The circumcision of males is emphatically linked to numerous sexual dysfunctions.
Many of the purported benefits do not hold up to the scrutiny of extensive
literature surveys. Involuntary circumcision, particularly when not medically
warranted, is also associated with many psychological and emotional traumas.
Current methods to reconstruct the ablated tissue have significant drawbacks and
produce a simple substitute that merely imitates the natural foreskin.
Extracellular matrix–based scaffolds have been shown to be highly effective in
the repair and regeneration of soft tissues; however, due to the unique nature
of the foreskin tissue, commercially available biomaterial scaffolds would yield
poor results. Therefore, this study discusses the development and evaluation of
a tissue engineering scaffold derived from decellularized human foreskin
extracellular matrix for foreskin reconstruction. A chemicophysical
decellularization method was applied to human foreskin samples, sourced from
consenting adult donors. The resulting foreskin dermal matrices were analyzed
for their suitability for tissue engineering purposes, by biological,
histological, and mechanical assessment; fresh frozen foreskin was used as a
negative control. Sterility of samples at all stages was ensured by
microbiological analysis. MTT assay was used to evaluate the absence of viable
cells, and histological analysis was used to confirm the maintenance of the
extracellular matrix structure and presence/integrity of collagen fibers.
Bioactivity was determined by submitting tissue extracts to enzyme-linked
immunosorbent assay and quantifying basic fibroblast growth factor content.
Mechanical properties of the samples were determined using tensile stress tests.
Results found foreskin dermal matrices were devoid of viable cells
(p < 0.0001) and the matrix of foreskin dermal matrices
was maintained. Basic fibroblast growth factor content doubled within after
decellularization (p < 0.0001). Tensile stress tests found
no statistically significant differences in the mechanical properties
(p < 0.05). These results indicate that the derived
foreskin dermal matrix may be suitable in a regenerative approach in the
reconstruction of the human foreskin.
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