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Zaaya S, Elbattawy W, Yusri S, Fawzy El-Sayed KM. Micro-needling versus acellular dermal matrix in RT1 gingival recession coverage: A randomized clinical trial. J Periodontal Res 2024. [PMID: 38660934 DOI: 10.1111/jre.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
AIMS This randomized trial assessed for the first time the efficacy of coronally advanced flap (CAF) followed by micro-needling (MN) in contrast to CAF with acellular dermal matrix (ADM) on gingival thickness (GT, primary outcome), keratinized tissue width (KTW), clinical attachment level (CAL), probing depth (PD), recession depth (RD), recession width (RW), recession reduction (Rec-Red), complete root coverage (CRC) and percentage of root coverage (all secondary outcomes) in management of RT1 gingival recession in patients with thin gingival phenotype. METHODS A total of 24 patients (n = 24) with a thin gingival phenotype and single RT1 gingival recession in the aesthetic zone were randomly allocated to test- (CAF + MN; n = 12) or control group (CAF + ADM; n = 12). All clinical parameters were evaluated at baseline, 3 and 6 months. RESULTS Both groups independently demonstrated significant gain in GT, RW, RD, CAL, PD, Rec-Red, CRC and percentage of root coverage, with reduced PI and BOP (p < .05) at 3 and 6 months, without intergroup differences (p > .05). At 6 months, KTW gain was significantly higher in CAF + MN (5.08 ± 0.9 mm) than in CAF + ADM-group (4.25 ± 1.06 mm; p < .05). Stepwise linear regression model with GT as dependent variable showed that base-line GT was the only statistically significant predictor for GT with a direct correlation between base-line GT and GT after 6 months. CONCLUSION CAF followed by MN could represent a promising graft-less approach for increasing gingival thickness, comparable to CAF with ADM, with superior keratinized tissue width improvement, in the treatment of RT1 recession defects in patients with thin gingival phenotype.
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Affiliation(s)
- Salma Zaaya
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Weam Elbattawy
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sarah Yusri
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Karim M Fawzy El-Sayed
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian Albrechts University, Kiel, Germany
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Zhu X, Zhao R, Feng C, Cheng Y, Zhang X, Deng Q, Liu H. [Application of acellular dermal matrix in prevention of laryngeal stenosis in glottic carcinoma]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2024; 38:321-324. [PMID: 38563176 DOI: 10.13201/j.issn.2096-7993.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Indexed: 04/04/2024]
Abstract
Objective:To investigate the effect of acellular dermal matrix in preventing laryngeal stenosis in glottic carcinoma patients. Methods:Fifty-five patients with glottic carcinoma(T2, T3) from February 2018 to December 2022 were divided into experimental group(28 cases) and control group(27 cases) according to their wishes. Acellular dermal matrix was placed in the operation cavity in the experimental group after laryngofission, while control group 12 cases were sutured by pulling the upper and lower edges, 15 cases were repaired with sternohyoid muscle fascia flap. Results:In the experimental group, 1 case had laryngeal stenosis caused by laryngeal mucosa swelling after operation, and extubated successfully after symptomatic treatment. In the control group, 7 cases had laryngeal stenosis after operation, of which 3 cases were caused by granulation tissue hyperplasia in laryngeal cavity, and extubated after symptomatic treatment. 2 cases extubated after operation suffered from progressive dyspnea during radiotherapy, and underwent tracheotomy again, extubation successful after treatment. 2 cases caused by laryngeal mucosa swelling, after symptomatic treatment, one case was successfully extubated, and one case had long-term intubation. The laryngeal stenosis rate of the experimental group was 3.6%(1/28) , which was lower than control group 25.9%(7/27), and the therapeutic effect of the experimental group was significantly better than control group (χ²=5.526, P=0.019). Conclusion:Implanting acellular dermal matrix in the operation cavity of glottic carcinoma can reduce the occurrence of laryngeal stenosis and have satisfactory preventive effect on laryngeal stenosis.
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Affiliation(s)
- Xin Zhu
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Rui Zhao
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Chengmin Feng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Yao Cheng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Xi Zhang
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Qicheng Deng
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
| | - Hai Liu
- Department of Otolaryngology,Affiliated Hospital of North Sichuan Medical College,Nanchong,637000,China
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Marra C, Pentangelo P, Losco L, Ceccaroni A, Barbato A, Alfano C. Lower Extremity Trauma: A Multidimensional Reconstructive Approach with Hyperbaric Oxygen Therapy. J Clin Med 2024; 13:1407. [PMID: 38592225 PMCID: PMC10931990 DOI: 10.3390/jcm13051407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Distal lower extremity reconstruction is challenging. This study aims to propose a protocol for the treatment of traumatic soft tissue defects. The key concept is to combine the surgical armamentarium of the reconstructive surgeon with the advantages provided by hyperbaric oxygen therapy. Methods: This retrospective study analyzed data of 57 patients affected with unilateral or bilateral lower extremity trauma distal to the knee and involving soft tissues with no indication of immediate reconstruction between 2010 and 2021. Before the reconstructive procedure, all the patients underwent a stick swab procedure for the collection of microbiological samples and debridement. Patients were divided into two treatment groups and only one group underwent a combined therapeutic procedure with hyperbaric oxygen therapy. Negative pressure wound therapy (NPWT) was employed only if deemed necessary according to the defect's depth and wound exudate. Surgical techniques, outcomes, and complications were discussed. Results: All patients achieved a complete recovery with no major complications and only minor complications observed. The study group treated with HBOT had a lower complication rate and lower percentages of minimal and partial graft loss compared with the same complications observed in the control group. No patients experienced HBOT-related complications. Significant reductions in the time to complete healing and the time from reconstruction to healing were found (p = 0.002 and p < 0.00001, respectively). Conclusions: A lower complication rate was observed in the group treated with HBOT. The administration of HBOT prior to soft tissue reconstruction significantly reduced the time to complete healing and the time interval from skin grafting to healing. However, prospective studies and randomized trials with larger cohorts should be designed to investigate the efficacy of HBOT for the treatment of lower extremity injuries with extensive soft tissue defects.
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Affiliation(s)
- Caterina Marra
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy; (C.M.); (P.P.)
| | - Paola Pentangelo
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy; (C.M.); (P.P.)
| | - Luigi Losco
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy; (C.M.); (P.P.)
| | - Alessandra Ceccaroni
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy; (C.M.); (P.P.)
| | - Alfonso Barbato
- Plastic Surgery Unit, Azienda Ospedaliera Universitaria OO.RR. San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, SA, Italy
| | - Carmine Alfano
- Plastic Surgery Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy; (C.M.); (P.P.)
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Durando M, Ferrando PM, Dianzani C, Galioto F, Mariscotti G, Regini E, Bartoli G, Malan F, Bogetti P, Fonio P. Acellular dermal matrix imaging features in breast reconstructive surgery: a pictorial review. Br J Radiol 2024; 97:505-512. [PMID: 38419148 DOI: 10.1093/bjr/tqad050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 10/29/2023] [Accepted: 11/29/2023] [Indexed: 03/02/2024] Open
Abstract
Acellular dermal matrices (ADMs) are biological engineered tissues, which may provide an immunologically inert scaffold in breast reconstruction. Since the literature on imaging features of ADMs is limited, radiologists must be aware of the common imaging appearances of ADM, to differentiate normal conformation from residual or recurrent disease. Our purpose is to review the current role of ADMs in implant-based breast reconstruction, describing the normal imaging findings at ultrasound, mammography, and MRI also considering the possible changes over time. In this pictorial essay, we reviewed imaging features of ADMs described in the literature and we reported our experience in patients who underwent reconstructive surgery with human or animal ADM for newly diagnosed breast cancer.
