Widgerow Alan D
Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa.
Ann Plast Surg. 2012 Jun;68(6):574-8. doi: 10.1097/SAP.0b013e31824b3d1c.
Initial efforts at biologic skin replacement strategies were mainly directed toward keratinocyte regeneration and epithelial replacement. It soon became evident that without a good dermal scaffold, the long-term efficacy of epithelial replacement was very limited. Further studies have focused on matrix replacement predominantly involving collagen frameworks with or without cellular additions. The fibroblast is central to the process of dermal regeneration and to the success of biologic matrix design. The sequence of cellular focal adhesion, integrin phosphorylated activation, intracellular and extracellular signaling, cytoskeletal activation, changes in cell morphology, and cytokine growth factor interaction are all important in influencing cell proliferation, cell spreading, neocollagenesis, and collagen translocation. A basic acellular matrix with chemical composition and correct physical structure (pore size and resistance) that takes cognizance of this sequence of matrix deposition and fibroblast functionality should be successful in promoting intrinsic healing and dermal replacement.
生物皮肤替代策略的最初努力主要针对角质形成细胞再生和上皮替代。很快就发现，没有良好的真皮支架，上皮替代的长期效果非常有限。进一步的研究主要集中在基质替代上，主要涉及有或没有细胞添加的胶原框架。成纤维细胞对于真皮再生过程和生物基质设计的成功至关重要。细胞粘着斑、整合素磷酸化激活、细胞内和细胞外信号传导、细胞骨架激活、细胞形态变化以及细胞因子生长因子相互作用的顺序，在影响细胞增殖、细胞铺展、新胶原形成和胶原转运方面都很重要。一种具有化学成分和正确物理结构（孔径和阻力）的基本无细胞基质，若能考虑到这种基质沉积顺序和成纤维细胞功能，应该能够成功促进内在愈合和真皮替代。
