Skip to main content

Advertisement

SpringerLink
Log in

Ultrastructural effects of topical dimethyl sulfoxide on collage fibers during acute skin expansion in a human ex-vivo model

  • Experimental Study
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Despite some studies confirming the effectiveness of dimethyl sulfoxide (DMSO) on acute skin expansion, the precise mechanism through which it quickens tissue expansion is yet unknown. No studies have been carried out to date to thoroughly investigate the ultrastructural effects of DMSO on intraoperative tissue expansion. The aim of the present study was to test the ex vivo ultrastructural effects of topical 60% DMSO on dermal collagen fibers of acutely expanded human cutaneous flaps.

Methods

Specimens were obtained and ultrastructurally examined from two groups of ex vivo cutaneous flaps from the anterior thigh: group A (experimental) DMSO-treated and acutely expanded flaps, and group B (control), acutely expanded flaps.

Results

A statistically significant difference was observed between groups A and B, with respect to the width of dermal collagen fibers, distance between dermal collagen fibers, and percentage of area not occupied by collagen fibers.

Conclusions

These findings demonstrate how DMSO affects collagen cross-linkage in the surrounding dermis, decreasing the mechanical resistance of the acutely expanded skin in this ex-vivo model, supporting its use in intra-operative tissue expansion.

Level of Evidence: Not ratable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sasaki GH (1988) Intraoperative expansion as an immediate reconstructive technique. Facial Plast Surg. 5:362–378

    Article  CAS  PubMed  Google Scholar 

  2. Sasaki GH (1987) Intraoperative sustained limited expansion (ISLE) as an immediate reconstructive technique. Clin Plast Surg 14:563–573

    CAS  PubMed  Google Scholar 

  3. Abramo AC, Viola JC, Angelo AJ (1993) Intraoperative rapid expansion in cleft palate repair. Plast Reconstr Surg 91:441–445

    Article  CAS  PubMed  Google Scholar 

  4. Auletta MJ, Matarasso SL, Glogau RG, Tromovitch TA (1993) Comparison of skin hooks and Foley catheters for immediate tissue expansion. J Dermatol Surg Oncol 19:1084–1088

    Article  CAS  PubMed  Google Scholar 

  5. Chretien-Marquet B (1995) Rapid intraoperative distension using isotonic saline solution. Plast Reconstr Surg 96:158–165

    Article  CAS  PubMed  Google Scholar 

  6. Man D (1989) Stretching and tissue expansion for rhytidectomy: an improved approach. Plast Reconstr Surg 84:561–569

    Article  CAS  PubMed  Google Scholar 

  7. Siegert R, Weerda H, Hoffmann S, Mohadjer C (1993) Clinical and experimental evaluation of intermittent intraoperative short-term expansion. Plast Reconstr Surg 92:248–254

    Article  CAS  PubMed  Google Scholar 

  8. Stein HC (1988) Foley catheter for immediate tissue expansion. Plast Reconstr Surg 81:990

    Article  CAS  PubMed  Google Scholar 

  9. Machida BK, Liu-Shindo M, Sasaki GH, Rice DH, Chandrasoma P (1991) Immediate versus chronic tissue expansion. Ann Plast Surg 26:227–231

    Article  CAS  PubMed  Google Scholar 

  10. Shapiro AL, Hochman M, Thomas JR, Branham G (1996) Effects of intraoperative tissue expansion and skin flaps on wound closing tensions. Arch Otolaryngol Head Neck Surg. 122:1107–1111

    Article  CAS  PubMed  Google Scholar 

  11. Aboelatta YA, Elshahm A, Saleh MA, Kamel IH, Aly HM (2015) Intraoperative and delayed wound approximation in closure of skin defects in different areas. J Wound Care 24:600–605

    Article  CAS  PubMed  Google Scholar 

  12. Verhaegen PD, Bloemen MC, van der Wal MB, et al. (2014) Skin stretching for primary closure of acute burn wounds. Burns 40:1727–1737

    Article  PubMed  Google Scholar 

  13. Turko A, Fuzaylov G, Savchyn V, Driscoll D (2013) Immediate and early tissue expander placement for acute closure of scalp wounds. Ann Plast Surg 71:160–165

    Article  CAS  PubMed  Google Scholar 

  14. Marquardt C, Bölke E, Gerber PA, et al. (2009) Correlation of cutaneous tension distribution and tissue oxygenation with acute external tissue expansion. Eur J Med Res 14:480–486

    CAS  PubMed  PubMed Central  Google Scholar 

  15. De Brito Henriques JG, Filho GP, Gusmão SN, Henriques KS, Miranda ME (2007) Intraoperative acute tissue expansion for the closure of large myelomeningoceles. J Neurosurg 107(2 Suppl):98–102

    PubMed  Google Scholar 

  16. Chandawarkar RY, Cervino AL, Pennington GA (2003) Intraoperative acute tissue expansion revisited: a valuable tool for challenging skin defects. Dermatol Surg 29:834–838

    PubMed  Google Scholar 

  17. Hochman M, Branham G, Thomas JR (1992) Relative effects of intraoperative tissue expansion and undermining on wound closing tensions. Arch Otolaryngol Head Neck Surg 118:1185–1187

