ABSTRACTS

34. Jahrestagung der Deutschen Plastischen Chirurgen
8. Jahrestagung der Deutschen Ästhetisch-Plastischen Chirurgen
Cell densitiy in group I: 0,08 x 106/cm2. Transplanted area: 3 x 3 cm.
Wounds observed until day 21 postoperatively. Histological observation
with H&E.
Results: In-vitro: In addition to human and porcine keratinocytes the spinning-culture-system
on fibrin-microcarriers is also appliable for microvascular
endothelial cells and human preadipocytes. Optimal proliferative
and migratory potential of cells in spinning-culture verified. Fibrinmicro-carriers
could be used as a one-step culture-, transplantation- and
carrier-system for the recombinant growth factor rhEGF.
In-vivo: One could demonstrate the capability of this system to reconstitute
a multilayered, stable and regenerative epithelium in the athymic
nude-mouse-model as well as with autologous cells in the immuncompetent
porcine model. Until day 14 wounds were completely closed. Histological
examinations:day 21: complete degradation of fibrin-carriers. No
cellular inflammatory reaction. Epithelial thickness comparable to results
of standard KFGS-group.
Pure epithelial graft with fibrin-microcarriers, without any dermal components
in matrix material, and only one sixth of the cell amount of the
mouse model was capable to reconstitute multilayerd, stratified and stable
epithelium with rete digits in immuncompetent porcine animal model.
Discussion: Spinning culture provides a great amount of cells in a short period
of time, easy to handle, cost-effective and avoids negative enzymatic
effects directly.before transplantation. Multiple cell types can be cultured
on fibrin-microcarriers. Therefore it is an interesting alternative for coculture
and co-transplantation in the field of tissue-engineering. Additional
in-vitro experiments were focused on loading the fibrin-carriers
with the recombinant growth factor (rhEGF).Levels of secreted rhEGF
by fibrin-carriers ranged constantly in the therapeutic level between 1500
and 200 pg/ml after day 4 (transplantation). These in-vitro results
demonstrate an interesting prospective for the in-vivo-stimulation of the
wound-healing process during the first days after transplantation with
fibrin-microcarrier.
P180 Natrium Chlorosum (DAC N-055) on the Brink of
Becoming a New Orphan Drug to Treat Leishmaniasis Cutanea in
Kabul?
K.W. Stahl 1 , F.M. Amin2 , S. Stecher1 , Br. Reto2 1 2 Waisenmedizin e.V. Freiburg, c/o Allgemeinpraxis S. Stecher, Freiburg, Dermatological Day Clinic „Dawarzee e
Lahory in Kabul“ of the German Medical Service, Christusträger Brüder Kloster Triefenstein
One of us reported the healing of an ulcerous lesion of a 77 year old Fontaine
IIIb patient with a 9.5 mM chlorite solution. This was suggested in
1984 [1] to act as a mineral oxygen carrier forming so called tetrachlorodeca-oxygen.
The clinical efficiency was true [2], the chemical hypothesis
and the explanations of the molecular pharmacology were not.
In 1992, commercially available sodium chlorite with its well known toxicity
[3] received a monograph in the Deutscher Arzneimittel Codex (DAC
N-055). As the German pharmacists believed TCDO to be a hoax, they
were convinced that commercial NaClO 2 would do the moist wound care
job of „TCDO“, as had been published in more detail in1986 [3], in a more
economic way.
The crucial need for an efficient low cost treatment of heavily infected
wounds in orthopaedic surgery in those 49 least developed countries
(LDC) which are in a post-war situation such as Afghanistan, prompted
us to look into the question again: Under which circumstances does the
chemical chlorite become a pharmaceutical? If chlorite (ClIII) is synthesized
from pure ClO 2 the formation of chlorate is prevented, this
NATRIUM CHLOROSUM (Na-Chl) acts as an anti-infective promoter
of tissue regeneration, apparently containing ClV as peroxychlorate
(NaOOClO 2) [4].
Plastische Chirurgie 3 (Suppl. 1): 107 (2003)
Leishmaniasis is endemic in Kabul and surroundings and the GMS has
photo documented and filed every case they treated on their PC during
recent years. In 2002, we found by accident that 0,1 % Na-Chl promotes
the healing process of Leishmaniasis ulcers. Meanwhile 5 cases initially
showing parasites in the non-necrotic wall of the ulcers have been followed
up by microscopic examination. To our great surprise the parasite
disappeared completely in all 5 cases in the course of wound healing.
One of us, who will present our findings, now also uses moist wound
treat-ment with a magistral preparation of 0.1 % Na-Cl for infected chronic
wounds of immune-depressed and diabetic patients in his general
practice in Freiburg. On demand he will demonstrate the case of a rheumatic
patient for whom wound healing could be achieved after a therapeutic
odyssey of 2.5 years.
[1] Hinz J, Kuhne FW, Stahl KW (1984) Local tetrachlorodecaoxide to improve oxygen
supply to non-healing wounds. Lancet I: 630. [2] Sodium chlorite CAS 7758-19-2, in Tome
6 „Kurzfassung Toxikologische Bewertungen der BG Chemie“ (2001) p 84 (18 volumes
of toxicological evaluations of NaClO2 to be obtained from Berufsgenossenschaft der Chemischen
Industrie, Heidelberg). [3] Hinz J, Hautzinger H, Stahl KW (1986) Rationale for
and results from a randomised, double-blind trial of tetrachlorodecaoxygen anion complex
in wound healing. Lancet 1: 825-828. [4] Svenson T, Nelander B, Bernhardsson, A. Karlström
G (1999) Infrared spectroscopic and ab initio study of HOOClO2. J Phys Chem A
103: 4432-4437
P181 Tissue Engineering von autologem Gelenksknorpel unter
Verwendung von PEGT/PBT-Copolymer-Trägern
und deren Transplantation zur Rekonstruktion von kleinen
Gelenken im Tiermodell
V. Wedler
Klinik für Wiederherstellungschirurgie, Universitätsspital Zürich
Abstracts
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