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Affiliation(s)
- Manuela Durando
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Pietro Maria Ferrando
- Plastic Surgery Department; Presidio ospedaliero CTO - A. O. U. Città della Salute e della Scienza di Torino; Via Zuretti, 29, Torino, 10126, Italy
| | - Chiara Dianzani
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Francesca Galioto
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Giovanna Mariscotti
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Elisa Regini
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Germana Bartoli
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
| | - Fabrizio Malan
- Plastic Surgery Department; Presidio ospedaliero CTO - A. O. U. Città della Salute e della Scienza di Torino; Via Zuretti, 29, Torino, 10126, Italy
| | - Paolo Bogetti
- Structure of Reconstructive and Aesthetic Plastic Surgery - University of Turin; Department of Surgical Sciences; Presidio Ospedaliero Molinette - A.O.U. Città della Salute e della Scienza di Torino; Torino, 10126, Italy
| | - Paolo Fonio
- Radiology - University of Turin; Department of Diagnostic Imaging and Interventional Radiology; Presidio Ospedaliero Molinette - A. O. U. Città della Salute e della Scienza di Torino; Via Genova 3, Torino, 10126, Italy
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Devina AA, Halim FC, Sulijaya B, Sumaringsih PR, Dewi RS. Simultaneous Implant and Guided Bone Regeneration Using Bovine-Derived Xenograft and Acellular Dermal Matrix in Aesthetic Zone. Dent J (Basel) 2024; 12:52. [PMID: 38534276 DOI: 10.3390/dj12030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Implant placement in the maxillary anterior area requires sufficient quantity and quality of both soft and hard tissue. In cases where soft and hard tissues are insufficient, additional regeneration using biomaterials is recommended. Treatment using bovine-derived xenograft and acellular dermal matrix (ADM) may increase bone volume and soft tissue thickness. Case and management: A 65-year-old woman sought help for discomfort and aesthetic issues with her denture, reporting missing teeth (11, 12, 13, 14, and 21) and bone volume shrinkage due to disuse atrophy. Intraoral examination revealed 1 mm gingival thickness. CBCT showed labio-palatal bone thickness of 6.0 mm, 5.8 mm, and 4.7 mm for teeth 21, 12 and 14, respectively. Implant planning and surgical guide fabrication were carried out before the surgery. Surgery included the placement of implants 3.3 mm in diameter and 12 mm in length, with the use of xenograft and ADM. Three months post-op, improvements in soft and hard tissues were observed, with a final prosthesis being a long-span implant-supported bridge. CONCLUSIONS Disuse alveolar atrophy causes soft and hard tissue deficiency. The use of xenograft and ADM show favourable results even on a geriatric patient.
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Affiliation(s)
- Anggun Alfreda Devina
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Felita Clarissa Halim
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Benso Sulijaya
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Patricia Rinanti Sumaringsih
- Prosthodontics Specialist Program, Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Ratna Sari Dewi
- Department of Prosthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
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Aodi J, Ying L, Chengyang S, Hongfeng Z. Acellular dermal matrix in urethral reconstruction. Front Pediatr 2024; 12:1342906. [PMID: 38405593 PMCID: PMC10884266 DOI: 10.3389/fped.2024.1342906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024] Open
Abstract
The management of severe urethral stricture has always posed a formidable challenge. Traditional approaches such as skin flaps, mucosal grafts, and urethroplasty may not be suitable for lengthy and intricate strictures. In the past two decades, tissue engineering solutions utilizing acellular dermal matrix have emerged as potential alternatives. Acellular dermal matrix (ADM) is a non-immunogenic biological collagen scaffold that has demonstrated its ability to induce layer-by-layer tissue regeneration. The application of ADM in urethral reconstruction through tissue engineering has become a practical endeavor. This article provides an overview of the preparation, characteristics, advantages, and disadvantages of ADM along with its utilization in urethral reconstruction via tissue engineering.
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Affiliation(s)
| | | | | | - Zhai Hongfeng
- Department of Plastic and Aesthetic Surgery, People’s Hospital of Henan University, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital, Zhengzhou, China
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Gao W, Cheng T, Tang Z, Zhang W, Xu Y, Han M, Zhou G, Tao C, Xu N, Xia H, Sun W. Enhancing cartilage regeneration and repair through bioactive and biomechanical modification of 3D acellular dermal matrix. Regen Biomater 2024; 11:rbae010. [PMID: 38414795 PMCID: PMC10898337 DOI: 10.1093/rb/rbae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/21/2024] [Indexed: 02/29/2024] Open
Abstract
Acellular dermal matrix (ADM) shows promise for cartilage regeneration and repair. However, an effective decellularization technique that removes cellular components while preserving the extracellular matrix, the transformation of 2D-ADM into a suitable 3D scaffold with porosity and the enhancement of bioactive and biomechanical properties in the 3D-ADM scaffold are yet to be fully addressed. In this study, we present an innovative decellularization method involving 0.125% trypsin and 0.5% SDS and a 1% Triton X-100 solution for preparing ADM and converting 2D-ADM into 3D-ADM scaffolds. These scaffolds exhibit favorable physicochemical properties, exceptional biocompatibility and significant potential for driving cartilage regeneration in vitro and in vivo. To further enhance the cartilage regeneration potential of 3D-ADM scaffolds, we incorporated porcine-derived small intestinal submucosa (SIS) for bioactivity and calcium sulfate hemihydrate (CSH) for biomechanical reinforcement. The resulting 3D-ADM+SIS scaffolds displayed heightened biological activity, while the 3D-ADM+CSH scaffolds notably bolstered biomechanical strength. Both scaffold types showed promise for cartilage regeneration and repair in vitro and in vivo, with considerable improvements observed in repairing cartilage defects within a rabbit articular cartilage model. In summary, this research introduces a versatile 3D-ADM scaffold with customizable bioactive and biomechanical properties, poised to revolutionize the field of cartilage regeneration.
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Affiliation(s)
- Wei Gao
- Qingdao Medical College of Qingdao University, Qingdao, 266071, China
| | - Tan Cheng
- Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200040, China
| | - Zhengya Tang
- Department of Plastic surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200023, China
| | - Wenqiang Zhang
- Department of Orthopaedics, The First Affiliated Hospital of Shandong First Medical University, Jinan, 266299, China
| | - Yong Xu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, China
| | - Min Han
- Department of Orthopedic Surgery, Shanghai Eighth People's Hospital, Shanghai, 200235, China
| | - Guangdong Zhou
- Department of Plastic surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200023, China
| | - Chunsheng Tao
- Department of Orthopaedics, Ninety-seventh Hospital of the Chinese People's Liberation Army Navy, Qingdao, 266071, China
| | - Ning Xu
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Department of Orthopedic Surgery, Shanghai Eighth People's Hospital, Shanghai, 200235, China
| | - Huitang Xia
- Department of Plastic Surgery & Jinan Clinical Research Center for Tissue Engineering Skin Regeneration and Wound Repair, The First Affiliated Hospital of Shandong First Medical University, Jinan, 266299, China
| | - Weijie Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Shushan, Hefei, 230022, China
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Karimi M, Mosaddad SA, Aghili SS, Dortaj H, Hashemi SS, Kiany F. Attachment and proliferation of human gingival fibroblasts seeded on barrier membranes using Wharton's jelly-derived stem cells conditioned medium: An in vitro study. J Biomed Mater Res B Appl Biomater 2024; 112:e35368. [PMID: 38247251 DOI: 10.1002/jbm.b.35368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/12/2023] [Accepted: 12/02/2023] [Indexed: 01/23/2024]
Abstract
The effect of Wharton's jelly mesenchymal stem cells conditioned medium (WJMSCs-CM) and zinc oxide nanoparticles (ZnO-NPs) on cultured human gingival fibroblasts on various barrier membranes was investigated in this study. In this study, human gingival fibroblasts were prepared and cultured on three membranes: collagen membrane, acellular dermal matrix (ADM) with ZnO-NPs, and ADM without ZnO-NPs. WJMSCs-CM was given to the testing groups, while control groups received the same membranes without WJMSCs-CM. Following 48 and 72 h, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) tests were performed to assess cell survival. Cell proliferation on the membranes was also evaluated using 4',6-diamidino-2-phenylindole (DAPI) staining after 48 and 72 h. Field emission scanning electron microscopy was used to determine membrane surface structure and cell adhesion. Nanoparticles were also subjected to an energy-dispersive x-ray analysis to identify their chemical structure. Two-way analysis of variance was used to conduct the statistical analysis. The p-value ≤.05 was considered significant. When ADM-ZnO-NPs were combined with CM, fibroblast viability, and adhesion significantly differed from ADM-ZnO-NPs alone. DAPI results confirmed cell proliferation in all six groups on both experiment days. The abundance and concentrated distribution of cells during cell proliferation were found in CM-containing membranes, specifically the ADM-ZnO-NPs membrane, demonstrating the improved biocompatibility of the ADM-ZnO-NPs membrane for cell proliferation. The other groups did not significantly differ from one another. WJMSCs-CM positively affected the viability and proliferation of gingival fibroblasts, but only marginally. Under certain conditions, ZnO-NPs below a specific concentration increased the biocompatibility of the membranes.
