Can plantar fibroblast implantation protect amputees from skin injury? A recipe for skin augmentation.
File(s)
Published version
Author(s)
Boyle, Colin J
Higgins, Claire A
Type
Journal Article
Abstract
Skin injuries remain a persistent problem for users of lower-limb prostheses despite sustained progress in prosthesis design. One factor limiting the prevention of skin injuries is that skin on the residual limb is not suited to bear the mechanical loads of ambulation. One part of the body that is suited to this task is the sole of the foot. Here, we propose a novel strategy to actively augment skin's tolerance to load, increasing its resistance to mechanically induced injuries. We hypothesise that the load tolerance of skin can be augmented by autologous transplantation of plantar fibroblasts into the residual limb dermis. We expect that introducing plantar fibroblasts will induce the overlying keratinocytes to express plantar-specific keratins leading to a tougher epidermis. Using a computational finite element model of a weight-bearing residual limb, we estimate that skin deformation (a key driver of pressure ulcer injuries) could be halved by reprogramming skin to a plantar-like phenotype. We believe this strategy could yield new progress in pressure ulcer prevention for amputees, facilitating rehabilitation and improving quality of life for patients.
Date Issued
2021-12
Date Acceptance
2021-06-23
Citation
Experimental Dermatology, 2021, 30 (12), pp.1829-1833
ISSN
0906-6705
Publisher
John Wiley and Sons
Start Page
1829
End Page
1833
Journal / Book Title
Experimental Dermatology
Volume
30
Issue
12
Copyright Statement
© 2021 The Authors. Experimental Dermatology published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Engineering & Physical Science Research Council (EPSRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34173264
Grant Number
EP/N026845/1
Subjects
Keratin 9
finite element model
load tolerance
pressure ulcer
residual limb
Publication Status
Published
Coverage Spatial
Denmark
Date Publish Online
2021-06-26