PURPOSE: Aim of this study was to assess the safety and effectiveness of Keraheal-Allo® (Biosolution Co., Ltd., Korea) in patients with deep second-degree burn as a part of post marketing surveillance. METHODS: Seventy-five patients with deep second-degree burn were enrolled from April 2017 to October 2017. Keraheal-Allo, a thermos-sensitive hydrogel-type allogeneic keratinocytes, was applied to 90 deep second-degree burn sites of 75 patients. After application of Keraheal-Allo, the efficacy was assessed as the period of 100% re-epithelialization that was evaluated every time dressing was changed. RESULTS: The mean re-epithelialization period in the treated sites with KeraHeal-allo was 13.67±5.11 days. There was no severe adverse event. CONCLUSION: In conclusion, this thermo-sensitive hydrogel-type allogeneic keratinocytes have the clinical usefulness in terms of the safety, efficacy and ease of use.
Bandages ; Burns* ; Humans ; Keratinocytes* ; Marketing ; Re-Epithelialization

PURPOSE: To compare the results of transepithelial photorefractive keratectomy (trans PRK) and brush-assisted photorefractive keratectomy (brush PRK) for the treatment of myopia. METHODS: A total of 146 eyes from 78 patients who received brush PRK or trans PRK with the Schwind Amaris laser platform were included in the present study. Uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent (MRSE) at postoperative 1 week, 1, 3, 6, and 12 months were compared between the 2 groups as well as epithelial healing time. RESULTS: The mean time to complete epithelial healing was 3.27 +/- 0.75 days in the trans PRK group and 3.67 +/- 0.93 days in the brush PRK group (P < 0.05). At 1 week after surgery, UDVA recovered more rapidly after trans PRK than brush PRK (brush PRK: 0.13 +/- 0.12 log MAR units, trans PRK: 0.09 +/- 0.08 log MAR units, P < 0.05), however, UDVA was not significantly different at 1, 3, 6, and, 12 months postoperatively between the 2 groups. CONCLUSIONS: Re-epithelialization and visual recovery were faster in the trans PRK group while visual outcome and postoperative complications were equivalent to the brush PRK group.
Humans ; Myopia ; Photorefractive Keratectomy* ; Postoperative Complications ; Re-Epithelialization ; Visual Acuity

Re-epithelialization is one of the core links that determines the healing process of skin wounds. The proliferation and differentiation of epidermal stem cells to form new epidermal tissue is the histological basis of re-epithelialization, and the smooth progress of the cell differentiation process of epidermal stem cells-precursor cells-terminal cells is the cytological basis for the continuous formation of new epidermal tissue. The proliferation of stem cells and their differentiation into precursor cells are the determinants of the proliferative potential of newly formed epidermal tissue, while the expansion and differentiation of precursor cells into terminal cells are key factors determining the rate of new epidermal tissue formation. The tissue microenvironment plays a key regulatory role in the process of wound re-epithelialization, and cell growth factor and inflammatory mediators are the two main components of tissue microenvironment, which play regulatory role in different aspects of proliferation and differentiation of epidermal stem cells, jointly promoting the smooth progress of wound re-epithelialization As an important part of skin immune system, the subsets of gamma-delta (γδ) T cells play crucial role in dynamically shaping early wound microenvironment via secreting different cell growth factors and inflammatory factors. From the prospective of immune microenvironment of wound, this paper discusses the role of skin γδ T cells in maintaining the balance of stem cell proliferation and differentiation and regulating wound re-epithelialization, providing a new direction for the prevention and treatment of refractory wound.
Prospective Studies ; Re-Epithelialization ; Skin ; T-Lymphocyte Subsets ; T-Lymphocytes

