New Composite Material May Be Used For Facial Reconstruction

Biomedical engineers at Johns Hopkins have developed a new liquid material that in early experiments in rats and humans shows promise in restoring damaged soft tissue relatively safely and durably. The material, a composite of biological and synthetic molecules, is injected under the skin, then “set” using light to form a more solid structure, like using cold to set gelatin in a mold. The researchers say the product one day could be used to reconstruct soldiers’ faces marred by blast injuries.

The researchers created their composite material from hyaluronic acid (HA), a natural component in skin of young people that confers elasticity, and polyethylene glycol (PEG), a synthetic molecule used successfully as surgical glue in operations and known not to cause severe immune reactions.

Jennifer Elisseeff, Ph.D. said the team has especially high hopes for the composite’s use in people with facial deformities, who endure social and psychological trauma. When rebuilding soft tissue, recreating natural shape often requires multiple surgeries and can result in scarring. “Many of the skin fillers available on the market consisting of HA-like materials used for face lifts are only temporarily effective, and are limited in their ability to resculpt entire areas of the face. Our hope is to develop a more effective product for people, like our war veterans, who need extensive facial reconstruction.”

More information from Johns Hopkins.

Related articles

• New material could help facial reconstruction for soldiers’ blast injuries (scienceblog.com)
• New composite material may restore damaged soft tissue (eurekalert.org)
• New gel can restore damaged soft tissue (news.bioscholar.com)
• Injectable implant to help doctors save face (nature.com)

 

Skin Changes during Pregnancy

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An interesting blog post by Dr. Linda Burke-Galloway discussing skin changes during pregnancy.

She discusses stretch marks (striae gravidarum), pregnancy related itching (pruritus gravidarum), skin lesions called spider angiomatas, red palms (palma erythema), rash that is associated with pregnancy, called PUPPPs (Pruritic Urticarial Papules and Plaques of Pregnancy), and the most serious skin disorder in pregnancy called Pemphigoid Gestationis which is a rare, autoimmune disease.

According to Dr. Linda Burke-Galloway, skin rashes during pregnancy should not be ignored or self-treated. At least three skin disorders that are associated with pregnancy can have an adverse effect on the fetus.

 

Related articles

• Skin changes during pregnancy: What to expect (mayoclinic.com)

 

Dog Bites

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We’ve dealt with dog bites and dog bite scars before.

Now, four organizations have joined forces to raise awareness during National Dog Bite Prevention Week, May 15-21. It’s estimated that 4. 7 million people are bitten by dogs every year. Yet most dog bites are entirely preventable through training, proper control of dogs, and education.

The American Academy of Pediatrics (AAP), the American Society of Plastic Surgeons (ASPS), the American Society for Reconstructive Microsurgery (ASRM), and the American Society of Maxillofacial Surgeons (ASMS) are concerned about dog bite injuries among patients of all ages. Children are the most common victims, followed by seniors and mail carriers. Every year about 600,000 children require medical attention for dog bites.

“Half of all children will be bitten by a dog by the time they are high school seniors,” said John Fraser, MD, FAAP, an injury prevention specialist who will represent the Texas Chapter of the American Academy of Pediatrics at the Houston event. “Every year about 600,000 children require medical attention for dog bites. As a pediatrician who has treated some of these kids, I want to do everything I can to prevent these injuries.”

Plastic surgeons, including reconstructive microsurgeons and maxillofacial surgeons, often treat victims of dog attacks and see firsthand how devastating these injuries can be. According to ASPS statistics, nearly 33,000 reconstructive procedures on dog bites were performed in 2010, up eight percent from 2009.

For more information and a brochure on dog bite prevention visit American Veterinary Medical Association web site.

 

Wound Care after Laser Treatments

An informative article on the subject of post-laser wound care was recently published on Plastic Surgery Practice web site.

The author, Joseph Niamtu III, DMD, FAACS, discusses recent trends in laser treatments and focuses on post-treatment care:

Inducing an intentional and controlled second-degree facial burn removes the entire epithelium and part of the dermis. This is obviously a giant insult to the normally intact integument. Patients who undergo fully ablative, high-fluence, high-density, multipass CO2 laser resurfacing have to understand in the preop period that this treatment will be their hobby for 4 to 6 weeks. I am very blunt with my patients who are considering this type of laser treatment, and I do not sugarcoat the recovery.

Read more of his discussion here.

