Bioengineered Skin for Aesthetic Reconstruction of the Tip of the Nose: A Case Report

Nicoletti, G.; Scevola, Silvia; Faga, Angela

doi:10.1111/j.1524-4725.2008.34276.x

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…In our practice, a split‐thickness skin graft is best indicated in large soft‐tissue loss that requires an easy‐to‐take skin graft, while a full‐thickness skin graft is indicated in small soft‐tissue loss where a better cosmetic result is a priority. In general, we used the bioengineered skin substitutes for the acute treatment of huge skin loss in patients in critical general conditions or for functional and aesthetic indications in secondary surgery, where a flap was not available (Nicoletti et al ., , ; Faga et al ., ).…”

Section: Discussionmentioning

confidence: 99%

“…In current clinical practice, artificial skin substitutes are generally used for the acute treatment of huge skin loss in patients in critical general conditions (Wolter et al ., ; Weigert et al ., ), for the treatment of burns (Heimbach et al ., ; Gros et al ., ; Gravante et al ., ), to promote regeneration in non‐healing wounds (Motolese et al ., ) or for functional and aesthetic indications in secondary surgery, thus replacing the traditional indications for flap surgery in an increasing number of cases (Giovannini and Teot, ; Nicoletti et al ., , ; Faga et al ., ). Nevertheless, there is a lack of biological background information on the design and use of different types of materials and their long‐term anatomical and functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term in vivo assessment of bioengineered skin substitutes: a clinical study

Nicoletti

Brenta

Bleve

et al. 2014

J Tissue Eng Regen Med

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The aim of the study was an objective in vivo assessment of skin properties after reconstruction with two artificial dermal substitutes, Integra ® and Hyalomatrix ® . Twenty-seven patients underwent reconstruction of 36 skin-loss sites with full-thickness skin graft, split-thickness skin graft, Hyalomatrix ® bioengineered skin substitute and sequential split-thickness skin graft and Integra ® bioengineered skin substitute and sequential split-thickness skin graft. Objective assessments were carried out using three instrumental devices: Multi Probe Adapter System MPA; 22 MHz ultrasound skin scan; and Primos Pico for a three-dimensional (3D) skin scan. The skin parameters under study in our sample were: corneometry, transepidermal water loss, elastometry, colorimetry, skin thickness and 3D skin surface pattern. A skin reconstruction with Hyalomatrix seemed to most closely approach the hydration, transepidermal water loss and skin surface 3D pattern of normal skin. A skin reconstruction with Integra seemed to demonstrate the best skin colour feature and elastic properties. Although no statistically significant differences were observed, the descriptive analysis of the outcomes might suggest a better cell regulation, regenerated extracellular matrix and neoangiogenesis with the use of Hyalomatrix, and the formation of a more elastic regenerated dermis, with overall better physical, mechanical and optical properties, with the use of Integra.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long‐term in vivo assessment of bioengineered skin substitutes: a clinical study

Nicoletti

Brenta

Bleve

et al. 2014

J Tissue Eng Regen Med

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“…Subsequently, as our learning curve progressed to a stage of established clinical confidence, the use of bioengineered skin was extended to several innovative indications and currently, it has replaced the traditional indications for flap surgery for both functional and aesthetic indications in an increasing number of cases, too. [ 7 8 9 ]…”

Section: Introductionmentioning

confidence: 99%

Versatile use of dermal substitutes: A retrospective survey of 127 consecutive cases

Nicoletti

Tresoldi

Malovini

et al. 2018

Indian J Plast Surg

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Background:Dermal substitutes are currently largely used for the treatment of huge skin loss in patients in critical general health conditions, for the treatment of severe burns and to promote the healing process in chronic wounds.Aims:The authors performed a retrospective assessment of their experience with bioengineered skin to possibly identify the most appropriate clinical indication and management for each substitute.Materials and Methods:The study involved 109 patients with 127 skin defects repaired with dermal substitutes over a 9 years period, from 2007 to 2016. Hyalomatrix® was used in 63 defects, whereas Integra® and Nevelia® were used in 56 and 8 defects, respectively.Results:The statistical analysis failed to reveal a correlation between the choice of a specific dermal substitute and any possible clinical variable except in the soft-tissue defects of the scalp where Hyalomatrix® was electively used.Conclusions:In the authors' experience, the scalp defects followed a radical excision of skin tumours that included the periosteum. Here, the preliminary cover with a hyaluronan three-dimensional scaffold constantly allowed for the regeneration of a derma-like layer with a rich vascular network fit for supporting a split-thickness skin graft. Nevertheless, the authors still prefer Integra® when the goal is a better cosmetic outcome and Hyalomatrix® when a faster wound healing is required, especially in the management of deep wounds where the priority is a fast obliteration with a newly formed tissue with a rich blood supply. However, these clinical indications still are anecdotally based.

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“…6 The use of a bioengineered dermal substitute for aesthetic reconstruction of the nasal lobule has already been reported in one of our previously submitted dissertations. 7 Further research on the comparison between two of the most popular bioengineered skin substitutes (Integra [Integra LifeSciences, Plainsboro, NJ] vs. Hyalomatrix [Fidia Farmaceutici s.p.a., Abano Terme, Italy]) demonstrated that hyaluronan-based bioengineered dermal substitutes most closely matched the normal skin surface three-dimensional pattern (G. Nicoletti et al, unpublished data, September 2013). Such promising evidence has encouraged us to use Hyalofill-F for cosmetic skin repair in this unique anatomical area.…”

Section: Discussionmentioning

confidence: 99%

Hyaluronan-Induced Cosmetic Reconstruction of the Nostril

et al. 2014

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Tissue loss of the nostrils presents a considerable surgical challenge due to the greatly reduced availability of local tissue within such a peculiar anatomical region. The traditional reconstructive methods, such as direct suture, secondary healing, skin grafts, and local skin flaps, have shown poor provision of desirable cosmetic outcomes in this area. The authors propose an innovative and alternative method of cosmetic reconstruction of small skin defects of the nostril based on a hyaluronan-induced skin regeneration. Such a procedure allowed the healing of relatively large areas of skin loss with the formation of a truly regenerated tissue whose clinical features closely resemble those of the local normal skin. Nevertheless, the proposed procedure is lengthy and time-consuming and requires high levels of cooperation from patients. In our practice, the hyaluronan-induced skin regeneration is now considered the first choice for cosmetic reconstruction of small defects of the nostril in needy patients.

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Bioengineered Skin for Aesthetic Reconstruction of the Tip of the Nose: A Case Report

Cited by 5 publications

References 18 publications

Long‐term in vivo assessment of bioengineered skin substitutes: a clinical study

Long‐term in vivo assessment of bioengineered skin substitutes: a clinical study

Versatile use of dermal substitutes: A retrospective survey of 127 consecutive cases

Hyaluronan-Induced Cosmetic Reconstruction of the Nostril

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