Recent Innovation in Pretreatment for Skin Grafts Using Regenerative Medicine in the East

Chronic ulcers remain a significant health care concern today, especially in the elderly and immobile population. Pedicled or free flap transfers are usually applied to deep wounds in which bone and/or tendon are exposed. Despite improvements in reconstructive surgery techniques, operative invasion and complications, including flap necrosis and infection, are serious problems in patients whose general condition is unfavorable. For these patients, skin graft provides less invasive coverage of wounds as compared to the flap procedures. However, skin graft cannot survive on deep and poorly vascularized defects. Conversion of such defects to applicable beds to simple skin graft requires technologies to induce highquality granulation tissue on compromised wounds. Stimulating the repair process after surgical debridement may achieve granulation tissue formation and shorten the period for skin grafts. For this purpose, regenerative medicine has attracted our attention. The characteristics of the methodology include the use of the three main tools of regenerative medicine; biomaterials, cytokines, and cells. This section introduces the technologies of regenerative medicine for wound bed preparation with particular focus on their progress in Asia. All the patients illustrated in this chapter consented to the treatment. Clinical trials were approved by the Institutional Review Board (IRB) of Saitama Medical University.