The ability to heal one’s wounds is perhaps one of the most fundamental and critical of physiologic processes. This coordinated and closely regulated sequential biological process involves a variety of migratory and resident cells. The activation, modulation, balance, and control of these functions depend upon soluble mediators that activate cells and modulate their diverse functions. Recent advances have identified mechanotransduction as functionally integral in many different cell types and physiologic processes. The mechanically sensitive ion channel Pieoz1 is expressed on platelets, neutrophils, macrophages, endothelial cells, keratinocytes, and fibroblasts, all of which are principally involved in wound healing. On a cellular level, there have been great advances in our understanding of the functional role of Piezo1 mechanotransduction in cutaneous wounding. The blocking of Piezo1 has recently been shown to reduce scarring in vivo and yet, thus far, a comprehensive understanding of the roles that Piezo1 plays in in vivo wound healing remains lacking. Recognizing the ever-present and critical importance of optimal and reparative wound healing, and with the availability of new physical mechanomodulating devices, the time is ripe for gaining deeper insights into optimizing wound healing. In this review, we describe the current knowledge of Piezo1 related to wound healing.

Background: Full-thickness burn injuries (FTBI) not only lead to a significant burden in multiple ways, including social life and self-esteem, but have also a tremendous impact on environmental interaction by reducing sensibility in manifold ways. On these grounds, possible ways and solutions to recover sensibility in burn wounds are essentials and should not be overlooked. Methods: A review of experimental, clinical studies and the related literature was performed with the aim to highlight post-burn nerve regeneration and discover ways for sensory re-integration to complement the therapeutic concept. Results: In human burn injuries, it has been hypothesized that grafted cells, partly multipotent stem cells, could be additionally responsible for nerve regeneration in burn wound areas. In addition, burn eschar excision, performed within a short post-burn time frame, can reduce or even avoid long-term nerve damage by reducing post-burn toxic mediator release. Various animal studies could demonstrate sensory reinnervation of different qualities in burn wounds. Post-burn scar tissue prevents, or at least decelerates, nerve reinnervation, but could be reduced by targeted mediators. Conclusion: Sensory loss is present in skin grafted areas following full-thickness burn-wound excision, thereby leading to a reduction in quality of life. In addition, various mediators might reduce or avoid nerve damage and should be considered at an early stage as part of a holistic burn-patient therapeutic approach. In addition, supportive multifaceted physical therapy strategies are essential.

The advancements in skin care methods and products show the rising interest in cosmetics. Recent studies emphasize the regenerative potential of fat grafting, platelet-rich plasma (PRP), microneedling, and carbon dioxide (CO2) fractional laser techniques. Combining these strategies into a protocol is yet to be explored. In this article, we demonstrate different types of fat grafts and their versatility in treating different facial problems found in our patient. This study evaluated the synergistic effect of lipoconcentrate and nanofat grafting, PRP, microneedling, and CO2 fractional laser to provide esthetic and regenerative facial skin care. This case report was conducted in Dr. Soliman Fakeeh Hospital, Saudi Arabia. Our case involved a 53-year-old woman who had traumatic facial injuries due to a car accident years ago that buried asphalt particles in her facial scars, causing bluish skin discoloration. She suffered from multiple deep atrophic scars in several areas on the left side of her face, causing asymmetry. She was treated using lipoconcentrate and nanofat grafting, followed by three PRP with microneedling sessions and then a final CO2 fractional laser session. The evaluation was based on the physician’s clinical assessment, image documentation, and patient satisfaction, which revealed significant improvement in skin appearance with respect to texture, color, symmetry, and overall health of the skin over a period of four months. The potentiality and efficacy of the combination therapy of lipoconcentrate, nanofat, PRP, microneedling, and CO2 fractional laser for skin rejuvenation and scar treatment showed promising results in this case report.

Tissue expansion (TE) is a rather widely accepted technique in plastic surgery, with variable indications; among numerous other indications, it is commonly used in scar management. In our research, we focused on the significance of TE as an important armamentarium and valid solution for the treatment of large and old post-burn scars, with good cosmetic and functional outcomes. Our study is a retrospective analysis conducted at Dr. Soliman Fakeeh Hospital, Jeddah, during the period from 2020 to 2023. This retrospective analysis included 15 tissue expanders, which were inserted in eight patients with large post-burn scars. Each patient underwent two stages of scar repair using variable-size tissue expanders. Post-operative assessment for scar quality and patient satisfaction was conducted using the POSAS score system in addition to standard documentation. Our study sheds light on the satisfactory and accepted cosmetic and functional outcomes for skin tissue expanders for post-burn scars and deformities.

Background/Objectives: Scarring frequently lowers quality of life and can have both functional and aesthetic impacts. Recently it has been debated whether platelet-rich plasma (PRP) can be used as a therapy modality for improving scar outcomes, given its abundance of cytokines and growth factors. This study attempts to methodically assess PRP’s efficacy in healing various scar types, such as burns, keloids, and postoperative scars, using randomized controlled trials (RCTs). Methods: A systematic search with PubMed, Google Scholar, Ovid Medline, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted for RCTs, up to 12 October 2024, evaluating the use of PRP in scar treatment. Outcomes were assessed using validated tools, including the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS), with only one study using ultrasound imaging. The Cochrane Risk of Bias 2.0 tool was used to analyze potential bias. Standardized mean differences were computed for continuous outcomes, and meta-analyses were conducted with random-effects models. Results: A total of 11 RCTs involving 539 participants were included, covering 5 postoperative scars, 4 burn scars, and 2 keloid studies. Although several individual trials indicated enhancements with PRP, the pooled data revealed no statistically significant alterations in scar appearance at three months, as assessed by the Observer Scar Assessment Scale (OSAS) and VSS scores. A statistically significant enhancement in patient-reported outcomes utilizing the Patient Scar Assessment Scale (PSAS) was noted at 6 months (mean difference = −0.825; 95% CI: −1.561 to −0.090; p = 0.028), suggesting PRP’s efficacy in alleviating symptoms, including pain, itching, and stiffness. High heterogeneity was noted in several analyses, likely due to variability in PRP preparation methods, administration protocols, and scar types. Conclusions: This meta-analysis indicates that PRP may provide significant subjective enhancements in scar quality, particularly from the patient’s viewpoint. The results show the need for standardized PRP protocols, prolonged follow-up periods, and the integration of both patient-centered and objective outcome measures. PRP has significant potential in early postoperative wound healing; nevertheless, additional high-quality, long-term studies are required to clarify its role in mature or fibrotic scars.

Background: Random pattern flaps are widely used in reconstructive surgery when inadequate vascularity precludes skin graft survival or when regional pedicled flaps are unavailable due to local burn injury. Here, thin tissue from the upper arm was utilized to cover exposed cartilage over the proximal interphalangeal (PIP) joints of the contralateral hand. Methods/Technical Note: We report the uncommon application of multiple cross-arm (Colson) flaps to reconstruct dorsal skin defects over the PIP joints of the index, middle, and ring fingers following a high-voltage burn injury, in conjunction with a comprehensive literature review. Results: Three separate random-pattern flaps were harvested from the upper arm and transferred to the contralateral hand. All flaps demonstrated good perfusion, durable coverage, and a clean wound bed postoperatively, with preservation of joint mobility. Conclusions: To our knowledge, this represents one of the first reported reconstructions of multiple adjacent PIP joints using individual cross-arm flaps. This technique remains a dependable salvage option that should be considered in complex reconstructive scenarios when local or microsurgical options are not feasible.