Craft Randall O, Rebecca Alanna M, Flahive Colleen, Casey William J, Dueck Amylou, Harold Kristi L
Harvard Plastic Surgery, Harvard College, Boston, Massachusetts;
Can J Plast Surg. 2011 Summer;19(2):51-2. doi: 10.1177/229255031101900203.
Acellular dermal matrices have been used with increasing frequency in both reconstructive and cosmetic surgery. While many studies have described the safety and morbidity profiles of these materials, little is known about the relative mechanical properties of individual sheets of allograft harvested from distinct donors.
Sixty-two individual sheets of an acellular dermal matrix from distinct lot numbers (signifying different donors of the dermis) were prospectively analyzed before use. Distribution of thickness according to manufacturer specifications in the dry state were as follows: 0.009 inches to 0.013 inches (1 [1.6%]); 0.79 mm to 1.78 mm (3 [4.8%]); 0.79 mm to 2.03 mm (5 [8%]); 0.8 mm to 3.3 mm (1 [1.6%]); 1.8 mm to 3.3 mm (10 [16.1%]) and 28 mm (6 [9.7%]). The size of the matrix was recorded while dry, after hydration and following stretch. The percentage change in surface area was recorded for each lot.
The 62 reconstructive cases included breast implant reconstruction (2 [3.2%]); ventral hernia repair (11 [17.7%]); abdominal closure following autologous tissue harvest (6 [9.6%]); autologous breast reconstruction (37 [59.6%]); extremity wound closures (3 [4.8%]) and reinforcement of vertical rectus abdominis muscle closure (3 [4.8%]). The mean percentage change in the size of the acellular dermal matrix to the hydrated state was 58% (36 of 62; thickness 0.06 mm to 3.30 mm); the mean percentage change in size from dry state was 7.14% (range 0% to 18.7%). The mean percentage change in the size of the hydrated matrix to the stretched state was 25.7% (range 0.25% to 70.6%). The variability in elasticity among the individual sheets was significant (P<0.0005).
The acellular dermal matrix displayed highly variable elastic properties among distinct donors. This may be significant in procedures in which symmetry is critical.
脱细胞真皮基质在重建手术和整形手术中的应用频率越来越高。虽然许多研究描述了这些材料的安全性和发病率情况，但对于从不同供体获取的同种异体移植个体皮片的相对力学性能却知之甚少。
对62张来自不同批号（代表不同真皮供体）的脱细胞真皮基质个体皮片在使用前进行前瞻性分析。根据制造商规格，干燥状态下的厚度分布如下：0.009英寸至0.013英寸（1张[1.6%]）；0.79毫米至1.78毫米（3张[4.8%]）；0.79毫米至2.03毫米（5张[8%]）；0.8毫米至3.3毫米（1张[1.6%]）；1.8毫米至3.3毫米（10张[16.1%]）以及28毫米（6张[9.7%]）。记录基质在干燥、水化后以及拉伸后的尺寸。记录每批基质表面积的百分比变化。
62例重建手术病例包括乳房植入物重建（2例[3.2%]）；腹疝修补（11例[17.7%]）；自体组织采集后的腹壁闭合（6例[9.6%]）；自体乳房重建（37例[59.6%]）；肢体伤口闭合（3例[4.8%]）以及腹直肌垂直闭合加固（3例[4.8%]）。脱细胞真皮基质尺寸到水化状态的平均百分比变化为58%（62例中的36例；厚度0.06毫米至3.30毫米）；从干燥状态起尺寸的平均百分比变化为7.14%（范围0%至18.7%）。水化基质尺寸到拉伸状态的平均百分比变化为25.7%（范围0.25%至70.6%）。个体皮片之间弹性的变异性显著（P<0.0005）。
脱细胞真皮基质在不同供体之间显示出高度可变的弹性特性。这在对称性至关重要的手术中可能具有重要意义。
