News

Mentor (Advisor):

MUDr. Robert Zajíček, Ph.D

Department:

Department of Burns Medicine

Contact information:

Tel. +420 26716 3365, fax +420 267313374,

Project Narrative:

Although the increased risk of mortality at specialized burn centers represents burn size over 60% of total body surface area (TBSA) (Jeschke et Herndon 2014), burn injury has remained the third leading cause of unintentional injury and death in children less than 9 years of age (Palmieri 2016). The first step of severely burned patient management involves burn shock fluid resuscitation by restoration of intravascular volume leading to adequate organ perfusion with several specific modifications in the management of pediatric patients (Romanowski et Palmieri 2017). The second step includes skin repair, a period that may take months (Herndon 2017).

Whereas the epidermis represents the primary barrier between outer and inner environments, the dermal components contribute to the mechanical, viscoelastic, functional and cosmetic properties of the skin and resulted scars (Wainwright et Bury 2011). Therefore deep burns, following excision of the dead tissue, covered only with split-thickness skin grafts (STSG) may tend to contract while defects repaired with full thickness transplants demonstrate improved function and appearance. The most widely used and best studied artificial skin is Integra® that is composed of porous matrix of cross-linked bovine tendon collagen and glycosaminoglycan (chondroitin 6-sulfate) covered by a semi-permeable silicone layer (Yannas et al. 1980; Yannas et al. 1980; Dagalakis et al. 1980; Yannas et al. 1981; Burke et al. 1981; Heimbach et al. 2003).

The major issue of treatment in extensively burned patients represents rapid wound closure. Here STSG re-harvesting has remained the hallmark of skin repair where the intervals between procedures may take 3 to 6 weeks and depend on patient’s condition (Barret-Nerin, Juan; Herndon, David N. 2004). Lack of donor sites as well as poor wound healing of the donor area increase the time period between repeated harvests and prolong overall treatment. Furthermore, with increasing time of donor area regeneration increases the frequency of serious complications such as infection and/or poor wound healing. From this point of view swift and efficient healing of the donor area is mandatory to improve healing and, thus closely related with the possibility of repairing in particular large body areas. In present case we have clearly shown that re-harvesting the scalp was possible within 12 days following complex treatment strategy involving NASC covered with XD whereas the routinely Grassolind® dressed donor site took 45 days to recover. All other donor areas were than covered with the biological sandwich technique and re-harvested in the range of 6 – 10 days.

Since the history of Prague Burn Centre is closely connected with the development and clinical applications of advanced biological wound dressing techniques, including keratinocytes cultured on acellular pig dermis (Matouskova et al. 1997; Dvorankova et al. 2003; Zajicek et al. 2011). In present project we therefore firstly plan to evaluate in cooperation with Institute of Molecular Genetics whether the expression profiles and course of skin healing at the STSG donor sites changes or remains its characteristic pattern with increasing number of repeated harvesting. Secondly, in cooperation with the Technical University in Liberec and Institute of Organic Chemistry and Biochemistry we plan to develop and test on experimental animal models and patients new active wound dressings preventing infections and improving regeneration of the STSG donor site.

Term:

January 1, 2020 – December 31, 2021

Application deadline:

July 29, 2019, (the interviews will be conducted on the first come first serve basis; therefore, the position may be offered already before the application deadline). As subject please write title of the position which you are applying for.

Conditions:

https://cuni.cz/UKEN-178.html

Mandatory attachments to the application:

https://cuni.cz/UKEN-178.html#7

Only applications which content all required documents will be accepted.