Zusammenfassung
GRUNDLAGEN: Die Haut stellt das größte Organ des Menschen dar, wobei sie aus mehreren Schichten aufgebaut ist und den Schichten jeweils spezifische Aufgaben zuzuschreiben sind. Die Haut spielt eine entscheidende Rolle den Körper gegenüber der Umwelt zu schützen. Ein teilweiser Verlust dieser Schutzhülle durch Verletzung oder Krankheit kann zu schwerem physiologischem Ungleichgewicht und schließlich zu wesentlichen körperlichen Einschränkungen oder sogar zum Tod führen. METHODIK: Dieser Artikel dient als Überblick über den derzeitigen Wissenstand zum Thema "Tissue Engineering" bei Wunden. ERGEBNISSE: Die häufigsten Ursachen für schwere Hautschädigungen sind thermale Verletzungen. Andere Ursachen für Schädigungen der Haut sind Verletzungen und chronische Ulzeration infolge Diabetes mellitus, Druckeinwirkung und Venenstauung. Während der letzten drei Jahrzehnte wurden bei der Untersuchung der zellulären und molekularen Prozesse bei der akuten Wundheilung und der Pathobiologie von chronischen Wunden enorme Fortschritte erzielt. SCHLUSSFOLGERUNGEN: Dieser verbesserte Wissensstand führte zu Innovationen bei der Wundbehandlung, die eine raschere Abheilung von chronischen und akuten Wunden ermöglichten bzw. zu einem besseren funktionellen und ästhetischen Ergebnis führten. Der Einsatz von Haut bzw. Hautersatzmaterialien hat die Behandlungsmöglichkeiten für komplizierte Wunden deutlich erhöht.
Summary
BACKGROUND: The skin is the largest organ system in humans, consisting of various distinctive layers, each stratum with a specific purpose. Consequently, our skin incorporates the most essential function, which is to protect our body. Loss of skin integrity because of injury or illness may acutely result in a substantial physiologic imbalance and ultimately in a disability with long-term morbidity or even death. METHODS: This article is an overview of current state-of-the-art concepts and possibilities in the treatment of cutaneous wounds by the use of tissue engineering. RESULTS: The most common cause of significant skin loss is thermal injury. Other causes of skin loss include trauma and chronic ulcerations secondary to diabetes mellitus, pressure, and venous stasis. Over the past three decades, extraordinary advances have been made in our understanding of the cellular and molecular processes involved in acute wound healing and in the pathobiology of chronic wounds. CONCLUSIONS: This knowledge has led to wound care innovations that have facilitated more rapid closure of chronic and acute wounds, better functional and aesthetic outcome. The use of tissue-engineered skin replacements has upgraded the therapeutic possibilities for recalcitrant wounds and for wounds that are not suitable for primary closure.
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Kamolz, L., Lumenta, D., Kitzinger, H. et al. Tissue engineering for cutaneous wounds: an overview of current standards and possibilities. Eur Surg 40, 19–26 (2008). https://doi.org/10.1007/s10353-008-0380-6
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DOI: https://doi.org/10.1007/s10353-008-0380-6