Vashi Christopher
The Plastic Surgery Group, Chapel Place II, 340 Thomas More Parkway, Crestview Hills, KY 41017, USA ; The Plastic Surgery Group of Greater Cincinnati, 4850 Red Bank Expressway, Cincinnati, OH 45227, USA.
Plast Surg Int. 2014;2014:704323. doi: 10.1155/2014/704323. Epub 2014 Mar 11.
Background. Decellularized human skin has been used in a variety of medical applications, primarily involving soft tissue reconstruction, wound healing, and tendon augmentation. Theoretically, decellularization removes potentially immunogenic material and provides a clean scaffold for cellular and vascular in growth. The use of acellular dermal matrix in two-stage postmastectomy breast reconstruction is described. Methods. Ten consecutive breast cancer patients were treated with mastectomies and immediate reconstruction from August to November 2011. There were 8 bilateral and 1 unilateral mastectomies for a total of 17 breasts, with one exclusion for chronic tobacco use. Reconstruction included the use of a new 6 × 16 cm sterile, room temperature acellular dermal matrix patch (DermACELL) soaked in a cefazolin bath. Results. Of the 17 breasts, 15 reconstructions were completed; 14 of them with expander to implant sequence and acellular dermal matrix. Histological analysis of biopsies obtained during trimming of the matrix at the second stage appeared nonremarkable with evidence of normal healing, cellularity, and vascular infiltration. Conclusion. Postoperative observations showed that this cellular dermal matrix appears to be an appropriate adjunct to reconstruction with expanders. This acellular dermal matrix appeared to work well with all patients, even those receiving postoperative chemotherapy, postoperative radiation, prednisone, or warfarin sodium.
背景。脱细胞人皮肤已用于多种医学应用,主要涉及软组织重建、伤口愈合和肌腱增强。从理论上讲,脱细胞可去除潜在的免疫原性物质,并为细胞生长和血管长入提供一个干净的支架。本文描述了脱细胞真皮基质在二期乳房切除术后乳房重建中的应用。方法。2011年8月至11月,连续10例乳腺癌患者接受了乳房切除术并立即进行了重建。其中8例双侧乳房切除术和1例单侧乳房切除术,共涉及17个乳房,1例因长期吸烟被排除。重建包括使用一块新的6×16厘米无菌、室温脱细胞真皮基质贴片(DermACELL),该贴片浸泡在头孢唑林溶液中。结果。17个乳房中,15例重建完成;其中14例采用先置入扩张器再植入假体的顺序,并使用了脱细胞真皮基质。在第二阶段修剪基质时获取的活检组织的组织学分析显示无明显异常,有正常愈合、细胞活性和血管浸润的迹象。结论。术后观察表明,这种脱细胞真皮基质似乎是扩张器重建的合适辅助材料。这种脱细胞真皮基质对所有患者似乎都效果良好,即使是那些接受术后化疗、术后放疗、泼尼松或华法林钠治疗的患者。