Question: How to regrow a severed finger in 4 weeks? (as seen on the Oprah Winfrey show.)
Answer: by using Matristem Wound Powder and a Band-Aid.

What is Matristem Wound Powder?
Matristem wound powder is an innovative regenerative medicine. It is made from the extracellular matrix (ECM) material that naturally occurs in pig bladders (pigs tissue has a collagen structure that is nearly identical to that of human tissue). Which is why this new product is sometimes popularly called pig powder.

What is this Extracellular Matrix?
Extracellular matrix is a network of biomolecules (mostly proteins) which hold the cells together. It is sometimes compared with a scaffold because it supports construction and repair on a cellular level.

Instead of the normal healing process which involves scabbing and scarring it stimulates cellular regeneration (promotes rapid donor site remodeling). This means that thanks to this medical innovation we can now grow back fingers (and possibly other body parts). There’s also no, or far less, scarring involved.

How Does Matristem Wound Powder Work?
The powder keeps the wound from healing and as a result the body focuses on creating new cells. Its main mechanism has to do with the fact that the body doesn’t have to regenerate so much extracellular matrix on its own.

Because the wound is covered in extracellular matrix there’s an increase of regenerative cells which are able to regrow the tissue. I’d like to compare it with a collapsed brick house of which the presence of the steel framework determines whether or not it can be rebuild the way it was.

The patient’s own cells and blood vessels grow into the material; it is completely absorbed, leaving behind new tissue instead of scar tissue. Source: Acell.

MatriStem Wound Powder vs. MatriStem Wound Care Matrix
Matristem is currently available in sheet and micronized particle form (powder). Ask your surgeon, dermatologist, or other health care professional about. This product is exclusively available commercially by keepers of a pharmacy license.

Is MatriStem™ Powder Safe?
For these and answers to other questions, on for example side effects and how to use instructions, visit this Finger Amputation Patient pdf file.

More news such as;

ACell’s MatriStem® Wound Powder heals toddler’s severed thumb
ACell’s MatriStem Wound Powder featured on the Oprah Winfrey Show
ACell’s MatriStem MicroMatrix® regenerates woman’s severed fingertip

on the Acell website.

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Especially keloid scars have a tendency to grow back. Even after they have been removed surgically. But soon a new medicine for the prevention and reduction of scarring following scar revision surgery may end the problem of recurrent keloids.

The UK based biopharmaceutical product company Renovo is currently developing a first‐in‐class pharmaceutical scar reduction drug called Juvista. This scar preventing medicine, which has to be injected in the skin just before surgery will soon be marketed in the US and Europe. (it’s currently in its research and development phase.)

Professor Mark Ferguson, CEO, Renovo Group commented:

“It was important to establish the safety of Juvista® when given to patients who develop keloids, as one can not necessarily predict which patients will go on to develop them.

This series of safety trials achieved the primary objective across a range of Juvista® doses and provided valuable new information on the natural history of keloid scar development to inform future trial design.

The main Juvista® Phase III programme in disfiguring scars remains on track as a potential first‐in‐class pharmaceutical for the prevention and reduction of scarring following scar revision surgery.” Source: Renovo.com (.pdf)

More research results will become available in 2011. The company is also working on a new formulation of Juvista that is specifically designed for children.

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Here’s a list of all the available silicone gel scar creams (or at least the ones I am aware of).

There are many brands to choose from. Some contain 100% silicones while others are made of a mix of ingredients. This post is not about which cream is the best. It’s only an overview of what’s available on the consumer market.

I will review some of these products later on. Some have links to my review behind them.

Creams in this list that are not available on Amazon (see below) are linked to online stores that do sell them.

