{"id":4295,"date":"2022-06-09T10:00:00","date_gmt":"2022-06-09T10:00:00","guid":{"rendered":"https:\/\/modernsciences.org\/staging\/4414\/?p=4295"},"modified":"2022-05-26T08:38:50","modified_gmt":"2022-05-26T08:38:50","slug":"skin-grafts-for-burns-injuries-can-lead-to-crippling-scars-a-drug-that-blocks-the-skins-ability-to-respond-to-physical-stimuli-could-promote-healing-new-research-in-pigs-finds","status":"publish","type":"post","link":"https:\/\/modernsciences.org\/staging\/4414\/skin-grafts-for-burns-injuries-can-lead-to-crippling-scars-a-drug-that-blocks-the-skins-ability-to-respond-to-physical-stimuli-could-promote-healing-new-research-in-pigs-finds\/","title":{"rendered":"Skin grafts for burns injuries can lead to crippling scars \u2013 a drug that blocks the skin\u2019s ability to respond to physical stimuli could promote healing, new research in pigs finds"},"content":{"rendered":"\n  <figure>\n    <img  decoding=\"async\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/464357\/original\/file-20220519-7630-f4vph0.jpg?ixlib=rb-1.1.0&#038;rect=0%2C0%2C2121%2C1412&#038;q=45&#038;auto=format&#038;w=754&#038;fit=clip\" >\n      <figcaption>\n        Burn injuries can lead to disfiguring and sometimes crippling scars.\n        <span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.gettyimages.com\/detail\/photo\/human-back-with-a-large-scar-after-burn-royalty-free-image\/1005298662\" target=\"_blank\" rel=\"noopener\">Staras\/iStock via Getty Images<\/a><\/span>\n      <\/figcaption>\n  <\/figure>\n\n<span><a href=\"https:\/\/theconversation.com\/profiles\/kellen-chen-1345439\" target=\"_blank\" rel=\"noopener\">Kellen Chen<\/a>, <em><a href=\"https:\/\/theconversation.com\/institutions\/university-of-arizona-959\" target=\"_blank\" rel=\"noopener\">University of Arizona<\/a><\/em><\/span>\n\n<p><em>The <a href=\"https:\/\/theconversation.com\/us\/topics\/research-brief-83231\" target=\"_blank\" rel=\"noopener\">Research Brief<\/a> is a short take about interesting academic work.<\/em><\/p>\n\n<h2 id=\"the-big-idea\">The big idea<\/h2>\n\n<p>Reducing a skin graft\u2019s responsiveness to its physical environment could help improve healing and reduce scarring from large injuries like burns or blast wounds, according to our recent study published in <a href=\"https:\/\/www.science.org\/doi\/10.1126\/scitranslmed.abj9152\" target=\"_blank\" rel=\"noopener\">Science Translational Medicine<\/a>.<\/p>\n\n<p>Historically, injuries that cover massive areas of the body like burns have <a href=\"https:\/\/dx.doi.org\/10.1097%2FCCM.0000000000000790\" target=\"_blank\" rel=\"noopener\">high death rates<\/a>. Over the past 50 years, advances in wound care using techniques like <a href=\"https:\/\/www.webmd.com\/skin-problems-and-treatments\/plastic-surgery-burns\" target=\"_blank\" rel=\"noopener\">skin grafting<\/a> have often allowed patients to survive. During this process, a thin layer of healthy skin is removed from an undamaged area of the body and transplanted to cover the burn. Typically, these skin grafts are meshed, or perforated, in order to cover larger areas, much the way a chain-link fence covers more space overall than a solid metal wall of the same weight.<\/p>\n\n<figure class=\"align-center zoomable\">\n            <a href=\"https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\" target=\"_blank\" rel=\"noopener\"><img  decoding=\"async\"  alt=\"Gloved hands holding meshed skin graft\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-ls-sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\"  data-pk-srcset=\"https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/464330\/original\/file-20220519-11071-iv8osh.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w\" ><\/a>\n            <figcaption>\n              <span class=\"caption\">Skin grafts are often meshed to maximize the surface area they can cover.<\/span>\n              <span class=\"attribution\"><a class=\"source\" href=\"https:\/\/www.gettyimages.com\/detail\/photo\/scientist-processing-skin-graft-in-laboratory-royalty-free-image\/1092323744\" target=\"_blank\" rel=\"noopener\">Westend61\/Getty Images<\/a><\/span>\n            <\/figcaption>\n          <\/figure>\n\n<p>However, skin grafting still leads to <a href=\"https:\/\/doi.org\/10.1016\/j.burns.2018.10.010\" target=\"_blank\" rel=\"noopener\">long-term problems<\/a>. Grafts can contract, shrinking in size and becoming much more dense and filled with scar tissue. If these skin contractions occur over joints or the face, they can restrict movement and become crippling over time. The appearance of the scar tissue may also be unappealing to patients. The only treatment currently available for skin contractions is to <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21321660\/\" target=\"_blank\" rel=\"noopener\">remove the affected graft<\/a> and replace it with a new one. But because skin contractions can re-form, this can lead to a vicious cycle, with some patients receiving more than 60 repeat operations over the course of their lives.