20 year evolution of Glyaderm® dermal regeneration matrix:the first non-commercial dermal regeneration matrix

The research of Dr. Pirayesh encompassed a series of carefully planned studies ranging from laboratory research to clinical applications. The goal was to develop and validate Glyaderm® as an effective dermal replacement. Long-term studies have shown that Glyaderm® can be effectively integrated with autologous skin grafting after wound bed preparation, resulting in reduced costs and morbidity.In a prospective, randomized clinical study, the effectiveness of Glyaderm® and autologous skin grafting was confirmed. This combination was found to be non-inferior to standard treatment in terms of graft uptake, scar scales and color. In addition, the two-stage procedure with Glyaderm® showed superior elasticity and better results in visual scar evaluation.Glyaderm® has proven to be an effective choice for burn treatment, with beneficial outcomes and a positive impact on patients' quality of life

Multiscale combination of physically-based registration and deformation modeling

Abstract 1 In this paper we present a novel multiscale approach to recovery of nonrigid motion from sequences of registered intensity and range images. The main idea o f our approach is that a nite element (FEM) model can naturally handle both registration and deformation modeling using a single model-driving strategy. The method includes a multiscale iterative algorithm based on analysis of the undirected Hausdor distance to recover corresp ondences. The method is evaluated with resp ect to speed, accur acy, and noise sensitivity. A dvantages of the pr oposed a p p r oach ar e demonstr ated using man-made elastic materials and human skin motion. Experiments with regular grid featur esare used for performance comparison with a conventional approach (separate snakes and FEM models). It is shown that the new method does not requir ea grid and can adapt the model to available object featur es

A systematic review of objective burn scar measurements

BackgroundProblematic scarring remains a challenging aspect to address in the treatment of burns and can significantly affect the quality of life of the burn survivor. At present, there are few treatments available in the clinic to control adverse scarring, but experimental pharmacological anti-scarring strategies are now beginning to emerge. Their comparative success must be based on objective measurements of scarring, yet currently the clinical assessment of scars is not carried out systematically and is mostly based on subjective review of patients. However, several techniques and devices are being introduced that allow objective analysis of the burn scar. The aim of this article is to evaluate various objective measurement tools currently available and recommend a useful panel that is suitable for use in clinical trials of anti-scarring therapies.MethodsA systematic literature search was done using the Web of Science, PubMed and Cochrane databases. The identified devices were then classified and grouped according to the parameters they measured.The tools were then compared and assessed in terms of inter- and intra-rater reproducibility, ease of use and cost.ResultsAfter duplicates were removed, 5062 articles were obtained in the search. After further screening, 157 articles which utilised objective burn scar measurement systems or tools were obtained. The scar measurement devices can be broadly classified into those measuring colour, metric variables, texture, biomechanical properties and pathophysiological disturbances.ConclusionsObjective scar measurement tools allow the accurate and reproducible evaluation of scars, which is important for both clinical and scientific use. However, studies to evaluate their relative performance and merits of these tools are scarce, and there remain factors, such as itch and pain, which cannot be measured objectively. On reviewing the available evidence, a panel of devices for objective scar measurement is recommended consisting of the 3D cameras (Eykona/Lifeviz/Vectra H1) for surface area and volume, DSM II colorimeter for colour, Dermascan high-frequency ultrasound for scar thickness and Cutometer for skin elasticity and pliability

An investigation into the efficacy of single low dose of insulin in the prevention of excessive cutaneous scarring in breast surgery

Early human fetuses have the ability to heal wounds by completely regenerating tissues, leaving no evidence of scarring. However in the adult scarring is the inevitable endpoint of the wound healing process. Sometimes these scars can be pathological in nature causing both functional and aesthetic problems to those affected. Every year millions of people around the globe acquire problematic or pathological scars either whilst undergoing surgery or from traumatic injuries and at present there remain a severely limited number of pharmacological treatment options to offer these patients. Importantly currently there exists no treatment that can either eliminate or reliably reduce acquired scars. Not only is the treatment of acquired scars problematic but also the clinical assessment of scars is largely subjective in nature and frequently relies on assessment scales that show large amounts of inter-rater variation and lack quantification. Especially subjective is the measurement of scar colour, which can be markedly different from the surrounding skin and cause significant distress to the patient. Without an objective assessment framework clinicians cannot reliably examine scars nor gauge responses to any treatment. The aim of this thesis is thus two-fold. Firstly a new anti-scarring treatment in the form of insulin will be tested in a randomised, double blind, intra-patient, placebo controlled trial where patients undergoing elective bilateral breast surgery will have low-dose insulin injected subcutaneously to one breast and placebo to the other at the time of surgery. Patients will be followed up for 12 months and their scars compared to examine the therapeutic effect of insulin upon scars. Secondly the thesis aims to test the validity of new methods of assessing the scar colour of a subset of patients within the insulin trial using previously untested photographic devices and software. These devices are hoped to add much needed quantification to scar assessment.Open Acces

The development of an anti-scarring burn dressing

Introduction: Scarring has a significant impact on the function and quality of life in burn patients. This thesis describes selected stages of the development of an anti-scarring burn dressing and an objective scar assessment panel. Methods: This thesis is divided into two sections. Section 1 covers the development of an objective scar measurement tool based panel and score via a systematic review and subsequent reliability testing and validation of selected devices. Section 2 covers different aspects of dressing formulation. The cytotoxicity effects of decorin were investigated in dermal fibroblast cultures to provide guidance to safe and effective decorin dosing. Manufacturing, sterilisation and clinical use exposes decorin to elevated temperatures and the effects of this on the structure of decorin and bio-activity of decorin is investigated with circular dichroism and in-vitro cell cultures respectively. Lastly, a skin contact study in healthy volunteers was performed to establish the safety of two gellan formulations (sheet and fluid gel). Results: Objective scar measurement tools were found to be more reliable than subjective scar scores and an objective scar score was created consisting of high frequency ultrasound and pliability measures. Decorin had no measurable cytotoxicity on dermal fibroblasts even at high concentrations. Conformational change in decorin structure was seen at relatively low temperatures however results suggest that heating may enhance its bio-activity. Both gellan formulations were found to be safe for use on intact skin. Conclusion: The new objective scar scale can be used to accurately measure the effects of antiscarring treatments. Decorin and gellan are safe to be used in patients but the dressings may need to be protected against high temperatures