PURPOSE: To evaluate clinical effects of intracameral voriconazole injection in fungal keratitis refractory to conventional therapy. METHODS: Thirty-eight eyes of 38 patients with fungal keratitis were included in this study. The patients were divided into 3 groups: 13 patients with intracameral voriconazole injection (50 microg/0.1 ml; group A), 11 patients with intracameral amphotericin B injection (10 microg/0.1 ml; group B), and 14 patients with conventional therapy only (group C). Clinical factors including treatment success rate and time to successful treatment were evaluated. RESULTS: Treatment success was accomplished in 12 eyes in group A (92.3%), 10 eyes in group B (90.9%), and 12 eyes in group C (85.7%). Time to treatment success in group A, B, and C was 36.1 +/- 10.4 days (p = 0.04), 34.2 +/- 7.8 days (p = 0.03), and 49.5 +/- 16.7 days, respectively. Patients who had received intracameral voriconazole injection or amphotericin B showed faster fungal keratitis improvement than patients who received conventional treatment. Time to re-epithelialization and time to disappearance of hypopyon showed a similar clinical course. CONCLUSIONS: Intracameral voriconazole injection, which has a similar therapeutic effect as intracameral amphotericin B injection in the management of fungal keratitis, can be helpful in the treatment of intractable fungal keratitis.
Amphotericin B ; Eye ; Humans ; Keratitis ; Pyrimidines ; Re-Epithelialization ; Time-to-Treatment ; Triazoles

PURPOSE: Laser epithelial keratomileusis (LASEK) is a refractive surgery technique in which the cornea is covered with the epithelial flap after keratectomy. However, there have been reports of tissue damage by the alcohol utilized in this procedure while preparing the epithelial flap, which has led to novel methods. One of these is the mechanical designing of the epithelial flap named epipolis laser assisted in situ keratomileusis (Epi-LASIK). This study evaluates the histologic features and wound healing process of the corneal flap using Epi-Tome, which is the epithelial cutter of the newly introduced Epi-Lasik. METHODS: Twenty-four eyes of 12 dogs were devided into two groups. In one group (n=12), 20% alcohol was used and, in the other group (n=12), Epi-Tome (Gebauer, Germany) was used to make a corneal flap. The size change of a fluorescein-stained epithelial defect was followed postoperatively at 6, 12, 24, and 36 hours. RESULTS: The maximum decrease in defect size were observed at 0 to 6 hours in the Epi-Tome group, and from 6 to 12 hours in the alcohol group; the value were 10.01+/-5.32 mm2 and 9.23+/-4.75 mm2 respectively. Histologic review revealed that there was less tissue damage and smoother cut edge in the Epi-Tome group compared to the alcohol group, and the adhesion between stroma and epithelium was faster in the Epi-Tome group. CONCLUSIONS: Mechanically detached corneal flaps had favorable chances of survival such that re-epithelialization occurred early in the postoperative phase. A few epithelial fragments at a corneal section plane prevent corneal opacification and minimize inflammatory reaction, thus reducing postoperative pain.
Animals ; Cornea ; Dogs ; Epithelium ; Pain, Postoperative ; Re-Epithelialization ; Refractive Surgical Procedures ; Wound Healing* ; Wounds and Injuries*

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.
Conjunctiva* ; Cornea ; Epithelium, Corneal ; Mitomycin ; Ophthalmic Solutions ; Pterygium ; Rabbits* ; Re-Epithelialization* ; Recurrence ; Sclera

Bare sclera technique for pterygium is used frequently because of its lower recurrence rate than those of other techniques. Various factors may influence reepithelialization of the bare sclera and the corneal defects. We excised various sizes of conjunctiva and abraded corneal epithelium in rabbits, and then studied at various intervals the pattern and the rate of their reepithelialization over the bare sclera and the cornea along with histologic findings, and the effect of 0.04 % mitomycin eyedrops on reepithelialization. We obtained the following results. 1. The bare sclera was epithelialized completely by the 7th or 8th day postoperatively, when the conjunctiva was serially excised, ranging from 3 X 3 mm to 6 X 6 mm in size. The rate of reepithelialization between the groups was not statistically significant(p>0.05). 2. The defect of the cornea was epithelialized by the 3rd day postoperatively in all experimental groups, and the reepithelialization rate between the groups was not statistically significant(p>0.05). 3. Reepithelialization over the bare sclera progressed posteriorly from the limbus, however, in the case of the cornea, epithelialization progressed from the margin of the defect to the limbus. 4. 0.04% mitomycin eyedrops did not have any effect on epithelialization over the bare sclera and the corneal defect.
Conjunctiva* ; Cornea ; Epithelium, Corneal ; Mitomycin ; Ophthalmic Solutions ; Pterygium ; Rabbits* ; Re-Epithelialization* ; Recurrence ; Sclera

