107 research outputs found
The Scarless Latissimus Dorsi Flap Provides Effective Lower Pole Prosthetic Coverage in Breast Reconstruction
No full textBackground: The evolution of surgical breast cancer treatment has led to the oncologically safe preservation of greater amounts of native skin, yet we are still often using flaps with large skin paddles, thereby resulting in significant donor-site scars. This explains the increasing appeal of acellular dermal matrix reconstructions. Acellular dermal matrices can, however, have significant problems, particularly if there is any vascular compromise of the mastectomy skin flaps. We have developed a method of raising the latissimus dorsi flap through the anterior mastectomy incisions without requiring special instruments or repositioning. This can provide autologous vascularized cover of the prosthesis.
Methods: A clear surgical description of the scarless latissimus dorsi flap harvest is provided, and our results of a retrospective cohort review of 20 consecutive patients with 27 traditional latissimus dorsi breast reconstructions were compared with those of 20 consecutive patients with 30 scarless latissimus dorsi breast reconstructions.
Results: Operative time, length of stay, and complication rates were reduced in the scarless group. Patients Breast-Q scores were equivalent in each group. The aesthetic assessment was good/excellent in 77% of both groups; however, subscale assessment was better in the scarless group. This was statistically significant (P = 0.0).
Conclusions: Breast reconstruction using the scarless latissimus dorsi flap is time effective, requires no patient repositioning, and uses standard breast instrumentation. It is safe and versatile while reducing the risk of exposed prosthesis if native skin necrosis occurs. It is a vascularized alternative to acellular dermal matrices
"Scarless" Umbilicoplasty A New Umbilicoplasty Technique and a Review of the English Language Literature
No full textMany techniques have been described for umbilicoplasty after abdominoplasty, but none of these techniques seems ideal. In this report, we wish to report a new "scarless" umbilicoplasty technique, which bears many of the characteristics of an ideal technique: it is easy to perform and results in the complete absence of visible scars and with a preferred vertical orientation. The aesthetic results of this technique are subjectively and objectively evaluated as compared with the classic umbilicoplasty and these results are discussed among the English language literature. In the period of 2004 to 2005, a series of 138 female patients have had an abdominoplasty with either the classic umbilicoplasty (n = 31) or with our scarless umbilicoplasty (n = 107). After a follow-up period of at least 3 (of 6) months, a questionnaire was send to all of these patients to evaluate patient satisfaction. Twenty-five patients from the classic umbilicoplasty group responded, 53 patients from the scarless umbilicoplasty group. Age (mean 45 with range, 22-66 years) and body mass index (29 with range, 22-35) did not differ among both groups. Also a random selection of fifteen photos from both groups was analyzed and rated according to the system of Strasser by an independent panel. There were no major complications in both groups, but in the classic group, there were some cases with hypertrophic scarring. Patients who underwent the scarless umbilicoplasty technique graded the appearance of their umbilicus significantly better on shape, depth, hygiene, and scar. No significant differences were found in grading size and wound healing. Objective evaluation of the photos demonstrated significant better results for the scarless umbilicoplasty technique. Based on our subjective and objective analysis we conclude that our new technique of the scarless umbilicoplasty features many of the characteristics of the ideal umbilicoplasty: a rather simple and reliable method for creating a natural looking umbilicus when performing an abdominoplasty
Collagen in the scarless fetal skin wound: Detection with Picrosirius-polarization
No full textOur group has developed an ovine model of deep dermal, partial-thickness burn where the fetus heals scarlessly and the lamb heals with scar. The comparison of collagen structure between these two different mechanisms of healing may elucidate the process of scarless wound healing. Picrosirius staining followed by polarized light microscopy was used to visualize collagen fibers, with digital capture and analysis. Collagen deposition increased with fetal age and the fibers became thicker, changing from green (type III collagen) to yellow/red (type I collagen). The ratio of type III collagen to type I was high in the fetus (166), whereas the lamb had a much lower ratio (0.2). After burn, the ratios of type III to type I collagen did not differ from those in control skin for either fetus or lamb. The fetal tissue maintained normal tissue architecture after burn while the lamb tissue showed irregular collagen organization. In conclusion, the type or amount of collagen does not alter significantly after injury. Tissue architecture differed between fetal and lamb tissue, suggesting that scar development is related to collagen cross-linking or arrangement. This study indicates that healing in the scarless fetal wound is representative of the normal fetal growth pattern, rather than a response to burn injury
臍帯血および臍帯組織由来間葉系幹細胞のscarless wound healingに対する効果
