Division of Surgical Oncology and Thoracic Surgery, Department of Surgery University Medical Centre Mannheim, University of Heidelberg, Germany.
J Biomater Appl. 2011 Jan;25(5):413-27. doi: 10.1177/0885328209347961. Epub 2009 Dec 30.
Soft tissue defects following resectional surgery or trauma often result in deadspaces and require free or pedicled flaps. A programmed formation of filling tissue with enhanced biomechanical properties could be helpful. This study examined the effects on wound healing of acellular dermal matrix (ADM) seeded with autologous fibroblasts in a standardized rodent model. As pre- or postoperative radiotherapy is standard in many treatments of malignancies, we also investigated the effects of additional radiotherapy. Fischer rats were randomised and received a standardized unilateral soft tissue defect at the buttock. The defect was filled with ADM+fibroblasts or ADM alone. Controls received no filling. Either no radiation, adjuvant (postoperative) or neoadjuvant (preoperative) radiation was applied to the defect site. Six weeks later the defect volume was measured by MR-tomography. Wound breaking strength was examined by tensiometry according to German Industrial Standards. Filling of the defect side was significantly larger in ADM and ADM+fibroblast treated groups compared to the control group in all settings. Wound breaking strength in the unimodal setting was significantly improved in the ADM+fibroblasts group compared to the ADM group. In the neoadjuvant setting there was no significant difference between control and ADM group. However, the ADM+fibroblasts groups showed a significantly increased wound breaking strength compared to the control and the ADM-alone group. Seeded or unseeded ADM is able to fill deadspace in this rodent model in all settings. Implanting non-irradiated, vital, proliferating autologous fibroblasts on ADM results in significantly increased wound breaking strength.
切除手术后或创伤后常常会导致软组织缺损，需要游离皮瓣或带蒂皮瓣。程序化形成具有增强的生物力学性能的填充组织可能会有所帮助。本研究在标准化啮齿动物模型中检查了脱细胞真皮基质（ADM）与自体成纤维细胞共培养对伤口愈合的影响。由于术前或术后放疗是许多恶性肿瘤治疗的标准方法，我们还研究了额外放疗的影响。将 Fischer 大鼠随机分组，在臀部接受标准化单侧软组织缺损。缺损部位用 ADM+成纤维细胞或 ADM 单独填充。对照组未进行填充。对缺损部位进行无照射、辅助（术后）或新辅助（术前）照射。6 周后，通过磁共振断层扫描测量缺损体积。根据德国工业标准，通过张力测定法检查伤口断裂强度。在所有设置中，与对照组相比，ADM 和 ADM+成纤维细胞治疗组的缺损侧填充明显更大。在单模态设置中，与 ADM 组相比，ADM+成纤维细胞组的伤口断裂强度显著提高。在新辅助设置中，对照组与 ADM 组之间无显著差异。然而，与对照组和单独 ADM 组相比，ADM+成纤维细胞组的伤口断裂强度显著增加。在所有设置中，接种或未接种的 ADM 均可填充该啮齿动物模型中的死腔。在 ADM 上植入非照射、有活力、增殖的自体成纤维细胞可显著提高伤口断裂强度。
