Vascularized Collagen-Glycosaminoglycan Matrix Provides a Dermal Substrate and Improves Take of Cultured Epithelial Autografts

Orgill, Dennis P.; Butler, Charles E.; Regan, John F.; Barlow, Mark; Yannas, Ioannis V.; Compton, Carolyn C.

doi:10.1097/00006534-199808000-00020

Cited by 68 publications

(33 citation statements)

References 16 publications

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“…18 Although in some instances the implanted gels have been shown to degrade rapidly 20 and the space previously occupied by the gels may not necessarily be replaced by neodermis, 21 successful neodermis formation has been reported using collagen-glycosaminoglycan gels. 20,[22][23][24] Alternatively, deepidermized xenograft porcine or human skin has been found to have modest value in treating fullthickness skin wounds in conjunction with immediate STSG autografts. 25,26 Such matrices may exhibit residual antigenicity as a result of the incomplete removal of cellular debris from the dermis or processing-dependent alterations in the connective tissue matrix.…”

Section: Resultsmentioning

confidence: 99%

Use of Porcine Acellular Dermal Matrix as a Dermal Substitute in Rats

Srivastava¹,

DeSagun²,

Jennings³

et al. 2001

Annals of Surgery

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ObjectiveTo examine porcine acellular dermal matrix (ADM) as a xenogenic dermal substitute in a rat model. Summary Background DataAcellular dermal matrix has been used in the treatment of fullthickness skin injuries as an allogenic dermal substitute providing a stable wound base in human and animal studies. MethodsXenogenic and allogenic ADMs were produced by treating porcine or rat skin with Dispase and Triton X-100. Full-thickness skin defects (225 mm 2 ) were created on the dorsum of rats (n ϭ 29), porcine or rat ADMs were implanted in them, and these were overlain with ultrathin split-thickness skin grafts (STSGs). In two adjacent wounds, 0.005-or 0.017-inch-thick autografts were implanted. In other experiments, the antimicrobial agent used during ADM processing (azide or a mixture of antibiotics) and the orientation of the implanted ADM (papillary or reticular side of ADM facing the STSG) were studied. Grafts were evaluated grossly and histologically for 30 days after surgery. ResultsSignificant wound contraction was seen at 14, 20, and 30 days after surgery in wounds receiving xenogenic ADM, allogenic ADM, and thin STSGs. Contraction of wounds containing xenogenic ADM was significantly greater than that of wounds containing allogenic ADM at 30 days after surgery. Graft take was poor in wounds containing xenogenic ADM and moderately good in those containing allogenic ADM. Wound healing was not significantly affected by the antimicrobial agent used during ADM preparation or by the ADM orientation. ConclusionDispase-Triton-treated allogenic ADM was useful as a dermal substitute in full-thickness skin defects, but healing with xenogenic ADM was poor.In extensive deep burns and other full-thickness skin wounds, permanent replacement of lost skin remains a major challenge. Several methods of wound closure are in use, and each has its own advantages and disadvantages. Porcine skin and preserved cadaver skin are used for temporary wound coverage, but 1 to 2 weeks after grafting, these tissues undergo immune-mediated rejection.1,2 Permanent wound coverage is usually accomplished using meshed, split-thickness autografts harvested from undamaged regions of skin. Extensively burned patients have limited donor sites, so thin split-thickness autografts are harvested repeatedly from the same sites. This results in substantial donor-site problems resulting from pain, infection, scarring, and sometimes keloid formation.3 Very thin (0.005-inchthick) meshed autografts can be used, but the lack of a sufficient dermal bed often results in extensive wound contraction at the recipient site. 4 The harvest of thicker splitthickness skin grafts (STSGs) reduces this contraction problem but causes increased problems at donor sites. Alternatively, cultured epidermal autografts expanded using cell culture methods can be used for wound coverage, but this technique is expensive, and cultured epidermal autografts often fail to survive or result in poor-quality wound healing.5-8 Many of these difficulties with STSGs and cul-

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Section: Resultsmentioning

confidence: 99%

Use of Porcine Acellular Dermal Matrix as a Dermal Substitute in Rats

Srivastava¹,

DeSagun²,

Jennings³

et al. 2001

Annals of Surgery

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“…Successful wound healing requires the presence of a dermis layer in the skin substitute [6,7], and clinical trials have also indicated the importance of dermal pregraftment in the grafttake of the autologous epidermal substitute [8,9] and in the reduction of graft contraction and scarring [10,11]. Acellular dermal substitutes based on allogeneic, xenogeneic, or synthetic materials [12] are commercial alternatives.…”

