Follicular Unit Grafting in Chronic Nonhealing Leg Ulcers: A Clinical Study
| Autor: | Sacchidananda A Sarvajnamurthy, Leelavathy Budamakuntla, Eswari Loganathan, H V Nataraj |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty medicine.medical_treatment lcsh:Surgery Dermatology wound healing Key message: Chronic non healing ulcers are very challenging to manage with compression therapy being the mainstay along with ulcer management. The use of scalp as donor area in this study is based on the concept that a lot of stem cells such as the bulge stem cells and mesenchymal stem cells are transferred to the ulcer bed thereby acting as hubs from where reinnervation and capillary sprouting of wound beds proceed. This has shown a promising healing response leg ulcers Elastic bandage Vaseline 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Follicular phase Varicose veins medicine Local anesthesia business.industry wound healing Key message: Chronic non healing ulcers are very challenging to manage bulge stem cells lcsh:RD1-811 medicine.disease Follicular unit graft digestive system diseases Surgery a lot of stem cells such as the bulge stem cells and mesenchymal stem cells are transferred to the ulcer bed thereby acting as hubs from where reinnervation and capillary sprouting of wound beds proceed. This has shown a promising healing response 030104 developmental biology medicine.anatomical_structure with compression therapy being the mainstay along with ulcer management. The use of scalp as donor area in this study is based on the concept that Scalp Original Article medicine.symptom business Pyoderma gangrenosum |
| Zdroj: | Journal of Cutaneous and Aesthetic Surgery Journal of Cutaneous and Aesthetic Surgery, Vol 10, Iss 4, Pp 200-206 (2017) |
| ISSN: | 0974-5157 0974-2077 |
| Popis: | Introduction and Objectives: The restoration of the epithelium after injury takes place by migration of epithelial cells adjoining a wound or by centrifugal migration from hair follicles. To evaluate the feasibility and potential healing capacity of scalp follicular unit grafts transplanted into the wound bed of chronic leg ulcers. Materials and Methods: Patients with chronic nonhealing ulcers of more than 6 weeks duration were selected for the study. Those with infected ulcers and uncontrolled diabetes were excluded from the study. Fifteen patients were included in the study. Follicular unit grafts were harvested under local anesthesia using small-diameter (1 mm) circular punches. A density of 5 follicular grafts/cm2 was implanted into the ulcer bed. The ulcer was dressed with Vaseline gauze and elastic bandage for 24 h. The wound area and volume were calculated by length × width × 0.7854 and length × width × depth × 0.7854, respectively. The treatment outcome was defined as the percentage in change of area and volume of the ulcer, 18 weeks after intervention. Results: A total of 15 patients with 17 ulcers were treated with the above method. Of these 17 ulcers, 11 were venous ulcers, 2 were pyoderma gangrenosum associated with varicose veins, 2 were traumatic ulcers, and 2 were trophic ulcers. The baseline mean area of the ulcer was 6.72 cm2 (SD 5.65) and baseline volume was 2.87 cm3 (SD 2.9). The final area of the ulcer at the end of 18 weeks after the procedure was 3.84 cm2 (SD 5.43) and the final volume was 1.21 cm3 (SD 2.45), which was statistically significant. The mean percentage improvement in the area and volume of the ulcer was 48.8% and 71.98%, respectively. Two patients did not respond to the treatment. There were no adverse events after the procedure. Conclusion: We conclude that follicular unit grafting into wound beds is feasible and represents a promising therapeutic alternative for managing nonhealing chronic leg ulcers. |
| Databáze: | OpenAIRE |
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