques......Page 179
9.7 Management of Bacteria in Wounds......Page 181
9.7.1 Antiseptics......Page 182
9.7.2.1 Effects of Iodine Compounds on the Bacterial Load of Wounds......Page 183
9.7.2.2 Effects of Iodine Compounds on the Wound Healing Process......Page 184
9.7.2.3 Iodine Compounds: Summary......Page 185
9.7.3 Silver Compounds......Page 191
9.8 Conclusion......Page 194
References......Page 195
Summary......Page 203
10.1 Introduction and History......Page 204
10.2 Oxygen in Normal and Injured Skin and Subcutaneous Tissue......Page 205
10.3.1 Immunity to Infection......Page 207
10.3.2 Collagen Synthesis......Page 208
10.3.4 Epithelization......Page 210
10.4 Controlling Oxygen in Normal and Wounded Tissue......Page 211
10.5 Clinical Strategies for Overcoming the Obstacles......Page 212
10.6 Other Chronic Wounds......Page 214
10.7 Conclusions......Page 215
References......Page 216
11.1 Introduction......Page 219
11.3 General Nutritional Support......Page 222
11.4 Specific Nutrient Needs......Page 223
11.4.2 Carbohydrates and Lactate......Page 224
11.4.5 Vitamin A......Page 225
11.4.6 Vitamin E......Page 226
11.4.7.3 Iron......Page 227
11.5.3 Anabolic Steroid (Oxandrolone)......Page 228
References......Page 229
12.1 Introduction......Page 235
12.2 Management of Necrotic and Dry Sloughy Wounds......Page 236
12.3 Management of Moist or Exuding Wounds......Page 239
12.4 Management of Epithelializing Wounds......Page 244
12.5 Management of Infected Wounds......Page 248
12.6 Management of Malodorous Wounds......Page 250
12.7 Conclusions......Page 251
References......Page 252
New Approaches to Understanding and Treating Wounds......Page 263
13.2 Gene Transfer Strategies......Page 265
13.3 Genes with Wound-Healing Effects......Page 269
Acknowledgment......Page 271
References......Page 272
14.1.1 Acute vs. Chronic......Page 275
14.2 Introduction......Page 276
14.3 Control of Bacterial Burden......Page 277
14.5 Control of Exudate......Page 279
14.6 Managing the Biological Microenvironment......Page 281
References......Page 283
15.1 Introduction......Page 285
15.2 Growth Factors and Wound Healing......Page 286
15.2.2 Epidermal Growth Factor......Page 288
15.2.5 Transforming Growth Factor......Page 289
15.2.7 Platelet-Derived Growth Factor......Page 290
15.4 Strategies of Gene Delivery......Page 291
15.4.1 Viral Gene Transfer Strategies......Page 292
15.4.2 Nonviral Gene Transfer Strategies......Page 294
15.5 Gene Transfer of Growth Factors to Full Thickness Wounds in a Porcine Experimental Model......Page 296
15.6 Regulation of the Gene Product......Page 297
15.7 Future Applications and Pitfalls......Page 298
References......Page 299
16.1 Introduction......Page 305
16.2 Skin Flaps and Skin Expansion......Page 306
16.3 Skin Grafts......Page 307
16.3.2 Split-Thickness Skin Grafts......Page 310
16.3.3 Pinch Grafts......Page 311
16.3.4 Minced Skin Grafts......Page 312
16.4.1 Keratinocytes......Page 314
16.4.2 Fibroblasts......Page 317
16.4.3 Melanocytes......Page 320
16.5 Gene Therapy and Skin Transplantation......Page 321
References......Page 323
17.1 Introduction......Page 333
17.2.2 Retinoid Receptors......Page 335
17.2.3 Effects and Mechanism of Action......Page 336
17.3.1 Acne......Page 337
17.3.2 Actinic Keratosis and Skin Cancers......Page 339
17.3.3 Reversal of Photoaging......Page 340
17.3.4 Epidermal Wound Healing......Page 342
17.4 New Uses of Retinoids......Page 344
References......Page 345
18.1 Introduction......Page 351
18.2 Superficial Intervention......Page 352
18.3 Nonablative Laser Intervention......Page 354
18.4 Photothermal Laser Ablation......Page 359
References......Page 367
Active Treatments for Acute and Chronic Wounds......Page 371
19.2.1 Background......Page 372
19.2.2.1 Combined Epidermal and Dermal Layers......Page 373
19.2.2.3 Dermal Layer......Page 375
19.2.3.1 AlloDerm® - Allogeneic Acellular Dermal Matrix......Page 376
19.2.3.3 TranscyteTM Extracellular Matrix of Allogeneic Human Dermal Fibroblasts......Page 377
19.3.2.1 Platelet-Derived Growth Factor......Page 378
19.3.3.1 Fibroblast Growth Factor......Page 380
19.3.3.2 Granulocyte-Macrophage Colony-Stimulating Factor......Page 381
19.3.3.3 Epidermal Growth Factor......Page 382
19.3.4.1 Transforming Growth Factor b......Page 383
19.3.5 Novel Approaches for the Delivery of Growth Factors......Page 384
19.4 Conclusion......Page 386
References......Page 387
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