Ichioka Shigeru, Kouraba Sachio, Sekiya Naomoi, Ohura Norihiko, Nakatsuka Takashi
Department of Plastic and Reconstructive Surgery, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan.
Br J Plast Surg. 2005 Dec;58(8):1124-30. doi: 10.1016/j.bjps.2005.04.054. Epub 2005 Jul 25.
This study aims to investigate the effect of collagen matrix impregnated with bone marrow on wound healing angiogenesis in an effective microcirculatory model and to describe our clinical experience.
We used a skinfold chamber of original design which visualises microcirculation following wound creation on the dorsal skin of the mouse to establish an in vivo experimental model to estimate angiogenesis. Animals were divided into two groups: a bone marrow group (n = 6) in which bone marrow-impregnated collagen matrix was applied to the wound; and a control group (n = 7), in which collagen immersed in saline was applied, and functional capillary density was quantified during the repair process.
The increase rate in functional capillary density during wound healing significantly increased in the bone marrow group on days 3, 5 and 7 after creation of the wound but no significant difference was detected on day 10. A patient with a chronic leg ulcer that had not responded to conventional therapy for 1 year was treated with autogenous bone marrow-impregnated collagen matrix and successful wound closure was obtained.
The present study suggested that collagen matrix impregnated with bone marrow significantly promoted the repair process, especially in the early stage. The features of the treatment, including the possible use of a patient's own cells, simple method, immediate application without any processing procedure and preservation of the inclusive potentiality of bone marrow suspension, offer significant advantages in terms of the anticipated routine clinical use.
本研究旨在探讨骨髓浸渍胶原基质在有效微循环模型中对伤口愈合血管生成的影响,并描述我们的临床经验。
我们使用了一种原始设计的皮褶腔室,该腔室可在小鼠背部皮肤伤口形成后可视化微循环,以建立体内实验模型来评估血管生成。将动物分为两组:骨髓组(n = 6),将骨髓浸渍胶原基质应用于伤口;对照组(n = 7),应用浸于盐水中的胶原,在修复过程中对功能性毛细血管密度进行定量。
伤口愈合期间功能性毛细血管密度的增加率在伤口形成后第3、5和7天在骨髓组中显著增加,但在第10天未检测到显著差异。一名慢性腿部溃疡患者,常规治疗1年无效,接受自体骨髓浸渍胶原基质治疗,伤口成功闭合。
本研究表明,骨髓浸渍胶原基质显著促进了修复过程,尤其是在早期。该治疗方法的特点,包括可能使用患者自身的细胞、方法简单、无需任何处理程序即可立即应用以及保留骨髓悬液的包容性潜能,在预期的常规临床应用方面具有显著优势。