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A study of suction induced dermo-epidermal separation and epidermal wound healing in the human

A STUDY OF SUCTION INDUCED DERMO-EPIDERMAL SEPARATION AND EPIDERI4AL WOUND HEALING IN THE HUMAN Alison Colette Lindsay 1984 Suction induced blisters were studied in human skin. The blisters were painlessly raised, without evidence of trauma, using negative pressures in the 200 300 mm. Hg. range, and temperatures from 34°C to 40°C. In normal subjects, the plane of cleavage was uniformly found to be through the lamina lucida. Paranuclear vacuolization, internalization of hemidesnosomes and microvillous transformation of the basal membrane were identified as suction induced cellular changes. Factors influencing blistering time were examined. These included pressure, temperature, diameter of suction cup, age and sex. Blistering time was noted to decrease with an increase in temperature from 34°C to 37°C; it was independent of diameter and tended to decrease with increasing age; females displayed prolonged blistering times when compared with males. The unroofed suction blister was used to study epidermal wound healing. The utility of Vasoflavine, a fluorescent dye reported to specifically strain stratum corneum, was evaluated as a a non-invasive tool for the study of wound healing. In addition, reepithel ial ization and the appearance of skin markings were used to evaluate the healing process. Digitized by the Internet Archive in 2017 with funding from The National Endowment for the Humanities and the Arcadia Fund https://archive.org/details/studyofsuctioninOOIind The wound environment was manipulated and the effect of altered environment on the rate of healing was investigated. Wounds occluded with a moisture vapor and O2 permeable film healed at a faster rate and with better cosmesis than non-occluded wounds. Other environmental alterations were studied, but results could not be definitively evaluated due to the limited number of wounds studied. The suction blister roof was used to graft the chronic non-healing ulcer. In an indirect graft, the epidermal cells were grown in tissue culture, into a multi-layered, differentiated sheet and then grafted to the ulcer. The site reepithelialized quickly and was totally healed by 20 days post grafting. Acknowledgements With deep appreciation to Dr. Martin Carter for acting as an exemplary role model as investigator, physician and teacher. With many thanks to Dr. Arthur Balin for always adding a fresh perspective, for his assistance and guidelines in approaching the writing of this thesis, and for his instruction in photography. Thanks to Dorothea Caldwell, NP, MPH, and Dr. Matthew Varghese for all tneir assistance, and for making the entire project a great deal of fun. Thanks to Ms. Joan Hoffman for all her assistance in facilitating actual production of the thesis. Thanks to Dr. McNutt and Ms. Amy Hsu of New York Hospital-Cornell Medical College, Department of Dermatopathology, for the processing of material for histologic examination, and for the electron micrographic prints.