Theoret Christine
Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada.
Vet Surg. 2009 Dec;38(8):905-13. doi: 10.1111/j.1532-950X.2009.00585.x.
Horses are predisposed to traumatic wounds that can be labor intensive and expensive to manage. Skin has a considerable potential for efficient and functional repair however, while cutaneous repair is a regenerative process in the fetus, this capability declines in late gestation as inflammation and scarring alter the outcome of healing. The historical gold standard for replacement of lost skin is the autologous skin graft. However, the horse's lack of redundant donor skin limits the practicality of full-thickness grafting to smaller wounds; moreover, graft failure is relatively common in equine patients as a result of infection, inflammation, fluid accumulation beneath the graft, and motion. Tissue engineering has emerged as an interdisciplinary field with the aim to regenerate new biological material for replacing diseased or damaged tissues or organs. In the case of skin, the ultimate goal is to rapidly create a construct that effects the complete regeneration of functional skin, including all its layers and appendages. Moreover, an operational vascular and nervous network, with scar-free integration within the surrounding host tissue, is desirable. For this to be achieved, not only is an appropriate source of cells required, but also a scaffold designed from natural or synthetic polymers. The newly created tissue might finally meet the numerous needs and expectations of practitioners and surgeons managing a catastrophic wound in a horse.
马容易受到创伤性伤口的影响，处理起来可能需要耗费大量人力且成本高昂。然而，皮肤具有高效且功能性修复的巨大潜力。虽然皮肤修复在胎儿期是一个再生过程，但随着炎症和瘢痕形成改变愈合结果，这种能力在妊娠后期会下降。替代缺失皮肤的历史金标准是自体皮肤移植。然而，马缺乏多余的供体皮肤，这限制了将全层移植用于较小伤口的实用性；此外，由于感染、炎症、移植下方的液体积聚和活动，移植失败在马患者中相对常见。组织工程已成为一个跨学科领域，旨在再生新的生物材料以替代患病或受损的组织或器官。就皮肤而言，最终目标是快速创建一种构建物，实现功能性皮肤的完全再生，包括其所有层次和附属器。此外，还需要一个在周围宿主组织内无瘢痕整合的可运作的血管和神经网络。要实现这一点，不仅需要合适的细胞来源，还需要由天然或合成聚合物设计的支架。新创建的组织最终可能满足治疗马灾难性伤口的从业者和外科医生的众多需求和期望。
