Mistry Riyam, Veres Mark, Issa Fadi
Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom.
John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
Front Surg. 2022 Apr 22;9:711094. doi: 10.3389/fsurg.2022.711094. eCollection 2022.
A reproducible, standardised model for cutaneous scar tissue to assess therapeutics is crucial to the progress of the field. A systematic review was performed to critically evaluate scarring models in both animal and human research.
All studies in which cutaneous scars are modelling in animals or humans were included. Models that were focused on the wound healing process or those in humans with scars from an existing injury were excluded. Ovid Medline was searched on 25 February 2019 to perform two near identical searches; one aimed at animals and the other aimed at humans. Two reviewers independently screened the titles and abstracts for study selection. Full texts of potentially suitable studies were then obtained for analysis.
The animal kingdom search yielded 818 results, of which 71 were included in the review. Animals utilised included rabbits, mice, pigs, dogs and primates. Methods used for creating scar tissue included sharp excision, dermatome injury, thermal injury and injection of fibrotic substances. The search for scar assessment in humans yielded 287 results, of which 9 met the inclusion criteria. In all human studies, sharp incision was used to create scar tissue. Some studies focused on patients before or after elective surgery, including bilateral breast reduction, knee replacement or midline sternotomy.
The rabbit ear scar model was the most popular tool for scar research, although pigs produce scar tissue which most closely resembles that of humans. Immunodeficient mouse models allow for engraftment and study of human scar tissue, however, there are limitations relating to the systemic response to these xenografts. Factors that determine the use of animals include cost of housing requirements, genetic traceability, and ethical concerns. In humans, surgical patients are often studied for scarring responses and outcomes, but reproducibility and patient factors that impact healing can limit interpretation. Human tissue use may serve as a good basis to rapidly screen and assess treatments prior to clinical use, with the advantage of reduced cost and setup requirements.
用于评估治疗方法的可重复、标准化的皮肤瘢痕组织模型对该领域的进展至关重要。本研究进行了一项系统综述，以严格评估动物和人体研究中的瘢痕模型。
纳入所有在动物或人体中建立皮肤瘢痕模型的研究。排除专注于伤口愈合过程的模型或针对已有损伤瘢痕的人体模型。于2019年2月25日检索Ovid Medline进行两项几乎相同的检索；一项针对动物，另一项针对人类。两名评审员独立筛选标题和摘要以选择研究。然后获取潜在合适研究的全文进行分析。
动物领域检索产生818条结果，其中71条纳入综述。使用的动物包括兔子、小鼠、猪、狗和灵长类动物。创建瘢痕组织的方法包括锐性切除、皮片损伤、热损伤和注射纤维化物质。人体瘢痕评估检索产生287条结果，其中9条符合纳入标准。在所有人体研究中，均采用锐性切口创建瘢痕组织。一些研究聚焦于择期手术前后的患者，包括双侧乳房缩小术、膝关节置换术或正中胸骨切开术。
兔耳瘢痕模型是瘢痕研究中最常用的工具，尽管猪产生的瘢痕组织与人类的最为相似。免疫缺陷小鼠模型可用于人瘢痕组织的移植和研究，然而，这些异种移植的全身反应存在局限性。决定动物使用的因素包括饲养成本、遗传可追溯性和伦理问题。在人体中，经常对手术患者的瘢痕反应和结果进行研究，但可重复性和影响愈合的患者因素可能会限制解释。人体组织的使用可为临床应用前快速筛选和评估治疗方法提供良好基础，具有成本降低和设置要求较低的优势。
