Affiliation:
1. From the Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Abstract
Background:
Removal of the eschar has gradually become a consensus on treatments of deep dermal necrosis after skin trauma in recent years, whereas exaggerated scar contracture and tissue proliferation developed during healing have received little attention. Here, the authors investigated the effects of eschar on excessive wound healing of small dermal damage and focused on the role M2 macrophages played, hoping to offer a theoretical basis to improve patients’ cosmetic satisfaction.
Methods:
A mouse dorsal wound model (n = 12) was established by electric heating pads heating for 20 seconds on each side of the spine, and the left side was the preserved group. Macrophage numbers, expression of wound-healing-associated proteins, and inflammatory cytokine levels were assessed at different time points by immunohistochemistry and quantitative real-time polymerase chain reaction. A co-culture system of M2 macrophages and myofibroblasts was created in vitro. Immunohistochemistry, real-time polymerase chain reaction, and Western blot were performed to evaluate the proliferation, migration, and protein expression of myofibroblasts.
Results:
Preserving eschar inhibited contraction-associated proteins (α-smooth muscle actin and vimentin) and collagen expression, inflammatory cytokine (IL-1β, IL-10, TFN-α, and IL-4) expression, and M2 macrophage infiltration. Mechanistically, M2 macrophages potentially contributed to excessive wound healing by promoting myofibroblasts proliferation, migration, and production of contraction-associated proteins.
Conclusion:
Eschar preservation in wounds could reduce inflammation and negatively modulate myofibroblasts by inhibiting M2 macrophage polarization and infiltration, preventing excessive wound contraction and collagen deposition.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference47 articles.
1. Evaluation of intraarterial thrombolysis in treatment of cosmetic facial filler-related ophthalmic artery occlusion.;Zhang;Plast Reconstr Surg,2020
2. Complications and litigation associated with injectable facial fillers: a cross-sectional study.;Beauvais;J Oral Maxillofac Surg,2021
3. Understanding, avoiding, and managing dermal filler complications.;Cohen;Dermatol Surg,2008
4. Wound bed preparation: TIME for an update.;Harries;Int Wound J,2016
5. Early excision and grafting versus delayed skin grafting in burns covering less than 15% of total body surface area; a non- randomized clinical trial.;Ayaz;Bull Emerg Trauma,2014