Acne.org Products
When keeping the wound wet, I wonder if it would be better to soak the gauze in one's own saliva instead of saline
Also, I am wondering, how you could use Low Level Laser Therapy (LLLT) while keeping the wound moist.
Found this online. I don't know if it applies to more superficial wound care or to the treatment of deeper tissues....
Low Level Laser Therapy is just as effective when used through clothing and it is a common practice in physical therapy and medical settings. The size of the laser light particles are tiny and can easily move through clothing as well as bandages and dressings on wounds. In fact, the patients that participated in the FDA double blind study for treatment of neck and shoulder pain were treated through their clothing. The study gave the first FDA approval to Erchonia Low Level Lasers in 2002. Since that time the FDA has passed similar studies by Erchonia for treating Carpal Tunnel Syndrome, Wounds and Scar Tissue.
When keeping the wound wet, I wonder if it would be better to soak the gauze in one's own saliva instead of saline
Also, I am wondering, how you could use Low Level Laser Therapy (LLLT) while keeping the wound moist.
Found this online. I don't know if it applies to more superficial wound care or to the treatment of deeper tissues....
Low Level Laser Therapy is just as effective when used through clothing and it is a common practice in physical therapy and medical settings. The size of the laser light particles are tiny and can easily move through clothing as well as bandages and dressings on wounds. In fact, the patients that participated in the FDA double blind study for treatment of neck and shoulder pain were treated through their clothing. The study gave the first FDA approval to Erchonia Low Level Lasers in 2002. Since that time the FDA has passed similar studies by Erchonia for treating Carpal Tunnel Syndrome, Wounds and Scar Tissue.
Great find!
I think using botox to paralyze surrounding muscles during the healing phase would be very smart:
http://www.articlesbase.com/non-fiction-ar...cars-82650.html
So, if I were to do Acell, my protocol (based on my knowledge so far) would be:
1.) Before ablating or excising the scarred area, treat it with botox, so all the muscles are totally frozen, thus preventing any wound tension. Wound tension is a big factor in scarring. This may not be feasible if you can't take a couple months off work, but this is my IDEAL scenario that I think would deliver the best healing.
2.) Keep the wound covered with Acell and *totally moist* throughout the entire healing process. It's my opinion that also having a moist wound lessens wound tension, as I imagine that the hard shell of a scab can pull on surrounding tissues and it can tear off.
3.) Apply Acell as often as possible until the wound is totally regenerated. I don't think you could do overkill when it comes to healing your face!
4.) Use a hand-held cold laser (cold laser are very gentle and emit no heat and do not cut tissues). Low Level Laser Therapy (LLLT) has even been used in conjunction with Acell ( http://www.innovations-report.de/html/beri...icht-35098.html )
LLLT has not only been shown to remodel existing scar tissue into normal tissues (this unfortunately doesn't mean filling in depressed scars, but means that the shiny, less flexible scar tissue can slowly over time be converted into more flexible, more organized tissues resembling normal tissue) but has also been shown to aid remarkably in the healing process and prevent scarring from happening.
5.) Perhaps go on a major cleanse and raw-foods diet for 6 months prior as well as making sure you're taking all the right pure, pharmaceutical grade vitamins to assist your body as much as possible in the healing process. I would say absolutely no alcohol, smoking, or junk food before during and 4-5 months after the treatment.
So this would be my formula so far:
botox + constant moist coverage over wound + frequent, repeated Acell applications + daily LLLT treatments + assist your immune system with purifying your system and taking all the right vitamins and nutrients
It's just my opinion. That's all it is. I'm just sharing my opinion with you guys...but I do think it's a smart protocol! : )
The thing that's worrysome about Botox is that it may impair the proper histological response in and around the regenerating wound.
What I think can make a real difference in healing is the amount and type of stem cells present in the area that needs to be regenerated. Furthermore, the various types of stem cells all fall within three categories: 1) Totipotent (present within the blastocyst in early embryogenesis) 2) Pluripotent (present in the foetus) and 3) Multipotent (present in adult tissues).
