Other uses of homologous skin grafts and skin bank bioproducts

The main use of homologous skin grafts or grafts of related bioproducts is in the treatment of severe bums. However, various new clinical and experimental sectors, in which this type of skill substitute can be useful, have recently emerged, The main new clinical indications for skill allografts include: skin loss, surgical wounds and bullous diseases. In these fields donor skill call be used for. different purposes: as a physiological biological dressing to control pain and protect deep structures such as tendons, bones, cartilage and nerves, and to promote reepithelization with a significant reduction in healing time, and as skill substitute with dermal tissue to guide repair and make it as physiological as possible. In particular, skin bank bioproducts are currently used in the treatment of several conditions such venous and arterial leg ulcers, pressure ulcers, diabetic foot ulcers. pyoderma gangrenosum, Post traumatic lesions, Mohs surgery, reconstructive surgery, wound cover in critical areas, aesthetic surgery. congenital epidermolysis bullosa and Lyell's syndrome. Skin bank bioproducts have also been used for experimental indications. to study in vitro toxicology and in vitro skin biology. Recently the demonstration that de-epidermized dermis (DED) has all the characteristics of an excellent dermal substitute into which various types of cells call he introduced and made to develop, opens exciting new possibilities of research in the field of wound healing and tissue engineering. Our preliminary observations seems to indicate that CD34+ stem cells from umbilical cord blood call survive in DED and in a few weeks populate collagen bundles. The observation of tubular structures without lumina close to collagen bundles as well as clusters of epithelioid or fibroblast-shaped cells may represent aspects of differentiation or CD34+ stein cells. More detailed and sophisticated studies are clearly needed to answer all the questions that these initial observations pose. Anyway the 3-dimensional model proposed seems to be suitable for the study of the behaviour of peripheral CD34 and perhaps also other types of stein cells in 3-dimensional dermal matrix. (c) 2005 Elsevier Inc. All rights reserved.