Reducing Side-effects of Autologous Skin Tissue Harvesting
Condition: Scar
Study type: Interventional
Phase: Early Phase 1

Summary: 
      The investigators are doing this research study to learn about how the skin heals after many
      microscopic skin biopsies are collected.

      Skin-grafting is a life-saving procedure for people with large area skin wounds caused by
      burns or trauma. Conventional autologous (self) skin grafting techniques require the creation
      of large donor site wounds, causing numerous complications including pain, infection,
      blistering, discoloration, and scarring. Based on previous research, many of these adverse
      effects can be improved, or even eliminated, by harvesting skin tissue in very small
      biopsies. These "micro-biopsies" are less than the size of a sewing pin. Then, they are put
      back together into a skin graft.

      This concept is based on clinical observations from fractional photothermolysis laser
      therapy, an FDA approved laser that has been previously developed by the investigators
      research group for the treatment of scars and ageing skin. With this laser technique,
      thousands to millions of small burns are produced by laser on a patient's skin, and the skin
      responds by healing the damaged areas to create new healthy skin within days and without
      scarring.

      Although the results of laser treatment are well-known, it is not known what happens when we
      harvest the skin using needles instead of using the laser to cut the skin. The investigators
      also would like to understand how the body heals the skin. Understanding how this works helps
      in understanding wound healing, and may lead to future treatments for healing large wounds,
      disfiguring burn scars, and preventing scar formation.

      A tummy tuck (abdominoplasty surgery) is done to remove excessive skin of the belly. This is
      an elective surgery, in other words, it is optional and usually done for cosmetics reasons
      (to improve the appearance).

      The skin of the belly that is removed during an abdominoplasty surgery (tummy tuck) is
      discarded. The skin of the area removed is called "pre-abdominoplasty skin". The
      investigators would like to study the effects of the micro-biopsies on pre-abdominoplasty
      skin to exam how the skin heals over time and to study the skin that will be removed during
      the abdominoplasty surgery.

      This is a pilot study. Pilot studies are done on a small group of subjects to learn if a
      larger study would be useful.

      The investigators are asking subjects to take part in this study who are healthy with an
      abdominoplasty surgery (tummy tuck) scheduled at Massachusetts General Hospital (MGH) by a
      plastic surgeon .

      The investigators will enroll about 28 subjects in this research study, all at MGH.

      The Department of Defense is paying for this study to be done.
    

Detailed description: 
      It will take you about 8 weeks to complete this research study. During this time, the
      investigators will ask you to make up to 7 study visits to MGH.
    

Intervention name(s): Micro biopsy; Lidocaine with epinephrine
Intervention type(s): Device; Procedure
Intervention description(s): This is a prospective, self-controlled study of the healing response after collecting micro skin biopsies of different sizes (from 200 µm to 2 mm in diameter) from up to seven 1.5 x 1.5 cm biopsy sites in pre-abdominoplasty skin areas that are scheduled for surgical removal. The collection procedure will be performed using similar techniques as standard skin biopsies: the skin area involved will be cleaned with alcohol pads, and 1% buffered lidocaine with epinephrine anesthesia will be administered locally, then micro biopsies of skin will be removed by biopsy punch/harvesting needle. No more than 10% of the skin area within each biopsy site will be collected. Tattoo ink as described will be applied to 4 micro-biopsies at the corners of each biopsy test site; The skin area involved will be cleaned with alcohol pads, and 1% buffered lidocaine with epinephrine anesthesia will be administered locally, prior to the surgical procedure
Other intervention name(s): Lidocaine
Intervention MeSH terms: Lidocaine; Epinephrine
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: wound healing