Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Use of Mitomycin C to Lessen Unsightly Scarring Questioned

20.09.2004


Using an animal model, investigators find that Mitomycin C, a common chemotherapy agent, offers limited benefit in reducing keloid or hypertrophic scars.



The tendency for extreme scarring is one reason many African Americans avoid plastic surgery and other surgical incisions. Though surgeons continue to develop less invasive techniques that minimize scarring, other options are needed to help these individuals who are prone to developing keloid scars.

Keloid scars are caused by an overproduction of fibroblasts, the structure on which cells build tissue to heal a wound. The fibroblasts continue to multiply after the wound is filled in and become a raised scar that grows beyond the original wound or point of incision. Dark skinned individuals tend to form keloids more readily than lighter skinned individuals. Hypertrophic scars are more common and occur in all racial groups. They appear raised but stay within the confines of the initial wound or point of incision. Both types of scars can occur through skin injuries such as surgical incisions, traumatic wounds, vaccination sites, burns, chickenpox, acne, or even minor scratches.


Mitomycin C (MMC) is a common chemotherapy agent that inhibits cell growth. It is also known to decrease the proliferation of fibroblasts, an essential element in the development of scar tissue. If too many fibroblasts are produced, a keloid of hypertrophic scar is produced.

Researchers set out to determine if the use of Mitomycin C can reduce keloid or hypertrophic scarring. To do this, they used an animal model that most closely parallels normal wound healing in humans. Clinical observations were used to assess the effect of topical and intradermal MMC on wound healing while evaluating for the presence of the protein, TGF-B1, to determine how MMC works to decrease fibroblast proliferation and scarring.

The authors of the study, “The Effects of Intradermal and Topical Mitomycin C on Wound Healing,” are Glen T. Porter, MD, and Swarupa Gadre, MD, of the University of Texas Medical Branch in Galveston, TX, and Karen Calhoun, MD Chair of University of Missouri Medical School. Their findings are being presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, being held September 19-22, 2004, at the Jacob K. Javits Convention Center, New York City, NY.

Methodology: Twenty-four adult male Sprague-Dawley rats (375-400g) were anesthetized and two incisions were placed on the back. Wound treatment was then administered according to randomization to one of the three study groups: injected MMC group, received intradermal injection with 1.0 ml of Mitomycin C (0.5mg/ml) into each wound; topical MMC group, received a four minute application of topical MMC (0.5mg/ml); saline group, received topical or intradermal saline in a similar manner. After treatment each wound was irrigated and closed with sterile staples. Two animals in each study arm were sacrificed at one and two weeks and one and six months after surgery. The wounds were then visually inspected and then a small sample was excised. Each wound was then serially sectioned. One section was sent for microscopic examination (blinded) with H&E staining and TGF-B1-specific immunohistochemical staining. Using a tensiometer, the remaining wound sections were tested to evaluate the force necessary to cause wound dehiscence (unblinded).

Results were evaluated using the SPSS software. Kruskal-Wallis and Mann-Whitney tests were used for statistical comparison. Study animals were treated in accordance to federal and state-mandated standards.

Results: Wound evaluation at the time of harvest showed an 88 percent (7/8) incidence of skin necrosis in the intradermal MMC group. Frank necrosis was noted in the wounds harvested at one and two weeks. Wounds harvested at one and six months showed corresponding areas of scarring consistent with areas of healing by secondary intention. No skin necrosis was noted in topical MMC and control animals. Wounds treated with topical MMC had poorer wound integrity compared with controls at one week (p<.001), two weeks (p<.001), one month (p<.001) and six months (p<.001). When compared to controls this represents a 3-4-fold decrease in wound strength at each time period. Intradermal MMC showed poorer wound integrity at two weeks (p<.001), one month (p<.001), and six months (p<.001) when compared with controls. Again, this represented at least a 3-fold decrease for the latter three time periods. There was a significant difference in wound strength when comparing topical and intradermal MMC only at the first week (p<.001) with injected wounds being weaker.

Blinded evaluation of H&E and immunohistochemical staining of wound sections showed no consistently identifiable difference between wounds in the three treatment groups. TGF-?1 was not consistently identified in any group.

Conclusions: The results of this study indicate that the application of MMC, whether topical or injected, will result in decreased wound strength which is still significantly different at six months after wounding. Intradermal injection appears to have no more affect on wound strength than topical, but carries an increased risk of skin necrosis. No consistently identifiable changes in histology or TGF-B1 expression was noted, which does not mean that TGF-B1 is not involved, only that the instrument of detection did not pick it up as the protein may not be present in quantities large enough to detect with immunohistochemical staining. This data suggests cautious use of MMC in clinical situations where wound breaking strength is critical. Intradermal MMC should be avoided as skin necrosis and scarring may result. Further study in humans is necessary to determine the effect of MMC on keloid and hypertrphic scars.

| newswise
Further information:
http://www.entnet.org

More articles from Health and Medicine:

nachricht Cystic fibrosis alters the structure of mucus in airways
28.06.2017 | University of Iowa Health Care

nachricht Mice provide insight into genetics of autism spectrum disorders
28.06.2017 | University of California - Davis

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Supersensitive through quantum entanglement

28.06.2017 | Physics and Astronomy

X-ray photoelectron spectroscopy under real ambient pressure conditions

28.06.2017 | Physics and Astronomy

Mice provide insight into genetics of autism spectrum disorders

28.06.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>