1 Division of Plastic and Reconstructive Surgery, Department of Surgery, Keck School of Medicine of University of Southern California , Los Angeles, California.
2 Department of Pathology, Keck School of Medicine of University of Southern California , Los Angeles, California.
Tissue Eng Part A. 2018 Apr;24(7-8):672-681. doi: 10.1089/ten.tea.2017.0119. Epub 2018 Jan 5.
Fascia-wrapped diced cartilage grafts have become a useful tool in modern rhinoplasty surgery. Unfortunately, fascial harvest is associated with donor site morbidity; therefore, a nonautologous alternative to fascia would be ideal. Decellularized porcine mesothelium (PM), Meso BioMatrix™, is an acellular scaffold that could potentially fill this need. To determine if PM could serve as an acceptable alternative, we histologically compared diced cartilage grafts wrapped in fascia versus PM.
Human rib cartilage and temporoparietal fascia were obtained under an IRB-approved protocol. Cartilage was diced into 0.5 mm pieces and implanted in subcutaneous pockets in nude rats. Implanted materials included cartilage alone, cartilage wrapped in fascia, cartilage wrapped in PM, fascia alone, or PM alone. Specimens were harvested at 8 weeks and stained with hematoxylin and eosin, Masson's trichrome, Safranin-O, and Verhoeff's stain to assess cartilage viability, architecture, and regenerative potential.
Unwrapped diced cartilage showed the highest cartilage viability, but was associated with loss of contour and dispersion of the cartilage pieces. Meso BioMatrix-wrapped grafts maintained contour and cartilage pieces had not dispersed; however, there was a significantly lower number of nucleated lacunae and a greater amount of basophilia than both fascia-wrapped cartilage and unwrapped cartilage. There was no significant difference in cartilage resorption between fascia-wrapped cartilage and Meso BioMatrix-wrapped cartilage or in the proteoglycan or collagen content between all groups.
Off-the-shelf decellularized PM was associated with lower cartilage viability than unprocessed fascial allograft. No cartilage piece dispersion, fibrosis, resorption, or a foreign body reaction to Meso BioMatrix was observed. PM, although not equivalent to autologous tissue, may be utilized to achieve acceptable clinical results and be a viable alternative that limits donor side morbidity. This experimental study supports further clinical investigation of this material in rhinoplasty procedures.
筋膜包裹的软骨碎块已成为现代鼻整形手术中的有用工具。不幸的是，筋膜采集与供体部位发病率相关；因此，非自体替代品将是理想的选择。去细胞猪胸膜（PM），Meso BioMatrix™，是一种无细胞支架，可能能够满足这一需求。为了确定 PM 是否可以作为一种可接受的替代品，我们从组织学上比较了包裹在筋膜中的软骨碎块与 PM。
根据 IRB 批准的方案从人体肋骨和颞顶筋膜中获取软骨。将软骨切成 0.5mm 的小块，并植入裸鼠的皮下袋中。植入材料包括单独的软骨、包裹在筋膜中的软骨、包裹在 PM 中的软骨、单独的筋膜或单独的 PM。在 8 周时采集标本，并用苏木精和伊红、马松三色染色、番红 O 和 Verhoeff 染色进行染色，以评估软骨的活力、结构和再生潜力。
未包裹的软骨显示出最高的软骨活力，但与轮廓丧失和软骨块分散有关。Meso BioMatrix 包裹的移植物保持了轮廓，并且软骨块没有分散；然而，与筋膜包裹的软骨和未包裹的软骨相比，有核腔的数量明显减少，嗜碱性物质的含量更多。筋膜包裹的软骨和 Meso BioMatrix 包裹的软骨之间，以及所有组之间的软骨吸收、糖胺聚糖或胶原蛋白含量没有显著差异。
现成的脱细胞 PM 与未经处理的同种异体筋膜移植物相比，其软骨活力较低。未观察到 Meso BioMatrix 包裹的软骨块分散、纤维化、吸收或异物反应。PM 虽然不能等同于自体组织，但可以用于获得可接受的临床效果，并且是一种可行的替代方法，可以限制供体部位发病率。这项实验研究支持在鼻整形手术中进一步临床研究这种材料。