<\/p>\n\n<p>To figure out a way to prevent these skin contractions, <a href=\"https:\/\/scholar.google.com\/citations?user=zY_J9IQAAAAJ&amp;hl=en\" target=\"_blank\" rel=\"noopener\">my<\/a> <a href=\"https:\/\/scholar.google.com\/citations?user=N_AEs1gAAAAJ&amp;hl=en\" target=\"_blank\" rel=\"noopener\">colleagues<\/a> <a href=\"https:\/\/www.longakerlab.com\" target=\"_blank\" rel=\"noopener\">and<\/a> <a href=\"https:\/\/scholar.google.com\/citations?user=TG52tUAAAAAJ&amp;hl=en\" target=\"_blank\" rel=\"noopener\">I<\/a> at Stanford University applied skin grafts to surgically treated pigs, the animals with <a href=\"https:\/\/doi.org\/10.1016\/j.molimm.2014.10.023\" target=\"_blank\" rel=\"noopener\">skin most similar to humans<\/a>. We examined the genetic material of the pig skin to identify which types of cells were likely to contribute to healing and scarring and found that skin grafts activated molecular pathways that control inflammation and mechanotransduction \u2013 the process by which cells sense and respond to physical stimuli.<\/p>\n\n<p>Next, we incorporated a drug called a <a href=\"https:\/\/doi-org.stanford.idm.oclc.org\/10.1038\/s41467-021-25410-z\" target=\"_blank\" rel=\"noopener\">focal adhesion kinase inhibitor<\/a> in hydrogel, a moist material that doesn\u2019t dissolve in water, and applied it directly to the healing skin grafts. Because this drug inhibits a cell\u2019s ability to respond to its physical environment, we hypothesized that it could turn off the inflammation and mechanotransduction pathways. Within 21 days, we found that skin grafts treated with the drug had reduced skin contraction and scarring as well as improved healing, compared with skin grafts without the drug.<\/p>\n\n<figure class=\"align-center zoomable\">\n            <a href=\"https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip\" target=\"_blank\" rel=\"noopener\"><img  decoding=\"async\"  alt=\"Diagram of pigs with skin grafts treated with or without drug (FAKI hydrogel), where skin grafts with drug had reduced inflammation and scar formation.\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-ls-sizes=\"(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px\"  data-pk-src=\"https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip\"  data-pk-srcset=\"https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=317&amp;fit=crop&amp;dpr=1 600w, https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=317&amp;fit=crop&amp;dpr=2 1200w, https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=317&amp;fit=crop&amp;dpr=3 1800w, https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=399&amp;fit=crop&amp;dpr=1 754w, https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=399&amp;fit=crop&amp;dpr=2 1508w, https:\/\/images.theconversation.com\/files\/464276\/original\/file-20220519-20-fl6nsj.jpeg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=399&amp;fit=crop&amp;dpr=3 2262w\" ><\/a>\n            <figcaption>\n              <span class=\"caption\">Pigs with skin grafts treated with a drug known as FAKI hydrogel had reduced inflammation and scar formation both early and later in the study as compared with pigs with skin grafts without the drug.<\/span>\n              <span class=\"attribution\"><span class=\"source\">Kellen Chen\/Created with BioRender.com<\/span>, <a class=\"license\" href=\"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/\" target=\"_blank\" rel=\"noopener\">CC BY-NC-ND<\/a><\/span>\n            <\/figcaption>\n          <\/figure>\n\n<p>We then looked at how well the cells within the healing skin grafts were functioning and found that cells treated with the drug were more similar to healthy, unwounded cells than were cells in untreated skin grafts. Cells in untreated skin grafts had highly activated inflammation and mechanotransduction pathways, leading to increased scar formation.<\/p>\n\n<h2 id=\"why-it-matters\">Why it matters<\/h2>\n\n<p>Burns are among the most <a href=\"https:\/\/doi.org\/10.1186\/s41038-015-0026-4\" target=\"_blank\" rel=\"noopener\">devastating<\/a> of skin injuries and pose a <a href=\"https:\/\/doi.org\/10.1097\/SCS.0b013e318175f3a7\" target=\"_blank\" rel=\"noopener\">major burden on global public health<\/a>, especially in <a href=\"https:\/\/apps.who.int\/iris\/handle\/10665\/97852\" target=\"_blank\" rel=\"noopener\">middle- and low-income countries<\/a>. There are at least <a href=\"https:\/\/ameriburn.org\/who-we-are\/media\/burn-incidence-fact-sheet\/\" target=\"_blank\" rel=\"noopener\">40,000 annual cases of hospitalization<\/a> related to burn injuries in the U.S., and an average of 200 annual admissions for burns and burn-related skin disorders at each of the country\u2019s 128 burn centers. Scars from burns and skin grafts can cause <a href=\"https:\/\/dx.doi.org\/10.1136%2Fbmj.326.7380.88\" target=\"_blank\" rel=\"noopener\">disfigurement, impaired mobility and psychological distress<\/a>.