Stratpharma AG, Swiss based specialty pharmaceutical company has developed Stratamed, the first silicone-based scar management product that may be applied to open wounds and compromised skin after procedures discussed in Dr Niamtu’s article, such as laser skin resurfacing. The new product helps with rapid epithelialization, reduces down-time, and is the only silicone gel treatment that improves the outcome of scarring by up to 78%.

 

Juvista Scar Treatment Fails in Phase III Trial

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Renovo, a UK company, announced on February 11 that Phase III trials of its lead scar reduction treatment, Juvista (human TGF-beta3) had failed on its primary endpoint (assessment of the scars by independent experts) and on its secondary endpoint (assessment by the patients themselves). The news was even worse as the company is now trying figure out why in some patients, the half of the scar treated with placebo seemed to heal better than the Juvista-treated half.

The REVISE Trial was a double blind, within patient, placebo controlled trial to assess the efficacy of two dose levels of Juvista (200ng and 500ng/100ul/linear cm of wound margin) given twice, following wound closure and 24 hours later, on the appearance of scars following scar revision surgery. Over 350 patients were recruited from 56 centres in UK France, Hungary, Germany, Italy, Poland, Spain, Denmark, Latvia and USA. The EMA agreed primary endpoint for efficacy was a photographic based assessment at 12 months following surgery by an independent panel of experts using the Global Scar Comparison Scale. Secondary endpoints included an assessment of the scars using the Global Scar Comparison Scale by the patients themselves and by the clinical trial investigator. None of the primary or secondary endpoints were met for either dose.

For some additional analysis visit IN VIVO blog.

 

Insulin to Prevent or Reduce Scar Tissue?

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PharmEcosse, a Scottish company, is starting clinical trials to explore the use of insulin (PE001) for the reduction or prevention of surgical scars in patients undergoing non-cancer bilateral breast surgery. The trial will commence in January 2011 and is expected to report in the first quarter of 2013.

Insulin was found to control the activity of the key cells involved in wound closure and subsequent scar formation which apparently slows down or stops the build up of scar tissue.

For more information about taking part in clinical trials, please go to pharmecosse.com

 

Q&A Time: Scar Related Questions

We occasionally receive questions by email or in the comments section. Let us know if you have any questions related to scars, scar treatment or scar prevention and we will try to answer them. You can ask the questions anonymously via the comments section below. And remember, the only stupid question is the one you don’t ask.

 

Heidi Montag’s post-surgery scars

 

In a recent interview with Life & Style, the former star of “The Hills” described a variety of post-surgery scars ranging from a two-inch long blemish under her chin to lumpy legs, uneven breasts and bald spots left from a brow lift.

“People have fewer scars from car accidents than I have on my body,” Montag told the magazine.

All plastic surgery but especially major surgeries like tummy tucks and breast reductions, can involve scarring. Ask your doctor to show you a picture of what the scar looks like beforehand. Another important question is what sort of treatments they offer to minimize scarring, for example silicone gel (e.g. Strataderm), silicone sheeting or laser procedures. It’s not always easy to know in advance whether or not you’re likely to scar. Some people are more prone to scarring than others. People heal differently, and patients with a poor history of wound healing or keloid scars are at high risk of scarring.

 

Hospital Visits Involving Dog Bites

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The number of Americans hospitalized for dog bites almost doubled over a 15-year-period, increasing to 9,500 in 2008 from 5,100 in 1993, a new government study reports (Emergency Department Visits and Inpatient Stays Involving Dog Bites, 2008). The increase vastly exceeded population growth, and pet ownership increased only slightly during the same period, said the report’s author, Anne Elixhauser, a senior research scientist with the Agency for Healthcare Research and Quality.

Common principal diagnoses for dog bite-related hospitalizations included skin and subcutaneous tissue infections; open wounds of extremities; open wounds of head, neck, and trunk; and fractures of upper limbs.

About 866 people a day went to the emergency room with dog bites in 2008, and about 26 people were admitted each day.

Children under 5 and adults 65 and older were most likely to be hospitalized after a bite, and residents of rural areas made four times as many emergency room visits and had three times as many hospital admissions for dog bites than those from nonrural areas, the report said.

Dog bite wounds are difficult to treat and can leave nasty scars. It is important to immediately contact a doctor who can provide the dog bite treatment needed to minimize infection and scarring.

 

The SCAR Project

 

The SCAR Project is a series of large-scale portraits of young breast cancer survivors shot by fashion photographer David Jay.

Dedicated to the more than 10,000 women under the age of 40 who will be diagnosed this year alone The SCAR Project is an exercise in awareness, hope, reflection and healing. The mission is three-fold: Raise public consciousness of early-onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.

Would you like to get involved?