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THE EPIDERMIS IN WOUND HEALING DERMATOLOGY: CLINICAL & BASIC SCIENCE SERIES Series Editor Howard I. Maibach, M.D. Published Titles: Protective Gloves for Occupational Use Gunh Mellström, J.E. Walhberg, and Howard I. Maibach Bioengineering of the Skin: Water and the Stratum Corneum Peter Elsner, Enzo Berardesca, and Howard I. Maibach Bioengineering of the Skin: Cutaneous Blood Flow and Erythema Enzo Berardesca, Peter Elsner, and Howard I. Maibach Bioengineering of the Skin: Methods and Instrumentation Enzo Berardesca, Peter Elsner, Klaus P. Wilhelm, and Howard I. Maibach Bioengineering of the Skin: Skin Surface, Imaging, and Analysis Klaus P. Wilhelm, Peter Elsner, Enzo Berardesca, and Howard I. Maibach Bioengineering of the Skin: Skin Biomechanics Peter Elsner, Enzo Berardesca, Klaus-P. Wilhelm, and Howard I. Maibach Skin Cancer: Mechanisms and Human Relevance Hasan Mukhtar Dermatologic Research Techniques Howard I. Maibach The Irritant Contact Dermatitis Syndrome Pieter van der Valk, Pieter Coenrads, and Howard I. Maibach Human Papillomavirus Infections in Dermatovenereology Gerd Gross and Geo von Krogh Contact Urticaria Syndrome Smita Amin, Arto Lahti, and Howard I. Maibach Skin Reactions to Drugs Kirsti Kauppinen, Kristiina Alanko, Matti Hannuksela, and Howard I. Maibach Dry Skin and Moisturizers: Chemistry and Function Marie Loden and Howard I. Maibach Dermatologic Botany Javier Avalos and Howard I. Maibach Hand Eczema, Second Edition Torkil Menné and Howard I. Maibach Pesticide Dermatoses Homero Penagos, Michael O’Malley, and Howard I. Maibach Nickel and the Skin: Absorption, Immunology, Epidemiology, and Metallurgy Jurij J. Hostýneck and Howard I. Maibach DERMATOLOGY: CLINICAL & BASIC SCIENCE SERIES THE EPIDERMIS IN WOUND HEALING Edited by David T. Rovee Howard I. Maibach CRC PR E S S Boca Raton London New York Washington, D.C. Library of Congress Cataloging-in-Publication Data The epidermis in wound healing / edited by David T. Rovee and Howard I. Maibach. p. ; cm. — (Dermatology) Includes bibliographical references and index. ISBN 0-8493-1561-1 (alk. paper) 1. Wound healing. 2. Epidermis. I. Rovee, David T. II. Maibach, Howard I. (Howard Ira) III. CRC series in dermatology. [DNLM: 1. Epidermis. 2. Wound Healing. WO 185 E644 2003] RD94.E65 2003 617.1—dc22 2003055712 This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from the publisher. All rights reserved. Authorization to photocopy items for internal or personal use, or the personal or internal use of specific clients, may be granted by CRC Press LLC, provided that $1.50 per page photocopied is paid directly to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 USA. The fee code for users of the Transactional Reporting Service is ISBN 0-8493-15611/04/$0.00+$1.50. The fee is subject to change without notice. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. The consent of CRC Press LLC does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from CRC Press LLC for such copying. Direct all inquiries to CRC Press LLC, 2000 N.W. Corporate Blvd., Boca Raton, Florida 33431. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation, without intent to infringe. Visit the CRC Press Web site at www.crcpress.com © 2004 by CRC Press LLC No claim to original U.S. Government works International Standard Book Number 0-8493-1561-1 Library of Congress Card Number 2003055712 Printed in the United States of America 1 2 3 4 5 6 7 8 9 0 Printed on acid-free paper Series Preface Our goal in creating the Dermatology: Clinical & Basic Science Series is to present the insights of experts on emerging applied and experimental techniques and theoretical concepts that are, or will be, at the vanguard of dermatology. These books cover new and exciting multidisciplinary areas of cutaneous research, and we want them to be the books every physician will use to become acquainted with new methodologies in skin research. These books can be also given to graduate students and postdoctoral fellows when they are looking for guidance to start a new line of research. The series consists of books that are edited by experts, with chapters written by the leaders in each particular field. The books are richly illustrated and contain comprehensive bibliographies. Each chapter provides substantial background material relevant to its subject. These books contain detailed tricks of the trade and information regarding where the methods presented can be safely applied. In addition, information on where to buy equipment and helpful Web sites for solving both practical and theoretical problems are included. We are working with these goals in mind. As the books become available, the efforts of the publisher, book editors, and individual authors will contribute to the further development of dermatology research and clinical practice. The extent to which we achieve this goal will be determined by the utility of these books. Howard I. Maibach, M.D. Preface Just 30 years ago, the book Epidermal Wound Healing was published. That collection of papers from leaders in the field presented an interdisciplinary view of various aspects of wound healing. The primary focus, while on the epidermis, did not exclude interaction with other tissues. At the time of that work, little of the emerging data on wounds was being applied clinically. Today, many of the so-called advanced wound therapies can be traced back to the ideas presented by the group of contributors to Epidermal Wound Healing. These include the use of film, hydrocolloid, and gel dressings, which have brought about the acceptance of “moist wound healing” to prevent dehydration necrosis in the wound and enhance epithelial migration for early wound closure. The moist environment has also been employed to reduce inflammation and subsequent scar formation in the dermis. One aspect of these dressings, which was not predicted by the work in 1972, was their utility in enhancing autolytic debridement in chronic wounds, such as decubitus, venous, and diabetic ulcers. Also included in the original publication was the early work on growth factors and their potential applications to wound therapy. Today, clinicians are able to employ platelet-derived growth factors (PDGF) and tissue-engineered living skin products, which deliver an array of other growth factors. The availability of new biological techniques and a renaissance of interest in both acute and chronic wound healing have led to a tremendously improved understanding of the cellular and chemical complexities of the healing process. We have begun to appreciate that much of what we have learned based upon acute wound healing does not always apply to the chronic wound. With this realization, much of today’s clinical and research practice focuses on decubitus ulcers, venous ulcers, and diabetic foot ulcers. Surprisingly, the original text from 1972 remains the only book focused on epidermal healing and is still frequently cited, even though there have been many further advances. The purpose of this second book on the topic is to update the information available on the epidermis, present a selection of the newest findings, and stimulate original research and development in wound therapy. Our intent is to focus on biological advances that improve our knowledge and lead to new opportunities for research and clinical applications in wound healing. David T. Rovee, Ph.D. Howard I. Maibach, M.D.