Schmidt Volker J, Wietbrock Johanna O, Leibig Nico, Gloe Torsten, Henn Dominic, Hernekamp J Frederik, Harhaus Leila, Kneser Ulrich
From the *Department of Hand, Plastic, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, and †Cardiovascular Physiology, Center for Biomedicine and Medical Technology Mannheim, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.
Ann Plast Surg. 2017 Jul;79(1):92-100. doi: 10.1097/SAP.0000000000001096.
Autologous free flaps are the criterion standard for reconstructions of complex soft tissue defects; however, they are limited by donor-site morbidities. The arteriovenous (AV) loop model enables the generation of soft tissue constructs based on acellular dermal matrices with a functional microvasculature and minimal donor site morbidity. The ideal scaffold for AV loop-based tissue engineering has not been determined.
AV loops were placed into subcutaneous isolation chambers filled with either a collagen-elastin scaffold or a collagen-glycosaminoglycan scaffold in the thighs of rats. Matrix elasticity, neoangiogenesis, cell migration, and proliferation were compared after 14 and 28 days.
Mean vessel count and area had increased in both matrices at 28 compared with 14 days. Collagen-elastin matrices showed a higher mean vessel count and area compared with collagen-glycosaminoglycan matrices at 14 days. At 28 days, a more homogeneous vascular network and higher cell counts were observed in collagen-elastin matrices. Collagen-glycosaminoglycan matrices, however, exhibited less volume loss at day 28.
Collagen-based scaffolds are suitable for soft tissue engineering in conjunction with the AV loop technique. These scaffolds exhibit distinct patterns of angiogenesis, cell migration, and proliferation and may in the future serve as the basis of tissue-engineered free flaps as an individualized treatment concept for critical wounds.
自体游离皮瓣是复杂软组织缺损重建的标准方法;然而,它们受到供区并发症的限制。动静脉(AV)环模型能够基于具有功能性微血管系统且供区并发症最小的脱细胞真皮基质生成软组织构建体。用于基于AV环的组织工程的理想支架尚未确定。
将AV环置于大鼠大腿中充满胶原蛋白 - 弹性蛋白支架或胶原蛋白 - 糖胺聚糖支架的皮下隔离室中。在14天和28天后比较基质弹性、新生血管形成、细胞迁移和增殖情况。
与14天时相比,两种基质在28天时的平均血管数量和面积均增加。在14天时,胶原蛋白 - 弹性蛋白基质的平均血管数量和面积高于胶原蛋白 - 糖胺聚糖基质。在28天时,在胶原蛋白 - 弹性蛋白基质中观察到更均匀的血管网络和更高的细胞数量。然而,胶原蛋白 - 糖胺聚糖基质在第28天时体积损失较少。
基于胶原蛋白的支架适用于结合AV环技术的软组织工程。这些支架表现出不同的血管生成、细胞迁移和增殖模式,未来可能作为组织工程游离皮瓣的基础,作为严重伤口的个体化治疗概念。