Role of Embryonic Histogenesis in the Healing of Chronic Wounds Using Integra Dermal Regenerative Template

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Object: Dermal regeneration after the placement of Integra, an artificial skin matrix, follows a distinctly separate pathway from the classic model of inflammatory wound repair and subsequent scar formation. The purpose of this study is to highlight the events in Integra histogenesis.
Methods: Skin punch biopsies from patients with chronic wounds were taken at multiple intervals after Integra placement, ranging from day 0 to 10 weeks. Sections were stained with hematoxylin and eosin and additional selected combinations of immunohistochemical markers.
Results: The wound repair after the placement of Integra clearly follows a pathway distinct from that of classic inflammatory wound repair. The arrival and matrical dissemination of unique “pioneer” cells seems to trigger this exceptional response.
Conclusions: The embryonic-type histogenesis seen in dermal wound repair after placement of Integra depends upon the early influx of unique cells, which initiate a noninflammatory wound-healing response. The end result is a compliant dermis with the structural properties more similar to that of normal dermis rather than scar tissue.
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