{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:31:32Z","timestamp":1791347492248,"version":"4.3.1"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,10,17]],"date-time":"2013-10-17T00:00:00Z","timestamp":1381968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Wound Repair Regeneration"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We present results of an original clinical study investigating efficacy of a decellularized dermal skin substitute (<jats:styled-content style=\"fixed-case\">DCD<\/jats:styled-content>) as part of a one\u2010stage therapeutic strategy for recalcitrant leg ulcers. Twenty patients with treatment\u2010resistant ulcers underwent hydrosurgical debridement, after which <jats:styled-content style=\"fixed-case\">DCD<\/jats:styled-content> was applied and covered with negative pressure dressings for 1 week. Participants were reviewed on seven occasions over 6 months. 3<jats:styled-content style=\"fixed-case\">D<\/jats:styled-content> photography, full\u2010field laser perfusion imaging, spectrophotometric intracutaneous analysis, and sequential biopsies were used to monitor healing. Mean ulcer duration and surface area prior to <jats:styled-content style=\"fixed-case\">DCD<\/jats:styled-content> placement were 4.76 years (range 0.25\u201340 years) and 13.11\u2009cm<jats:sup>2<\/jats:sup> (range 1.06\u201340.75\u2009cm<jats:sup>2<\/jats:sup>), respectively. Seventy percent of ulcers were venous. Surface area decreased in all patients after treatment (range 23\u2013100%). Mean reduction was 87% after 6 months, and 60% of patients healed completely. Wound bed hemoglobin flux increased significantly 6 weeks after treatment (<jats:italic>p<\/jats:italic>\u2009=\u20090.005). Histological and immunohistochemical analysis confirmed progressive <jats:styled-content style=\"fixed-case\">DCD<\/jats:styled-content> integration with colonization by host fibroblasts, lymphocytes, and neutrophils, resulting in fibroplasia, reepithelialisation, and angiogenesis, with correlating raised <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>31, collagen <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>, and collagen <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> levels. Subgroup analysis showed differing cellular behavior depending on wound duration, with delayed angiogenesis, reduced collagen deposition, and smaller reductions in surface area in ulcers present for over 1 year. The stain intensities of immunohistochemical markers including fibronectin, collagen, and <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>31 differed depending on depth from the wound surface and presence of intact epithelium. <jats:styled-content style=\"fixed-case\">DCD<\/jats:styled-content> safely produced significant improvement in treatment\u2010resistant leg ulcers. With no requirement for hospital admission, anesthetic, or autogenic skin grafting, this treatment could be administered in hospital and community settings.<\/jats:p>","DOI":"10.1111\/wrr.12113","type":"journal-article","created":{"date-parts":[[2013,10,17]],"date-time":"2013-10-17T14:45:46Z","timestamp":1382021146000},"page":"813-822","source":"Crossref","is-referenced-by-count":27,"title":["Single\u2010stage application of a novel decellularized dermis for treatment\u2010resistant lower limb ulcers: Positive outcomes assessed by <scp>SIA<\/scp>scopy, laser perfusion, and 3<scp>D<\/scp> imaging, with sequential timed histological analysis"],"prefix":"10.1111","volume":"21","author":[{"given":"Nicholas S.","family":"Greaves","sequence":"first","affiliation":[{"name":"Plastic and Reconstructive Surgery Research Manchester Institute of Biotechnology The University of Manchester  Manchester United Kingdom"},{"name":"Wythenshawe Hospital University Hospital of South Manchester NHS Foundation Trust  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Benatar","sequence":"additional","affiliation":[{"name":"The Pennine Acute Hospitals NHS Trust Histopathology Department The Royal Oldham Hospital  Oldham United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Baguneid","sequence":"additional","affiliation":[{"name":"Wythenshawe Hospital University Hospital of South Manchester NHS Foundation Trust  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardeshir","family":"Bayat","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery Research Manchester Institute of Biotechnology The University of Manchester  Manchester United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.08.048"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(98)00183-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000331979704800111"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_2_6_6_1","volume-title":"The cost of pressure sores","author":"Touche Ross","year":"1993"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800791015"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7108.576"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800730905"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0142-9612(96)85569-4"},{"issue":"11","key":"e_1_2_6_11_1","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD010182","article-title":"Compression for venous leg ulcers","author":"O'Meara S","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12029"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000178867"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2006.00209.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000323532.98003.26"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2009.00585.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-4801.2005.00099.x"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001737.pub3"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10561-012-9333-1"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0141-5425(91)90125-Q"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/jidsymp.2008.6"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5700701"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000225431.63010.1b"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411006"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1159\/000065611"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/ten.2006.12.2407"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2007.08.007"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2006.06.044"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.cdd.4401632"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7330.160"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.a.32881"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbcan.2003.07.002"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(03)00306-4"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.10.1835"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.135.8.920"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2002.04569.x"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001898.pub2"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2007.00317.x"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1524-475X.11.s2.1.x"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.01.042"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-821X(05)80313-5"}],"container-title":["Wound Repair and Regeneration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fwrr.12113","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/wrr.12113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T08:41:08Z","timestamp":1696149668000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/wrr.12113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,17]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1111\/wrr.12113"],"URL":"https:\/\/doi.org\/10.1111\/wrr.12113","archive":["Portico"],"relation":{},"ISSN":["1067-1927","1524-475X"],"issn-type":[{"value":"1067-1927","type":"print"},{"value":"1524-475X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,17]]}}}