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Affiliation(s)
- Mohammadreza Karimi
- Student Research Committee, Department of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Mosaddad
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hengameh Dortaj
- Department of Tissue Engineering, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh-Sara Hashemi
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farin Kiany
- Oral and Dental Disease Research Center, Department of Periodontology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Ma T, Ren D, Wang J, Fu F, Sun WQ, Sun H. Enhanced osteogenicity of the demineralized bone-dermal matrix composite by the optimal partial demineralization for sustained release of bioactive molecules. J Biomed Mater Res B Appl Biomater 2024; 112:e35358. [PMID: 38247243 DOI: 10.1002/jbm.b.35358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 01/23/2024]
Abstract
Allogenic demineralized bone matrix (DBM), processed to expose bioactive proteins imbedded by calcium salts, is widely used for bone repair and regeneration as an alternative to the autologous bone graft. However, demineralized bone matrices from tissue banks vary significantly in residual calcium content and osteogenicity for clinical bone regeneration. The present study produced DBM with various residual calcium contents by partial demineralization using ethylenediaminetetraacetic acid disodium (EDTA) and hydrochloric acid. Compositional analysis reveals that, as the percent weight loss of bone materials increases from 0% to 74.9% during demineralization, the residual calcium content of DBM decreases from 24.8% to 0.2% and collagen content increases from 29.7% to 92.6%. Calorimetrical analysis and Fourier transform infrared (FTIR) analysis demonstrated that demineralization to the residual calcium content of <4% enables the complete exposure and/or release of bone collagen fibers and other bioactive molecules. In order to evaluate the relationship between the extent of demineralization and the osteogenicity of DBM, DBM particles were fabricated with the aid of acellular dermal matrix (ADM) microfibers to form flexible foam-like DBM/ADM composites. Proteomic analysis identified various type collagens and bone formation-related bioactive molecules in both ADM and DBM. Using the rat bilateral Φ = 5 mm calvarium defect repair model, the study had shown that the DBM/ADM composite with ~20% DBM residual calcium (e.g., ~40% calcium being removed) maximized the osteogenicity for bone defect repair after 4 and 8 weeks. DBM with ~40% calcium removal had the maximal osteogenicity presumably through the sustained release of bioactive molecules during the process of bone regeneration.
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Affiliation(s)
- Tong Ma
- Institute of Biothermal Science and Technology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Dangli Ren
- Tianjin Key Laboratory of Neurotrauma Repair, Institute of Neurotrauma Repair, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Jingjing Wang
- Tianjin Key Laboratory of Neurotrauma Repair, Institute of Neurotrauma Repair, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Feng Fu
- Tianjin Key Laboratory of Neurotrauma Repair, Institute of Neurotrauma Repair, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Wendell Q Sun
- Institute of Biothermal Science and Technology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongtao Sun
- Tianjin Key Laboratory of Neurotrauma Repair, Institute of Neurotrauma Repair, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- First Clinical Medical College of Lanzhou University, Lanzhou, China
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10
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Park JS, Jin US. Improvement of Shoulder Motion in Two-Stage Dual-Plane Implant-Based Breast Reconstruction followed by Radiation Therapy through Delayed Prepectoral Conversion. Arch Plast Surg 2024; 51:52-61. [PMID: 38425848 PMCID: PMC10901588 DOI: 10.1055/s-0043-1775591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/04/2023] [Indexed: 03/02/2024] Open
Abstract
Background Although prepectoral implant-based breast reconstruction has recently gained popularity, dual-plane reconstruction is still a better option for patients with poor-quality mastectomy skin flaps. However, shoulder morbidity is aggravated by subpectoral reconstruction, especially in irradiated patients. This study aimed to demonstrate shoulder exercise improvement in subpectoral reconstruction by delayed prepectoral conversion with an acellular dermal matrix (ADM) inlay graft technique at the time of expander-to-implant exchange after irradiation. Methods Patients with breast cancer treated for expander-to-implant exchange after subpectoral expander insertion and subsequent radiotherapy between January 2021 and June 2022 were enrolled. An ADM inlay graft was inserted between the pectoralis major muscle and the previously inserted ADM. The ADM was sutured partially overlapping the pectoralis muscle from the medial side with the transition part, to the muscle border at the lateral side. Perioperative shoulder joint active range-of-motion (ROM) for forward flexion, abduction, and external rotation was also evaluated. Results A total of 35 patients were enrolled in the study. Active shoulder ROM significantly improved from 163 degrees preoperatively to 176 degrees postoperatively in forward flexion, 153 to 175 degrees in abduction, and 69 to 84 degrees in external rotation. There was no difference in patient satisfaction regarding the final outcome between the conventional prepectoral reconstruction group and the study group. Conclusion Shoulder exercises in irradiated patients who underwent subpectoral reconstruction were improved by delayed prepectoral conversion using an ADM inlay graft. It is recommended that subpectoral reconstruction not be ruled out due to concerns regarding muscle contracture and shoulder morbidity in radiation-planned patients with poor mastectomy skin flaps.
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Affiliation(s)
- Jin Sol Park
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ung Sik Jin
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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Zhao P, Yang F, Jia X, Xiao Y, Hua C, Xing M, Lyu G. Extracellular Matrices as Bioactive Materials for In Situ Tissue Regeneration. Pharmaceutics 2023; 15:2771. [PMID: 38140112 PMCID: PMC10747903 DOI: 10.3390/pharmaceutics15122771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/28/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
Bioactive materials based on a nature-derived extracellular matrix (NECM) represent a category of biomedical devices with versatile therapeutic applications in the realms of tissue repair and engineering. With advancements in decellularization technique, the inherent bioactive molecules and the innate nano-structural and mechanical properties are preserved in three-dimensional scaffolds mainly composed of collagens. Techniques such as electrospinning, three-dimensional printing, and the intricate fabrication of hydrogels are developed to mimic the physical structures, biosignalling and mechanical cues of ECM. Until now, there has been no approach that can fully account for the multifaceted properties and diverse applications of NECM. In this review, we introduce the main proteins composing NECMs and explicate the importance of them when used as therapeutic devices in tissue repair. Nano-structural features of NECM and their applications regarding tissue repair are summarized. The origins, degradability, and mechanical property of and immune responses to NECM are also introduced. Furthermore, we review their applications, and clinical features thereof, in the repair of acute and chronic wounds, abdominal hernia, breast deformity, etc. Some typical marketed devices based on NECM, their indications, and clinical relevance are summarized.
