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Suture Techniques and Selection
Published in Chih-Chang Chu, J. Anthony von Fraunhofer, Howard P. Greisler, Wound Closure Biomaterials and Devices, 2018
S.S. Kang, W. Irvin, J.R. Perez-Sanz, H. P. Greisler
Skin repair can be effected with the use of tape strips, various forms of suture techniques, or with staples. Tape strips have the advantage of not interfering with host defenses and therefore can minimize the risk of infection, but they require more meticulous subcutaneous apposition and hemostasis to be effective.85–87
Keratinocytes-hair follicle bulge stem cells-fibroblasts co-cultures on a tri-layer skin equivalent derived from gelatin/PEG methacrylate nanofibers
Published in Journal of Biomaterials Science, Polymer Edition, 2020
Babitha Sumathy, Prabha D Nair
Skin is the largest organ of the vertebrate body and because it interfaces with the environment, skin is the first line of defence against a host of environmental aggressors. The skin has two principle layers-the epidermis, which is the epithelial tissue layer of the skin and the dermis, the connective tissue layer of the skin. Embedded within the dermis are the adnexal structures including hair follicles and sweat glands as well as blood vessels and sensory nerve endings. Hair follicles, sebaceous glands, and sweat glands are epithelial invaginations from the epidermis. A third layer, the hypodermis is composed mainly of fat and a layer of loose connective tissue. These three layers play a vital role in protecting the body from any mechanical damage such as wounding. Skin with its adnexa maintains internal homeostasis by preventing excessive water and heat loss. When normal anatomic structure and function of the skin is disrupted by means of a wound or burn, the normal homeostatic functions of the skin are lost. Normally, tissue loss or damage initiates the wound healing process that involves orchestrated interaction of multiple growth factors, cytokines, chemokines, and different cell types [1]. Wound heals by epithelialization from the margins of the wound, where the basal keratinocytes change into a proliferating migratory cell type and cover the damaged area. Any dysregulation of the wound healing process could result in chronic or “hard- to- heal” wounds. Current treatment methods include wound dressings [2], autologous skin grafts [3], allogeneic skin grafts [4] and tissue-engineered skin repair [5]. The downsides of wound dressings are the low adhesion to the lesion, ineffective in achieving skin regeneration and sufficient recovery of skin appendages – hair follicles, sweat and sebaceous glands – that are critical for skin to exert its biological functions [6]. Being non-immunogenic, autologous skin grafts are considered as the gold standard for skin regeneration. However, the limited availability of autologous skin, especially in case of large wound area; scarring, infection and pain at the donor site are some of the significant drawbacks of autologous skin grafts [7]. Allogeneic skin grafts from non-genetically identical individuals or cadaver skin and xenogeneic skin grafts from different species can evoke strong immune responses that lead to acute rejection of the graft tissues [8].