Busra MF, Chowdhury SR, bin Ismail F, bin Saim A, Idrus RB, et al.
Advances in skin & wound care. Date of publication 2016 Mar 1;volume 29(3):120-9.
1. Adv Skin Wound Care. 2016 Mar;29(3):120-9. doi:
10.1097/01.ASW.0000480556.78111.e4.
Tissue-Engineered Skin Substitute Enhances Wound Healing after Radiation Therapy.
Busra MF(1), Chowdhury SR, bin Ismail F, bin Saim A, Idrus RB.
Author information:
(1)Mohd Fauzi bin Mh Busra, BSc, is a PhD candidate at the Tissue Engineering
Centre of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in Kuala
Lumpur, Malaysia. Shiplu Roy Chowdhury, PhD, is a Research Fellow at the Tissue
Engineering Centre of the UKMMC. Fuad bin Ismail, MD, is the Head of the
Department of Radiotherapy and Oncology at the UKMMC. Aminuddin bin Saim, MD, is
an Ear, Nose, and Throat Specialist at the Ear, Nose, and Throat Consultant
Clinic, at the Ampang Puteri Specialist Hospital in Selangor, Malaysia, as well
as a Consultant at the Tissue Engineering Centre of the UKMMC. Ruszymah Bt Hj
Idrus, MD, PhD, is a Professor in the Department of Physiology at UKMMC.
OBJECTIVE: When given in conjunction with surgery for treating cancer, radiation
therapy may result in impaired wound healing, which, in turn, could cause skin
ulcers. In this study, bilayer and monolayer autologous skin substitutes were
used to treat an irradiated wound.
MATERIALS AND METHODS: A single dose of 30 Gy of linear electron beam radiation
was applied to the hind limb of nude mice before creating the skin lesion (area
of 78.6 mm). Monolayer tissue-engineered skin substitutes (MTESSs) were prepared
by entrapping cultured keratinocytes in fibrin matrix, and bilayer
tissue-engineered skin substitutes (BTESSs) were prepared by entrapping
keratinocytes and fibroblasts in separate layers. Bilayer tissue-engineered skin
substitute and MTESS were implanted to the wound area. Gross appearance and wound
area were analyzed to evaluate wound healing efficiency. Skin regeneration and
morphological appearance were observed via histological and electron microscopy.
Protein expressions of transforming growth factor β1 (TGF-β1), platelet-derived
growth factor BB (PDGF-BB), and vascular endothelial growth factor (VEGF) in skin
regeneration were evaluated by immunohistochemistry (IHC).
RESULTS: Macroscopic observation revealed that at day 13, treatments with BTESS
completely healed the irradiated wound, whereas wound sizes of 1.1 ± 0.05 and 6.8
± 0.14 mm were measured in the MTESS-treated and untreated control groups,
respectively. Hematoxylin-eosin (H&E) analysis showed formation of compact and
organized epidermal and dermal layers in the BTESS-treated group, as compared
with MTESS-treated and untreated control groups. Ultrastructural analysis
indicates maturation of skin in BTESS-treated wound evidenced by formation of
intermediate filament bundles in the dermal layer and low intercellular space in
the epidermal layer. Expressions of TGF-β1, PDGF-BB, and VEGF were also higher in
BTESS-treated wounds, compared with MTESS-treated wounds.
CONCLUSIONS: These results indicate that BTESS is the preferred treatment for
irradiated wound ulcers.
DOI: 10.1097/01.ASW.0000480556.78111.e4
PMID: 26866868 [Indexed for MEDLINE]