For practical reasons we'll focus on the multipotent type that can easily be found within adult tissues such as bone marrow, adipose tissue, skeletal muscles tissue, hair follicles, etc... Keep in mind however that the pluripotent type may offers even better regenerative capabilities. This however is a topic for another day.
Anyway, experiments with damaged (scarred) heart muscles has shown that an injection of hematopoetic and even mesenchymal stem cells in the scar tissue has improved general heart function when nothing else would. Parts of the scarred area were also seemingly remodelled, albeit to a limited extent from one injection. This has led some scientists to believe that stem cells do not only have plasticity (an ability to incorporate themselves into various tissues), but they also produce various gorwth factors that guide the host cells to do certan things they may not do otherwise. The hope is that stem cells can guide regeneration of diseased tissues.
There are however two primary problems: 1) We don't know how exactly stem cells function, and 2) damaged tissues don't have access to enough stem cells to really get the hypothesized and clinically demonstrated regenerative boost.
So, in order to really get enough stem cells to damaged tissues, you have to a) extract them from somewhere (ie: your adipose tissue), b) isolate them (using certain enzymes such as trypsin and a lab centrifuge), c) culture them (using special mediums and a cell incubator), and then d) inject them into the area that needs treatment.
However, you can't just take any stem cell and inject it into the dermis. Some stem cells would simply not belong there and they may not be able to properly adapt to the local environment. Stem cells that I believe would however work quite well for skin injections are mesenchymal stem cells. Over the last few weeks I have already told a few people about this in private messages.
How do we know that stem cells can have an impact on damaged skin? Well, many physicians and patients have noticed positive skin changes after autologous fat transplants. The theory is that the limited number of stem cells in the fat tissue are responsible for these. So the idea is that if these cells are isolated, expanded and concentrated as stated above and then injected into hypotrophic scars then both the fibrous tissues and dermal atrophy can be corrected.
Of course stem cells can help in many different ways. For example if anyone was to get dermabrasion, a prior stem cell injection into the skin would help recovery from the procedure. Same goes for any other related procedure, whether it would involve chemical peels, lasers, excisions, etc... However coupling stem cells to an ECM scaffold can further potentiate a scar revision type procedure. A minimally invasive technique would be to inject an appropriate ECM solution into an atrophied scar and then inject the necessary stem cells. In my humble opinion, the interplay between the two would be quite synergistic.
I truly believe that stem cells will play a part in scar revision surgery. The problem is that many doctors think it's something that will happen in the future, while not realizing they can already work with stem cells today if they chose to get their butts moving and their heads buzzing. There are many companies that specialize in providing extraction and culturing equipment for stem cell research and therapy. So it really is a matter of pushing the medical community in a new direction and getting narrow minded "experts" to recognize that there are fundamentally better ways of doing their job then just trying to sell ideas and methodologies that have been around for decades. It also doesn't help to tell people that "someday" things will be better... They can get better today!
PS: I will be conducting adipose derived mesenchymal stem cells experiments as soon as I get some bureaucratic issues sorted out. Hopefully I'll have some solid results/answers in a few months.
When keeping the wound wet, I wonder if it would be better to soak the gauze in one's own saliva instead of saline
Also, I am wondering, how you could use Low Level Laser Therapy (LLLT) while keeping the wound moist.
If one was being treated with ACELL after an excised scar, could daily LED therapy really be effective if the gauze was soaked in saline? Here is a quote from BRD "saline is not pigmented like blood and thus will not be able to absorb as high of a percentage of the LED light..."
Would a solution to this be to have the gauze soaked in one's own saliva and blood and have this done each time the bandage is changed? Is this really practical, though, especially if the bandage is changed every other day for a couple weeks?
New Acell photos:
Looks like a scar to me. It appears that the patient never returned to Jone's office after the initial treatment since all the photos, except for the first series, seem to have been taken at the patient's place of work. I would have thought that the patient should have returned to Jonesa office at least once a week to have Acell reapplied and the scab or scar cut out upon its appearance.
Yes it does look like a scar but much better than his original, looks to be about 80% improvment. If this is what Acell can do when not used correctly there is no doubt that when used correctly scarless healing would result. Dr Jones stated himself that there would need to be more trials to work out the best way of using Acell and although this result isn't perfect no one was expecting that.
