Orthopaedic Research Laboratory, University of Utah Orthopaedic Center, Salt Lake City, UT 84108, USA.
Med Eng Phys. 2013 Jun;35(6):743-53. doi: 10.1016/j.medengphy.2012.08.002. Epub 2012 Aug 31.
Epidermal downgrowth, commonly associated with long-term percutaneous implants, weakens the skin-implant seal and greatly increases the vulnerability of the site to infection. To improve the skin attachment and early tissue integration with porous metal percutaneous implants, we evaluated the effect of bone marrow-derived mesenchymal stem cells (BMMSCs) to provide wound healing cues and vascularization to the dermal and epidermal tissues in establishing a barrier with the implant. Two porous metal percutaneous implants, one treated with BMMSCs and one untreated, were placed subdermally on the dorsum of Lewis rats. Implants were evaluated at 0, 3, 7, 28, and 56 days after implantation. Histological analyses evaluated cellular infiltrates, vascularization, quantity and quality of tissue ingrowth, epidermal downgrowth, and fibrous encapsulation. The amount of collagen infiltrating the porous coating was significantly greater for the BMMSC-treated implants at 3 and 28 days post implantation compared to untreated implants. There was an early influx and resolution of cellular inflammatory infiltrates in the treated implants compared to the untreated, though not statistically significant. Vascularization increased over time in both treated and untreated implants, with no statistical significance. Epidermal downgrowth was minimally observed in all implants with or without the BMMSC treatment. Our results suggest that BMMSCs can influence an early and rapid resolution of acute and chronic inflammation in wound healing, and can stimulate early collagen deposition and granulation tissue associated with later stages of wound repair. These findings provide evidence that BMMSCs can stimulate a more rapid and improved barrier between the skin and porous metal percutaneous implant.
表皮下生长，通常与长期经皮植入物有关，削弱了皮肤-植入物的密封，大大增加了该部位感染的脆弱性。为了改善多孔金属经皮植入物的皮肤附着和早期组织整合，我们评估了骨髓间充质干细胞（BMMSCs）的作用，以向真皮和表皮组织提供伤口愈合线索和血管生成，从而在植入物上建立屏障。将两个多孔金属经皮植入物，一个用 BMMSCs 处理，一个未处理，皮下放置在 Lewis 大鼠的背部。植入物在植入后 0、3、7、28 和 56 天进行评估。组织学分析评估细胞浸润、血管生成、组织内生长的数量和质量、表皮下生长和纤维包裹。与未处理的植入物相比，BMMSC 处理的植入物在植入后 3 天和 28 天的多孔涂层中胶原的浸润量明显更大。与未处理的植入物相比，处理的植入物中细胞炎症浸润的早期涌入和解决更快，但没有统计学意义。在处理和未处理的植入物中，血管生成随着时间的推移而增加，但没有统计学意义。表皮下生长在有或没有 BMMSC 处理的所有植入物中都很少观察到。我们的结果表明，BMMSCs 可以影响伤口愈合中急性和慢性炎症的早期和快速解决，并可以刺激与伤口修复后期相关的早期胶原沉积和肉芽组织。这些发现提供了证据表明，BMMSCs 可以刺激皮肤和多孔金属经皮植入物之间更快和更好的屏障。