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Affiliation(s)
- Peng Zhao
- Burn & Trauma Treatment Center, Affiliated Hospital of Jiangnan University, Wuxi 214122, China
- Engineering Research Center of the Ministry of Education for Wound Repair Technology, Jiangnan University, Affiliated Hospital of Jiangnan University, Wuxi 214000, China; (F.Y.); (Y.X.)
| | - Fengbo Yang
- Engineering Research Center of the Ministry of Education for Wound Repair Technology, Jiangnan University, Affiliated Hospital of Jiangnan University, Wuxi 214000, China; (F.Y.); (Y.X.)
| | - Xiaoli Jia
- Engineering Research Center of the Ministry of Education for Wound Repair Technology, Jiangnan University, Affiliated Hospital of Jiangnan University, Wuxi 214000, China; (F.Y.); (Y.X.)
| | - Yuqin Xiao
- Engineering Research Center of the Ministry of Education for Wound Repair Technology, Jiangnan University, Affiliated Hospital of Jiangnan University, Wuxi 214000, China; (F.Y.); (Y.X.)
| | - Chao Hua
- Burn & Trauma Treatment Center, Affiliated Hospital of Jiangnan University, Wuxi 214122, China
| | - Malcolm Xing
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Guozhong Lyu
- Burn & Trauma Treatment Center, Affiliated Hospital of Jiangnan University, Wuxi 214122, China
- Engineering Research Center of the Ministry of Education for Wound Repair Technology, Jiangnan University, Affiliated Hospital of Jiangnan University, Wuxi 214000, China; (F.Y.); (Y.X.)
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12
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Reddy SSP, Krishnan SA, Singh S, Ramachandra KK, Singh H, Harish R, Francis DL. Envelope coronally advanced flap with site-specific bilaminar acellular dermal matrix or connective tissue graft for management of multiple marginal tissue recessions: A retrospective analysis of cases. Clin Adv Periodontics 2023; 13:247-252. [PMID: 36825604 DOI: 10.1002/cap.10240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND A proper case selection and decision making is essential for management of multiple marginal tissue recessions (MTR) using a conventional or bilaminar approach. Coronally advanced flap (CAF) is one of the commonly used methods for management of MTR. CAF has been advocated in combination with soft tissue grafts as bilaminar technique, which had showed significant success in terms of root coverage. METHODS AND RESULTS Aim of this case series was to retrospectively evaluate Zucchelli's modification of envelope CAF (eCAF) and site-specific bilaminar methods using Acellular Dermal Matrix (ADM) and Connective Tissue Graft (CTG) for management of MTR. A total of 15 subjects (five subjects/25 sites per technique, total number of sites = 75) who were managed by three different techniques with 12 months postoperative records were retrospectively evaluated. All patients showed significant clinical improvement in root coverage outcomes when compared to baseline. Mean root coverage achieved at 3 months (90%), 6 months (95%) and 12 months (95%) postoperatively did not reveal significant difference between three methods. Complete root coverage was observed in 86.6% of eCAF cases and in 86.6% and 95% of ADM/CTG with eCAF, respectively. There was an increase in width of keratinised tissue, both individually and collectively across all of the groups. CONCLUSION Clinical outcomes suggested that bilaminar techniques should be used only in specific cases. Predictable results can be obtained without the use of a soft tissue graft or substitute if a careful treatment plan for technique selection is developed on an individual case-by-case basis. KEY POINTS Why is this case new information? Comparison of site-specific bilaminar modalities with modified coronally advanced flap alone What are the keys to successful management of such cases? Flap advancement and mobilisation Flap passivity What are the primary limitations to success in such cases? Case selection Flap tension Soft tissue phenotype Thickness of graft Operator skills.
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Affiliation(s)
| | | | - Sangeeta Singh
- Department of Health Policy, London School of Economics and Political Sciences, London, UK
| | | | - Harjeet Singh
- Department of Periodontology, Army Dental Centre (Research and Referral), New Delhi, India
| | - Ruchi Harish
- Department of Periodontology, Army Dental Centre (Research and Referral), New Delhi, India
| | - Delfin Lovelina Francis
- Department of Public Health Dentistry, Saveetha Dental College and Hospitals, SIMATS, Chennai, India
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Liang NE, Griffin MF, Berry CE, Parker JB, Downer MA, Wan DC, Longaker MT. Attenuating Chronic Fibrosis: Decreasing Foreign Body Response with Acellular Dermal Matrix. Tissue Eng Part B Rev 2023; 29:671-680. [PMID: 37212342 DOI: 10.1089/ten.teb.2023.0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Surgical implants are increasingly used across multiple medical disciplines, with applications ranging from tissue reconstruction to improving compromised organ and limb function. Despite their significant potential for improving health and quality of life, biomaterial implant function is severely limited by the body's immune response to its presence: this is known as the foreign body response (FBR) and is characterized by chronic inflammation and fibrotic capsule formation. This response can result in life-threatening sequelae such as implant malfunction, superimposed infection, and associated vessel thrombosis, in addition to soft tissue disfigurement. Patients may require frequent medical visits, as well as repeated invasive procedures, increasing the burden on an already strained health care system. Currently, the FBR and the cells and molecular mechanisms that mediate it are poorly understood. With applications across a wide array of surgical specialties, acellular dermal matrix (ADM) has emerged as a potential solution to the fibrotic reaction seen with FBR. Although the mechanisms by which ADM decreases chronic fibrosis remain to be clearly characterized, animal studies across diverse surgical models point to its biomimetic properties that facilitate decreased periprosthetic inflammation and improved host cell incorporation. Impact Statement Foreign body response (FBR) is a significant limitation to the use of implantable biomaterials. Acellular dermal matrix (ADM) has been observed to decrease the fibrotic reaction seen with FBR, although its mechanistic details are poorly understood. This review is dedicated to summarizing the primary literature on the biology of FBR in the context of ADM use, using surgical models in breast reconstruction, abdominal and chest wall repair, and pelvic reconstruction. This article will provide readers with an overarching review of shared mechanisms for ADM across multiple surgical models and diverse anatomical applications.
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Affiliation(s)
- Norah E Liang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Michelle F Griffin
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Charlotte E Berry
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jennifer B Parker
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Mauricio A Downer
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Derrick C Wan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Michael T Longaker
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California, USA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California, USA
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Lingyan L, Han Z, Jialu L, Bingyang H, Yuanyuan M, Peiwei Q, Peifen M, Liwei X. Acellular Dermal Matrix for Treatment of Diabetic Foot Ulcer: An Overview of Systematic Reviews. INT J LOW EXTR WOUND 2023:15347346231201696. [PMID: 38018121 DOI: 10.1177/15347346231201696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Aims: To evaluate the reliability of the methodological quality and outcome measures of systematic reviews (SRs)/metaanalyses (MAs) of the acellular dermal matrix (ADM) for diabetic foot ulcer (DFU). Methods: We searched and retrieved SRs and MAs on the application of ADM for DFU from PubMed, Web of Science, The Cochrane Library, EMBASE, CNKI, CBM, WanFang, and VIP databases. We employed AMSTAR 2 to assess methodological quality, Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system to grade, and the strength of evidence of included SRs/MAs. We excluded the overlapping randomized controlled trials (RCTs) and conducted a re-MA of the primary RCTs. Results: A total of 7 SRs/MAs were included. Results from the AMSTAR 2 evaluation revealed a low overall quality; the GRADE system showed that the evidence was of moderate to very low quality. Our re-MA showed that ADM was superior to standard of care (SOC), with regards to complete wound healing rate at 12 weeks (RR = 1.74, 95% CI:1.34-2.25, P < .0001), complete wound healing rate at 16 weeks (RR = 1.50, 95% CI: 1.26-1.77, P < .00001); healing time (MD = -2.06, 95% CI: -2.57 to -1.54, P < .00001) and adverse events (RR = 0.62, 95% CI: 0.49-0.80, P = .0002). However, a consensus has not yet been reached between ADM and SOC groups with regard to outcome indicators of the reduction of ulcer area and quality of life; and subgroup analyses showed no statistically significant differences between the xenograft ADM and SOC groups (RR = 1.36, 95% CI: 0.95-1.93, P = .09) at 12 weeks. Conclusion: Current evidence suggests that ADM is more effective than the standard of care in the treatment of DFU, particularly for full-thickness, noninfected, and nonischemic foot ulcers, but with low evidence quality. Therefore, the results of this overview should be interpreted dialectically and prudently, and the role of ADM in DFU needs further exploration.
