Oral epithelialization in wound healing

Over one million tonsillectomies are performed annually in the United States and Europe. Secondary post-tonsillectomy hemorrhage (PTH) is a significant burden to the health care system in terms of emergency department revisits, inpatient readmissions, and reoperation.

It has been previously theorized that secondary PTH is due to premature separation of an eschar or fibrin scab from the underlying wound, although this theory is not universally accepted and has not been demonstrated histologically in any prior studies.

Our research shows that the likely cause of secondary PTH is epithelial separation and wound contraction occurring concurrently with neovascularization. This exposes neovasculature to an uncovered and unprotected surface leaving new vessels at a higher risk of bleeding. This occurs most commonly from post-operative day six to nine.

Our lab developed a growth factor intervention that altered the timing of the wound healing events so that wound contraction and epithelial separation occurred prior to maximal neovascularization. Neovascularization therefore occurs at a time when there is a more mature epithelial covering of the wound, reducing the risk of exposed blood vessels in the wound bed.

  1. Chen, J. Bekale, LA. Khomtchouk, KM. Xia, A. Cao, Z. Ning, S. Knox, SJ. Santa Maria, PL. Locally Administered Heparin-Binding Epidermal Growth Factor-Like Growth Factor Reduces Radiation-Induced Oral Mucositis in Mice. Sci Reports 2020.10. PMID: 33060741
Oral Wound Overlay drawing

Oral Apthous Ulcer Disease

Funded by the NIDCR we are collaborating with Auration Biotech to translate a topical regenerative treatment for oral mouth ulcers. Chronic recurrent oral aphthous ulcers, the most common type of inflammatory condition of the oral mucosa with a prevalence of 2% to 10% in Caucasian populations, can be a manifestation of trauma or systemic inflammatory process or are truly idiopathic, and no effective medical therapies have been identified to date that shorten the disease.

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