I would love to know if there are any other doctors using Acell for trials as the more doctors using different methods the faster the optimal method will be discovered. I've been trawling the internet for others but have yet to find any. Does anyone else here know of them?
New Acell photos:
Looks like a scar to me. It appears that the patient never returned to Jone's office after the initial treatment since all the photos, except for the first series, seem to have been taken at the patient's place of work. I would have thought that the patient should have returned to Jonesa office at least once a week to have Acell reapplied and the scab or scar cut out upon its appearance.
I've read it takes from three to six months for the skin to remodel and slowly knit across the ecm, were the ecm gets degraded and slowly replaced with regenerated ecm.
Things for me,
these pictures are not so good (camera problem? shaky hand instead of using a tripod?), we also cant touch the area;
but using the pictures if that was the final result, to me, that would suggest the ecm has been denatured and cross linked by something as currently my perception says it looks like a slight fibrotic response over a regeneration remodelling response, however this may be the skin and ecm remodelling and slowly degrading;
If we eventually get hair then that to me is a suggestion of an ECM that is not denatured, One thing I theorise is that the first thing to go after denaturing maybe be hair follicles, then on the slippy slope the more you denature the more you scar. I theorise if we get hair then that means the skin will certainly be scar free;
The past scabing has worried me.
Based on these photos I can't help but think that if a) the wound was kept wet and bandaged the entire time and b) Acell was reapplied atleast once a week if not more often and c) LLLT was used then results would be nearly complete and at least 95% scarless.
I'm expecting more than 95%. Anyway my concern is the fact that on the right of the wound it looks like it is making hard work of the ecm a sign of denaturing, and fibrin which has been cited by some to be a player in the formation of scars and scabs, and the fact that on the right of the wound it looks like it is making hard work of the ecm, a signof denaturing. Also someone has phoned up Acell and Manning has stated the ecm should not scab...
I think there is a difference between scarless healing and complete regeneration with near-perfect fidelity to surrounding tissues. There have been cases of skin growing back with no "scar tissue" per se, but the cosmetic result was unsatisfactory...to say the least.
Case in point: the study performed at the University Hospital of Lausanne Switzerland, which was published in the Lancet in 2005 where eight children with third second and third degree burns Here's an excerpt from the study:
"Autologous skin-grafting is the gold standard for treatment of deep second and third degree burns. Available bioengineered skin products also necessitate this two-step surgical procedure. Therefore, we developed fetal skin constructs to improve healing of such degree burns. A bank of fetal skin cells was developed from one organ donation (4 cm2 of skin allowing the preparation of several million three-dimensional skin constructs, 912 cm, on native horse collagen). Successive fetal constructs were applied to eight patients at every change of dressing during 1a3 weeks in an outpatient setting. Complete closure was rapid (mean 15A3 days [sD 5A5]) with little hypertrophy of new skin and no retraction seen. This simple technique provided complete treatment without auto-grafting, showing that fetal skin cells might have great potential to treat burns and eventually acute and chronic wounds of other types."
You can click on this link: http://www.box.net/shared/glb4bpzxet to download a 3.6 MB pdf which includes a few photos and a chart that was excerpted from the 3-page study. They are of the before during and after treatment. The images are of the highest resolution possible.
Also regarding this study is an excerpt from a Nature.com report on this same study:
"Other forms of treating similar burns frequently take up to six times as long. The remarkable flexibility of the skin mended with the fetal cells meant that the patients recovered full movement of their hands and fingers, the authors add.
The result not only gave the patients nearly perfect skin, but also spared them the trauma of having a graft taken from elsewhere on their body, Hohlfeld (Hohlfeld is the doc who headed the study) adds."
-------------------------------------------------------------------------------------------
Here's what I have to say after reading through that pdf, viewing the photos, and reading the above statement, "The result not only gave the patients nearly perfect skin..."
