VU University Medical Center (VUA)

VU University Medical Center
De Boelelaan 1117
1081 HV

Lead Investigator

Prof. Dr. Esther Middelkoop

Prof. Dr. Esther Middelkoop
Leader of Workpackage 07
Phone: +31 20 444 1426
Fax: +31 20 444 0151

Project Staff

Dr. Margriet Mullender
Data analysis
Phone: +31 20 444 1426

Institute Presentation

VUmc University Medical Center is a comprehensive health care facility, dedicated to patient care, research, and the education of health care professionals.  The hospital has experienced tremendous physical growth in the last few decades and is supported by the most up-to-date systems and technology.  VUmc is a centre of excellence which makes it a patient referral centre not only for Amsterdam but also for its wide surroundings.  

Research is a valuable part of the VUmc and that refers also to the Department of Plastic Surgery. Plastic Surgery Research is multifaceted and involves a professor for wound healing and  regeneration, a professor for burn wounds, a research coordinator,  an associate professor, 1,5 post-doc, and 5 PhD students.  Also many VUmc medical students participate in projects with questions arising from clinical practice. Plastic surgery residents have an opportunity to engage in research projects (clinically based or basic science based) during their tenure as residents. In close collaboration with the Dutch Burn centers we possess excellent expertise in conducting clinical trials in the field of skin substitutes and clinimetric measurements of scar quality.

One of our preclinical research topics is to develop new treatment strategies for healing of (deep) burn wounds which improve the outcome of healing.
Wound healing is a cascade of different processes that have to be closely orchestrated in order to regain normal functional restoration of the damaged tissue. Derailment of this system results in impaired wound healing and hypertrophic scar formation. A number of factors seem to be responsible for the generation of often invalidating scars, such as the depth and location of the wound and an excessive inflammatory reaction (possibly as a result of an infection). Although ample research has been performed on many aspects of wound healing, the precise mechanism of wound healing and scar formation or scarless healing is still lacking.

Our research efforts include:

A.  Basic science research to the process of cicatrization and skin regeneration
Together with the Department of Molecular Cell Biology, Dermatology and The Burns (Unit) Centre Beverwijk we focus, amongst others, on the biological (immunological and mechanical) processes involved in the formation of scar tissue.

Current research projects are:

  • Inflammation and angiogenesis; The dynamic of scar hypertrophy
  • The role of macrophages in excessive scarring of the burned skin
  • The role of chemokines, macrophages, and fibroblasts in skin and mucosal scar
  • Anti-fibrotic/anti-inflammatory treatments to improve the quality of scars after burns
  • Scarless healing in NOD/SCID mice; a pilot study
  • Cellular responses to mechanical loading: an in vitro model for splinting regimes

B.    Pre-clinical and clinical research to the treatment of wound healing and scars
The focus of the research involves the treatment of wounds and scars, such as hypertrophic and keloid scar treatment, and treatment of surgical, burn and trauma wounds. The research includes also the application of regenerative medicine in skin reconstruction by means of  (biological) scaffolds and/or cell transplantation.

Current research projects are:

  • The technique of skin stretching for acute burn treatment and scar reconstruction: clinical applications and working mechanisms
  • Adapation of dermal architecture of scar tissue and normal skin to tension forces

C. Regenerative Medicine
Basic science and applied research studies are conducted to regenerate a functional skin while diminishing  fibrosis.

Current studies are:

  • Application of cultured autologous keratinocytes in combination with a meshed split skin autograft for burn wound healing
  • Cartilage regeneration with adipose tissue derived stem cells
  • Composite Tissue Allotransplantation by Modulation of Immunosuppression
  • Assessment of lipofilling methods

Our attention is focused on fundamental research and efforts are made to detect the cellular and molecular mechanisms of wound healing and scarring. When the underlying processes which lead to scarring are understood, new treatments can be developed in which scarring is decreased or even prevented. In addition, the insight in processes which lead to a normal functioning skin are of interest in developing optimal skin substitutes.  Therefore we are proud to be part be part of the European FP7 research consortium EuroSkinGraft to develop skin-regenerative therapies.