McCall, Blake, Rana, Karan, Sugden, Kate and Junaid, Sarah (2024). In-vitro External Fixation Pin-Site Model Proof of Concept: A Novel Approach to Studying Wound healing in Transcutaneous Implants. Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 238 (4), pp. 403-411.
Abstract
External fixation is an essential surgical technique for treating trauma, limb lengthening and deformity correction, however infection is common, with infection rates ranging from 4.5 to 100% of cases. Throughout the literature researchers and clinicians have highlighted a relationship between excessive movement of the pin and skin and an increase in the patient’s risk of infection, however, currently no studies have addressed this role of pin-movement on pin-site wounds. This preliminary study describes a novel in vitro pin-site model, developed using a full-thickness human skin equivalent (HSE) model in conjunction with a bespoke mechanical system which simulates pin-movement. The effect of pin-movement on the wound healing response of the skin equivalents was assessed by measuring the expression of pro-inflammatory cytokines. Six human skin equivalent models were divided into three test groups: no pin as the control, static pin-site wound and dynamic pin-site wound (n = 3). On day 3 concentrations of IL-1α and IL-8 showed a significant increase compared to the control when a static fixation pin was implanted into the skin equivalent (p < 0.05) and (p < 0.005) respectively. Levels of IL-1α and IL-8 increased further in the dynamic sample compared to the static sample (p < 0.05) and (p < 0.0005). This study demonstrates for the first time the application of HSE model to study external-fixation pin-movement in vitro. The results of this study demonstrated pin-movement has a negative effect on soft-tissue wound-healing, supporting the anecdotal evidence reported in the literature, however further analysis of wound heading would be required to verify this hypothesis.
Publication DOI: | https://doi.org/10.1177/09544119241234154 |
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Divisions: | College of Engineering & Physical Sciences > School of Engineering and Technology > Mechanical, Biomedical & Design College of Health & Life Sciences > School of Biosciences College of Engineering & Physical Sciences > Aston Institute of Materials Research (AIMR) College of Engineering & Physical Sciences Aston University (General) |
Funding Information: | The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Aston University College of Engineering and Physical Science. |
Additional Information: | Copyright © IMechE 2024. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
Uncontrolled Keywords: | External fracture fixation,human skin equivalent,pin-site infection,Surgical Wound Infection/therapy,Bone Nails,External Fixators,Humans,Wound Healing/physiology,Fracture Fixation/methods,Interleukin-8,Mechanical Engineering |
Publication ISSN: | 2041-3033 |
Last Modified: | 02 Dec 2024 09:04 |
Date Deposited: | 04 Mar 2024 17:50 |
Full Text Link: | |
Related URLs: |
https://journal ... 544119241234154
(Publisher URL) http://www.scop ... tnerID=8YFLogxK (Scopus URL) |
PURE Output Type: | Article |
Published Date: | 2024-03-03 |
Published Online Date: | 2024-03-03 |
Accepted Date: | 2024-02-13 |
Authors: |
McCall, Blake
Rana, Karan ( 0000-0003-3061-5156) Sugden, Kate ( 0000-0001-6323-1082) Junaid, Sarah ( 0000-0001-9460-710X) |