A minimally invasive human in vivo cutaneous wound model for the evaluation of innate skin reactivity and healing status

Abstract

Individual variability in skin reactivity and healing capacity after trauma are important clinical issues. The aims were to develop an in vivo, human wound model based on a standardised minimal skin injury and to demonstrate therapeutic effect of simple wound therapies in terms of morphological wound outcome with changes in skin blood perfusion as a quantified indicator of wound healing. In a series of experiments, wounds were induced on the normal forearm skin of volunteers using a blood collection lancet. This was well tolerated. Wounds were assessed by naked eye examination or laser Doppler perfusion imaging (LDPI) at baseline and at up to 6 further time points up to 96 h in control wounds and wounds treated by commonly used occlusive dressing options. Assessment by clinical observation with 10x magnification showed over 96 h a progression of erythema, surface crust, a new keratinisation layer and finally healed areas. LDPI quantifying wound erythema showed a peak at 24 h and near normal levels at 96 h. Inter-individual variability was evident but intra-individual variability was much less pronounced. Wounds treated with occlusion showed a statistically significant more rapid return to baseline blood perfusion as measured by LDPI compared to controls supported by favourable healing parameters in the clinical assessment. The paper exemplifies use of non-invasive, bioengineering technique for quantification of individual innate variability in skin reactivity, wound healing capacity and therapeutic effect in a well-tolerated in vivo, human, minimal skin trauma model.

Superficial wounding model for epidermal barrier repair studies: Comparison of erbium:YAG laser and the suction blister method

“…Skin blood flow data agree with those in the literature of an inflammatory phase which peaks around 2–3 days post‐wounding, which was the same for both wound models 1. In another human wound model using a blood collection lancet, Varol and Anderson 18 however reported a much shorter inflammation peak (assessed by laser Doppler perfusion imaging) occurring only 24 hours after wounding and followed by a rapid decrease.…”

Guided Regeneration of the Human Skin : in vitro and in vivo studies

“…It then subsided over time and had returned close to baseline levels after 14 days. The results, when we used TiVi instead of laser Doppler-based technologies, are in concordance with earlier studies [102]. However, no inflammatory response could be detected between the interventions, suggesting that exogenous intradermal HA does not affect the inflammatory response as measured by TiVi.…”

“…This model allows standardized, highly reproducible, multiple skin wounds to be studied for re-epithelialization and dermal regeneration following different interventions [101]. Further on, we have developed an earlier described minimally invasive in vivo wound model [102]. In this process, we produced standardized deep dermal wounds with blood collection lancets and analyzed the wounds by tissue viability imaging, histology and proteomics.…”

Angiogenesis Is Induced and Wound Size Is Reduced by Electrical Stimulation in an Acute Wound Healing Model in Human Skin

“…This is proportional to the speed and concentration of red blood cells in the tissue [ 20 ]. This device has been used in an acute human wound model and demonstrated that this technique is useful for small acute wounds [ 21 ].…”