Burns surgeons have long recognised the association between the depth of dermal injury and the speed of healing and degree of subsequent scarring. The work described in this thesis set out to study this relationship using a controlled wound healing model in healthy volunteers. A new model was developed that used a surgical jig to produce a standardised and reproducible wound in human skin. Pilot studies in cadaveric skin and ex vivo breast skin demonstrated that the model produced a graded, partial-thickness dermal wound, deep at one end and superficial end at the other, with a shallow gradient to enable a clinical distinction to be made between different depths of injury. This wound was made on the lateral aspect of the hip in 113 healthy volunteers. The progress of wound healing and scar development was studied using digital photography and image analysis software, high frequency ultrasound scanning and laser Doppler imaging, The deep end of the wound healed with. the formation of a scar and the superficial end healed without detectable scarring. Dermal injury was associated with an increase in dermal thickness and blood flow that was dependent on the depth of injury and the time after injury. The early inflammatory phase of wound healing was studied in 16 subjects prior to breast reduction. The acute inflammatory response was studied using immunohistochemistry. Leukocyte infiltration varied with the depth of dermal injury, with significantly greater numbers of all leukocyte subtypes at the deep end of the wound. The ultimate goal of wound healing research is to modify wound healing towards a non- scarring response. The results presented in this thesis might inform further work to identify potential targets for the development of anti-scarring agents.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:582539 |
| Date | January 2007 |
| Creators | Dunkin, Christopher Simon Jonathan |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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