No full textPostnatally, scars occur as a consequence of cutaneous wound healing. Scarless wound healing is highly desired for patients who have undergone surgery or trauma, especially to exposed areas. Based on the properties of mesenchymal stem cells (MSCs) for tissue repair and immunomodulation, we investigated the potential of MSCs for scarless wound healing. MSCs were expanded from umbilical cord blood (UCB-MSCs) and Wharton's jelly (WJ-MSCs) from healthy donors who underwent elective full-term pregnancy caesarean sections. UCB-MSCs expressed lower levels of the pre-inflammatory cytokines IL1A and IL1B, but higher levels of the extracellular matrix (ECM)-degradation enzymes MMP1 and PLAU compared with WJ-MSCs, suggesting that UCB-MSCs were more likely to favor scarless wound healing. However, we failed to find significant benefits for stem cell therapy in improving wound healing and reducing collagen deposition following the direct injection of 1.0 × 10 5 UCB-MSCs and WJ-MSCs into 5 mm full-thickness skin defect sites in nude mice. Interestingly, the implantation of UCB-MSCs tended to increase the expression of MMP2 and PLAU, two proteases involved in degradation of the extracellular matrix in the wound tissues. Based on our data, UCB-MSCs are more likely to be a favorable potential stem cell source for scarless wound healing, although a better experimental model is required for confirmation.長崎大学学位論文 学位記番号:博(医歯薬)甲第864号 学位授与年月日:平成28年3月18日Author: Hanako Doi, Yuriko Kitajima, Lan Luo, Chan Yan, Seiko Tateishi, Yusuke Ono, Yoshishige Urata, Shinji Goto, Ryoichi Mori, Hideaki Masuzaki, Isao Shimokawa, Akiyoshi Hirano, Tao-Sheng LiCitation: Scientific Reports, 6, 18844; 201
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Identification of differentially expressed proteins involved in fetal scarless wound healing using a rat model of cleft lip
No full textIn early pregnancy, fetal skin wounds can heal quickly and undergo a transition period from scarless healing to scar formation. The aim of the present study was to identify potential biomarkers associated with scarless repair of cleft lips, in order to determine the intrinsic factors leading to scar formation in embryonic tissue. A stable model of cleft lip was established using microsurgery by constructing a wedge‑shaped cleft lip‑like defect in fetal rats at gestational age (GA) 16.5 and GA18.5. The GA16.5 and GA18.5 groups were used to model scarless healing and scar formation, respectively. The fetuses were returned to the uterus following surgery, then removed 72 h after the procedure. Macroscopic observation of the cleft defect and histological examination were carried out. Reverse transcription‑quantitative (RT‑q) PCR and parallel reaction monitoring (PRM) were used to detect mRNA and protein expression levels, respectively. The upper‑left lip completely healed 72 h after surgery in the GA16.5 group of fetal rats. However, this was not the case in the GA18.5 group. Histological examination indicated new follicles visible under the epidermis of the scarless group (GA16.5). Scarring was visible on the upper‑left cleft lip wound of the fetal rats in the GA18.5 group. The expression of some growth and pro‑inflammatory factors, including TNF‑α, were also different between two groups. Label‑free quantification was used to identified differentially expressed proteins and five differentially expressed proteins (Smad4, Fabp5, S100a4, S100a8 and S100a9) were identified. The relative expression of these molecules at the mRNA and protein levels were measured using RT‑qPCR and PRM. These molecules may represent potential biomarkers for the scarless repair of fetal rat cleft lip wounds
Start-Stop Assembly: a functionally scarless DNA assembly system optimized for metabolic engineering
No full text© The Author(s) 2018. Published by Oxford University Press on behalf of Nucleic Acids Research. DNA assembly allows individual DNA constructs or libraries to be assembled quickly and reliably. Most methods are either: (i) Modular, easily scalable and suitable for combinatorial assembly, but leave undesirable 'scar' sequences; or (ii) bespoke (non-modular), scarless but less suitable for construction of combinatorial libraries. Both have limitations for metabolic engineering. To overcome this trade-off we devised Start-Stop Assembly, a multi-part, modular DNA assembly method which is both functionally scarless and suitable for combinatorial assembly. Crucially, 3 bp overhangs corresponding to start and stop codons are used to assemble coding sequences into expression units, avoiding scars at sensitive coding sequence boundaries. Building on this concept, a complete DNA assembly framework was designed and implemented, allowing assembly of up to 15 genes from up to 60 parts (or mixtures); monocistronic, operon-based or hybrid configurations; and a new streamlined assembly hierarchy minimizing the number of vectors. Only one destination vector is required per organism, reflecting our optimization of the system for metabolic engineering in diverse organisms. Metabolic engineering using Start-Stop Assembly was demonstrated by combinatorial assembly of carotenoid pathways in Escherichia coli resulting in a wide range of carotenoid production and colony size phenotypes indicating the intended exploration of design space
Fetuin-A: A Major Fetal Serum Protein that Promotes "Wound Closure" and Scarless Healing (Letter to the editor)
No full textBurn-wound healing is a dynamic, interactive process involving a number of cellular and molecular events and is characterized by inflammation, granulation tissue formation, re-epithelialization, and tissue remodeling (Greenhalgh, 2002; Linares, 2002). Unlike incisional-wound healing, it also requires extensive re-epithelialization due to a predominant horizontal loss of tissue and often heals with abnormal scarring when burns involve deep dermis. The early mammalian fetus has the remarkable ability to regenerate normal epidermis and dermis and to heal dermal incisional wounds with no signs of scarring. Extensive research has indicated that scarless healing appears to be intrinsic to fetal skin (McCallion and Ferguson, 1996; Ferguson and O'Kane, 2004). Previously, we reported a fetal burn model, in which 80-day-old ovine fetuses (gestation=145–153 days) healed deep dermal partial thickness burns without scars, whereas postnatal lambs healed equal depth burns with significant scarring (Cuttle et al., 2005; Fraser et al., 2005). This burn model provided early evidence that fetal skin has the capacity to repair and restore dermal horizontal loss, not just vertical injuries
Small intestine submucosa and mesenchymal stem cells composite gel for scarless vocal fold regeneration.