    Article  CAS  PubMed  Google Scholar 

  18. Bartell TH, Mustoe TA (1989) Animal models of human tissue expansion. Plast Reconstr Surg 83:681–686

    Article  CAS  PubMed  Google Scholar 

  19. Raposio E, Nordström REA (1996) Topical agents and drugs to enhance tissue expansion. In: Nordström REA (ed) Tissue Expansion. Butterworth-Heinemann, Boston, pp 219–224

    Google Scholar 

  20. Jacob S, Rosenbaum E, Wood D (1971) DMSO: basic concepts. New York: Marcel Dekker 4:131–143

    Google Scholar 

  21. Raposio E, Caregnato P, Renzi M, et al. (2002) Experimental model for the evaluation of topical application of a solution to help myocutaneous flap transposition. Ann Chir Plast Esthet 47:219–221

    Article  CAS  PubMed  Google Scholar 

  22. Raposio E, Santi PL (1999) Topical application of DMSO as an adjunct to tissue expansion for breast reconstruction. Br J Plast Surg 52:194–197

    Article  CAS  PubMed  Google Scholar 

  23. Pasyk KA, Argenta LC, Austad ED. Histopathology of human expanded tissue. Clin Plast Surg. 1987;14(3):435–445.

  24. Austad ED, Pasyk KA, McClatchey KD, Cherry GW (1982) Histomorphologic evaluation of guinea pig skin and soft tissue after controlled tissue expansion. Plast Reconstr Surg 70:704–710

    Article  CAS  PubMed  Google Scholar 

  25. Pasyk KA, Austad ED, McClatchey KD, Cherry GW (1982) Electron microscopic evaluation of guinea pig skin and soft tissues "expanded" with a self-inflating silicone implant. Plast Reconstr Surg 70:37–45

    Article  CAS  PubMed  Google Scholar 

  26. Mustoe TA, Bartell TH, Garner WL (1989) Physical, biomechanical, histologic, and biochemical effects of rapid versus conventional tissue expansion. Plast Reconstr Surg 83:687–691

    Article  CAS  PubMed  Google Scholar 

  27. van Rappard JH, Sonneveld GJ, Borghouts JM (1988) Histologic changes in soft tissues due to tissue expansion. Facial Plast Surg 5:280–286

    Article  PubMed  Google Scholar 

  28. Timmenga EJ, Das PK (1992) Histomorphological observations on dermal repair in expanded rabbit skin: a preliminary report. Br J Plast Surg 45:503–507

    Article  CAS  PubMed  Google Scholar 

  29. Timmenga EJ, Andreassen TT, Houthoff HJ, Klopper PJ (1991) The effect of mechanical stress on healing skin wounds: an experimental study in rabbits using tissue expansion. Br J Plast Surg 44:514–519

    Article  CAS  PubMed  Google Scholar 

  30. Timmenga EJ, Schoorl R, Klopper PJ (1990) Biomechanical and histomorphological changes in expanded rabbit skin. Br J Plast Surg 43:101–106

    Article  CAS  PubMed  Google Scholar 

  31. Liang MD, Dick GO, Narayanan K (1987) Enhancement of tissue expansion using DMSO. Surg Forum 38:593–597

    Google Scholar 

  32. Vinnik CA, Jacob SW (1991) Dimethylsulfoxide (DMSO) for human single-stage intraoperative tissue expansion and circulatory enhancement. Aesthetic Plast Surg 15:327–337

  33. Yasui T, Tohno Y, Araki T (2004) Determination of collagen fiber orientation in human tissue by use of polarization measurement of molecular second-harmonic-generation light. Appl Opt 43:2861–2867

    Article  PubMed  Google Scholar 

  34. Van Rappard JHA (1996) Histologic changes. In: Nordström REA (ed) Tissue expansion. Butterworth-Heinemann, Boston, pp 19–26

    Google Scholar 

  35. Raposio E, Cella A, Panarese P, Caregnato P, Gualdi A, Santi PL (2000) Quantitative benefits provided by acute tissue expansion: a biomechanical study in human cadavers. Br J Plast Surg 53:220–224

    Article  CAS  PubMed  Google Scholar 

  36. Khorasani H, Zheng Z, Nguyen C et al (2011) A quantitative approach to scar analysis. Am J Pathol 178:621–628

    Article  PubMed  PubMed Central  Google Scholar 

  37. Erk Y, Raskin DJ, Mace M Jr, Spira M (1983) Dimethyl sulfoxide alteration of collagen. Ann N Y Acad Sci 411:364–368

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Sciences, Plastic Surgery Division, University of Parma, Via Gramsci 14, 43126, Parma, Italy

    Edoardo Raposio & Nicolò Bertozzi

  2. Cutaneous, Mininvasive, Regenerative and Plastic Surgery Unit, Parma University Hospital, Via Gramsci 14, 43126, Parma, Italy

    Edoardo Raposio & Nicolò Bertozzi

Authors
  1. Edoardo Raposio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicolò Bertozzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edoardo Raposio.

Ethics declarations

Conflict of interest

Edoardo Raposio and Nicolò Bertozzi declare that they have no conflict of interest.

Funding

This article did not require any sources of funding.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raposio, E., Bertozzi, N. Ultrastructural effects of topical dimethyl sulfoxide on collage fibers during acute skin expansion in a human ex-vivo model. Eur J Plast Surg 40, 271–276 (2017). https://doi.org/10.1007/s00238-017-1301-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-017-1301-3

Keywords

Search

Navigation