Schiestl Clemens, Biedermann Thomas, Braziulis Erik, Hartmann-Fritsch Fabienne, Böttcher-Haberzeth Sophie, Arras Margarete, Cesarovic Nikola, Nicolls Flora, Linti Carsten, Reichmann Ernst, Meuli Martin
Pediatric Burn Center, Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital, Steinwiesstrasse 75, Zurich, Switzerland.
Pediatr Surg Int. 2011 Mar;27(3):249-54. doi: 10.1007/s00383-010-2792-1.
Tissue engineering of skin with near-normal anatomy is an intriguing novel strategy to attack the still unsolved problem of how to ideally cover massive full-thickness skin defects. After successful production of large, pig cell-derived skin analogues, we now aim at developing an appropriate large animal model for transplantation studies.
In four adult Swiss pigs, full-thickness skin defects, measuring 7.5 × 7.5 cm, were surgically created and then shielded against the surrounding skin by a new, self-designed silicone chamber. In two animals each, Integra dermal regeneration templates or cultured autologous skin analogues, respectively, were applied onto the wound bed. A sophisticated shock-absorbing dressing was applied for the ensuing 3 weeks. Results were documented photographically and histologically.
All animals survived uneventfully. Integra healed in perfectly, while the dermo-epidermal skin analogues showed complete take of the dermal compartment but spots of missing epidermis. The chamber proved effective in precluding ("false positive") healing from the wound edges and the special dressing efficiently kept the operation site intact and clean for the planned 3 weeks.
We present a novel and valid pig model permitting both transplantation of large autologous, laboratory-engineered skin analogues and also keeping the site of intervention undisturbed for at least three postoperative weeks. Hence, the model will be used for experiments testing whether such large skin analogues can restore near-normal skin, particularly in the long term. If so, clinical application can be envisioned.
构建具有接近正常解剖结构的皮肤组织工程是一种引人关注的新策略，旨在攻克如何理想地覆盖大面积全层皮肤缺损这一尚未解决的问题。在成功制备出大型猪细胞源皮肤替代物后，我们现在致力于开发一种适用于移植研究的大型动物模型。
对4只成年瑞士猪进行手术，制造出面积为7.5×7.5厘米的全层皮肤缺损，然后用一种新的自行设计的硅胶室将伤口与周围皮肤隔开。在每两只动物中，分别将Integra真皮再生模板或培养的自体皮肤替代物应用于创面。在接下来的3周内使用一种精密的减震敷料。通过拍照和组织学方法记录结果。
所有动物均顺利存活。Integra完美愈合，而真皮 - 表皮皮肤替代物的真皮部分完全成活，但有表皮缺失的斑点。该硅胶室被证明能有效防止伤口边缘的（“假阳性”）愈合，并且这种特殊敷料在计划的3周内有效地保持了手术部位的完整和清洁。
我们提出了一种新颖且有效的猪模型，既允许移植大型自体实验室工程皮肤替代物，又能使干预部位在术后至少三周内不受干扰。因此，该模型将用于测试这种大型皮肤替代物是否能恢复接近正常的皮肤，特别是从长期来看。如果可以，那么就可以设想其临床应用。