No full textThe purpose of this study is to demonstrate scarless vocal fold (VF) regeneration
by using a composite gel composed of small intestine submucosa (SIS) and
mesenchymal stem cells (MSCs). A scar was made with an electrocoagulator on both
VFs in 24 rabbits, followed by injection of either MSCs, SIS, or MSCs-SIS
composite gel in the right side VF, while the left side VF was left untreated. VF
scars were evaluated with in vivo fluorescence live imaging system (IFLIS),
endoscopy, histology, and videokymography (VKG) after eight weeks. IFLIS
demonstrated that SIS enabled the MSCs to survive and be engrafted in the VF. The
histological analysis showed increased hyaluronic acid accumulation and
controlled collagen deposition by MSCs-SIS composite gel. VKG analysis showed
more favorable vibrations of MSCs-SIS injected VF, compared to other treatment
group. In conclusion, the injectable SIS supplied a niche for the MSCs to stably
settle down in scarred VFs and helped to regulate ECM synthesis. The ECM
remodeling underwent by the surviving MSCs eventually led to the functional
improvement of the VF. The results of the present investigation suggest that
SIS-MSCs composite gel is a plausible biomaterial for prolonged survival of MSCs
in VFs and promotes scarless VF healing
Dual-Anchor Cog Threads in Fat Grafting Breast Augmentation: A Novel Scarless Method for Defining Breast Footprint and Enhancing Shape
No full textBACKGROUND: Modern fat grafting breast augmentation allows successful breast enhancement. However, there is no fine control of breast footprint, shape, and inframammary fold. The purpose of this article is to report a novel scarless technique and to evaluate its beneficial effect by retrospectively reviewing case-control consecutive data from 51 patients. METHODS: Fifty-one consecutive patients undergoing cosmetic breast augmentation with fat only between September of 2012 and August of 2016 were retrospectively reviewed. In the first 29 cases (56 percent), the authors did not use threads (group A, control group), whereas in the remaining 22 cases (44 percent), the authors used dual-anchor cog threads (group B, case group). Breast shape analysis was performed separately by a blinded group of plastic surgeons and by the attending surgeon using a standardized evaluation method. The BREAST-Q was used to study patient satisfaction. The Mann-Whitney U and chi-square tests were used for categorical variables, and the independent-samples t test was used for continuous variables. RESULTS: No significant difference in mean graft take was found (group A, 71.2 percent; group B, 71.6 percent; p < 0.05). Group B showed a significantly higher rating than group A for lower pole profile, inframammary fold, and lateral footprint definition. No major postoperative complications were experienced in either group. In group B, no thread-related complications were experienced. CONCLUSIONS: The dual-anchor thread suture is a novel, effective, simple, reliable, safe, and scarless method of improving breast shape in fat grafting breast augmentation. Larger series are needed to further confirm the authors' findings. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III
Tools and strategies for scarless allele replacement in Drosophila using CRISPR/Cas9
No full textGenome editing via the CRISPR/Cas9 RNA-guided nuclease system has opened up exciting possibilities for genetic analysis. However, technical challenges associated with homology-directed repair have proven to be roadblocks for producing changes in the absence of unwanted, secondary mutations commonly known as “scars.” To address these issues, we developed a 2-stage, marker-assisted strategy to facilitate precise, “scarless” edits in Drosophila with a minimal requirement for molecular screening. Using this method, we modified 2 base pairs in a gene of interest without altering the final sequence of the CRISPR cut sites. We executed this 2-stage allele swap using a novel transformation marker that drives expression in the pupal wings, which can be screened for in the presence of common eye-expressing reporters. The tools we developed can be used to make a single change or a series of allelic substitutions in a region of interest in any D. melanogaster genetic background as well as in other Drosophila species
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