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Affiliation(s)
- Li Lingyan
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Zhao Han
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Li Jialu
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - He Bingyang
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Ma Yuanyuan
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Qin Peiwei
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Ma Peifen
- School of Nursing, Lanzhou University, Lanzhou, Gansu Province, P. R. China
- Department of Nursing, The Second Hospital of Lanzhou University, Lanzhou, Gansu Province, P. R. China
| | - Xu Liwei
- Department of Burns, The Second Hospital of Lanzhou University, Lanzhou, Gansu Province, P. R. China
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Ru J, Zhang Q, Zhu S, Cai J, He Y, Lu F. Delivery of adipose-derived growth factors from heparinized adipose acellular matrix accelerates wound healing. Front Bioeng Biotechnol 2023; 11:1270618. [PMID: 37854882 PMCID: PMC10579818 DOI: 10.3389/fbioe.2023.1270618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
Dermal white adipocytes are closely associated with skin homeostasis and wound healing. However, it has not been fully investigated whether adipose-derived products improve wound healing. Here, we obtained adipose acellular matrix (AAM) and adipose-derived growth factors (ADGFs) from human adipose tissue and fabricated an ADGF-loaded AAM via surface modification with heparin. The product, HEP-ADGF-AAM, contained an adipose-derived scaffold and released ADGFs in a controlled fashion. To test its efficacy in promoting wound healing, mice with full thickness wound received three different treatments: HEP-ADGF-AAM, AAM and ADM. Control mice received no further treatments. Among these treatments, HEP-ADGF-AAM best improved wound healing. It induced adipogenesis in situ after in vivo implantation and provided an adipogenic microenvironment for wounds by releasing ADGFs. HEP-ADGF-AAM not only induced adipocyte regeneration, but also enhanced fibroblast migration, promoted vessel formation, accelerated wound closure, and enhanced wound epithelialization. Moreover, there was a close interaction between HEP-ADGF-AAM and the wound bed, and collagen was turned over in HEP-ADGF-AAM. These results show that HEP-ADGF-AAM might substantially improve re-epithelialization, angiogenesis, and skin appendage regeneration, and is thus a promising therapeutic biomaterial for skin wound healing.
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Affiliation(s)
| | | | | | | | - Yunfan He
- *Correspondence: Yunfan He, ; Feng Lu,
| | - Feng Lu
- *Correspondence: Yunfan He, ; Feng Lu,
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16
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Blasi G, Vilarrasa J, Abrahamian L, Monje A, Nart J, Pons R. Influence of immediate postoperative gingival thickness and gingival margin position on the outcomes of root coverage therapy: A 6 months prospective case series study using 3D digital measuring methods. J ESTHET RESTOR DENT 2023; 35:1039-1049. [PMID: 37021694 DOI: 10.1111/jerd.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND To assess linear and volumetric changes following the treatment of gingival recessions (GRs) by means of a modified coronally advanced tunnel technique combined with acellular dermal matrix (MTUN + ADM). MATERIALS AND METHODS Patients presenting GR type 1 (RT1) GRs underwent root coverage surgery consisting of MTUN + ADM. Clinical measurements were made, and intraoral scans were obtained at baseline, postoperatively, and 6 weeks, 3 and 6 months after surgery, to evaluate changes in probing depth (PD), keratinized tissue width (KTW), recession depth (RD), recession area (RA), marginal gingival thickness (MGT), and mucosal volume (MV). The impact of patient-level and surgical-site variables upon percentage root coverage (% RC) and the likelihood of achieving complete root coverage (CRC) were explored. RESULTS A total of 20 patients (n = 47 teeth) were treated. After 6 months, RD and RA decreased, while KTW, MGT, and MV increased. The mean % RC was 93% at 6 months and CRC was found on 72.3% of the sites at 6 months. The postoperative MGT changes at 1.5 and 3 mm were significantly correlated to % RC and CRC at 6 months. Each additional mm of postoperative gain of gingival thickness resulted in a 4-fold increase in the probability of achieving CRC. Additionally, gingival margin positioned ≥0.5 mm coronal to the cementoenamel junction immediately after surgery was a strong predictor of CRC. CONCLUSIONS The MGT gain at 1.5 and 3 mm achieved in the immediate postoperative period is a significant predictor of CRC at 6 months when treating multiple GRs via MTUN + ADM. CLINICAL SIGNIFICANCE The Scientific rationale for the study relies on the lack of 3D digital measuring tools in the assessment of soft tissue healing dynamics after root coverage therapy. The principal findings of this study can be summarized as follows: tooth type, tooth position, and post-operative gingival margin position and gingival thickness and volume changes are predictors of CRC. Therefore, the practical implications are that the more thickness and more coronal advancement achieved immediately after root coverage surgery, the higher chance of achieving CRC.
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Affiliation(s)
- Gonzalo Blasi
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, Baltimore School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Javi Vilarrasa
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Lory Abrahamian
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - José Nart
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ramón Pons
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
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Ning X, Liu N, Sun T, You Y, Luo Y, Kang E, Chen Z, Wang Y, Ren J. Promotion of adipose stem cell transplantation using GelMA hydrogel reinforced by PLCL/ADM short nanofibers. Biomed Mater 2023; 18:065003. [PMID: 37647920 DOI: 10.1088/1748-605x/acf551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/30/2023] [Indexed: 09/01/2023]
Abstract
Adipose-derived mesenchymal stem cells (ADSCs) show poor survival after transplantation, limiting their clinical application. In this study, a series of poly(l-lactide-co-ϵ-caprolactone) (PLCL)/acellular dermal matrix (ADM) nanofiber scaffolds with different proportions were prepared by electrospinning. By studying their morphology, hydrophilicity, tensile mechanics, and biocompatibility, PLCL/ADM nanofiber scaffolds with the best composition ratio (PLCL:ADM = 7:3) were selected to prepare short nanofibers. And based on this, injectable gelatin methacryloyl (GelMA) hydrogel loaded with PLCL/ADM short nanofibers (GelMA-Fibers) was constructed as a transplantation vector of ADSCs. ADSCs and GelMA-Fibers were co-cultured, and the optimal loading concentration of PLCL/ADM nanofibers was investigated by cell proliferation assay, live/dead cell staining, and cytoskeleton stainingin vitro. In vivoinvestigations were also performed by H&E staining, Oil red O staining, and TUNEL staining, and the survival and apoptosis rates of ADSCs transplantedin vivowere analyzed. It was demonstrated that GelMA-Fibers could effectively promote the proliferation of ADSCsin vitro. Most importantly, GelMA-Fibers increased the survival rate of ADSCs transplantation and decreased their apoptosis rate within 14 d. In conclusion, the constructed GelMA-Fibers would provide new ideas and options for stem cell tissue engineering and stem cell-based clinical therapies.
