Ten years later – scalp still a primary donor site in children

Wyrzykowski, Dariusz; Chrzanowska, B; Czauderna, Piotr

doi:10.1016/j.burns.2014.07.009

Cited by 14 publications

(21 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…CM from three distinct fibroblast subtypes found in human scalp skin (DPFi, PFi, and RFi) were assessed, revealing that DPFi CM significantly accelerated wound reepithelialization both in vitro and ex vivo. Normally in a wound, there are no hair follicles to promote faster reepithelialization; however, hairy skin does heal faster than hairless skin (Mimoun et al, 2006;Weyandt et al, 2009;Wyrzykowski et al, 2015). The role of hair follicle epithelial cells in wound re-epithelialization has been well described (Ito et al, 2005), whereas our work shows that the hair follicle dermis has a paracrine effect on KC reepithelialization during wound closure.…”

Section: Discussionmentioning

confidence: 58%

“…One difference in skin across body sites is its ability to heal. For example, scalp skin containing large terminal hair follicles has superior healing compared with trunk skin, making it a gold standard site for harvesting skin for split thickness grafts (Mimoun et al, 2006;Weyandt et al, 2009;Wyrzykowski et al, 2015). Grafting of hair-bearing scalp skin into chronic venous ulcers has also been shown to promote wound closure, over and above closure observed when skin plugs from abdominal skin (containing small vellus hair follicles) are used (Alam et al, 2019;Jiménez et al, 2012;Martínez et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Harnessing the Secretome of Hair Follicle Fibroblasts to Accelerate Ex Vivo Healing of Human Skin Wounds

Topouzi

Boyle

Williams³

2020

Journal of Investigative Dermatology

View full text Add to dashboard Cite

In skin homeostasis, dermal fibroblasts are responsible for coordinating the migration and differentiation of overlying epithelial keratinocytes. As hairy skin heals faster than nonhairy skin, we took bio-inspiration from the follicle and hypothesized that follicular fibroblasts would accelerate skin re-epithelialization after injury faster than interfollicular fibroblasts. Using both in vitro and ex vivo models of human skin wound closure, we found that hair follicle dermal papilla fibroblasts could accelerate closure of in vitro scratch wounds by 1.8-fold and epithelial growth capacity by 1.5-fold compared with controls (P < 0.05). We used a cytokine array to determine how the dermal papilla fibroblasts were eliciting this effect and identified two cytokines, sAXL and CCL19, that are released at significantly higher levels by follicular fibroblasts than by interfollicular subtypes. Using sAXL and CCL19 individually, we found that they could also increase closure of epithelial cells in a scratch wound by 1.2-and 1.5-fold, respectively, compared with controls (P < 0.05). We performed an unbiased transcriptional analysis, combined with pathway analysis, and postulate that sAXL accelerates wound closure by promoting migration and inhibiting epithelial differentiation of skin keratinocytes. Long term, we believe these results can be exploited to accelerate wound closure of human skin in vivo.

show abstract

Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Harnessing the Secretome of Hair Follicle Fibroblasts to Accelerate Ex Vivo Healing of Human Skin Wounds

Topouzi

Boyle

Williams³

2020

Journal of Investigative Dermatology

View full text Add to dashboard Cite

show abstract

“…The mean age of the patients in the 20 articles that included that information was 23.6 years. The mean age of the patients was 5.13 years in the nine articles with children [3,[8][9][10]12,14,22,26,27], 27.67 years in the seven articles with children and adults [5][6][7]11,18,23,28], and 59.08 years in the four articles with adults. Seven articles [2,4,13,16,20,21,24] did not mention the mean age (Table 1).…”

Section: Age and Sex Distributionmentioning

confidence: 99%

“…In terms of sex distribution, male patients were predominant in most articles [11,14,15,[17][18][19][22][23][24][25], except for two articles [5,28]. Fifteen articles did not mention the sex distribution.…”

