Miami, Fla.; and Providence and Warwick, R.I. From the Division of Plastic Surgery, University of Miami, Miller School of Medicine; the Department of Molecular Pharmacology, Physiology, and Biotechnology, Brown University; and C. R. Bard, Inc. (Davol).
Plast Reconstr Surg. 2013 May;131(5):741e-751e. doi: 10.1097/PRS.0b013e3182865c6d.
Postmastectomy breast reconstruction remains one of the most frequently performed plastic surgery procedures in the United States. Acellular dermal matrix has been used extensively in expander-implant breast reconstruction and therefore is an appropriate material to be used to develop a clinically relevant animal model of breast reconstruction.
The study population consisted of 18 female Yorkshire pigs, which were assigned randomly to bilateral expander breast reconstruction with either AlloMax Surgical Graft or AlloDerm Regenerative Tissue Matrix (n = 9 per group). Each group was further randomized to 4-, 8-, or 12-week time points (n = 3), to evaluate integration and neovascularization by means of microcirculatory and histologic techniques.
Microcirculatory analysis revealed early acellular dermal matrix angiogenesis at 4 weeks on the skin flap surfaces only, and well-formed vasculature on both acellular dermal matrix surfaces at 8 weeks. Both surfaces were vascularized and exhibited detectable flow at 12 weeks after implantation. Progressive acellular dermal matrix angiogenesis was also histologically observed over time by means of hematoxylin and eosin-stained slides, as indicated by direct vascular identification/scoring at 4, 8, and 12 weeks.
The authors have developed a clinically relevant large-animal model of breast reconstruction using acellular dermal matrix. The acellular dermal matrix inflammatory, neovascularization, and tissue integration response should be evaluated in an in vivo setting that accurately simulates the anatomy, biomaterials, surgical techniques, and timeframes encountered in human postmastectomy breast reconstruction to appropriately predict clinical performance. Neovascularization of the acellular dermal matrix with detectable blood flow took place after postimplantation week 8, a much slower process than previously reported in models not clinically relevant to acellular dermal matrix-assisted tissue expander breast reconstruction.
乳房再造术是美国最常施行的整形手术之一。脱细胞真皮基质已广泛应用于扩张器-植入物乳房再造术，因此是开发乳房再造术临床相关动物模型的合适材料。
研究人群包括 18 头雌性约克夏猪，随机分为双侧扩张器乳房再造术，分别使用 AlloMax 外科移植物或 AlloDerm 再生组织基质（每组 n = 9）。每组进一步随机分为 4、8 或 12 周时间点（每组 n = 3），通过微循环和组织学技术评估整合和新生血管化。
微循环分析显示，在皮肤瓣表面仅在 4 周时可见脱细胞真皮基质早期血管生成，在 8 周时在脱细胞真皮基质表面可见形成良好的脉管系统。植入后 12 周时，两个表面均有血管化，并可检测到血流。随着时间的推移，通过苏木精和伊红染色切片也可以在组织学上观察到渐进性脱细胞真皮基质血管生成，这表明在 4、8 和 12 周时直接血管识别/评分。
作者使用脱细胞真皮基质开发了一种临床相关的乳房再造大型动物模型。应在体内环境中评估脱细胞真皮基质的炎症、新生血管化和组织整合反应，该环境准确模拟了人类乳房再造术后遇到的解剖结构、生物材料、手术技术和时间框架，以适当预测临床性能。在植入后第 8 周后，脱细胞真皮基质的新生血管化出现了可检测到的血流，这一过程比以前报道的与脱细胞真皮基质辅助组织扩张器乳房再造术不相关的模型要慢得多。