NEARLY PERFECT SKIN??? If you look at the photos, you'll understand why I'm so incredulous at that comment. Perhaps viewing the skin microscopically it was normal in structure to healthy skin without the disorganized, fibrous collagen bundles associated with scarring, and a hell of a lot better than other outcomes, but the macroscopic appearance is not even close to "nearly perfect" or normal in any way. If this is what doctors think scarless healing is then that's not much to look forward to.
My feeling is that scarless healing is not sufficient. What we're really looking for is REGENERATION OF NEW TISSUES WITH NEAR-PERFECT FIDELITY TO SURROUNDING TISSUES. This means the newly regenerated skin will look almost imperceptibly like the undamaged surrounding tissues. That should be our goal. And quite honestly, I don't think it's going to just take ECM to get it there. I think it's going to take ECM plus our own stem cell injections plus LLLT plus some yet-to-be-discovered method of leveling the newly regenerated skin that will most likely have an uneven surface to really obtain the right result.
Any thoughts? Regardless of how emphatic my posts are, I do welcome constructive criticism of my opinion.
Holdontohope ECM material can be denatured. It could have been denatured accidently and if it was youad get a fibrotic response and people spinning it a certain way maybe to fuck up Acells standing.
Anyway every tissue our body has is very clever, tissues have been regenerating with ecm for thousands and thousands of years.
To every tissue, ECM is kind of like a 3d book, a manual. If page 26 is glued together it cant access the information on page 26 and we get more of a fibrotic response. If pages 36, 37 are glued we get more of a fibrotic response and so on. And if the whole book is glued togethera
How does one ensure that ECM is not denatured before use?
Many thanks for your post.
We've been looking forward to people carrying out revolutionary studies.
I truly believe that stem cells are all-important in wound healing.
I think using botox to paralyze surrounding muscles during the healing phase would be very smart:
http://www.articlesbase.com/non-fiction-ar...cars-82650.html
So, if I were to do Acell, my protocol (based on my knowledge so far) would be:
1.) Before ablating or excising the scarred area, treat it with botox, so all the muscles are totally frozen, thus preventing any wound tension. Wound tension is a big factor in scarring. This may not be feasible if you can't take a couple months off work, but this is my IDEAL scenario that I think would deliver the best healing.
2.) Keep the wound covered with Acell and *totally moist* throughout the entire healing process. It's my opinion that also having a moist wound lessens wound tension, as I imagine that the hard shell of a scab can pull on surrounding tissues and it can tear off.
3.) Apply Acell as often as possible until the wound is totally regenerated. I don't think you could do overkill when it comes to healing your face!
4.) Use a hand-held cold laser (cold laser are very gentle and emit no heat and do not cut tissues). Low Level Laser Therapy (LLLT) has even been used in conjunction with Acell ( http://www.innovations-report.de/html/beri...icht-35098.html )
LLLT has not only been shown to remodel existing scar tissue into normal tissues (this unfortunately doesn't mean filling in depressed scars, but means that the shiny, less flexible scar tissue can slowly over time be converted into more flexible, more organized tissues resembling normal tissue) but has also been shown to aid remarkably in the healing process and prevent scarring from happening.
5.) Perhaps go on a major cleanse and raw-foods diet for 6 months prior as well as making sure you're taking all the right pure, pharmaceutical grade vitamins to assist your body as much as possible in the healing process. I would say absolutely no alcohol, smoking, or junk food before during and 4-5 months after the treatment.
So this would be my formula so far:
botox + constant moist coverage over wound + frequent, repeated Acell applications + daily LLLT treatments + assist your immune system with purifying your system and taking all the right vitamins and nutrients
It's just my opinion. That's all it is. I'm just sharing my opinion with you guys...but I do think it's a smart protocol! : )
The thing that's worrysome about Botox is that it may impair the proper histological response in and around the regenerating wound.
What I think can make a real difference in healing is the amount and type of stem cells present in the area that needs to be regenerated. Furthermore, the various types of stem cells all fall within three categories: 1) Totipotent (present within the blastocyst in early embryogenesis) 2) Pluripotent (present in the foetus) and 3) Multipotent (present in adult tissues).
