Journal_1_2014_final_WEB

12th Scientific Meeting of the
Diabetic Foot
Study Group
of the EASD
12-14 September 2014
Bratislava, Slovakia
Conference theme:
Advancement
of knowledge
on all aspects of
diabetic foot care
Main subjects during conference:
Epidemiology
Basic and clinical science
Diagnostics
Classification
Foot clinics
Biomechanics, Osteoarthropathy
Orthopaedic surgery
Infection
Revascularisation
Uraemia
Wound healing/outcome
www.dfsg.org
cells is distinctly different from normal dermal tissue, and
because cell function and tissue performance is largely
dependent on the cellular microenvironment, the healing
process is trapped in a vicious circle. Ideally, tissue engineering
could play an important role in the development
of a scaffold that is able to guide the stem cells into the
proper phenotype. Although various preclinical (animal)
studies have been performed and show promising results,
translation into clinical trials remains limited (reviewed
in 22 ).
Future perspectives
Despite the substantial progress in skin tissue engineering
over the past several decades, the regeneration of fully
functional skin following a burn wound still has not been
achieved. Elucidating the signals that are required to guide
the cells into the desired phenotype and away from the
myofibroblast phenotype will be useful for scaffold design.
Such scaffolds should create the microenvironment
necessary for skin regeneration instead of scar formation.
In addition to the aesthetic problems and functional
impairments due to diminished joint mobility of scars,
other problems may occur from scarring as a result of
the absence of skin appendages. For example, the lack of
sweat glands may impair the thermoregulatory function
of the skin. In addition, scars often lack hair follicles and
sebaceous glands. Hair transplantation and skin expansion
techniques have been used to restore the lack of hair follicles
in scars 23, 24 . In vitro and in vivo experiments have
shown that a tissue engineering approach may be successful
to reconstitute hair follicles 25 . The use of stem cells in
skin substitutes have also shown promising results with
respect to hair follicle induction 26 . Further research to
elucidate the mechanisms involved in the development
of sebaceous glands and sweat glands is needed to address
the lack of these structures in the healing wound. m
20. Jurgens WJ, Oedayrajsingh-Varma MJ, Helder MN, Zandiehdoulabi B, Schouten TE,
Kuik DJ, et al. Effect of tissue-harvesting site on yield of stem cells derived from
adipose tissue: implications for cell-based therapies. Cell Tissue Res.
2008;332(3):415-26.
21. van der Veen VC, Vlig M, van Milligen FJ, de Vries SI, Middelkoop E, Ulrich MM.
Stem Cells in Burn Eschar. Cell Transplant. 2012. Epub 2011/09/29.
22. Jackson WM, Nesti LJ, Tuan RS. Concise review: clinical translation of wound
healing therapies based on mesenchymal stem cells. Stem cells translational
medicine. 2012;1(1):44-50.
23. Oh SJ, Koh SH, Lee JW, Jang YC. Expanded flap and hair follicle transplantation for
reconstruction of postburn scalp alopecia. JCraniofacSurg. 2010;21(6):1737-40.
24. Gho CG, Martino Neumann HA. Donor hair follicle preservation by partial follicular
unit extraction. A method to optimize hair transplantation. JDermatologTreat.
2010;21(6):337-49.
25. Sriwiriyanont P, Lynch KA, McFarland KL, Supp DM, Boyce ST. Characterization of
hair follicle development in engineered skin substitutes. PLoSOne.
2013;8(6):e65664.
26. Liang X, Ding Y, Zhang Y, Tse HF, Lian Q. Paracrine mechanisms of Mesenchymal
Stem cell-based therapy: Current status and perspectives. Cell Transplant. 2013.