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Affiliation(s)
- Xuchao Ning
- Department of Cosmetic and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
- Department of Plastic Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, Qingdao, People's Republic of China
| | - Na Liu
- Institute of Neuroregeneration and Neurorehabilitation, Qingdao Medical College, Qingdao University, Qingdao, People's Republic of China
| | - Tiancai Sun
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao, People's Republic of China
| | - Yong You
- Department of Cosmetic and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Yanan Luo
- Department of Cosmetic and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Enhao Kang
- Department of Pathology, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Zhenyu Chen
- Department of Cosmetic and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Yuanfei Wang
- Central Laboratory, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, People's Republic of China
| | - Jizhen Ren
- Department of Cosmetic and Plastic Surgery, Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
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Shi W, Meng Q, Hu X, Cheng J, Shao Z, Yang Y, Ao Y. Using a Xenogeneic Acellular Dermal Matrix Membrane to Enhance the Reparability of Bone Marrow Mesenchymal Stem Cells for Cartilage Injury. Bioengineering (Basel) 2023; 10:916. [PMID: 37627801 PMCID: PMC10451227 DOI: 10.3390/bioengineering10080916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Due to its avascular organization and low mitotic ability, articular cartilage possesses limited intrinsic regenerative capabilities. The aim of this study is to achieve one-step cartilage repair in situ via combining bone marrow stem cells (BMSCs) with a xenogeneic Acellular dermal matrix (ADM) membrane. The ADM membranes were harvested from Sprague-Dawley (SD) rats through standard decellularization procedures. The characterization of the scaffolds was measured, including the morphology and physical properties of the ADM membrane. The in vitro experiments included the cell distribution, chondrogenic matrix quantification, and viability evaluation of the scaffolds. Adult male New Zealand white rabbits were used for the in vivo evaluation. Isolated microfracture was performed in the control (MF group) in the left knee and the tested ADM group was included as an experimental group when an ADM scaffold was implanted through matching with the defect after microfracture in the right knee. At 6, 12, and 24 weeks post-surgery, the rabbits were sacrificed for further research. The ADM could adsorb water and had excellent porosity. The bone marrow stem cells (BMSCs) grew well when seeded on the ADM scaffold, demonstrating a characteristic spindle-shaped morphology. The ADM group exhibited an excellent proliferative capacity as well as the cartilaginous matrix and collagen production of the BMSCs. In the rabbit model, the ADM group showed earlier filling, more hyaline-like neo-tissue formation, and better interfacial integration between the defects and normal cartilage compared with the microfracture (MF) group at 6, 12, and 24 weeks post-surgery. In addition, neither intra-articular inflammation nor a rejection reaction was observed after the implantation of the ADM scaffold. This study provides a promising biomaterial-based strategy for cartilage repair and is worth further investigation in large animal models.
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Affiliation(s)
- Weili Shi
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Qingyang Meng
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Xiaoqing Hu
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Jin Cheng
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Zhenxing Shao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Yuping Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
| | - Yingfang Ao
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Beijing 100191, China; (W.S.); (Q.M.); (X.H.); (J.C.); (Z.S.)
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing 100190, China
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Chintalapudi N, Rice OM, Hsu JR. The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider? OTA Int 2023; 6:e237. [PMID: 37448569 PMCID: PMC10337846 DOI: 10.1097/oi9.0000000000000237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 07/15/2023]
Abstract
Optimal treatment of orthopaedic extremity trauma includes meticulous care of both bony and soft tissue injuries. Historically, clinical scenarios involving soft tissue defects necessitated the assistance of a plastic surgeon. While their expertise in coverage options and microvascular repair is invaluable, barriers preventing collaboration are common. Acellular dermal matrices represent a promising and versatile tool for orthopaedic trauma surgeons to keep in their toolbox. These biological scaffolds are each unique in how they are used and promote healing. This review explores some commercial products and offers guidance for selection in different clinical scenarios involving traumatic wounds.
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Affiliation(s)
- Nainisha Chintalapudi
- Corresponding author. Address: Nainisha Chintalapudi, MD, Atrium Health Mercy, 2001 Vail Ave, Charlotte, NC 28207. E-mail:
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Cammarata E, Toia F, Rossi M, Cipolla C, Vieni S, Speciale A, Cordova A. Implant-Based Breast Reconstruction after Risk-Reducing Mastectomy in BRCA Mutation Carriers: A Single-Center Retrospective Study. Healthcare (Basel) 2023; 11:1741. [PMID: 37372859 DOI: 10.3390/healthcare11121741] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Women with BRCA gene mutations have a higher lifetime risk of developing breast cancer. Furthermore, cancer is usually diagnosed at a younger age compared to the wild-type counterpart. Strategies for risk management include intensive surveillance or risk-reducing mastectomy. The latter provides a significant reduction of the risk of developing breast cancer, simultaneously ensuring a natural breast appearance due to the preservation of the skin envelope and the nipple-areola complex. Implant-based breast reconstruction is the most common technique after risk-reducing surgery and can be achieved with either a submuscular or a prepectoral approach, in one or multiple stages. This study analyzes the outcomes of the different reconstructive techniques through a retrospective review on 46 breasts of a consecutive, single-center case series. Data analysis was carried out with EpiInfo version 7.2. Results of this study show no significant differences in postoperative complications between two-stage tissue expander/implant reconstruction and direct-to-implant (DTI) reconstruction, with DTI having superior aesthetic outcomes, especially in the prepectoral subgroup. In our experience, the DTI prepectoral approach has proven to be a safe and less time-consuming alternative to the submuscular two-stage technique, providing a pleasant reconstructed breast and overcoming the drawbacks of subpectoral implant placement.
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Affiliation(s)
- Emanuele Cammarata
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Francesca Toia
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Matteo Rossi
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Calogero Cipolla
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Salvatore Vieni
- Oncological Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Antonino Speciale
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Adriana Cordova
- Plastic and Reconstructive Surgery Unit, Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Boeriu S, Steigmann L, Di Gianfilippo R. Acellular dermal matrix for the treatment of multiple gingival recession defects associated with carious and previously-restored cervical lesions: a case report with 10 years of follow-up. Clin Adv Periodontics 2023. [PMID: 37116504 DOI: 10.1002/cap.10245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/23/2023] [Accepted: 04/26/2023] [Indexed: 04/30/2023]
Abstract
INTRODUCTION Limited evidence exists on the outcome of the modified coronally advanced tunnel (MCAT) with acellular dermal matrix (ADM) for the treatment of gingival recession defects (GRD) especially when complicated by restored cervical lesions. Therefore, the aim of this case report was to assess the short- and long-term clinical outcomes of maxillary Type 1 recession defects (RT1) associated with restored cervical lesions treated with MCAT with ADM. CASE PRESENTATION A 43-year-old female patient, presented with multiple adjacent RT1 recessions in the left maxilla, previously treated with overhanging cervical resin restorations. The case was approached with a careful evaluation of the diagnostic determinants of root coverage, removal of the aberrant resin restorations, treatment with MCAT with ADM, and periodical evaluation over a follow-up of 10 years. The treatment was followed by complete root coverage, improvement of gingival phenotype and perfect root coverage esthetic score. Outcomes were periodically assessed, and were maintained over 10 years of follow-up. CONCLUSION MCAT with ADM is an effective technique for the treatment of multiple GRD complicated by cervical restorations. Complete root coverage and excellent esthetic outcomes were obtained and maintained in the long term. This article is protected by copyright. All rights reserved One-sentence summary: Complete root coverage was obtained and maintained over 10 years with modified coronally advanced tunneling and acellular dermal matrix for treatment of multiple gingival recessions with cervical restorations.
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Affiliation(s)
- Sorin Boeriu
- Private Practice, Toledo-Findlay-Maumee, Ohio, USA
| | - Larissa Steigmann
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Riccardo Di Gianfilippo
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Mansour RN, Hasanzadeh E, Abasi M, Gholipourmalekabadi M, Mellati A, Enderami SE. The Effect of Fetal Bovine Acellular Dermal Matrix Seeded with Wharton's Jelly Mesenchymal Stem Cells for Healing Full-Thickness Skin Wounds. Genes (Basel) 2023; 14:genes14040909. [PMID: 37107668 PMCID: PMC10138153 DOI: 10.3390/genes14040909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/23/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
The treatment of full-thickness skin wounds is a problem in the clinical setting, as they do not heal spontaneously. Extensive pain at the donor site and a lack of skin grafts limit autogenic and allogeneic skin graft availability. We evaluated fetal bovine acellular dermal matrix (FADM) in combination with human Wharton's jelly mesenchymal stem cells (hWJ-MSCs) to heal full-thickness skin wounds. FADM was prepared from a 6-month-old trauma-aborted fetus. WJ-MSCs were derived from a human umbilical cord and seeded on the FADM. Rat models of full-thickness wounds were created and divided into three groups: control (no treatment), FADM, and FADM-WJMSCs groups. Wound treatment was evaluated microscopically and histologically on days 7, 14, and 21 post-surgery. The prepared FADM was porous and decellularized with a normal range of residual DNA. WJ-MSCs were seeded and proliferated on FADM effectively. The highest wound closure rate was observed in the FADM-WJMSC group on days 7 and 14 post-surgery. Furthermore, this group had fewer inflammatory cells than other groups. Finally, in this study, we observed that, without using the differential cell culture media of fibroblasts, the xenogeneic hWJSCs in combination with FADM could promote an increased rate of full-thickness skin wound closure with less inflammation.
