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At least 73 records · Page 4Linked to original sources
PubMed1976

Cancer of the skin of the nose. Treatment by total skin excision and three-quarter thickness skin graft.

We describe a method of treatment and repair of superficial cancers of the skin of the nose. In 124 patients in whom excision of the lesion and a split thickness skin graft were used, 77% were alive and free of their disease after five years of follow-up. Three patients in whom a skin graft was performed were unavailable for follow-up, and 15 patients developed local recurrence either in the area of excision or in the surrounding skin. The method is easy, reliable, and the cosmetic results are satisfactory.

Aged↗
PubMed1976

In vitro studies of antimicrobial effects of biological dressings. A comparison of the effect of human cadaver split skin grafts; irradiated and deep frozen porcine split skin; and fresh split skin from living humans and pigs.

The in-vitro antimicrobial effect of certain biological dressings was analysed. Glass basins lined with inverted human or pig skin treated and stored in various ways were inoculated with Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Glass basins served as controls. Human split skin from cadavers or living donors, deep frozen or preserved in Histocon and fresh-frozen pig had marked inhibitory activity. Heated skin and beta-irradiated pig skin did not have this effect. The antimicrobial effect was not observed during the first 2 hours of incubation but was present after 24 and 48 hours. It was not dependent on serum factors, It is concluded that when a biological dressings is used, advantage should be taken of its bactericidal activity, as infection is often a problem in sound dressing.

Animals↗
PubMed1992

[Treatment of large skin defect with 6:1 meshed skin autograft and 1.5:1 meshed fresh porcine skin overlay].

The use of expanded mesh skin graft from limited donor sites has greatly increased wound coverage. However, grafts with an expansion size of 6:1 or greater often heal slowly or are lost because of local infection. Three patients with large skin defects in lower extremity have been treated with 6:1 mesh autograft overlayed by 1.5:1 fresh porcine skin mesh graft. Epithelium grown from both grafts could be found. The autografts continuously expanded under the xenografts. The outer xenografts gradually separated and desquamated, on an average, in 14 days. This technique enables resurfacing of a large area of skin defect from smaller donor sites.

Aged↗
PubMed1987

Occurrence and distribution of neuropeptides in the human skin. An immunocytochemical and immunochemical study on normal skin and blister fluid from inflamed skin.

The content and distribution of substance P (SP), somatostatin, vasoactive intestinal peptide (VIP), calcitonin gene-related peptide (CGRP) and neuropeptide Y (NPY) in human skin were investigated. Radioimmunoassay was performed on pooled tissue samples from several regions (fingers, toes, axillas and thighs) and on tissue fluid from spontaneous blisters on inflamed skin. Immunocytochemical localization showed all peptides examined except somatostatin to be present in nerve fibers. Nerve fibers storing SP and CGRP, which were found to coexist, were mostly present as free nerve endings in the superficial part of dermis and in epidermis. SP/CGRP fibers were most abundant in fingers and toes. VIP fibers and NPY fibers were localized in the deeper parts of dermis around blood vessels and acini of sweat glands. Also fibers containing these neuropeptides were most common in fingertips and toes. VIP occurred in relatively high amounts also in skin from axilla whereas NPY in this region was below detection limit. Immunoreactive somatostatin was found in low concentrations in tissue extracts and was not present in amounts sufficient for reliable immunostaining. Fluid from spontaneous blisters on inflamed skin contained detectable amounts of all neuropeptides.

Adolescent↗
PubMed1995

[Dynamic skin suture for secondary skin closure and treatment of skin defects].

Dynamic skin suture exerts progressive traction to the wound margins which allows a stepwise closure of a defect. It consists of interrupted sutures with two additional plastic tubes lying parallel to the wound margins on the surface of the skin. The extracuticular slopes of the sutures and the knots pass over these tubes. This decreases local pressure on the skin. The knots are performed in a way that, once they have been tied, permits further tightening without opening them. A viscoelastic property of the skin--stress-relaxation- reduces the tension on the sutures over time and allows a further tightening. As an example for the use of this technique, the results of closures of fasciotomies in compartment syndromes are presented. In 1993, 50 fasciotomies in 35 patients were treated with dynamic suture. In 42 defects (84%) a complete obliteration was possible. In the residual 8 defects reduction of size was significant. The mean time until obliteration was 11.5 days, in average sutures were tightened 4 times. The results suggest that dynamic suture is a useful technique for repair in fasciotomies. It helps avoiding tissue transplantations. The operative procedure itself is speedy and simple. Possible indications in limited excisional defects are demonstrated in a case report.

