Differential Capability of Clinically Employed Dermal Regeneration Scaffolds to Support Vascularization for Tissue Bioengineering

Abstract

The loss of skin integrity has always represented a major challenge for clinicians dealing with dermal defects, such as ulcers (diabetic, vascular and chronic), postoncologic resections (i.e., radical vulvectomy) or dermatologic disorders. The introduction in recent decades of acellular dermal matrices (ADMs) supporting the repair and restoration of skin functionality represented a significant step toward achieving clean wound repair before performing skin grafts. Hard-to-heal ulcers generally depend on local ischemia and nonadequate vascularization. In this context, one possible innovative approach could be the prevascularization of matrices with vessel-forming cells (inosculation). This paper presents a comparative analysis of the most widely used dermal templates, i.e., Integra® Bilayer Matrix Wound Dressing, PELNAC®, PriMatrix® Dermal Repair Scaffold, Endoform® Natural Dermal Template, and Myriad Matrix®, testing their ability to be colonized by human adult dermal microvascular endothelial cells (ADMECs) and to induce and support angiogenesis in vitro and in vivo. By in vitro studies, we demonstrated that Integra® and PELNAC® possess superior pro-adhesive and pro-angiogenetic properties. Animal models allowed us to demonstrate the ability of preseeded ADMECs on Integra® to promote the engraftment, integration and vascularization of ADMs at the site of application.

Optical coherence tomography for in vivo longitudinal monitoring of artificial dermal scaffold

“…Consequently, a tight dermal scaffold fit is highly desired to achieve a high survival rate of the transplanted skin. 33,66 As for the IRDR measurement, the ADS underwent an IRDR increase at a similar speed for patients 1 and 3. This may be explained by the fact that both wounds are on the ankle.…”

“…The degradation rate also plays a key role in cell adhesion, proliferation and penetration in wound recovery 31 and consequently needs to be under control 32 . As for the scaffold‐tissue fit, there often exist air gaps between the scaffold and the tissue, which may slow down the vascularization of the scaffold and consequently needs to be eliminated 33 …”

“…32 As for the scaffold-tissue fit, there often exist air gaps between the scaffold and the tissue, which may slow down the vascularization of the scaffold and consequently needs to be eliminated. 33 In comparison to the continuously growing use of ADS, the supporting evaluation techniques are behindhand. Currently, the cell in-growth, vascular regeneration, and scaffold degradation are often evaluated in vitro through imaging the excised tissues under a microscope which are stained with hematoxylin-eosin or Masson's trichrome.…”

Frozen bean curd-inspired xenogeneic acellular dermal matrix with triple pretreatment approach of freeze–thaw, laser drilling and ADSCs pre-culture for promoting early vascularization and integration

“…Endothelial cells (ECs) exhibited differences in adhesion, proliferation and tube formation on varied dermal templates, and vascularization of dermal templates was the key factor in successful engraftment and integration [ 29 ]. Thus, promoting ECs adhesion, proliferation and tube formation on ADM is beneficial to achieving desired therapeutic results.…”

Ischemic wound revascularization by the stromal vascular fraction relies on host-donor hybrid vessels

“…We either injected mT + SVF cells in the subcutaneous tissue surrounding the wound perimeter, to mimic the procedure used by the majority of clinical trials, or seeded them on a clinical-grade scaffold prior to its application on the wound bed. Among the various skin substitutes, we chose INTEGRA, as it outperformed over a few alternative wound dressing devices available on the market and it is extensively used in the clinics 14 . As shown in Supplementary Fig.…”