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Affiliation(s)
- Reyhaneh Nassiri Mansour
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
| | - Elham Hasanzadeh
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
| | - Mozhgan Abasi
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
| | - Mazaher Gholipourmalekabadi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran 1449614535, Iran
- Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
- Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran
| | - Amir Mellati
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
- Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
| | - Seyed Ehsan Enderami
- Immunogenetics Research Center, Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari 4815733971, Iran
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Liu P, Li Q, Yang Q, Zhang S, Yi K, Zhang G, Tang Z. Evaluation of the effect of 3D-bioprinted gingival fibroblast-encapsulated ADM scaffolds on keratinized gingival augmentation. J Periodontal Res 2023; 58:564-574. [PMID: 37042165 DOI: 10.1111/jre.13126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/20/2023] [Accepted: 03/28/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The keratinized gingiva plays an important role in maintaining healthy periodontal and peri-implant tissue. Acellular dermal matrix (ADM), as a substitute biomaterial, has a porous structure and good biocompatibility. 3D-bioprinting has the potential for tissue engineering because it enables precise loading of cells layer-by-layer. Herein, we bioprinted ADM scaffold encapsulating gingival fibroblasts (GFs) and evaluated its efficacy in keratinized gingiva augmentation in vivo to assess its potential for clinical periodontal tissue regeneration. METHODS GFs were extracted from the gingiva of beagles and transfected with a green fluorescent protein (GFP). The ADM scaffold (ADM cell-free group) was constructed using ADM, gelatin, and sodium alginate mixed at an appropriate ratio via 3D-bioprinting. The ADM cell scaffold (ADM cell group) was established by adding extra GFs in the same manner. Six beagles were divided into blank control, ADM cell-free, and ADM cell groups; and implant surgery was performed. The keratinized gingiva was clinically and histologically evaluated at baseline and after 2 months. RESULTS GFs transfected with GFPs expressed green fluorescence and were present in new tissue in the ADM cell group and not observed in the ADM cell-free group. At 2 months after surgery, the keratinized gingival augmentation in the ADM cell group was significantly more than that in the ADM cell-free group. Attached gingival augmentation was also observed more in the ADM cell group than that in the ADM cell-free group. Histological staining showed that the tissue in the ADM cell group displayed a more integrated structure and higher expression of COL I, COL III, and VEGF-A than those in the ADM cell-free group. CONCLUSION 3D-bioprinted GF-encapsulated ADM scaffolds increased the amount of keratinized gingiva in vivo, suggesting that 3D-bioprinting has great potential for oral soft tissue regeneration.
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Affiliation(s)
- Peng Liu
- Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100101, P. R. China
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, P. R. China
| | - Qing Li
- Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100101, P. R. China
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
- National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, P. R. China
| | - Qiaolin Yang
- National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 100081, P. R. China
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Shihan Zhang
- Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, P. R. China
| | - Ke Yi
- Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100101, P. R. China
| | - Guifeng Zhang
- State Key Laboratories of Biochemical Engineering, Institute of Process Engineering, Beijing, 100190, P. R. China
| | - Zhihui Tang
- Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, 100101, P. R. China
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Stec E, Lombardi J, Augustin J, Sandor M. Acellular Dermal Matrix Susceptibility to Collagen Digestion: Effect on Mechanics and Host Response. Tissue Eng Part A 2023; 29:269-281. [PMID: 36641639 DOI: 10.1089/ten.tea.2022.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Various tissue origins and manufacturing processes can differentially affect the retention of native properties of acellular dermal matrices (ADMs); however, comparative studies are limited. Head-to-head comparisons between different configurations of porcine-derived Strattice (Allergan Aesthetics, an AbbVie Company, Irvine, CA) and bovine-derived SurgiMend (Integra LifeSciences, Billerica, MA) ADMs were performed to evaluate mechanical integrity and host tissue biologic response. Thermodynamic profile and morphology, which affect retention of mechanical strength, were evaluated through differential scanning calorimetry, scanning electron microscopy, and histology. Mechanical strength was assessed through tensile testing following collagenase exposure in vitro and following subcutaneous implantation in a rodent model. Host biologic response was evaluated through histopathology. Compared with respective native tissues, reductions in onset melting temperature following tissue processing were smaller for Strattice Firm versus SurgiMend 1.0 (Δ0.79°C vs. Δ5.77°C), Strattice Extra Thick versus SurgiMend 3.0 (Δ1.57°C vs. Δ4.79°C), and Strattice Perforated versus SurgiMend Microperforated (Δ1.18°C vs. Δ7.76°C), with similar trends for peak melting temperature. Strattice maintained native dermal architecture versus compacted collagen with process-induced interstices observed for SurgiMend. Strattice Firm, Extra Thick, and Perforated retained 33.44%, 65.65%, and 17.20% of initial strength after 48 h exposure to excess collagenase, while the SurgiMend ADMs were completely digested by 48 h. At 6 weeks postimplantation, both Strattice and SurgiMend showed minimal inflammatory response, but greater fibroblast repopulation was evident for Strattice. Strattice Firm had higher maximum load (145.85 ± 33.05 N/cm vs. 24.29 ± 12.35 N/cm, p ≤ 0.01), maximum stress (8.20 ± 1.91 MPa vs. 2.24 ± 1.27 Mpa, p ≤ 0.01), and stiffness (7491.00 ± 1981.32 N/cm vs. 737.56 ± 292.55 N/cm, p ≤ 0.01) than SurgiMend 1.0. Strattice Extra Thick had lower maximum load (198.54 ± 58.79 N/cm vs. 303.08 ± 76.76 N/cm, p < 0.05) than SurgiMend 3.0, but similar maximum stress (6.96 ± 1.78 Mpa vs. 8.73 ± 2.15 Mpa) and stiffness (13386.11 ± 3123.28 N/cm vs. 9389.02 ± 4860.67 N/cm). Strattice Perforated had higher maximum load (72.65 ± 41.44 N/cm vs. 10.23 ± 4.67 N/cm, p < 0.05) and maximum stress (4.08 ± 2.08 Mpa vs. 0.44 ± 0.19 p < 0.05) than SurgiMend Microperforated. Maximum load retention rates following implantation were higher for Strattice Firm versus SurgiMend 1.0 (37.85% vs. 8.03%), Strattice Extra Thick versus SurgiMend 3.0 (45.03% vs. 37.80%), and Strattice Perforated versus SurgiMend Microperforated (28.04% vs. 6.21%). Similar results were obtained for maximum stress and stiffness. In conclusion, Strattice retained greater mechanical strength in vitro and in vivo, while exhibiting greater fibroblast cell infiltration.