Adolescent↗
PubMed1978

Skin tumours in white South Africans. Part IV. Influence of occupation, sun sensitivity, colouring and associated skin tumours on the incidence of skin tumours.

Outdoor and industrial occupations in the southern Transvaal do not increase the incidence of any skin tumour excepting that of squamous cell carcinoma. However, they accelerate the onset of solar keratoses and squamous and basal cell carcinomas. A fair, sun-sensitive skin, red hair and blue eyes are more important factors predisposing towards the development of skin cancer. Unduly large numbers of seborrhoeic keratoses were found in association with polyps, and of intradermal naevi with both cavernous haemangiomas and lentigines. A high proportion of solar keratosis was found in both squamous cell carcinoma and Bowen's disease, and of basal cell carcinoma in superficial basal carcinoma, but the reverse associations were not significant.

Humans↗
PubMed1980

A controlled trial to evaluate and compare a sutureless skin closure technique (Op-Site skin closure) with conventional skin suturing and clipping in abdominal surgery.

Sutureless wound closure employing a new product, Op-Site Skin Closure, was evaluated in comparison with two standard techniques of skin closure, using interrupted nylon sutures and Michel clips. The trial involved 110 patients undergoing elective and emergency abdominal surgery. The results showed that Op-Site Skin Closure was as good as the conventional techniques of skin closure with the advantages that it is easier and quicker to apply, produces a superior cosmetic result and, consequently, has gained excellent patient and nurse acceptance.

Abdomen↗
PubMed1991

Skin oxygen tension, skin oxygen consumption, and skin blood flow measured by a tc-pO2 electrode.

By use of a combined tc-pO2 skin blood flow sensor E5250 and measurement of cutaneous and subcutaneous blood flows with the 133Xenon washout method it was demonstrated that blood flow in both tissues increases with a factor of 3-4 when the electrode temperature increases from 37 to 45 degrees C. In order to examine the influence of the gas diffusion barrier within the epidermal membrane the stratum corneum of the forearm was removed selectively by stripping with adhesive tape. Stripping increased the oxygen tension values from 10.98 +/- 0.63 kPa to 14.58 +/- 1.03 kPa, and skin oxygen consumption ranged from 0.208 to 0.251 ml O2.(100g.min)-1. The combination of a Clark type electrode with a heat sensor allows determination of oxygen delivery to the skin as well as the oxygen supplying cutaneous blood flow. The distribution of blood flow between nutritional and shunt vessels at various local temperatures remains to be clarified.

Blood Flow Velocity↗
PubMed1989

Expression of parathyroid hormone related protein in normal skin and in tumours of skin and skin appendages.

Parathyroid hormone related protein (PTHrP) has been demonstrated in the tumour cells of squamous cell carcinomas originating in a variety of organs, in undifferentiated small cell tumours of the bronchus, and in carcinoma of the kidney. The protein hormone is thought to produce the hypercalcaemia which may complicate some of these malignancies. By using an antibody raised in rabbits against the N-terminal portion of the molecule, the polypeptide may be demonstrated in cells of the prickle cell layer of normal skin and in the cells of hair follicles. Skin tumours showing squamous or hair follicle differentiation are shown to contain the protein antigen, while basal cell carcinomas and tumours with sweat gland differentiation do not. The hormone may be primordial in origin and the progenitor of parathyroid hormone.

Carcinoma, Squamous Cell↗
PubMed1984

[Skin tanning and light protection-theory, agents and analytic aspects. 1. Skin tanning and skin tanning agents].

The different approaches to achieving skin tanning with emphasis on natural tanning, due to UV radiation of the sun or solaria, and artificial tanning through tannings agents are described. In contrast to the artificial tan the natural tan is a protection against UV radiation and is caused by pigmentation (melanin formation). The artificial tanning is based on a chemical reaction usually by means of dihydroxy acetone (melanoidin formation). Reaction mechanisms by both agents are reported. The determination of dihydroxy acetone in cosmetic tanning preparations by TLC, GC, HPLC, enzymatic tests and by a new method for capillary GC including sample preparation is described. When exceeding the natural protection mechanisms the skin should be protected by physico-chemical measures. The active principles in sunscreens are the UV filtering substances. UV filters permitted in the EG are listed. 2-Hydroxy benzophenone is used as an example to explain the mechanism of UV filtering substances. Analysis of UV filtering substances in cosmetic sunscreens by TLC, GC, HPLC is described as well as a fast and simple method for separation of lipophilic UV filters followed by capillary GC determination.