For practical reasons we'll focus on the multipotent type that can easily be found within adult tissues such as bone marrow, adipose tissue, skeletal muscles tissue, hair follicles, etc... Keep in mind however that the pluripotent type may offers even better regenerative capabilities. This however is a topic for another day.
Anyway, experiments with damaged (scarred) heart muscles has shown that an injection of hematopoetic and even mesenchymal stem cells in the scar tissue has improved general heart function when nothing else would. Parts of the scarred area were also seemingly remodelled, albeit to a limited extent from one injection. This has led some scientists to believe that stem cells do not only have plasticity (an ability to incorporate themselves into various tissues), but they also produce various gorwth factors that guide the host cells to do certan things they may not do otherwise. The hope is that stem cells can guide regeneration of diseased tissues.
There are however two primary problems: 1) We don't know how exactly stem cells function, and 2) damaged tissues don't have access to enough stem cells to really get the hypothesized and clinically demonstrated regenerative boost.
So, in order to really get enough stem cells to damaged tissues, you have to a) extract them from somewhere (ie: your adipose tissue), b) isolate them (using certain enzymes such as trypsin and a lab centrifuge), c) culture them (using special mediums and a cell incubator), and then d) inject them into the area that needs treatment.
However, you can't just take any stem cell and inject it into the dermis. Some stem cells would simply not belong there and they may not be able to properly adapt to the local environment. Stem cells that I believe would however work quite well for skin injections are mesenchymal stem cells. Over the last few weeks I have already told a few people about this in private messages.
How do we know that stem cells can have an impact on damaged skin? Well, many physicians and patients have noticed positive skin changes after autologous fat transplants. The theory is that the limited number of stem cells in the fat tissue are responsible for these. So the idea is that if these cells are isolated, expanded and concentrated as stated above and then injected into hypotrophic scars then both the fibrous tissues and dermal atrophy can be corrected.
Of course stem cells can help in many different ways. For example if anyone was to get dermabrasion, a prior stem cell injection into the skin would help recovery from the procedure. Same goes for any other related procedure, whether it would involve chemical peels, lasers, excisions, etc... However coupling stem cells to an ECM scaffold can further potentiate a scar revision type procedure. A minimally invasive technique would be to inject an appropriate ECM solution into an atrophied scar and then inject the necessary stem cells. In my humble opinion, the interplay between the two would be quite synergistic.
I truly believe that stem cells will play a part in scar revision surgery. The problem is that many doctors think it's something that will happen in the future, while not realizing they can already work with stem cells today if they chose to get their butts moving and their heads buzzing. There are many companies that specialize in providing extraction and culturing equipment for stem cell research and therapy. So it really is a matter of pushing the medical community in a new direction and getting narrow minded "experts" to recognize that there are fundamentally better ways of doing their job then just trying to sell ideas and methodologies that have been around for decades. It also doesn't help to tell people that "someday" things will be better... They can get better today!
PS: I will be conducting adipose derived mesenchymal stem cells experiments as soon as I get some bureaucratic issues sorted out. Hopefully I'll have some solid results/answers in a few months.
Holdontohope ECM material can be denatured. It could have been denatured accidently and if it was youad get a fibrotic response and people spinning it a certain way maybe to fuck up Acells standing.
Anyway every tissue our body has is very clever, tissues have been regenerating with ecm for thousands and thousands of years.
To every tissue, ECM is kind of like a 3d book, a manual. If page 26 is glued together it cant access the information on page 26 and we get more of a fibrotic response. If pages 36, 37 are glued we get more of a fibrotic response and so on. And if the whole book is glued togethera
How does one ensure that ECM is not denatured before use?
Franklins, reviewing my reply below I have realized Iave went of on a tangent, I honestly donat know, however the good thing about ecm IMO is you can always revise.
