(WHS-P4.05) THE USE OF THERAPEUTICS PEPTIDES WITH FULL-THICKNESS SKIN COLUMNS TO IMPROVE HEALING OF EXCISIONAL WOUNDS
Friday, May 17, 2024
10:30 AM – 11:30 AM East Coast USA Time
Introduction: In split thickness skin grafting (STSG) a very thin layer of skin containing the epidermis and a small portion of the dermis is grafted. This is done to create a quick coverage on the receiving site but also to minimize donor site morbidity. One of the drawbacks is the absence of adnexal structures and thus the grafted wounds lack basic skin functions such as durability, thermoregulation, maintenance of hydration and lubrication. An alternative technique to solve this problem is fractional autologous skin grafting using full-thickness skin columns (FTSC). Harvesting occurs orthogonally by taking numerous individual skin columns containing the epidermis down through the dermis including the skin appendages. Bioactive peptides have been shown to rescue hair follicular unit survivals. The purpose of this study is to investigate whether transplantation of FTSCs in combination with bioactive peptides would better reconstitute skin function due to the positive effect of the peptides on adnexal structures within FTSCs. Materials and
Methods: Up to 16 standardized full-thickness excisional wounds were created on the dorsum of two anesthetized pigs. Analgesia was provided prior to all surgical procedures and the animals were monitored for pain twice every 24 hours for the first 72 hours. FTSC biopsies were harvested from donor sites located on the cranial-dorsum at a ratio of up to sixteen 1.5 mm-diameter skin columns/1cm2. The wounds were randomized to receive either FTSC + bioactive peptide hydrogel (carboxymethyl cellulose), FTSC + scrambled peptide hydrogel, FTSC only or left untreated. Healing was monitored for up to 28 days. The wounds were excised and fixed in formalin for histologic analyses. In addition, non-invasive imaging systems were utilized to assess both wound healing and quality of healing.
Results: By day 14, the FTSC + bioactive peptide, FTSC + scrambled peptide, FTSC only and untreated wounds were 71 %, 55 %, 88 % and 27 % re-epithelialized respectively. The FTSC + bioactive peptide and the FTSC only treated wounds were significantly more re-epithelialized than the untreated wounds (p < 0.05). By day 28 all the FTSC transplanted wounds were fully re-epithelialized and the difference to the untreated wounds was statistically significant (p < 0.05). The results demonstrated that wound treated with the FTSC + bioactive peptide had more mature epidermis at day 28 post transplantation. The FTSC + bioactive peptide treated wounds had significantly more rete ridges and more mature epidermis in comparison to the other groups. In terms of wound contraction, no significant differences were observed.
Conclusions: FTSC can be transplanted in a hydrogel to close a full-thickness wound. Furthermore, it was shown that transplantation of FTSC in combination with bioactive peptides increased quality of wound healing.