Chromatography, Gas↗
PubMedDate not supplied

Cefdinir versus cephalexin for the treatment of skin and skin-structure infections. The Cefdinir Adult Skin Infection Study Group.

Because of increasing resistance to older antimicrobial agents, newer drugs need to be evaluated for the treatment of skin and skin-structure infections (SSSIs). This double-masked, randomized, comparative, multicenter study enrolled patients aged 13 years or older with SSSIs to receive either cefdinir 300 mg BID or cephalexin 500 mg QID for 10 days. Nine hundred fifty-two patients (474 in the cefdinir group and 478 in the cephalexin group) took part, primarily white males between 18 and 65 years of age. There were two follow-up visits, with efficacy determined at the test-of-cure visit, 7 to 16 days posttherapy. Many patients were not microbiologically assessable, primarily because of negative cultures at study admission. Patients who required surgical intervention (e.g., incision and drainage) at the site of infection more than 24 hours after the initiation of drug therapy were defined as treatment failures. Significantly more isolated pathogens were resistant to cephalexin than to cefdinir. In the 178 efficacy-assessable cefdinir-treated patients, the rate of pathogen eradication was 93% (200/215), and the rate of successful clinical response was 88% (157/178), compared with 89% (221/247) and 87% (177/204), respectively, in the 204 efficacy-assessable cephalexin-treated patients. Using confidence-interval analysis, the microbiologic and clinical response rates of the cefdinir-treated patients were statistically equivalent to those of the cephalexin-treated patients. At the follow-up visits, patients were questioned about any adverse events occurring since their previous visit. Any untoward symptom occurring during or within 2 days after completion of drug treatment was considered an adverse reaction if the investigator judged it to be definitely, probably, or possibly related to the study drug. One hundred twenty-three (26%) cefdinir-treated patients and 77 (16%) cephalexin-treated patients experienced at least one adverse reaction, a statistically significant difference. Study drug was discontinued for adverse reactions in 20 (4%) cefdinir-treated patients and 13 (3%) cephalexin-treated patients; in the two groups, 10 and 7 patients, respectively, were discontinued for diarrhea. Cefdinir taken BID was as effective as cephalexin taken QID in the treatment of mild-to-moderate SSSIs and was well tolerated by most patients. The increased antibacterial activity of cefdinir must be balanced against the higher rate of diarrhea seen in patients treated with this drug.

Adolescent↗
PubMed2000

Effect of radiation on skin expansion and skin flap viability in pigs.

The aim of the present study was to investigate the effect of radiation treatment both on skin tissue expansion with the chronic inflation of subcutaneous expanders and on skin flap viability in surgically delayed and expanded skin in the pig. One flank in each of six pigs (initially weighing 17 +/- 1.8 kg) was randomly assigned for radiation treatment, and the contralateral flank served as a nonirradiated control. Three mirror-image, 8 x 10 cm, rectangular templates were marked on each flank; these templates were randomly assigned to the construction of a delayed skin flap (group A), a skin flap raised on expanded skin (group B), or a skin flap raised on expanded skin with a capsulectomy before flap surgery (group C). Radiation treatment was performed using sequential radiation with three fractions per week (810 cGy/fraction) for 2 weeks, with a total dose of 4,860 cGy. Twelve weeks after radiation treatment, skin expanders (8 x 10 cm) were installed subcutaneously in the locations assigned for skin expansion. Skin expansion by the inflation of subcutaneous skin expanders with saline twice weekly was started 8 weeks later and lasted for 3 weeks. Two weeks after surgical delay and the last skin expansion, 8 x 20 cm skin flaps were raised on the locations assigned for delayed skin flaps, expanded skin flaps, and expanded skin flaps with a capsulectomy. Skin flap viability was assessed 24 hours later using a fluorescein dye-staining technique. Skin expansion by the inflation of subcutaneous expanders with saline was slower (p < 0.05) in the radiated skin (39 +/- 6 ml/filling) than in the nonirradiated control skin (51 +/- 6 ml/filling). Radiation reduced the overall area of expanded skin by 23 percent (p < 0.05) compared with the control. Radiation treatment also reduced skin viability by 36 percent (p < 0.05) in the delayed skin flaps, 27 percent (p = 0.10) in the expanded skin flaps, and 36 percent (p < 0.05) in the expanded skin flaps with a capsulectomy when compared with their contralateral, nonirradiated controls. There were no significant differences in skin viability among these three types of skin flaps within the radiated and nonirradiated groups. Taken together, these observations indicate that radiation treatment reduced the effectiveness of the surgical delay procedure, the amount of subcutaneous skin expansion (by an increase in skin area), and skin flap viability. However, a capsulectomy alone did not affect the viability of skin flaps raised on expanded skin.

