From Bank Preparation to Clinical Use of Homologous Skin Allografts in Wound Healing: A Sustainable Approach

Given progressive population ageing and the increase in the number of patients with comorbidities, the management of chronic and/or hard-to-heal wounds (HHWs) nowadays represents a common problem in many clinical settings. In these cases, standard strategies may not be sufficient. Autologous graftin...

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Vydané v:Life (Basel, Switzerland) Ročník 14; číslo 10; s. 1285
Hlavní autori: Amoroso, Laura, Agueci, Serena, Pianigiani, Elisa, Ierardi, Francesca, Calabrese, Laura, Rubegni, Pietro, Tognetti, Linda
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Switzerland MDPI AG 01.10.2024
MDPI
Predmet:
allografting
Allografts
Banking
Cadavers
Comorbidity
Cryopreservation
Cytomegalovirus
Dermatology
Dermis
Detergents
Evaluation
Glycerol
Good Manufacturing Practice
Grafting
histology
HIV
Homografts
homologous skin allograft
Human immunodeficiency virus
immunohistochemistry
Integrated approach
Methods
Morphology
MTT assay
Patient outcomes
Patients
Physiology
Quality standards
Serology
Skin
Skin & tissue grafts
skin bank
Surgery
Wound healing
Italy
allografting
practical application
skin bank
wounds
histology
hard-to-heal wounds
immunohistochemistry
MTT assay
homologous skin allograft
ulcers
ISSN:2075-1729, 2075-1729
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Popis
Shrnutí:Given progressive population ageing and the increase in the number of patients with comorbidities, the management of chronic and/or hard-to-heal wounds (HHWs) nowadays represents a common problem in many clinical settings. In these cases, standard strategies may not be sufficient. Autologous grafting represent the gold standard for permanent wound closure, but is almost never realized when the skin loss is extensive/the patient is young. The grafting of homologous skin/dermal tissue procured from cadaver donors (i.e., allografting) represents the best alternative, especially when the dermal component is lost. This request supports the activities of skin bank establishments (including donor screening, skin procurement, processing, storage, and distribution) that are regulated by specific guidelines and need to continuously meet quality standard requirements. The aim of this work is to both give specific insights of all the procedures implied in allograft preparation as well as an overview of their practical application in the treatment of different HHWs. The particular characteristics of each skin/dermal allograft released by Siena Skin Bank (cryopreserved/glycerol-preserved skin/de-epidermized dermis, acellular lyophilized de-epidermized dermis/reticular dermis) are also discussed. The exemplificative series of HHWs managed in the Dermatology Department of Siena were classified according their etiology into post-traumatic, vascular (arterial/venous/mixed/lymphatic), inflammatory, surgical, and heat/chemical burns. Globally, the clinical advantages obtained include: acceleration of healing process, pain sparing, resistance to bacterial contamination, dermal regeneration (instead of scarring), and better aesthetic–functional outcome.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:2075-1729
2075-1729
DOI:10.3390/life14101285