PURPOSE: The purpose of this study was to develop porcine full thickness skin wound healing model of thermal burn and skin defect and to compare wound healing process between them. METHODS: Twelve thermal burns and 12 skin defect wounds were created on the back of 3 domestic pigs. A round shaped heated electric iron was contacted for 30 seconds to develop full thickness burn. Appropriate dressings were applied for 30 days after wounding. Full thickness skin biopsies were obtained for histologic analysis by a pathologist. The amount of wound discharge, the surface area of each wound, and wound culture results were compared between skin defect and burn wound. RESULTS: Of 12 burn wound sections, 7 (58%) were identified to full thickness dermal injury. Complete wound reepithelialization was seen between postburn days 21 and 28 in both wounds. The initial wound area was smaller in burn than skin defect (P<0.001, 14.4+/-0.8 cm2 vs 22.8+/-3.4 cm2). The wound area of both burn and skin defect was slightly increased for 9 days after wounding and rapidly decreased after that time. The linear advancement length of wound edge was significantly slower in burn (P=0.009, 1.06+/-0.28 vs 1.48+/-0.42 cm). The amount of wound discharge was greater in skin defect than burn (P=0.002, 35.1+/-8.3 vs 49.5+/-11.2 g). CONCLUSION: We developed a porcine model of both thermal burn and skin defect. Time for complete reepithelialization was similar but the linear advancement length of wound edge was slower in burn than skin defect wound.
Bandages ; Biopsy ; Burns ; Hot Temperature ; Iron ; Models, Animal ; Re-Epithelialization ; Skin ; Sus scrofa ; Wound Healing

PURPOSE: Numerous experimental studies have shown the benefits of treating thermal burns by cooling. Nevertheless, few studies have shown the clinical effect of cooling therapy on thermal burns. This study aimed to identify the clinical effect of immediate cooling therapy. METHODS: The research was conducted as a retrospective, case-control study. All patients had thermal injuries characterized as a superficial second-degree burn. In the cooling group, 14 patients had first-aid cooling therapy delivered by either parents, caregivers, general practitioners, local hospitals, and/or Myongji hospital. Included in the study were 22 control patients who were not treated with any cooling therapies. Other clinical factors, such as age, sex, cause of burn injury, and burn area (Total Body Surface Area %), were taken into consideration. The duration of treatment was defined as the time from the occurrence of the injury to the presence of complete re-epithelialization, as confirmed by two surgeons. RESULTS: The duration of treatment in the cooling group was significantly less than that the control group (p < 0.05). CONCLUSION: Cooling therapy as an initial emergent treatment is clinically effective for superficial seconddegree burn injuries.
Body Surface Area ; Burns ; Caregivers ; Case-Control Studies ; General Practitioners ; Humans ; Parents ; Re-Epithelialization ; Retrospective Studies

BACKGROUND: The plantar aspect of the foot is a difficult area for wound coverage and offers restricted/limited possibility for surgical repair. Due to the shearing and ground-reactive forces that the sole of the foot encounters and its unique organizational makeup of plantar skin and fat pad, reconstructive surgical techniques used on other parts of the body cannot be readily adapted to the plantar foot. OBJECTIVE: The authors present an overview of wound repair after excision of benign or malignant tumor on plantar area. METHODS: Retrospective review was done on 27 patients whose benign or malignant tumors on the plantar area were excised. From January 2007 to December 2012, we repaired defects on the plantar foot after simple excision of benign cutaneous tumors or wide excision of malignant melanomas. Patients were reviewed for results and complications. RESULTS: Simple elliptical closure was used for the defects of which the short diameter was below 1.5 cm in 13 patients. Transposition flap was used in 2 patients. The local flap was used when the length to width ratio was smaller than 3 to 1, and the laxity of the skin adjacent to the defect was available. Larger defects of other 12 cases needed to be reconstructed with full thickness skin graft (FTSG) or by secondary intention healing (SIH). The re-epithelialization was shown to be faster in the FTSG group, but the functional and cosmetic results were better in the SIH group. CONCLUSION: Many defects on the sole were difficult to repair because of the distinct anatomy. In order to treat such large wounds in weight bearing area, both FTSG and SIH are relatively good options.
Adipose Tissue ; Foot ; Humans ; Intention ; Melanoma ; Re-Epithelialization ; Retrospective Studies ; Skin* ; Transplants ; Weight-Bearing ; Wounds and Injuries