• ScarAway 100% Silicone Gel Serum
• Kelo-cote Advanced Formula Scar Gel
• Scar Esthetique Healing & Reduction Cream (w/Silicone, Arnica, Antioxidants, Copper Peptides, Co-Q10,
• ScarGuard MD ScarGuard Scar Care (read my review)
• Rejuvasil (read my review )
• Pro-Sil Roll-On Scar Reduction Stick (by Biodermis)
• Scarsil Scars
• Cimeosil Scar Gel
• Sudden Change Scar Zone Topical Scar Diminishing Cream
• Xeragel 100% silicone ointment (by Biodermis)
• Dermatix Ultra (May be a few bucks cheaper here than on Amazon.)
• Spectragel (polysiloxane)
• Scarprin
• Zeraderm (not available in the U.S)

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Before silicone sheeting became widespread, pressure therapy has been the appropriate method to treat (burn) scars.

During the nineteenth century the use of pressure in the treatment and prevention of hypertrophic scars or keloids became popular.

Compression garments, made from elasticized fabric shaped as sleeves, gloves, or masks, became standard treatment modalities in burn centers and other health care institutions.

Nowadays compression garments are still commonly used. For example after (cosmetic) surgery. This because of the specific benefits of these garments.

Benefits of the pressure applied are;

• improved blood circulation,
• minimized swelling after the procedure,
• drainage of potentially harmful fluids,
• acceleration of the healing process,
• and prevention of problematic scar development.

So How Do Compression Garments Work?

• The mechanism of pressure therapy has to do with the fact that in case of (burn) scars the top layer of the skin is missing. Therefore it can’t put pressure on the skin as healthy skin would do and this is what may lead to hypertrophic and keloid scarring.
• Another probable benefit of post surgery compression garments is that the pressure applied on the scar protects the tissue from overstretching. This reduced tension on the healing tissue prevents scars from widening (or thickening).  For the same reason scar taping is sometimes administered.
• Furthermore, pressure may theoretically break up excessive scar tissue (collagen bundles) and soften the keloid mass however, therapy must be instituted for long periods (>23 h/d for 6 mo) before significant effects can be achieved.
• When used following a facial procedure, the compression garment also provides support to surgical areas for more comfort and helps the skin fit better to it new contours.

Used When?
Plastic surgery compression garments are available for most  types of cosmetic surgery and for every part of the body (face, upper body, mid body, lower body, chest, abdomen, arms, back, shoulders, thighs, legs, calves, and all other body areas).

There are several online stores who offer these garments.

Makemeheal for example, offers a wide range of medical grade garments for various procedures. (The term medical grade refers to the fact that these are high quality post-operative, medical compression garments which are specifically designed to be worn for long time periods during the recovery process from a cosmetic surgery.)

Examples of cosmetic surgeries after which pressure garments are used are; breast surgery, face lifts, buttock surgery, arm, thigh lift, liposuction and other weight loss procedures.

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A few studies have demonstrated that topical retinoic acid (the strongest form of vitamin A) has beneficial effects on scar appearance. However, because of the, sometimes serious, possible side effects associated with this type of treatment its use is disencouraged by professionals in the health care sector.

But what about its less strong, thus less risky, sisters retinol and retinyl palmitate?

“In vitro studies demonstrated that collagen synthesis * could be markedly reduced in cultures treated with retinoid acid and its derivates.” [1]

* collagen synthesis plays a role in excessive scar tissue creation.

‘Its derivates’ are retinyl palmitate and retinol which are less strong forms of vitamin A associated with less side effects. For more clarity:

• retinyl palmitate – safest form, best tolerance, fewest side effects, no prescription needed
• retinol, stronger so more likely to cause reactions and is not suited to all skin types.’
• Retinoic acid is the active form of retinol, with prescription only

Since the researchers concluded that its derivates also reduce collagen synthesis retinol and retinyl palmitate creams may help in the treatment of scars.

An interesting NY Times article titled; ‘The Thing About Retin-A: It Works‘, provides some additional insights.

For example: “Retinol, a less potent form of Retin-A, also has some strong science to support its effectiveness.”

“[..] consistent use of Retin-A helps normalize the cells,” said Dr. Min-Wei Christine Lee, a dermatologist in Walnut Creek, Calif.”

“Retin-A can improve skin texture and fade dark spots and freckles because it causes skin cells to turn over more rapidly. It shrinks dilated pores and improves cell turnover within the pores so they are less likely to clog and become blackheads and whiteheads.”

