Pediatric Surgery Wound Healing and Regenerative Medicine

Scarless fetal skin healing

Scar formation in the skin is a consequence of injury to the skin. This injury can be the result of trauma, burns, or even elective surgery. Scar formation can result in poor functional and aesthetic outcomes, including the inability to perform activities of daily living, and represents a significant healthcare problem. In contrast, the healing of skin injuries in the fetus is scarless, with restoration of normal skin architecture.

Since the original description of scarless skin healing, much work has been done to characterize the mechanism of fetal regeneration but has had limited impact on treatments for scar formation. This limitation may be due to examining differences in fetal and adult wounds, which does not take into consideration other differences between the fetus and the adult not related to wound healing. Researchers at UMMC's Center for Fetal Medicine have developed a novel model to examine scarless regeneration and scar formation in the fetus. In this model small wounds in the fetus heal without scar whereas large wounds heal with scar formation. This model removes differences between the fetus and adult that are not related to wound healing.

Using this model investigators have demonstrated that inflammation plays central role in whether a skin wound heals by regeneration or scar formation. The investigators are also using sophisticated gene expression arrays, gene transfer techniques, and histology to characterize the mechanisms involved in the scarless fetal response and to develop successful treatments to prevent scar formation.

Scarless fetal tendon healing

Tendon scar formation and contracture formation are a consequence of tendon injury. The tendon injury can be the result of trauma, tendon surgery, or immobility following injury or paralysis. Scar tissue is weaker than normal tissue and can lead to tendon failure. In addition, scar formation can lead to joint contractures. In contrast, the healing of tendon injuries in the fetus is scarless, with restoration of normal tendon architecture and function.

Researchers at UMMC's Center for Fetal Medicine have developed a novel model to examine scarless regeneration and scar formation in the fetal tendons. In this model small wounds in the fetal tendon heal without scar whereas large wounds heal with scar formation. This model removes differences between the fetus and adult that are not related to wound healing.

Using this model investigators have demonstrated that inflammation plays central role in whether a tendon wound heals by regeneration or scar formation. The investigators are also using sophisticated gene expression arrays, gene transfer techniques, and histology to characterize the mechanisms involved in the scarless fetal response and to develop successful treatments to prevent tendon scar formation.

Fetal stem cell therapy

Fetal stem cells have the unique ability to develop into multiple different cell and tissue types. This property has resulted in much interest in the use of fetal cells to treat adult disease processes and to regenerate injured tissues.

Investigators in UMMC's Center for Fetal Medicine are currently funded by the National Institutes of Health to study the ability of fetal mesenchymal stem cells to correct the wound healing complications associated with diabetes. The investigators are using state of the art molecular biology and gene transfer techniques to characterize the mechanisms by which fetal cells can improve healing.