Treatment of Hypertrophic Scar in Human with Autologous Transplantation of Cultured Keratinocytes and Fibroblasts along with Fibrin Glue

Objective: Hypertrophic scar involves excessive amounts of collagen in dermal layer and may be painful. Nowadays, we can’t be sure about effectiveness of procedure for hypertrophic scar management. The application of stem cells with natural scaffold has been the best option for treatment of burn wounds and skin defect, in recent decades. Fibrin glue (FG) was among the first of the natural biomaterials applied to enhance skin deformity in burn patients. This study aimed to identify an efficient, minimally invasive and economical transplantation procedure using novel FG from human cord blood for treatment of hypertrophic scar and regulation collagen synthesis. Materials and Methods: In this case series study, eight patients were selected with hypertrophic scar due to full-thickness burns. Human keratinocytes and fibroblasts derived from adult skin donors were isolated and cultured. They were tested for the expression of cytokeratin 14 and vimentin using immunocytochemistry. FG was prepared from pooled cord blood. Hypertrophic scars were extensively excised then grafted by simply placing the sheet of FG containing autologous fibroblast and keratinocytes. Histological analyses were performed using Hematoxylin and eosin (H&E) and Masson’s Trichrome (MT) staining of the biopsies after 8 weeks. Results: Cultured keratinocytes showed a high level of cytokeratin 14 expression and also fibroblasts showed a high level of vimentin. Histological analyses of skin biopsies after 8 weeks of transplantation revealed re-epithelialization with reduction of hypertrophic scars in 2 patients. Conclusion: These results suggest may be the use of FG from cord blood, which is not more efficient than previous biological transporters and increasing hypertrophic scar relapse, but could lead to decrease pain rate

The Effectiveness of Reengineering Moheb Project to Improve Knowledge, Attitude, and Performance of Individuals & Local Communities in Response to Earthquake: A Case Study

Background: Evaluating the effectiveness of reengineering Moheb (interventions and sociopsychological supports in disasters) project helps the managers of the Welfare Organization have feedback on the status of community empowerment against disasters. In this regard, this study aimed to determine the effectiveness of reengineering Moheb project to improve the knowledge, attitude, and performance of individuals and local communities in respond to earthquake. Materials and Methods: This quasi-experimental study with two groups of control and case was conducted in Iran, in 2013. Hormozgan, Isfahan, Fars, and South Khorasan provinces were selected as the setting for the case group and Tehran, Markazi, Semnan, and Khorasan Razavi provinces were selected as the setting for the control group. A total number of 399 samples were assessed using questionnaires of evaluating effectiveness of Moheb project (a=0.704) and checklist of empowerment preparedness of local people. The assessed data were analyzed through independent t test, analysis of variance, Chi-square, Mann-Whitney, and Kruskal-Wallis tests by using SPSS 20. Results: Based on the results, the proceedings done in the reengineering Moheb project, including organizing local disaster management teams, briefing/training sessions, as well as executed maneuvers have been instrumental in all subscales, i.e. participants of case provinces compared to participants of control provinces were better with regard to knowledge, attitude, and performance. Conclusion: Regarding the fact that knowledge, attitude, and performance of the people at local communities about earthquake were improved, the interventional programs, especially educational and promotional plan, can effectively empower individuals to face disasters