Animals↗
PubMed2003

Oxygenation and microcirculation during skin stretching in undermined and nonundermined skin.

The aim of this experimental study was to assess the skin microcirculation of undermined and nonundermined wound edges closed with a skin-stretching device. In eight piglets, 9 x 9-cm wounds were created on both flanks by excision of the skin and the subcutaneous layer down to the muscular fascia, with general anesthesia. On one flank, the surrounding skin was completely undermined. For a period of 30 minutes, wound closure was performed with a stretching device, using the principle of load cycling. The device stretched the skin and moved the opposing wound edges toward each other. During this period, laser Doppler flowmetry and transcutaneous oximetry were simultaneously used to monitor microcirculation and oxygenation in the stretched skin of both flanks. Undermining of the surrounding skin produced a 12 percent decrease in the laser Doppler flowmetry signal and a 21 percent decrease in the transcutaneous oximetry value. Skin stretching resulted in decreases in the laser Doppler flowmetry signals and the transcutaneous oximetry values, whether or not the skin was undermined. Releasing the stretching device resulted in rapid normalization of the laser Doppler flowmetry values in undermined and nonundermined skin and a slow return of the transcutaneous oximetry values to close to baseline levels in nonundermined skin. The transcutaneous oximetry values in undermined skin did not return to baseline levels; each period of skin stretching resulted in an additional decrease in the transcutaneous oximetry values. Stretching of undermined skin for 30 minutes produced a significant (p < 0.0001) decrease in skin oxygenation. As a result, 50 percent of the undermined stretched skin demonstrated skin necrosis at the wound edges, which was still present after 1 week. Wound healing in the nonundermined stretched skin proceeded without problems. It is concluded from these experiments that the viability of undermined skin becomes compromised as a result of significantly decreased oxygen availability in the skin during and after stretching. Consequently, it is recommended that skin stretching be performed on nonundermined skin, rather than undermined skin. In addition, when skin is stretched to close a large defect, it is logical to use cyclic loading, so that recuperation of the skin circulation can occur. Furthermore, laser Doppler flowmetry seemed to produce atypical signals in monitoring of skin viability of wound edges closed with a skin-stretching device.

Animals↗
PubMed1995

Pharmacokinetics of 2-ethyl-1,3-hexanediol. III. In vitro skin penetration comparisons using the excised skin of humans, rats, and rabbits.

Excised skin from Fischer 344 rats, New Zealand White rabbits, and human females (obtained from mammoplasty patients) were compared for their in vitro skin penetration potential with 2-[14C]-ethyl-1,3-hexanediol (EHD). EHD was applied as both an undiluted dose and a 3% v/v aqueous dose using a flowthrough skin penetration chamber design and was analyzed over 0-6 hr. The undiluted dose was equivalent to a 150 mg/kg dose used in vivo with rats (Frantz et al., Drug Metab. Dispos. 20(1), 6-18, 1992), but normalized on a per cm2 surface area basis, and applied under occluded conditions (covered as for in vivo studies). Undiluted applications of EHD did not substantially penetrate skin, with effluent recoveries of approximately 0.9% of the applied dose for human skin, 2-4% for rat skin, and 3-6% for rabbit skin. By comparison, nonoccluded human skin showed lower effluent radioactivity (0.6%), which was attributed to EHD evaporation from skin. With undiluted EHD, approximately 97% of the recovered 14C was an unabsorbed dose for human skin, with 94% for rat skin and 85% for rabbit skin (expressed as a percentage of the recovered dose). Based on HPLC analysis of effluent samples, 99-100% of the undiluted [14C]EHD penetrated rat, rabbit, and human skin in the unmetabolized form. In contrast, approximately 5% of the applied aqueous dose was recovered in the effluents for human skin, while 6-9% appeared in effluents for rat skin; rabbit skin was not evaluated for aqueous doses. The fraction of unabsorbed aqueous EHD dose totaled 53% of the applied dose for human skin and 63% for rat skin. Evaporative loss of undiluted [14C]EHD was also measured (captured on activated charcoal) in separate experiments and compared with a known standard chemical, N,N[14C]diethyl-m-toluamide (DEET). Evaporation of EHD was clearly a competing factor with penetration, particularly for human skin preparations, and evaporative losses were similar to those seen in previous studies. Penetration of skin was also greater for both EHD and DEET when evaporation was not permitted (stopped chamber). Permeability constant (kp) values were calculated using the pseudo steady-state slopes from plots for cumulative mg/cm2 penetration vs time. For undiluted EHD, human skin had the slowest penetration rate, while rabbit skin kp values were the largest. The kp values for water solutions of EHD on rat and human skin demonstrated a slightly higher penetration, with values of the same order of magnitude as that observed for a concurrently run [14C]ethanol control. The minimal skin penetration observed in vitro in this study, taken together with in vivo percutaneous pharmacokinetic studies (Frantz et al., 1992) and the known percutaneous toxicology of EHD, suggests that penetration through human skin and systemic adverse effects should be minimal.

