Generation of Skin Tissue Using Adipose Tissue-Derived Stem Cells.

BACKGROUND: The aim of this study was to generate skin tissue using adipose tissue-derived mesenchymal stem cells. METHODS: Thirty Wistar albino rats were used. A 2-cm-diameter full-thickness skin defect on the back of each rat was formed. A secondary wound healing model was constituted in group 1, fibrin matrix only was applied in group 2, a keratinocyte-coated fibrin matrix was applied in group 3, an adipose tissue-derived mesenchymal stem cell-seeded fibrin matrix was applied in group 4, and a keratinocyte-coated and adipose tissue-derived mesenchymal stem cell-seeded fibrin matrix was applied to the defects in group 5. RESULTS: A similar form of wound healing, with contraction from the edges and ulceration at the center, was observed in groups 1, 2, and 3. The wound contraction was reduced in group 4, and the epidermis was creeping from the surrounding tissue but with some ulcerations in the central part of the wounds. In group 5, the defect area was almost totally epithelialized, with minimal wound contraction. By microscopic analysis, significant increases in the collagen volume ratios and vascular volume ratios were determined in groups 4 and 5. From the fluorescent micrographs, fibroblastic differentiation and extracellular matrix synthesis, endothelial differentiation of stem cells, and neoangiogenesis and epithelium derived from marked keratinocytes were observed in group 5. CONCLUSION: Formation of the adipose tissue-derived mesenchymal stem cell-seeded and keratinocyte-coated autologous fibrin scaffold leads to significant skin replacement.

One-Stage Cleft Lip and Palate Repair in an Older Population.

BACKGROUND: In underdeveloped countries one-stage definitive repair of cleft lip and palate is considered for late-presenting patients. MATERIALS AND METHODS: A total of 25 patients with unoperated cleft lip and palate more than 2 years of age were enrolled in this study for one-stage simultaneous repair of cleft lip and palate. According to Veau-Wardill-Kilner push-back technique, 2 flap palatoplasties were performed for palatal repairs; all of the lips were repaired with the Millard II rotation-advancement technique. RESULTS: The authors experienced no perioperative or postoperative life-threatening complications. With respect to the registered operation periods, longer times were required to perform these double operations, but this elongation is shorter than the sum of the periods if the 2 operations had been performed separately. Although the authors were unable to evaluate the late postoperative results because the authors could not follow-up the patients after they were discharged the day after surgery, the early results related to the success of the operation without any surgical complication were prone to meet the parents' and patients' expectations. DISCUSSION: The authors presented their experiences with many volunteer cleft lip and palate trips to third world countries; however the structure of this article is not a new hypothesis and data based to support a scientific study, but observations are objective to get a conclusion. To perform one-stage definitive repair of the cleft lip and palate in late-presented patients was the reality that they had only 1 chance to undergo these operations. According to the terms and conditions of this challenging operation, one-stage simultaneous repair of cleft lip and palate is a more demanding and time-consuming procedure than is isolated cleft lip repair or cleft palate repair. Although technically challenging, single-stage repair of the whole deformity in late-presenting patients is a feasible, reliable, successful, and safe procedure in authors' experience.

A novel approach to soft-tissue repair: reoverexpanded flaps.

Postburn sequelae or excisional defect reconstruction after significant burn injury or resection of giant hairy nevus continues to be a significant challenge for the reconstructive surgeon. Unfortunately, the quality and quantity of available tissue for the repair of extensive defects is often limited. The techniques of tissue expansion have been used for many years to expand normal skin adjacent to the defect for the reconstruction of even wider defects in various parts of the body with its numerous advantages.Nine patients in whom reoverexpanded neighboring skin flaps were used to improve the capacity of wider soft-tissue defect coverage for postburn scar revision or excisional defect of giant hairy nevus in the various parts of the body is reported here.