Bondioli Elena, Purpura Valeria, Orlandi Catuscia, Carboni Andrea, Minghetti Paola, Cenacchi Giovanna, De Luca Giovanni, Capirossi Daniela, Nigrisoli Evandro, Melandri Davide
Burns Centre and Emilia Romagna Regional Skin Bank, "Bufalini" Hospital, AUSL Romagna, Cesena, Italy.
Biomedical and Neuromotor Sciences Department, University of Bologna, Bologna, Italy.
Cell Tissue Bank. 2019 Jun;20(2):183-192. doi: 10.1007/s10561-019-09755-w. Epub 2019 Feb 14.
Full-thickness skin wounds occur in many different clinical cases and the use of biological acellular dermal matrices (ADMs) to reconstruct the damaged area is increasing in the field of plastic and reconstructive surgery. In particular, the ability of ADMs to maintain the structural properties of extracellular matrix as well as to provide a suitable environment for cell growth makes their use suitable for the improvement of wound healing and the reduction of side effects deriving from contracture and scar tissue formation. In this study, we describe the clinical use of a recently developed human dermal matrix (HDM) in combination with graft skin as an alternative reconstructive solution for the treatment of full-thickness skin wounds. The HDM was applied in combination with autologous graft skin on three different clinical cases in which full-thickness skin wounds occurred. The clinical outcomes were evaluated in the patients during their follow-up. Histological as well as ultra-structural analysis were also performed on skin biopsy of the clinical case 3 one year after the treatment with HDM. The use of HDM stimulates the wound healing process in all clinical cases of full-thickness skin wounds here described with a functional and aesthetic rescue of the damaged area. Histological and ultra-structural analysis show a regenerative healing of the wound area with well-organized/oriented connective tissue in which cellular infiltration as well as blood vessels are evident. Our results support the clinical use of HDM as a permanent dermal replacement for the treatment of full-thickness skin wounds.
全层皮肤伤口出现在许多不同的临床病例中，在整形和重建外科领域，使用生物脱细胞真皮基质（ADM）来重建受损区域的情况正在增加。特别是，ADM能够维持细胞外基质的结构特性，并为细胞生长提供合适的环境，这使得其适用于改善伤口愈合以及减少挛缩和瘢痕组织形成所产生的副作用。在本研究中，我们描述了一种最近开发的人真皮基质（HDM）与移植皮肤联合使用，作为治疗全层皮肤伤口的一种替代性重建解决方案。HDM与自体移植皮肤联合应用于三例出现全层皮肤伤口的不同临床病例。在患者随访期间评估临床结果。在使用HDM治疗一年后，还对临床病例3的皮肤活检进行了组织学和超微结构分析。HDM的使用促进了此处所描述的所有全层皮肤伤口临床病例的伤口愈合过程，对受损区域进行了功能和美学修复。组织学和超微结构分析显示伤口区域再生愈合，结缔组织排列良好/有序，其中细胞浸润和血管明显。我们的结果支持将HDM作为治疗全层皮肤伤口的永久性真皮替代物进行临床应用。