Section: Age and Sex Distributionmentioning

confidence: 99%

A systematic review of the scalp donor site for split-thickness skin grafting

2020

Arch Plast Surg

View full text Add to dashboard Cite

Split-thickness skin grafting (STSG) is the gold standard for coverage of acute burns and reconstructive wounds. However, the choice of the donor site for STSG varies among surgeons, and the scalp represents a relatively under-utilized donor site. Understanding the validity of potential risks will assist in optimizing wound management. A comprehensive literature search was conducted of the PubMed database to identify studies evaluating scalp skin grafting in human subjects published between January 1, 1964 and December 31, 2019. Data were collected on early and late complications at the scalp donor site. In total, 27 articles comparing scalp donor site complications were included. The selected studies included analyses of acute burn patients only (21 of 27 articles), mean total body surface area (20 of 27), age distribution (22 of 27), sex (12 of 27), ethnicity (5 of 27), tumescent technique (21 of 27), depth setting of the dermatome (24 of 27), number of harvests (20 of 27), mean days of epithelization (18 of 27), and early and late complications (27 of 27). The total rate of early complications was 3.82% (117 of 3,062 patients). The total rate of late complications was 5.19% (159 of 3,062 patients). The literature on scalp skin grafting has not yet identified an ideal surgical technique for preventing donor site complications. Although scalp skin grafting provided superior outcomes with fewer donor site complications, there continues to be a lack of standardization. The use of scalp donor sites for STSG can prevent early and late complications if proper surgical planning, procedures, and postoperative care are performed.

show abstract

“…Other reported advantages are the faster epithelialisation of the scalp [ 9 ] and good colour matching [ 10 ] with the skin of the face. The faster epithelialisation is due to the high amount of dermal appendages—and thus, a substantial supply of follicular epithelial stem cells—and the scalp’s rich vascularity [ 3 , 4 , 6 , 7 , 9 ]. This allows for multiple harvests from the same site [ 3 , 5 – 7 , 9 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

The scalp as a donor site for skin grafting in burns: retrospective study on complications

Roodbergen

Vloemans

Rashaan³

et al. 2016

Burns &Amp; Trauma

View full text Add to dashboard Cite

BackgroundSplit skin grafting (SSG) is the cornerstone in the treatment of deep burns and large skin defects. Frequently used donor sites are the thigh, abdomen and buttocks. The scalp is less common while considered as a reliable donor site. Advantages are a large surface area, rapid wound healing, cosmetically favourable results and multiple harvests from the same donor site. Complications include scab formation, chronic folliculitis and alopecia but have been recorded sporadically in previous studies. This article evaluates the complication rate of the scalp donor site in the treatment of deep burns in the Beverwijk Burn Centre.MethodsA retrospective study was performed of all patients who received a skin graft from the scalp at the Beverwijk Burn Centre between January 2004 and December 2012. Data were collected from medical files of included patients, including gender, age, type of burn (scald, flame, other) and total body surface area (TBSA) burned at the time of first surgery. Postoperative variables were healing time of the donor site and incidence of complications. During follow-up, the incidence of late complications was reviewed.ResultsA total number of 105 grafts were analysed in 93 patients: 58 males (62 %) and 35 females (38 %), with a median age of 2 years and 3 months old. Of the patients, 30 (32 %) had flame burns and 57 (61 %) had scald burns. Eighty-seven percent of patients had a TBSA burned of 5 % or less. All donor sites healed within 14 days. No alopecia or scar hypertrophy developed at the donor sites. Two patients (2.2 %) developed folliculitis; one patient (1.1 %) showed scab formation.ConclusionsThe scalp as a donor site in our Burn Centre shows a comparable short-term complication rate to the previous literature, with quick healing and no long-term complications. Therefore, we propose the consideration of the scalp as a primary donor site, especially in young children, where the scalp offers a larger donor site area than the buttocks or thighs.

show abstract

Ten years later – scalp still a primary donor site in children

Cited by 14 publications

References 28 publications

Harnessing the Secretome of Hair Follicle Fibroblasts to Accelerate Ex Vivo Healing of Human Skin Wounds

Harnessing the Secretome of Hair Follicle Fibroblasts to Accelerate Ex Vivo Healing of Human Skin Wounds

A systematic review of the scalp donor site for split-thickness skin grafting

The scalp as a donor site for skin grafting in burns: retrospective study on complications

Contact Info

Product

Resources

About