Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Int Wound J. 2023 Apr;20(4):1053-1060. doi: 10.1111/iwj.13958. Epub 2022 Sep 27.
Acellular dermal matrix (ADM) grafts can provide coverage for full-thickness skin defects and substitute for dermal defects. We tested the effectiveness of micronized ADM (mADM) as a dressing material, combined with negative pressure wound therapy (NPWT), for managing superficial wounds. We compared the wound healing effect of mADM in combination with NPWT with those of gelatin and mADM applied with a foam dressing. These therapeutic materials were applied to 36 cm excisional wounds in a porcine full-thickness skin defect model. Wound healing kinetics and new tissue formation were assessed 10 days after the initial treatment by measuring the wound area. Collagen deposition and neovascularization were histologically evaluated. Compared with the other two groups, mADM plus NPWT combination group had a significantly larger wound area at the baseline (P = .0040), but the smallest on the 7th day (P = .0093). In addition, collagen formation and neovascularization were more histologically promoted than in the other two groups. mADM showed better results than the gelatin group but less collagen and revascularization than the combination group, and there was no significant difference in wound area. Our results show that the combination of mADM and NPWT has a synergistic wound healing effect.
脱细胞真皮基质(ADM)移植物可覆盖全层皮肤缺损并替代真皮缺损。我们测试了微米化 ADM(mADM)作为敷料材料与负压伤口治疗(NPWT)联合应用于管理浅表伤口的效果。我们比较了 mADM 联合 NPWT 与明胶和泡沫敷料应用 mADM 的伤口愈合效果。这些治疗材料应用于猪全层皮肤缺损模型中的 36cm 切除伤口。在初始治疗后 10 天,通过测量伤口面积评估伤口愈合动力学和新组织形成。通过组织学评估胶原蛋白沉积和新生血管形成。与其他两组相比,mADM 加 NPWT 联合组在基线时的伤口面积明显更大(P=.0040),但在第 7 天时最小(P=.0093)。此外,与其他两组相比,组织学上促进了更多的胶原形成和新生血管形成。mADM 的效果优于明胶组,但胶原蛋白和再血管化少于联合组,伤口面积无显著差异。我们的结果表明,mADM 和 NPWT 的联合具有协同的伤口愈合作用。