Nilsen Todd J, Dasgupta Anouska, Huang Yen-Chen, Wilson Henry, Chnari Evangelia
Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA.
Aesthet Surg J. 2016 Nov;36(suppl 2):S7-S22. doi: 10.1093/asj/sjw163. Epub 2016 Oct 3.
The use of acellular dermal matrices (ADMs) has become the standard of practice in many reconstructive and aesthetic surgical applications. Different methods used to prepare the allograft tissue for surgical use can alter the ADMs natural properties. Aseptic processing has been shown to retain the natural properties of ADMs more favorably than terminally sterilized ADMs. Terminal sterilization has been historically linked to alteration of biological materials. In vitro work was conducted to compare ADM processing methods.
Characterize aseptically processed ADMs and compare cell-matrix interaction characteristics to terminally sterilized ADMs.
Two aseptically processed ADMs, FlexHD Pliable and BellaDerm, were characterized via histological evaluation, biomechanical integrity, enzymatic degradation, and in vitro cell studies. FlexHD Pliable was compared to Alloderm Ready-to-Use (RTU).
Histological evaluation revealed that FlexHD Pliable had a uniform, open structure compared to BellaDerm. Mechanical characterization demonstrated that BellaDerm had higher strength and stiffness compared to FlexHD Pliable, which maintained higher elasticity. Immunohistochemical analysis verified that key matrix proteins remained intact after aseptic processing. Cell studies found that fibroblasts attached more readily, and proliferated faster on FlexHD Pliable compared to BellaDerm. Additionally, fibroblasts infiltrated into FlexHD Pliable from both sides and on the dermal side in BellaDerm and produced an abundance of multi-layered matrix proteins (collagen, fibronectin) when compared to AlloDerm RTU which was sparse.
Aseptically processed FlexHD Pliable and BellaDerm provide a suitable, biocompatible option for tissue repair and regeneration in aesthetic and reconstructive surgical applications.
脱细胞真皮基质（ADM）的应用已成为许多重建和美容外科手术的标准做法。用于外科手术的同种异体移植组织的不同制备方法会改变ADM的天然特性。已证明无菌处理比终端灭菌的ADM更能保留ADM的天然特性。从历史上看，终端灭菌与生物材料的改变有关。进行了体外研究以比较ADM的处理方法。
表征无菌处理的ADM，并将细胞-基质相互作用特性与终端灭菌的ADM进行比较。
通过组织学评估、生物力学完整性、酶降解和体外细胞研究对两种无菌处理的ADM（FlexHD Pliable和BellaDerm）进行表征。将FlexHD Pliable与即用型Alloderm（RTU）进行比较。
组织学评估显示，与BellaDerm相比，FlexHD Pliable具有均匀的开放结构。力学特性表明，与FlexHD Pliable相比，BellaDerm具有更高的强度和刚度，而FlexHD Pliable保持更高的弹性。免疫组织化学分析证实关键基质蛋白在无菌处理后保持完整。细胞研究发现，与BellaDerm相比，成纤维细胞在FlexHD Pliable上更容易附着且增殖更快。此外，与稀疏的AlloDerm RTU相比，成纤维细胞从两侧渗入FlexHD Pliable，并在BellaDerm的真皮侧渗入，并产生大量多层基质蛋白（胶原蛋白、纤连蛋白）。
无菌处理的FlexHD Pliable和BellaDerm为美容和重建外科手术中的组织修复和再生提供了合适的生物相容性选择。