Section: Introductionmentioning

confidence: 99%

Dermal Papilla Cells Improve the Wound Healing Process and Generate Hair Bud-Like Structures in Grafted Skin Substitutes Using Hair Follicle Stem Cells

Leirós

Kusinsky

Drago³

et al. 2014

Stem Cells Translational Medicine

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Tissue-engineered skin represents a useful strategy for the treatment of deep skin injuries and might contribute to the understanding of skin regeneration. The use of dermal papilla cells (DPCs) as a dermal component in a permanent composite skin with human hair follicle stem cells (HFSCs) was evaluated by studying the tissue-engineered skin architecture, stem cell persistence, hair regeneration, and graft-take in nude mice. A porcine acellular dermal matrix was seeded with HFSCs alone and with HFSCs plus human DPCs or dermal fibroblasts (DFs). In vitro, the presence of DPCs induced a more regular and multilayered stratified epidermis with more basal p63-positive cells and invaginations. The DPC-containing constructs more accurately mimicked the skin architecture by properly stratifying the differentiating HFSCs and developing a well-ordered epithelia that contributed to more closely recapitulate an artificial human skin. This acellular dermal matrix previously repopulated in vitro with HFSCs and DFs or DPCs as the dermal component was grafted in nude mice. The presence of DPCs in the composite substitute not only favored early neovascularization, good assimilation and remodeling after grafting but also contributed to the neovascular network maturation, which might reduce the inflammation process, resulting in a better healing process, with less scarring and wound contraction. Interestingly, only DPC-containing constructs showed embryonic hair bud-like structures with cells of human origin, presence of precursor epithelial cells, and expression of a hair differentiation marker. Although preliminary, these findings have demonstrated the importance of the presence of DPCs for proper skin repair.

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“…The amount of keratinocyte cells remaining on the wound bed, depending on bed conditions and other factors, reaches 15.55% (5,8). For example, when these cells are transplanted onto a chronic granulation tissue, 15% of live weight is observed, and when they are transplanted on a newly or recently removed granulation tissue, 28% -47% shows successful transplantation and 75% -45% of tissues survive if affected areas are already covered with dead skin (9). On the other hand, in the first few weeks after the burn and when keratinocyte proliferation remains insufficient, the risk of mortality is very high due to complications, such as water disorders and electrolyte, other burns, and infections.…”

Section: Application Of Fibroblasts In Burn Woundsmentioning

confidence: 99%

Application of Dermal Fibroblast Cells in Cell Therapy of Wound

et al. 2017

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Context and Evidence Acquisition: Cell therapy, with autologous dermal fibroblasts, shows remarkable potential and is currently achieved by different methods, such as spraying, grafting, and injecting to treat various types of ulcers, wrinkles, acne scars, and surgical wounds. Results: To prepare fibroblasts for clinical use, some critical points must be taken into consideration: isolation and culture of these cells to produce a homogeneous population of non-contaminated cells, a method for rapid growth, and development of a proportional number of fibroblast cells with proper strength and viability. In addition, an appropriate site for a biopsy should be selected based on indications of treatment and maintenance. Conclusions: Ultimately, the clinical use of fibroblasts in wound healing obviates the need for ready to use reservoir of these cells. In this regard, dermal allografts can be used in both fresh and frozen forms. The fresh type is more desirable due to its high chance of survival. Developing the appropriate preservation methods for allogeneic fibroblasts is the emerging research field of interest. Furthermore, applying biomaterials will increase the efficacy of fibroblasts in wound healing.

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Vascularized Collagen-Glycosaminoglycan Matrix Provides a Dermal Substrate and Improves Take of Cultured Epithelial Autografts

Cited by 68 publications

References 16 publications

Use of Porcine Acellular Dermal Matrix as a Dermal Substitute in Rats

Use of Porcine Acellular Dermal Matrix as a Dermal Substitute in Rats

Dermal Papilla Cells Improve the Wound Healing Process and Generate Hair Bud-Like Structures in Grafted Skin Substitutes Using Hair Follicle Stem Cells

Application of Dermal Fibroblast Cells in Cell Therapy of Wound

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