There are many things that can denature it that harm the integrity of the ECMas composition and structure.
breakage of the packaging allowing oxidisation, exposure to high temperatures, exposure to ultra violet light. Exposure to foreign materials, like cat gut suture, chemicals or other may make the material ineffective. Solutions like Alcohol and any alcohol based solution; Detergents and soaps; Iodine containing products; Any product with silver nitrate; Hydrogen peroxide. Dakinas Soin (bleach) Chlorine; Cortisone based products (e.g. topical ant-inflammatory mediations). And it is noted direct contact between antibiotics like amino glycosides and products that contain sulfa,
http://www.pharmcast.com/Patents/Yr2003/Ju...issue061703.htm
http://www.acell.com/vetfaq.php
Also I logically put forward that afibrina denatures it, fibrin which you find in scabs and which some claim plays a part in fibrosisa Or it is one indicator of denaturing.
I get the impression it is easy to denature and there are many ways to denature it, who knows. It might get denatured in manufacturing, or the application process might denature or the patient might even denature by sleeping on a washed pillow case etc.
Also here is an article that shows ECM in the past has been severely hindered because of chemical additives,
http://www.canada.com/topics/news/story.ht...73-6d4cbabe6cd3
"Previous attempts to find better ways of encouraging skin cell growth have used chemical additives and other elaborate techniques to produce scaffolds, but their success has been limited," said Tony Ryan, a professor in the university's department of chemistry, in a news release. "We've found that skin cells are actually very 'smart.' It's in their DNA to sort themselves into the right arrangement. They just need a comparatively uncomplicated scaffold (and each other) to help them grow in a safe, natural way."
Our skin has been using this scaffold for thousands of years (It is much smarter at regenerating than man and mans additives), all our smart tissue needs is a simple scaffold, it is all down to the right scaffold.
Holdontohope,
The material you have shown is not pure ecm IMO you cant compare it to a simple nanoscaffold, and though it will have ECM in it, it is embroyonic tissue that has been sourced from a fetus that was been grown in a lab. I bet the ecm in it has had many additives added to it through the process of growing the embryonic tissue in the lab.
The pictures you have shown look like they have been denatured, they look like they have scarred slightly (though the result is better than if you just left the wound). It looks to me that in the balance of regeneration and fibrosis they have still not completely removed the scarring. The scales are still tipped towards scarring in those images.
Could "REGENERATION OF NEW TISSUES WITH NEAR-PERFECT FIDELITY TO SURROUNDING TISSUES" be accomplished if mesenchymal stem cells were injected into the scar tissue before an excision and the frequent application of Acell / ECM? Or would the use of stem cells not be as effective (or effective at all) compared to if they were injected after the excision?
Interesting article: "Combining Adipose-Derived Stem Cells, Resorbable Scaffolds and Growth Factors: An Overview of Tissue Engineering" (published March 2008)
http://www.cda-adc.ca/jcda/vol-74/issue-2/167.pdf
The stanford-scar-war team has finally made an anti-scar product by manipulating wound environment. It was faster than expected.
http://www.thaindian.com/newsportal/india-...e_10048248.html
It's encouraging! 
People like Dr. Geoff Gurtner and Dr. Mark Ferguson can salvage our lives.
Here is an interview with Dr. Geoff Gurtner
http://170.224.106.75/stemcells/2008/0806/...ls.2008.95.html
The stanford-scar-war team has finally made an anti-scar product by manipulating wound environment. It was faster than expected.http://www.thaindian.com/newsportal/india-...e_10048248.html
It's encouraging!
People like Dr. Geoff Gurtner and Dr. Mark Ferguson can salvage our lives.
Here is an interview with Dr. Geoff Gurtner
http://170.224.106.75/stemcells/2008/0806/...ls.2008.95.html
Yes, isoflous, I agree, it's all very encouraging and interesting. I think in the interview with Gurtner, when asked what kinds of things he'd be discussing in a paper entitled "Wound Healing and Regeneration" 15 years from now was interesting. It was like he almost changed the subject and didn't want to make a projection in to the future. I dunno. It's still cool
The stanford-scar-war team has finally made an anti-scar product by manipulating wound environment. It was faster than expected.http://www.thaindian.com/newsportal/india-...e_10048248.html
It's encouraging!
People like Dr. Geoff Gurtner and Dr. Mark Ferguson can salvage our lives.
Here is an interview with Dr. Geoff Gurtner
http://170.224.106.75/stemcells/2008/0806/...ls.2008.95.html
When is this supposed to be available to physicians?