So in conclusion, retinol may have clinical support behind its efficacy but I haven’t found yet what it exactly does for scars. I’m wondering if anyone has used retinol creams on their raised, red scars? And if so, what did it do for you? (A close look at the sense and nonsense of retinol creams in acne scar treatment will follow.)

Read more on the benefits and potential side effects of topical retinoic acid on scars.

[1] Sense and Nonsense of Scar Creams and Gels Cees J. M. van den Helder, M.D., and J. Joris Hage, M.D., Ph.D. Amsterdam, The Netherlands

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Vitamin A comes in several forms. The strongest is called retinoic acid which, because of its strength, may cause adverse reactions. Therefore, this active form of retinol is not suited to all skin types. Retinoic acid creams are only available with prescription from a doctor or dermatologist. Because of its potency it’s classed as a pharmaceutical and not a beauty product.

Retinoic acid is not a new product. It has been clinically tested and is used in skin care for almost three decades. Some of these studies, instigated by the observation that oral vitamin A improved the appearance of keloid scars, have examined the effects of the topical use of this potent vitamin A on scars.

Conclusion of examining these reports is that the use of topical retinoic acid on scars, although seemingly effective, is not recommended. This because of potential side effects.

One study report is titled: Reduction of Keloids and Hypertrophic Scars Following Systemic Administration of Vitamin A:

[..] examined the effect of a topically applied 0.05% solution of retinoic acid on keloids and hypertrophic scars. [..] Slight to marked reduction of the size of these scars and a decrease of complaints such as itching were noted in the majority of the cases.

In addition, Hansen reported a 75% subjective and objective improvement in scars as old as three years old treated with a 0.05% topical retinoic acid. This improvement meant softening and flattening of hypertrophy and fading of the scar’s color once the effects of the acid had worn off.

In his series, vertical scars on the abdomen and those across the lines of minimum tension elsewhere on the body showed the most dramatic improvement. Areas that did not seem to respond well were the breast, chin, and jawline.

Another report by Daly et al. [2] presented the results of a randomized, double-blind, prospective study on the effects of topically applied vitamin A:

A statistically significant difference (20% reduction in scar size) was noted between the group treated with 0.05% retinoic acid and the control group treated with the base cream.

In the retinoid-treated group, lesion size was reduced by approximately 20%. Daly and coworkers concluded that the clinical effects of retinoids had been demonstrated to be consistent with the in vitro data.

Side Effects
In some case scarring actually was the result of inappropriate use of 0.05% retinoid gel. Gels seem to provoke skin irritation more often than retinoin creams [3].

Topical retinoids may be absorbed in the body. Therefore it may cause side effects due to excessive vitamin A (specifically retinoid) intake (hypervitaminosis). Especially for those who take vitamin supplements.

Another possible side effect is damage to unborn children (teratogenicity). So pregnant women should steer clear of retinoic acid.

Because of these possible complications and the absence of sufficient research data some experts do not recommend the use of topical retinoic acid on scars.

Conclusion
I would personally opt for silicones because these have no side effects. In case silicone sheeting doesn’t catch on I would possibly consult my doctor about retinoic acid treatment for scars. Although I think steroid injections would be a more appropriate next step.

Maybe prolonged use of an retinyl palmitate or retinol cream could help fade scars. Since these creams are rather safe to use and easy to obtain (I would advice to always start moderately with new skin care products to monitor the results) such creams may offer a valuable addition in case other treatments don’t work.

Read more about the topical use of retinol creams on scars.

[1] Janssen de Limpens AMP: The local treatment of hypertrophic scars and keloids with topical retinoic acid. Br J Dermatol 103:319, 1980

[2] Daly T, et al. A double-blind placebo-controlled efficacy study of tretinoin cream 0.05% in the treatment of keloids and hypertrophic scars. J Invest Dermatol 1986;86:470.