<\/p>\n\n<p>Our drug therapy offers a way to reduce scarring and promote regenerative healing without any extra procedures. The hydrogels our treatment uses are <a href=\"https:\/\/dx.doi.org\/10.3389%2Ffbioe.2021.660145\" target=\"_blank\" rel=\"noopener\">already commonly used<\/a> in wound care. We believe that our drug could easily be incorporated with standard wound care in the clinic with no additional burden to patients or physicians.<\/p>\n\n<figure>\n            <iframe loading=\"lazy\" width=\"440\" height=\"260\" src=\"https:\/\/www.youtube.com\/embed\/TLVwELDMDWs?wmode=transparent&amp;start=0\" frameborder=\"0\" allowfullscreen=\"\"><\/iframe>\n            <figcaption><span class=\"caption\">Researchers are still figuring out how to reduce scar formation.<\/span><\/figcaption>\n          <\/figure>\n\n<h2 id=\"what-still-isnt-known\">What still isn\u2019t known<\/h2>\n\n<p>While our study offers one way to prevent scarring after injury, not much is known on how to effectively remove existing scars or reverse the scar formation process. In our future work, we hope to develop similar therapies to reverse scars and help the <a href=\"https:\/\/dx.doi.org\/10.1136%2Fbmj.326.7380.88\" target=\"_blank\" rel=\"noopener\">millions of Americans suffering from skin scarring<\/a>. <\/p>\n\n<h2 id=\"whats-next\">What\u2019s next<\/h2>\n\n<p>We are now preparing to test this therapy in clinical trials with human patients.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img  loading=\"lazy\"  decoding=\"async\"  src=\"data:image\/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABAQMAAAAl21bKAAAAA1BMVEUAAP+KeNJXAAAAAXRSTlMAQObYZgAAAAlwSFlzAAAOxAAADsQBlSsOGwAAAApJREFUCNdjYAAAAAIAAeIhvDMAAAAASUVORK5CYII=\"  alt=\"The Conversation\"  width=\"1\"  height=\"1\"  style=\"border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important\"  class=\" pk-lazyload\"  data-pk-sizes=\"auto\"  data-pk-src=\"https:\/\/counter.theconversation.com\/content\/183313\/count.gif?distributor=republish-lightbox-basic\" ><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https:\/\/theconversation.com\/republishing-guidelines --><\/p>\n\n<p><span><a href=\"https:\/\/theconversation.com\/profiles\/kellen-chen-1345439\" target=\"_blank\" rel=\"noopener\">Kellen Chen<\/a>, Assistant Professor of Surgery, <em><a href=\"https:\/\/theconversation.com\/institutions\/university-of-arizona-959\" target=\"_blank\" rel=\"noopener\">University of Arizona<\/a><\/em><\/span><\/p>\n\n<p>This article is republished from <a href=\"https:\/\/theconversation.com\" target=\"_blank\" rel=\"noopener\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/skin-grafts-for-burns-injuries-can-lead-to-crippling-scars-a-drug-that-blocks-the-skins-ability-to-respond-to-physical-stimuli-could-promote-healing-new-research-in-pigs-finds-183313\" target=\"_blank\" rel=\"noopener\">original article<\/a>.<\/p>\n\n","protected":false},"excerpt":{"rendered":"Burn injuries can lead to disfiguring and sometimes crippling scars. Staras\/iStock via Getty Images Kellen Chen, University of&hellip;\n","protected":false},"author":86,"featured_media":4296,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","fifu_image_url":"","fifu_image_alt":"","footnotes":""},"categories":[12],"tags":[519,474],"class_list":{"0":"post-4295","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-and-body","8":"tag-skin","9":"tag-the-conversation","10":"cs-entry","11":"cs-video-wrap"},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/4295","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/users\/86"}],"replies":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/comments?post=4295"}],"version-history":[{"count":1,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/4295\/revisions"}],"predecessor-version":[{"id":4297,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/posts\/4295\/revisions\/4297"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/media\/4296"}],"wp:attachment":[{"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/media?parent=4295"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/categories?post=4295"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/modernsciences.org\/staging\/4414\/wp-json\/wp\/v2\/tags?post=4295"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}