• Archives of Plastic Surgery
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• 제36권5호
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• pp.578-582
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• 2009

Purpose: In extensive deep burn of the lower limb, due to less amount of soft tissue, bone is easily exposed. When it happens, natural healing or reconstruction with skin graft only is not easy. Local flap is difficult to success, because adjacent skins are burnt or skin grafted tissues. Muscle flap or free flap are also limited and has high failure rate due to deep tissue damage. The authors acquired good outcome by performing one - stage operation on bone exposed soft tissue defect with AlloDerm$^{(R)}$(LifeCell, USA), an acellular dermal matrix producted from cadaveric skin. Methods: We studied 14 bone exposed soft tissue defect patients from March 2002 to March 2009. Average age, sex, cause of burn, location of wound, duration of admission period, and postoperative complications were studied. We removed bony cortex with burring, until conforming pinpoint bone bleeding. Then rehydrated AlloDerm$^{(R)}$(25 / 1000 inches, meshed type) was applicated on wound, and thin split thickness(6 ~ 8 / 1000 inches) skin graft was done at the immediately same operative time. Results: Average age of patients was 53.6 years(25 years ~ 80 years, SD = 16.8), and 13 patients were male(male : female = 13 : 1). Flame burn was the largest number. (Flame burn 6, electric burn 3, contact burn 4, and scalding burn 1). Tibia(8) was the most affected site. (tibia 8, toe 4, malleolus 1, and metatarsal bone 1). Thin STSC with AlloDerm$^{(R)}$ took without additional surgery in 12 of 14 patients. Partial graft loss was shown on four cases. Two cases were small in size under $1{\times}1cm$, easily healed with simple dressing, and other two cases needed additional surgery. But in case of additional surgery, granulation tissue has easily formed, and simple patch graft on AlloDerm$^{(R)}$ was enough. Average duration of admission period of patients without additional surgery was 15 days(13 ~ 19 days). Conclusion: AlloDerm$^{(R)}$ and thin split thickness skin graft give us an advantage in short surgery time and less limitations in donor site than flap surgery. Postoperative scar is less than in conventional skin graft because of more firm restoration of dermal structure with AlloDerm$^{(R)}$. We propose that AlloDerm$^{(R)}$ and thin split thickness skin graft could be a solution to bone exposured soft tissue defects in extensive deep burned patients on lower extremities, especially when adjacent tissue cannot be used for flap due to extensive burn.

• 대한화장품학회지
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• 제45권2호
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• pp.175-184
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• 2019

상피세포성장인자(epidermal growth factor, EGF)는 인간의 표피 및 진피에서 세포막 수용체와 상호작용을 통하여 세포의 생장 및 증식을 유도하는 기능을 갖고 있다. 이 같은 EGF의 기능은 의료 및 화장품 분야에서 상처치유 의약품 및 노화방지 화장품의 주요원료로 사용되고 있다. 화장품 원료로서 EGF는 피부장벽으로 알려져 있는 피부 각질층의 투과가 잘 안되기 때문에 가지고 있는 본연의 효능을 구현하는 데 문제가 있다. 본 연구에서는 EGF의 경피투과 효율을 개선하기 위하여 피부 투과능이 확인된 거대분자 전송 도메인(macromolecule transduction domain, MTD) 151이 융합된 형태로 재조합 인간 상피세포성장인자 ($MTD_{151}-EGF$)를 개발하였다. $MTD_{151}-EGF$의 유전자가 coding된 vector로 형질전환된 대장균에서 $MTD_{151}-EGF$ 발현시킨 후 정제를 진행하였다. 정제된 MTD-EGF를 대상으로 세포증식시험, 세포독성시험, 생체외 피부흡수시험 그리고 인공피부를 이용한 경피투과능을 평가하였다. 99% 이상 고순도로 정제된 $MTD_{151}-EGF$의 세포증식 활성은 EGF 대비 동등 이상의 수준이었으며, 세포독성은 관찰되지 않았다. 또한, 인공피부 투과모델에서 FITC로 표지된 EGF와 $MTD_{151}-EGF$의 진피층까지의 투과를 공초점 현미경으로 관찰한 결과, $MTD_{151}-EGF$는 EGF 대비 우수한 투과능을 보였으며, 경피흡수 시스템을 이용한 투과물질의 정량분석 결과, EGF 대비 약 16 배 이상 투과량이 많은 것으로 확인되었다. 이러한 결과들은 다양한 활성물질들의 화장품용 원료로서의 경피투과에 MTD가 기존의 물리적인 경피투과 방법을 효율적으로 개선한 대안이 될 것으로 판단된다.