[3] Hogan DJ: Scarring following inappropriate use of 0.05% tretoin gel. J Am Acad Dermatol 17:1056, 1987

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There’s a plethora of commercially available home remedies for scars. Think about scar creams based on vitamin E or onion extract like Mederma, Bio Oil, cocoa butter, Aloe Vera, cucumber butter, lime juice, skin remodeling copper peptides and so on.


The superabundance of positive online reviews and upbeat testimonials would indicate these remedies to be helpful in the struggle to reduce scars.


However, considered from a scientific perspective, there’s only one type of home remedy that is proven effective. With proven effective I mean backed by science.



Silicone Gel Sheeting
This is the type of home remedy I am talking about: silicones for scars. Several clinical trials and other studies [1],[2] have demonstrated that silicone gel sheeting prevents the development of problematic scars. It has also shown to be an effective home remedy for keloid and hypertrophic scars.




Silicone gel sheets significantly and clinically improved the appearance of scars. More specific; this remedy makes red, raised, stiff scars more skin colored, softer, pliable, and flat. Also the anti-itch and pain reducing abilities have been proven by studies. It will not surprise that silicone sheets, recommended by many plastic surgeons, burn centers and dermatologists, are called ‘the golden standard in scar treatment’. However early treatment is ideal, silicone gel sheets may also be beneficial for older scars



Medical grade honey for wound care
Wound healing, which can be a of major influence on scarring, can get a real boost when wound care products based on medical-grade honey are used.

A review in which 22 clinical trials were evaluated concluded that honey minimizes scarring, removes infected and dead tissue and speeds healing by stimulating new tissue growth. Some researchers even suspect this type of honey to have beneficial effects when applied directly on scars but at present there’s no research done.

A 1996 preliminary study from India showed that burns treated with honey healed sooner than those treated with conventional methods (petrolatum and gauze) and that scarring was reduced. (6.2% of the 450 patients treated ended up with scars compared to 19.7% of the same number of patients who received conventional treatment)



Conclusion
When we rely on medical science we can conclude that the best home remedies for scars are silicone gel sheets (or gels) and, in case of wound care, medical grade honey dressings. Recently, FDA approved medical grade honey dressings have become available on the consumer market.

More on how silicone gel sheeting works. The best brands to buy, and Medihoney wound care products.

[1] Topical treatments for hypertrophic scars Journal of the American Academy of Dermatology – Volume 55, Issue 6 (December 2006)
[2] Evolution of Silicone Therapy and Mechanism of Action in Scar Management by Dr. Thomas A. Mustoe Aesth Plast Surg (2008) 32:82–92 link (.pdf)

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Silicones do work on various types of scars. They are the only proven effective OTC products available. This treatment, commonly referred to as ‘The Golden Standard in Scar Treatment’ is non-invasive and easy to use. But how do they work?

Various theories circulate on the mechanism of silicone scar sheets and gels. Some state that the scar improving effects are due to pressure administered by the sheets. Others say that the reduced elevation and redness of scars are the result of a static electric field created by the silicones.

But there’s no evidence these assumptions are right. Also theories on improved oxygen supply, or an increased blood flow as a result of administering silicones have not been proven. Hydration does seem to play a major role but there’s more to it than simply moisturizing scar tissue.

According to various experts it is occlusion which is the key to the efficacy of silicone scar treatment. To understand we have to take a closer look at the water retaining function of the skin.

Healthy skin conserves water and functions as a barrier to microbial infection. The outermost layer of the skin (stratum corneum) normally contains water and is responsible for water conservation, but its function is disrupted when the skin is damaged.

“After a full-thickness wound, transepidermal water loss (TEWL) is increased and can take longer than 1 year to recover to basal levels. In addition, this water loss (TEWL) is greater with hypertrophic scars and keloids than with atrophic scars or normal skin [1].”

Water loss caused by skin injury leads to dehydration of the tissue which, on its turn, is thought to stimulate the production of small proteins (cytokines). These proteins are theorized to lead to changes in the skin (dermis) and increased scar tissue creation (collagen production) by cells that play a major role in wound healing (fibroblasts).

Although application of silicone sheeting to skin causes hydration of the stratum corneum, the extent of hydration is less than that produced by a plastic film, and the increase in hydration compared with normal skin decreases after repeated treatment [2].

