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Plast Reconstr Surg Glob Open. 2015 Aug 10;3(7):e468. doi: 10.1097/GOX.0000000000000426. eCollection 2015 Jul.

Autologous Graft Thickness Affects Scar Contraction and Quality in a Porcine Excisional Wound Model.

Plastic and reconstructive surgery. Global open

Rodney K Chan, Lloyd F Rose, Jesse C Wu, David I Tucker, Maren M Chan, Robert J Christy, Robert G Hale, Kai P Leung

Affiliations

  1. US Army Institute of Surgical Research, Fort Sam Houston, Tex.; Dental and Trauma Research Detachment, US Army Institute of Surgical Research, Fort Sam Houston, Tex.; and Department of Pathology and Area Laboratory Services, San Antonio Military Medical Center, Fort Sam Houston, Tex.

PMID: 26301157 PMCID: PMC4527642 DOI: 10.1097/GOX.0000000000000426

Abstract

BACKGROUND: Texture, color, and durability are important characteristics to consider for skin replacement in conspicuous and/or mobile regions of the body such as the face, neck, and hands. Although autograft thickness is a known determinant of skin quality, few studies have correlated the subjective and objective characters of skin graft healing with their associated morphologic and cellular profiles. Defining these relationships may help guide development and evaluation of future skin replacement strategies.

METHODS: Six-centimeter-diameter full-thickness wounds were created on the back of female Yorkshire pigs and covered by autografts of variable thicknesses. Skin quality was assessed on day 120 using an observer scar assessment score and objective determinations for scar contraction, erythema, pigmentation, and surface irregularities. Histological, histochemical, and immunohistochemical assessments were performed.

RESULTS: Thick grafts demonstrated lower observer scar assessment score (better quality) and decreased erythema, pigmentation, and surface irregularities. Histologically, thin grafts resulted in scar-like collagen proliferation while thick grafts preserves the dermal architecture. Increased vascularity and prolonged and increased cellular infiltration were observed among thin grafts. In addition, thin grafts contained predominately dense collagen fibers, whereas thick grafts had loosely arranged collagen. α-Smooth muscle actin staining for myofibroblasts was observed earlier and persisted longer among thinner grafts.

CONCLUSIONS: Graft thickness is an important determinant of skin quality. High-quality skin replacements are associated with preserved collagen architecture, decreased neovascularization, and decreased inflammatory cellular infiltration. This model, using autologous skin as a metric of quality, may give a more informative analysis of emerging skin replacement strategies.

References

  1. J Anat. 1955 Jan;89(1):114-23 - PubMed
  2. Plast Reconstr Surg. 2004 Jun;113(7):1960-5; discussion 1966-7 - PubMed
  3. Burns. 2011 Dec;37(8):1367-77 - PubMed
  4. Br J Dermatol. 2006 May;154(5):820-8 - PubMed
  5. J Invest Dermatol. 2006 Dec;126(12):2607-13 - PubMed
  6. Clin Sci (Lond). 1986 Oct;71(4):437-43 - PubMed
  7. Am J Surg. 1946 Nov;72(5):683-93 - PubMed
  8. Biol Blood Marrow Transplant. 2003 Jul;9(7):417-25 - PubMed
  9. Skin Res Technol. 2002 May;8(2):78-83 - PubMed
  10. J Burn Care Res. 2014 Nov-Dec;35(6):474-9 - PubMed
  11. Lab Invest. 2013 Jan;93(1):72-80 - PubMed
  12. Plast Reconstr Surg. 1986 May;77(5):744-51 - PubMed
  13. J Invest Dermatol. 2012 Feb;132(2):458-65 - PubMed
  14. Burns. 2006 Sep;32(6):669-77 - PubMed
  15. Burns. 2008 Mar;34(2):153-63 - PubMed
  16. Pharmacol Res. 2008 Aug;58(2):112-6 - PubMed
  17. J Burn Care Rehabil. 1988 Jan-Feb;9(1):72-4 - PubMed
  18. Plast Reconstr Surg. 2006 Jun;117(7 Suppl):127S-142S - PubMed
  19. Arch Dermatol Res. 2011 Dec;303(10):771-6 - PubMed
  20. Wound Repair Regen. 2004 May-Jun;12(3):305-19 - PubMed
  21. Burns. 1992 Aug;18(4):301-7 - PubMed
  22. Wound Repair Regen. 2011 May-Jun;19(3):292-301 - PubMed
  23. Zhonghua Zheng Xing Wai Ke Za Zhi. 2003 Jul;19(4):254-7 - PubMed
  24. Burns. 2005 Jun;31(4):445-52 - PubMed
  25. J Interferon Cytokine Res. 2008 Jul;28(7):423-34 - PubMed
  26. Acta Morphol Hung. 1984;32(1):47-55 - PubMed
  27. Burns. 2013 Feb;39(1):89-97 - PubMed
  28. Dermatol Surg. 2005 Jan;31(1):48-58 - PubMed
  29. J Trauma. 1983 Oct;23(10):895-8 - PubMed
  30. Burns. 2011 Sep;37(6):925-9 - PubMed
  31. Crit Care Med. 2007 Sep;35(9 Suppl):S519-23 - PubMed
  32. Nat Rev Immunol. 2004 Aug;4(8):583-94 - PubMed

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