When we get injured, our body naturally tries to heal. In adults, this healing often leads to scars - thick, stiff tissue known as fibrotic tissue. Unlike normal tissue, fibrotic tissue doesn't function properly and can cause serious health problems, depending on the affected organ. Once it forms, fibrosis is usually permanent. A good example of the fibrosis process is the healing of our skin: after a cut or surgery, the resulting scar is a type of fibrosis. Special cells called fibroblasts are key players in this process. Our study looks at a drug called verteporfin, which is already approved both in Europe and the U.S. Previous research on mice and human cells suggests it can reduce or even prevent fibrosis. We are now testing, clinically, histologically and by scRNA-seq, whether injecting verteporfin into the skin during wound healing, specifically after surgical procedures, can prevent thick, rigid scars from forming. Since the skin is easy to observe and sample, it offers a great model for studying this. Will verteporfin have an impact on how surgical wounds heal? That's what we aim to find out.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
DOUBLE
Enrollment
24
During the safety margin excision, the placebo (NaCl) will be injected into the wound before suturing.
During the safety margin excision, the study drug (Verteporfin) will be injected into the wound before suturing.
Quantification of the profibrotic mesenchymal fibroblast subpopulation in the study group compared to the placebo group.
For comparison between groups, skin samples of the repaired tissue taken at visit 4 (Day 90 +/- 10) will be compared between the patients of both groups.
Time frame: There are 90 +/- 10 days between visit 1 and visit 4.
The changes of fibroblast subpopulations, clusters, and their different cell-cell interactions in both groups before and after the study intervention.
For comparison over time in both groups, skin samples of the repaired tissue taken at visit 4 (Day 90 +/- 10) will be compared to the scar sample of visit 1 (Day 0) in all patients of both groups.
Time frame: There are 90 +/- 10 days between visit 1 and visit 4.
Quantification of pilosebaceous units and profibrotic activity (quantity of collagen I and III and its ratio, fibronectin, α-SMA, nuclear localization of YAP1 and En1-staining) and its change over time
For comparison over time in both groups, skin samples of the repaired tissue taken at visit 4 (Day 90 +/- 10) will be compared to the scar sample of visit 1 (Day 0) in all patients of both groups.
Time frame: There are 90 +/- 10 days between visit 1 and visit 4.
Quantification of the different fibroblast subpopulations in unwounded, healthy skin.
In all patients, 2 slices of the initial FFPE skin samples will be analyzed.
Time frame: The initial excision will take place 21 to 54 days before V1.
The changes of different fibroblast subpopulations passing from unwounded skin to scarred, to repaired skin.
Analysis of the initial FFPE skin samples compared to the analysis on Day 0 and Day 90 (+/- 10).
Time frame: There are a maximum of 56 days + 90 +/- 10 days between the inital mole removal and visit 4.
Comparison of the clinical outcomes of the scars in both groups.
The clinical outcomes will be evaluated by VSS scoring at visit 3 (Day 14 +/- 2), visit 4 (Day 90 +/- 10) and visit 5 (Day 180 +/- 10).
Time frame: There are a minimum of 154 and a maximum of 178 days between visit 3 and visit 5.
The comparison of PROMs
PROMs will be assessed in both groups by SCAR-Q scoring at Day 14 (+/- 2), Day 90 (+/- 10) and Day 180 (+/- 10).
Time frame: There are a minimum of 154 and a maximum of 178 days between visit 3 and visit 5.
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