脱细胞真皮替代物在皮肤肿瘤外科手术中的伤口愈合情况：一项前瞻性对比研究。
Wound Healing after Acellular Dermal Substitute Positioning in Dermato-Oncological Surgery: A Prospective Comparative Study.
作者信息
Paganelli Alessia, Naselli Andrea Giovanni, Bertoni Laura, Rossi Elena, Azzoni Paola, Pisciotta Alessandra, Cesinaro Anna Maria, Benassi Luisa, Kaleci Shaniko, Garbarino Federico, Ferrari Barbara, Fiorentini Chiara, Reggiani Camilla, Magnoni Cristina
机构信息
Dermatologic Surgery Unit, Modena University Hospital, Via del Pozzo 71, 41124 Modena, Italy.
PhD Course in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41121 Modena, Italy.
出版信息
Life (Basel). 2023 Feb 7;13(2):463. doi: 10.3390/life13020463.
BACKGROUND
MatriDerm and Integra are both widely used collagenic acellular dermal matrices (ADMs) in the surgical setting, with similar characteristics in terms of healing time and clinical indication. The aim of the present study is to compare the two ADMs in terms of clinical and histological results in the setting of dermato-oncological surgery.
METHODS
Ten consecutive patients with medical indications to undergo surgical excision of skin cancers were treated with a 2-step procedure at our Dermatologic Surgery Unit. Immediately after tumor removal, both ADMs were positioned on the wound bed, one adjacent to the other. Closure through split-thickness skin grafting was performed after approximately 3 weeks. Conventional histology, immunostaining and ELISA assay were performed on cutaneous samples at different timepoints.
RESULTS
No significant differences were detected in terms of either final clinical outcomes or in extracellular matrix content of the neoformed dermis. However, Matriderm was observed to induce scar retraction more frequently. In contrast, Integra was shown to carry higher infectious risk and to be more slowly reabsorbed into the wound bed. Sometimes foreign body-like granulomatous reactions were also observed, especially in Integra samples.
CONCLUSIONS
Even in the presence of subtle differences between the ADMs, comparable global outcomes were demonstrated after dermato-oncological surgery.
背景
MatriDerm和Integra都是外科手术中广泛使用的胶原无细胞真皮基质（ADM），在愈合时间和临床适应症方面具有相似的特征。本研究的目的是在皮肤肿瘤外科手术中，比较这两种ADM在临床和组织学结果方面的差异。
方法
在我们的皮肤科手术单元，对10例有手术切除皮肤癌医学指征的连续患者采用两步法进行治疗。肿瘤切除后立即将两种ADM放置在创面床，彼此相邻。大约3周后通过断层皮片移植进行闭合。在不同时间点对皮肤样本进行常规组织学、免疫染色和ELISA检测。
结果
在最终临床结果或新生真皮的细胞外基质含量方面均未检测到显著差异。然而，观察到MatriDerm更频繁地引起瘢痕收缩。相比之下，Integra显示出更高的感染风险，并且被创面床重新吸收的速度更慢。有时还观察到异物样肉芽肿反应，尤其是在Integra样本中。
结论
即使ADM之间存在细微差异，皮肤肿瘤外科手术后仍显示出相当的总体结果。
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