Animals↗
PubMed2001

Tension decrease during skin stretching in undermined versus not undermined skin: an experimental study in piglets.

In a controlled study using 15 piglets, the efficacy of skin stretching using a skin stretching device was tested by quantifying the tension decrease during skin stretching in undermined and not undermined wounds. The viability of the skin margins was examined in both situations. Thirty standardized wounds was created: around 15 wounds on one flank, the surrounding skin was undermined; whereas around the 15 wounds on the opposite flank, the surrounding skin was not undermined. The force required to close the 9 x 9 cm defect was measured at the beginning, after undermining, and after 30 minutes of skin stretching. Also examined was the wound healing after 1 day and 1 week. A tension decrease of 3.02 N (13.6 percent reduction of the total force that is required to close the wound at the beginning) was seen due to undermining the surrounding skin. Skin stretching for 30 minutes without undermining the skin showed a tension decrease of 6.10 N (26.5 percent). Therefore, the tension decrease due to skin stretching was twice as high in comparison with undermining the skin margins alone. This has been statistically proven to be significant (-d (difference) = 3.08, 95 percent confidence interval = 2.16; 4.00, p < 0.001). When the undermined skin of the wound was stretched for 30 minutes, we measured a total tension decrease of 7.60 N (34.1 percent). There was a statistically significant but small difference in total tension decrease as a result of undermining combined with skin stretching in comparison with skin stretching without undermining (-d = 1.51, 95 percent confidence interval = 0.77; 2.23, p < 0.001). Undermining the surrounding skin involved cutting musculocutaneous perforating vessels. Looking at the viability of the skin, seven wounds, all found in the undermined group, showed skin necrosis after 1 week. Excessive seroma formation was seen in all wounds around which the skin was undermined. In the not undermined wounds, there were no problems in wound healing. In conclusion, skin stretching for only 30 minutes using a skin stretching device significantly reduces wound closing tension. The additional advantage of skin stretching over that of undermining alone is clearly shown. Undermining the wound margins before skin stretching gives a small additional tension decrease but has well-known complications, such as skin-edge necrosis and seroma formation.

Animals↗
PubMed1998

Effects of gestational and postnatal age on body temperature, oxygen consumption, and activity during early skin-to-skin contact between preterm infants of 25-30-week gestation and their mothers.

Temporary skin-to-skin contact between preterm infant and the mother is increasingly used in neonatal medicine to promote bonding. It is not known at which gestational age (GA) and postnatal age skin-to-skin contact outside the incubator is a sufficiently warm environment and is tolerated by preterm infants without a decrease in body temperature, oxygen consumption (VO2) increase, or unrest. We conducted a prospective clinical study of 27 spontaneously breathing preterm infants of 25-30-wk GA. Rectal temperature (Trecta), VO2 (indirect calorimetry), and activity were continuously measured in the incubator (60 min), during skin-to-skin contact (60 min), and back in the incubator (60 min) in wk 1 and 2 of life. In wk 1 the change in Trectal during skin-to-skin contact was related to GA (r=0.585, p=0.0027): infants of 25-27-wk GA lost heat during skin-to-skin contact, whereas infants of 28-30 wk gained heat and their mean Trectal during skin-to-skin contact was 0.3 degrees C higher than before (p < 0.01). No significant changes of VO2 or activity occurred. In wk 2 the infants' VO2 was higher than in wk 1, but VO2 during skin-to-skin contact was the same as in the incubator. Only small fluctuations in Trectal occurred. In wk 2 all infants slept more during skin-to-skin contact than in the incubator (p < 0.02). We conclude that, for preterm infants of 28-30-wk GA, skin-to-skin contact was a sufficiently warm environment as early as postnatal wk 1. For infants of 25-27-wk GA skin-to-skin contact should be postponed until wk 2 of life, when their body temperature remains stable and they are more quiet during skin-to-skin contact than in the incubator.

Adult↗