Department of Trauma Surgery and Orthopaedics, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
Int J Mol Sci. 2024 Jun 28;25(13):7088. doi: 10.3390/ijms25137088.
The field of regenerative medicine is increasingly in need of effective and biocompatible materials for tissue engineering. Human acellular dermal matrix (hADM)-derived collagen matrices stand out as a particularly promising candidate. Their ability to preserve structural integrity, coupled with exceptional biocompatibility, positions them as a viable choice for tissue replacement. However, their clinical application has been largely confined to serving as scaffolds. This study aims to expand the horizon of clinical uses for collagen sheets by exploring the diverse cutting-edge clinical demands. This review illustrates the clinical utilizations of collagen sheets beyond traditional roles, such as covering skin defects or acting solely as scaffolds. In particular, the potential of Epiflex, a commercially available and immediately clinically usable allogeneic membrane, will be evaluated. Collagen sheets have demonstrated efficacy in bone reconstruction, where they can substitute the induced Masquelet membrane in a single-stage procedure, proving to be clinically effective and safe. The application of these membranes allow the reconstruction of substantial tissue defects, without requiring extensive plastic reconstructive surgery. Additionally, they are found to be apt for addressing osteochondritis dissecans lesions and for ligament reconstruction in the carpus. The compelling clinical examples showcased in this study affirm that the applications of human ADM extend significantly beyond its initial use for skin defect treatments. hADM has proven to be highly successful and well-tolerated in managing various etiologies of bone and soft tissue defects, enhancing patient care outcomes. In particular, the application from the shelf reduces the need for additional surgery or donor site defects.
再生医学领域越来越需要用于组织工程的有效且生物相容的材料。人去细胞真皮基质（hADM）衍生的胶原基质作为一种特别有前途的候选材料脱颖而出。其保留结构完整性的能力，加上卓越的生物相容性，使它们成为组织替代的可行选择。然而，其临床应用主要局限于用作支架。本研究旨在通过探索各种前沿临床需求，拓展胶原片的临床应用范围。本综述说明了胶原片超越传统用途的临床应用，例如覆盖皮肤缺损或仅作为支架。特别地，将评估一种商业上可获得且可立即临床应用的同种异体膜 Epiflex 的潜在用途。胶原片已在骨重建中证明了其功效，在单阶段手术中可以替代诱导的 Masquelet 膜，证明其在临床上是有效且安全的。这些膜的应用允许重建大量组织缺损，而无需进行广泛的整形重建手术。此外，它们还适用于治疗剥脱性骨软骨炎病变和腕骨的韧带重建。本研究中展示的引人注目的临床实例证实，hADM 的应用远远超出了最初用于皮肤缺损治疗的范围。hADM 在治疗各种骨和软组织缺损的病因方面已被证明非常成功且耐受良好，提高了患者护理的效果。特别是，从货架上应用减少了对额外手术或供体部位缺陷的需求。
