Srivastava A, DeSagun E Z, Jennings L J, Sethi S, Phuangsab A, Hanumadass M, Reyes H M, Walter R J
Burn Center, Cook County Hospital, Chicago, Illinois 60612, USA.
Ann Surg. 2001 Mar;233(3):400-8. doi: 10.1097/00000658-200103000-00015.
To examine porcine acellular dermal matrix (ADM) as a xenogenic dermal substitute in a rat model.
Acellular dermal matrix has been used in the treatment of full-thickness skin injuries as an allogenic dermal substitute providing a stable wound base in human and animal studies.
Xenogenic and allogenic ADMs were produced by treating porcine or rat skin with Dispase and Triton X-100. Full-thickness skin defects (225 mm2) were created on the dorsum of rats (n = 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.
Significant 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.
Dispase-Triton-treated allogenic ADM was useful as a dermal substitute in full-thickness skin defects, but healing with xenogenic ADM was poor.
在大鼠模型中研究猪脱细胞真皮基质(ADM)作为异种真皮替代物的情况。
在人和动物研究中,脱细胞真皮基质已被用作全层皮肤损伤治疗的同种异体真皮替代物,可提供稳定的伤口基底。
用中性蛋白酶和曲拉通X-100处理猪或大鼠皮肤来制备异种和同种异体ADM。在大鼠(n = 29)背部制造全层皮肤缺损(225平方毫米),植入猪或大鼠ADM,并用超薄刃厚皮片(STSG)覆盖。在两个相邻伤口中植入0.005英寸或0.017英寸厚的自体皮片。在其他实验中,研究了ADM处理过程中使用的抗菌剂(叠氮化物或抗生素混合物)以及植入ADM的方向(ADM的乳头面或网状面朝向STSG)。术后30天对移植物进行大体和组织学评估。
接受异种ADM、同种异体ADM和薄STSG的伤口在术后14天、20天和30天出现明显的伤口收缩。术后30天,含异种ADM的伤口收缩明显大于含同种异体ADM的伤口。含异种ADM的伤口移植物成活率低,含同种异体ADM的伤口移植物成活率中等。ADM制备过程中使用的抗菌剂或ADM方向对伤口愈合无明显影响。
经中性蛋白酶-曲拉通处理的同种异体ADM可作为全层皮肤缺损的真皮替代物,但异种ADM的愈合效果较差。