Department of Hand-, Plastic-, and Burn Surgery, University Hospital of Linköping, Sweden.
J Plast Reconstr Aesthet Surg. 2010 May;63(5):848-57. doi: 10.1016/j.bjps.2009.01.068. Epub 2009 May 13.
If a biodegradable scaffold is applied, the dermis can be regenerated by guided tissue regeneration. Scaffolds can stimulate in-growth of cells from the surroundings that migrate into them and start to produce autologous extracellular matrix as the scaffold is degraded. Several materials are available, but most of them are in the form of sheets and need to be laid on an open wound surface. A number of injectable fillers have been developed to correct soft-tissue defects. However, none of these has been used for guided tissue regeneration. We present a new technique that could possibly be used to correct dermal defects by using macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration. In eight healthy volunteers, intradermal injections of macroporous gelatine spheres were compared with injections of saline and hyaluronic acid (Restylane). Full-thickness skin biopsy specimens of the implants and surrounding tissue were removed 2, 8, 12 and 26 weeks after injection, and the (immuno)histological results were analysed. The Restylane merely occupied space. It shattered the dermal tissue and compressed collagen fibres and cells at the interface between the implant and the dermis. No regeneration of tissue was found with this material at any time. The macroporous gelatine spheres were populated with fibroblasts already after 2 weeks. After 8 weeks the spheres were completely populated by fibroblasts producing dermal tissue. After 12 and 26 weeks, the gelatine spheres had been more or less completely resorbed and replaced by vascularised neodermis. There were no signs of capsular formation, rejection or adverse events in any subject. Further in vivo studies in humans are needed to evaluate the effect of the macroporous spheres fully as a matrix for guided tissue regeneration with and without cellular pre-seeding. However, the results of this study indicate the possibility of using macroporous gelatine spheres as an injectable, three-dimensional, degradable matrix for guided tissue regeneration.
如果使用可生物降解的支架，则可以通过引导组织再生来再生真皮。支架可以刺激周围细胞向内生长，并在支架降解时开始产生自体细胞外基质。有几种材料可用，但大多数都是片状的，需要铺在开放的伤口表面上。已经开发出许多可注射填充物来纠正软组织缺陷。但是，这些都没有用于引导组织再生。我们提出了一种新技术，该技术可能可以使用多孔明胶球作为引导组织再生的可生物降解支架来纠正皮肤缺陷。在八名健康志愿者中，将多孔明胶球的皮内注射与盐水和透明质酸（瑞蓝）的注射进行了比较。在注射后 2、8、12 和 26 周，切除了植入物和周围组织的全层皮肤活检标本，并对（免疫）组织学结果进行了分析。瑞蓝仅占据空间。它破坏了真皮组织，并在植入物与真皮之间的界面处压缩了胶原纤维和细胞。在任何时候都没有发现该材料有组织再生。在 2 周后，多孔明胶球中已经充满了成纤维细胞。8 周后，球体完全被产生真皮组织的成纤维细胞填充。12 周和 26 周后，明胶球或多或少已完全吸收并被血管化的新生真皮所取代。在任何受试者中都没有包膜形成，排斥或不良事件的迹象。需要在人体内进行进一步的研究，以评估多孔球作为引导组织再生的基质（有或没有细胞预接种）的效果。但是，这项研究的结果表明，使用多孔明胶球作为可注射的，三维的，可降解的基质来进行引导组织再生是可能的。
