Scar outcomes in dermatological surgery

Kim, Burcu; Sgarioto, Melissa; Hewitt, D. Brock; Paver, Robert; Norman, Julia F.; Fernández‐Peñas, Pablo

doi:10.1111/ajd.12570

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…While the goal of closing a wound surgically with sutures or other material is to facilitate primary wound healing and yield the best functional and cosmetic outcome, unpredictable factors such as wound infection, dehiscence, or ‘spitting’ of sutures ( Kim et al, 2018 ) can disrupt wound integrity and lead to healing by secondary intention. This process is characterized by the deposition of an excess of granulation tissue and leads to hypertrophic scarring ( Azmat and Council, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

Shibuya

Okawa

Kondo

et al. 2022

eLife

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Attempts to minimize scarring remain among the most difficult challenges facing surgeons, despite the use of optimal wound closure techniques. Previously, we reported improved healing of dermal excisional wounds in circadian clock neuronal PAS domain 2 (Npas2)-null mice. In this study, we performed high-throughput drug screening to identify a compound that downregulates Npas2 activity. The hit compound (Dwn1) suppressed circadian Npas2 expression, increased murine dermal fibroblast cell migration, and decreased collagen synthesis in vitro. Based on the in vitro results, Dwn1 was topically applied to iatrogenic full-thickness dorsal cutaneous wounds in a murine model. The Dwn1-treated dermal wounds healed faster with favorable mechanical strength and developed less granulation tissue than the controls. The expression of type I collagen, Tgfb1, and a-smooth muscle actin was significantly decreased in Dwn1-treated wounds, suggesting that hypertrophic scarring and myofibroblast differentiation are attenuated by Dwn1 treatment. NPAS2 may represent an important target for therapeutic approaches to optimal surgical wound management.

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Section: Resultsmentioning

confidence: 99%

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

Shibuya

Okawa

Kondo

et al. 2022

eLife

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“…2 Placing sutures superficially in the dermis has been found to increase the rate of spitting. 5 Throwing more knots per closure also has been found to increase the rate of spitting. 5 How to Decrease Spitting-Careful choice of suture material and proper depth of suture placement might decrease the risk for spitting in dermatologic surgery.…”

Section: The Techniquementioning

confidence: 99%

“…5 Throwing more knots per closure also has been found to increase the rate of spitting. 5 How to Decrease Spitting-Careful choice of suture material and proper depth of suture placement might decrease the risk for spitting in dermatologic surgery. Furthermore, if polyglactin 910 or a long-lasting suture is to be used, sutures should be placed deeply.…”

Section: The Techniquementioning

confidence: 99%

“…Fortunately, in the absence of superimposed infection, spitting sutures have not been shown to worsen outcomes of healing and scarring. 5 Nevertheless, it is important to identify and appropriately treat this common complication. The simple algorithm we provide (Figure 2) aids in cutaneous surgery by providing a straightforward approach to managing spitting sutures and their complications.…”

Section: Practical Implicationsmentioning

confidence: 99%

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An Algorithm for Managing Spitting Sutures

Thornton

Winsett

Wagner

2021

Cutis

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“…While the goal of closing a wound surgically with sutures or other material is to facilitate primary wound healing and yield the best functional and cosmetic outcome, unpredictable factors such as wound infection, dehiscence, or "spitting" of sutures (30) can disrupt wound integrity and lead to healing by secondary intention. This process is characterized by the deposition of an excess of granulation tissue and leads to hypertrophic scarring (31).…”

Section: Murine Dorsal Incisional Wound Modelmentioning

confidence: 99%

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

Shibuya¹,

Okawa²,

Kondo³

et al. 2021

Preprint

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Attempts to minimize scarring remain among the most difficult challenges facing surgeons, despite the use of optimal wound closure techniques. Previously, we reported improved healing of dermal excisional wounds in circadian clock neuronal PAS domain 2 (Npas2)-null mice. In this study, we performed high-throughput drug screening to identify a compound that downregulates Npas2 activity. The hit compound (Dwn1) suppressed circadian Npas2 expression, increased murine dermal fibroblast cell migration, and decreased collagen synthesis in vitro. Based on the in vitro results, Dwn1 was topically applied to iatrogenic full-thickness dorsal cutaneous wounds in a murine model. The Dwn1-treated dermal wounds healed faster with favorable mechanical strength and developed less granulation tissue than the controls. The expression of type I collagen, Tgfβ1, and α-smooth muscle actin was significantly decreased in Dwn1-treated wounds, suggesting that hypertrophic scarring and myofibroblast differentiation are attenuated by Dwn1 treatment. NPAS2 may represent an important target for therapeutic approaches to optimal surgical wound management.

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Scar outcomes in dermatological surgery

Abstract: Background/Objectives: Significant functional

Cited by 8 publications

References 17 publications

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

An Algorithm for Managing Spitting Sutures

Therapeutic downregulation of neuronal PAS domain 2 (Npas2) promotes surgical skin wound healing

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