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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Wound Healing Research In 1986, Wiete Westerhof started a research group on the topic of wound healing. Many researchers started their career in wound healing research; in total 8 academic theses were written on this subject. The research projects were financed entirely from external sources, including some large and prestigious grants from the government. That same year, the punch graft technique for venous leg ulcers was developed. By 1989, Wiete Westerhof and Bart Nanninga, in cooperation with TNO (Dutch Organization for Applied Scientific Research), had developed a sophisticated cultured skin equivalent consisting of autologous keratinocytes on a layer of fibroblasts. These grafts were successfully used in venous leg ulcers. Their efficacy was compared to the punch grafting method in a clinical study.[1] Enzymatic debridement was another research subject. Jan Mekkes and Caroline Le Poole investigated various proteolytic enzymes such as fibrinolysin/DNAse, collagenase, papaine, and peptidases, derived from Antarctic krill, in vitro, in animal studies, and in randomized controlled clinical trials in venous leg ulcers.[2,3] The enzymes were effective in vitro and in animal studies, but not in venous leg ulcers, due to the excessive amount of proteolytic enzymes that are already present in chronic wounds. As a result of these negative clinical results, several commercial enzymes for wound debridement were withdrawn from the European market. Growth factors such as the epidermal growth factor and platelet-derived growth factor were investigated in clinical studies, and were shown to be ineffective in chronic wounds, because of the same aggressive proteolytic wound environment. Animal wound models, cell cultures and tissue culture wound models, were developed and used to investigate enzymes, growth factors and other products. A novel computer-image analysis system was designed objecti- vely to measure the wound size and percentage of granulation tissue for clinical trials. Henry de Vries and Dory Enomoto used laboratory methods such as the Fournier analysis of laser scatter images and skin 44 Large hypertrophic burn scar illustrating the need for better wound healing techniques. BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:39 Pagina 44