These results have been interpreted to suggest that the semi-occlusive nature of silicone gel sheeting improves scars by providing adequate but not excessive hydration [2]. A plausible explanation for the mechanism of action of silicone-based products, therefore, is that occlusion causes a decrease in TEWL and normalizes the hydration  state of keratinocytes, which then signal dermal fibroblasts to downregulate extracellular matrix production.[3]

Or in other, less technical words, silicone sheeting is thought to provide the exact right amount of occlusion which restores the water balance in the skin and scar tissue. Certain processes in the scar tissue are more balanced out which results in less abnormal scar tissue creation.

[1] Suetake T, Sasai S, Zhen YX, Ohi T, Tagami H (1996) Functional analyses of the stratum corneum in scars: Sequential studies after injury and comparison among keloids, hypertrophic scars, and atrophic scars. Arch Dermatol 132:1453–1458

[2]Suetake T, Sasai S, Zhen YX, Tagami H (2000) Effects of silicone gel sheet on the stratum corneum hydration. Br J Plast Surg 53:503–507

[3] Evolution of Silicone Therapy and Mechanism of Action in Scar Management Thomas A. Mustoe. Aesth Plast Surg (2008) 32:82–92

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The use of topical vitamin E for scars is probably the most popular home treatment. There’s an overwhelming amount of anecdotal proof. Take a look at any forum, website, or other source where scar treatment questions are answered and there’s a big chance someone states vitamin E to be the best option to treat a scar. However, there’s no scientific proof confirming this statement.

A few studies on this matter have been conducted the past years. This particular study among 159 test persons, of which the report was published in The Journal of Burn Care and Rehabilitation in 1986 demonstrated that;

“Those in the vitamin E group showed no noticeable improvement in the size, thickness or appearance of their scars by the end of the study.

The conclusion of a more recent study (1999) conducted by the University of Miami stated that:

“This study shows that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar.

In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore we conclude that use of topical vitamin E on surgical wounds should be discouraged.”

That’s why, despite the many positive reviews, the topical use of vitamin E on scars is discouraged. Alternatives are moisturizing agents (such as Vaseline) and silicone gel. More on silicone scar treatment.

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This may sound unbelievable but just like salamanders are able to grow back their tails medical science is now capable of growing back fingertips and other tissue. Several cases have demonstrated tissue regeneration in human beings.

Here’s a short Youtube video about how doctors were able to regrow the severed top part of a little boy’s thumb with the use of wound tissue regeneration.

Acell, the manufacturer of innovative tissue regeneration products (MatriStem) states that their products “promote cell development and regeneration of site specific tissue, may recruit adult progenitor cells, and reduce scarring and restore tissue to its normal state and function.”

Progenitor cells (like stem cells) have a tendency to differentiate into a specific type of cell. In contrast to stem cells, however, they are already far more specific because they have the ability to differentiate into site specific tissues such as muscle, skin, tendons, and bone.

Commonly two types of tissue regenerative agents are used. Wound powder and biodegradable scaffolds which are matrix structured dressings which foster the regeneration of new tissue that resembles the original tissue in structure and function.

According to the wound healing page on Wikipedia: “biodegradable scaffolds inhibit wound contraction, thereby allowing the healing process to proceed towards a more-regenerative/less-scarring pathway.”

Problematic wounds such as diabetic, venous, arterial, and pressure ulcers, traumatic wounds, first and second degree burns, and surgical wounds can benefit from this fairly new type of treatment.

Since they are said to reduce scarring and even prevent scars from developing, as impossible as it sounds, patients might want to ask their surgeon, dermatologist, or other health care professional about this treatment. MatriStem Wound Matrix is available on Amazon but can only be purchased by keepers of a pharmacy license.

Read more about the miraculous opportunities modern medical science has to offer in this CNN article: Woman’s persistence pays off in regenerated fingertip. There are some tips on how to be a proactive patient and how to contribute to getting the most optimal treatment available today. Or as stated in the article; realize your doctor doesn’t know everything.

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