Xu Jingjing, Cai Jinglong, Wang Qian, Li Yi, Jiao Hu, Zong Xianlei
Department of Sixteen, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Beijing 100144, China.
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Zhonghua Yi Xue Za Zhi. 2015 Mar 17;95(10):770-5.
To explore the structural and biomechanical properties of acellular dermal matrix (ADM) of human scar tissue.
Randomly choose 8 human mature scar tissue, 8 human hypertrophic scar tissue, and 4 normal human tissue as experimental samples respectively. Then 0.5 mm split-thickness skin grafts were obtained by drum-type scalpel, further acellularized by 2.5 g/L trypsin-0.5% TritonX-100. Structural analyses were performed by macroscopic observation, hematoxylin and eosin histological staining and scanning electron microscope. Then human epithelial stem cells were inoculated, cultured on those materials and observe their adhesive properties. Finally the biomechanical properties of ADM were analyzed through the detection of stress-strain relation, stress relaxation, creep and ultimate stress strength to distinguish different origins.
Prepared ADM was milky white in color despite their distinct origins, physiological and mature scar tissue derived ADM was soft and flexible in texture while ADM from hypertrophic scar showed a more tenacious character. Optical microscopic and electron microscopic analyses showed no sign of visible cellular structures. ADM from physiological group had relatively homogeneous and inerratic collagenous fibers, ADM from hypertrophic group presented with fibers of various diameters and arrayed in a compact and disordered manner. ADM from mature scar tissue possessed traits between the other two groups. Adhesion growth could be observed 2 weeks after inoculating human epithelial stem cells on ADM and cells grew in a cohesive fashion on ADM both from normal skin and mature scar tissue and in an adhesive fashion on hypertrophic scar tissue ADM. Stress-strain β value (3.024 ± 0.413, 2.595 ± 0.443, 2.590 ± 0.366), creep slope (0.018 ± 0.003, 0.019 ± 0.009, 0.023 ± 0.010) and ultimate stress strength (8.971 ± 2.434, 11.011 ± 1.492, 15.567 ± 2.931) of ADM showed no significant differences in hypertrophic scar, mature scar and normal skin tissues (all P > 0.05). ADM from mature scar and normal skin tissue showed no differences in stress-strain stretch ratio (0.238 ± 0.083 vs 0.291 ± 0.048), relaxation slope (-0.041 ± 0.009 vs -0.047 ± 0.008), total relaxation (0.775 ± 0.194 vs 0.968 ± 0.211) or total creep (0.033 ± 0.022 vs 0.049 ± 0.020) (all P > 0.05). However, the above related indices of ADM from hypertrophic scar tissue (0.188 ± 0.036, -0.033 ± 0.006, 0.481 ± 0.058, 0.020 ± 0.005) were significantly lower than those from normal tissue (all P < 0.05).
No significant differences exist between mature scar and normal skin tissues derived ADM both in structural and biomechanical properties. However ADM from mature scar appears to be superior in biomechanical properties than hypertrophic scar derived ADM so that it may become a replacement for original dermis in wound repair.
探讨人瘢痕组织脱细胞真皮基质(ADM)的结构和生物力学特性。
分别随机选取8例人成熟瘢痕组织、8例人增生性瘢痕组织和4例正常人体组织作为实验样本。然后用鼓式取皮刀获取0.5mm厚的断层皮片,再用2.5g/L胰蛋白酶-0.5% TritonX-100进行脱细胞处理。通过大体观察、苏木精-伊红组织学染色和扫描电子显微镜进行结构分析。接着接种人上皮干细胞,在这些材料上培养并观察其黏附特性。最后通过检测应力-应变关系、应力松弛、蠕变和极限应力强度来分析ADM的生物力学特性,以区分不同来源。
制备的ADM无论其来源如何均为乳白色,生理和成熟瘢痕组织来源的ADM质地柔软且有弹性,而增生性瘢痕来源的ADM质地更坚韧。光学显微镜和电子显微镜分析显示无可见细胞结构迹象。生理组的ADM胶原纤维相对均匀且规则,增生性组的ADM呈现出不同直径的纤维,排列紧密且无序。成熟瘢痕组织来源的ADM具有介于其他两组之间的特征。在ADM上接种人上皮干细胞2周后可观察到黏附生长,细胞在正常皮肤和成熟瘢痕组织来源的ADM上以聚集方式生长,在增生性瘢痕组织ADM上以黏附方式生长。增生性瘢痕、成熟瘢痕和正常皮肤组织的ADM的应力-应变β值(3.024±0.413,2.595±0.443,2.590±0.366)、蠕变斜率(0.018±0.003,0.019±0.009,0.023±0.010)和极限应力强度(8.971±2.4ˌ11.011±1.492,15.567±2.931)均无显著差异(均P>0.05)。成熟瘢痕和正常皮肤组织来源的ADM在应力-应变拉伸率(0.238±0.083对0.291±0.048)、松弛斜率(-0.041±0.009对-0.047±0.008)、总松弛(0.775±0.194对0.968±0.211)或总蠕变(0.033±0.022对0.049±0.020)方面均无差异(均P>0.05)。然而,增生性瘢痕组织来源的ADM的上述相关指标(0.188±0.036,-0.033±0.006,0.481±0.058,0.020±0.005)显著低于正常组织来源的ADM(均P<0.05)。
成熟瘢痕和正常皮肤组织来源的ADM在结构和生物力学特性方面均无显著差异。然而,成熟瘢痕来源的ADM在生物力学特性方面似乎优于增生性瘢痕来源的ADM,因此它可能成为伤口修复中原始真皮的替代品。