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Affiliation(s)
- Eric Stec
- Allergan Aesthetics, an AbbVie Company, Branchburg, New Jersey, USA
| | - Jared Lombardi
- Allergan Aesthetics, an AbbVie Company, Branchburg, New Jersey, USA
| | - Jephte Augustin
- Allergan Aesthetics, an AbbVie Company, Branchburg, New Jersey, USA
| | - Maryellen Sandor
- Allergan Aesthetics, an AbbVie Company, Branchburg, New Jersey, USA
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25
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Lin W, Chen J, Tan Q. [Renaissance of prepectoral implant-based breast reconstruction: theoretical basis and research status]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2023; 37:233-239. [PMID: 36796822 DOI: 10.7507/1002-1892.202210100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Objective To overview the theoretical basis and research status of prepectoral implant-based breast reconstruction. Methods The domestic and foreign researches on the application of prepectoral implant-based breast reconstruction in breast reconstruction were retrospectively analyzed. The theoretical basis, clinical advantages, and limitations of this technique were summarized and the future development trend in this field was discussed. Results The recent advances in breast cancer oncology, the development of materials and the concept of oncology reconstruction have provided a theoretical basis for prepectoral implant-based breast reconstruction. The selection of patients and the experience of surgeons are crucial for postoperative outcomes. Ideal thickness and blood flow of flaps are the most important considerations for the selection of prepectoral implant-based breast reconstruction. However, its long-term reconstruction outcomes and clinical benefits and risks in Asian populations still need to be confirmed by more studies. Conclusion Prepectoral implant-based breast reconstruction has a broad application prospect in breast reconstruction following mastectomy. However, the evidence is limited at present. Randomized study with long-term follow-up is urgently in need to provide sufficient evidence to evaluate the safety and reliability of prepectoral implant-based breast reconstruction.
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Affiliation(s)
- Weiyi Lin
- Department of Breast Surgery, Clinical Center for Breast, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China
| | - Jie Chen
- Department of Breast Surgery, Clinical Center for Breast, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China
| | - Qiuwen Tan
- Department of Breast Surgery, Clinical Center for Breast, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China
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26
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Sala L, Bonomi S, Fabbri A, Ciniselli CM, Bardelli A, Verderio P, Pruneri G, Cortinovis U. Use of PEAK PlasmaBlade in implant-based breast reconstruction and radiotherapy: new strategy to reduce complications. Tumori 2023; 109:86-96. [PMID: 34719290 DOI: 10.1177/03008916211056072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Implant-based breast reconstruction in the setting of radiotherapy often leads to higher complications rates (mainly capsular contracture and wound dehiscence) and poor cosmetic outcomes. We hypothesized that the combination of pulsed-electron avalanche knife (PEAK) PlasmaBlade (a pulsed radiofrequency electrosurgery) and acellular dermal matrix Veritas® in postmastectomy radiotherapy implant-based breast reconstruction could result in lower complications rate, better reconstructive results, and patient satisfaction. METHODS A prospective observational study focused on the use of PEAK PlasmaBlade in implant-based breast reconstruction and radiotherapy was carried out in the Plastic Reconstructive Surgery Unit at Fondazione IRCCS Istituto Nazionale Tumori Milano between December 2017 and 2019 (2017-2018: enrollment; 2018-2019: follow-up). Patient demographics were queried and complication rates and patient and surgeon satisfaction were assessed. RESULTS A total of 88 patients were enrolled; 2 patients received bilateral reconstruction, leading to a total of 90 procedures. Sixty-two women received contralateral symmetrization. Seroma was the most frequent minor complication (8.8%); implant exposure was the most recorded among major complications (5.5%). Preoperative lipofilling was the most substantial protective factor for preventing complications (p < 0.001). A significant association between capsular thermal damage thickness and the type of electrosurgery used (traditional electrosurgery vs PEAK PlasmaBlade) was observed, with lower values with PEAK PlasmaBlade (p < 0.0001). CONCLUSIONS Our protocol results in low rates of surgical complications and a high level of patient and surgeon satisfaction although longer follow-up is needed.
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Affiliation(s)
- Laura Sala
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Stefano Bonomi
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Alessandra Fabbri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milano University of Milan, School of Medicine, Milano, Italy
| | - Chiara Maura Ciniselli
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Annalisa Bardelli
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Paolo Verderio
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Giancarlo Pruneri
- Department of Pathology, Fondazione IRCCS Istituto Nazionale Tumori, Milano University of Milan, School of Medicine, Milano, Italy
| | - Umberto Cortinovis
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
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Mansour RN, Karimizade A, Enderami SE, Abasi M, Talebpour Amiri F, Jafarirad A, Mellati A. The effect of source animal age, decellularization protocol, and sterilization method on bovine acellular dermal matrix as a scaffold for wound healing and skin regeneration. Artif Organs 2023; 47:302-316. [PMID: 36161305 DOI: 10.1111/aor.14415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Healing the full-thickness skin wounds has remained a challenge. One of the most frequently used grafts for skin regeneration is xenogeneic acellular dermal matrices (ADMs), including bovine ADMs. This study investigated the effect of the source animal age, enzymatic versus non-enzymatic decellularization protocols, and gamma irradiation versus ethylene oxide (EO) sterilization on the scaffold. METHODS ADMs were prepared using the dermises of fetal bovine or calf skins. All groups were decellularized through chemical and mechanical methods, unless T-FADM samples, in which an enzymatic step was added to the decellularization protocol. All groups were sterilized with ethylene oxide (EO), except G-FADM which was sterilized using gamma irradiation. The scaffolds were characterized through scanning electron microscopy, differential scanning calorimetry, tensile test, MTT assay, DNA quantification, and real-time PCR. The performance of the ADMs in wound treatment was also evaluated macroscopically and histologically. RESULTS All ADMs were effectively decellularized. In comparison to FADM (EO-sterilized fetal ADM), morphological, and mechanical properties of G-FADM, T-FADM, and CADM (EOsterilized calf ADM) were changed to different extents. In addition, the CADM and G-FADM were thermally more stable than the FADM and T-FADM. Although all ADMs were noncytotoxic, the wounds of the FADM, T-FADM, and G-FADM groups were contracted to almost 30.0% of the original area on day 7, significantly faster than the CADM (17.5% ± 1.7) and control (12.2% ± 1.59) groups. However, by day 21, all ADMs were mostly closed except for the untreated group (60.1 ± 1.8). CONCLUSION Altogether, fetal source and EO-sterilized samples performed better than calf source and gamma-sterilized samples unless in some mechanical properties. There was no added value in using enzymatic treatment during the decellularization process. Our results suggest that the age, decellularization, and sterilization methods of animal source should be selected based on the clinical requirements.
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Affiliation(s)
- Reyhaneh Nassiri Mansour
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ayoob Karimizade
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Ehsan Enderami
- Immunogenetics Research Center, Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mozhgan Abasi
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Abdolreza Jafarirad
- Department of Surgery, Zare Psychiatry and Burn Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amir Mellati
- Department of Tissue Engineering and Regenerative Medicine, School of Advanced Technologies in Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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28
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Melkonyan KI, Popandopulo KI, Bazlov SB, Verevkin AA, Rusinova TV, Asyakina AS, Suprun IV, Zaborova VA, Gurevich KG. Results of Experimental Hernioplasty with Acellular Dermal Matrix. Bull Exp Biol Med 2023; 174:514-517. [PMID: 36913093 DOI: 10.1007/s10517-023-05739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Indexed: 03/14/2023]
Abstract
We performed a comprehensive assessment of the acellular dermal matrix obtained during the detergent-enzymatic treatment of the porcine dermis. Acellular dermal matrix was used for the experimental treatment of a hernial defect in a pig using the sublay method. Sixty days after the surgery, biopsy specimens were obtained from the area of hernia repair. The acellular dermal matrix can be easily modeled depending on the size and shape of the defect during surgical procedures, can eliminate the defect of the anterior abdominal wall, and is resistant to cutting by the suture material. Histological examination demonstrated replacement of the acellular dermal matrix with newly formed connective tissue.
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Affiliation(s)
- K I Melkonyan
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia.
| | - K I Popandopulo
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - S B Bazlov
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - A A Verevkin
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - T V Rusinova
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - A S Asyakina
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - I V Suprun
- Ministry of Health of the Russian Federation, Kuban State Medical University, Krasnodar, Russia
| | - V A Zaborova
- Ministry of Health of the Russian Federation (Sechenov University), I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - K G Gurevich
- Ministry of Health of the Russian Federation, A. I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
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Lee YJ, Kanchwala SK, Cho H, Jolly JC, Jablonka E, Tanis M, Kamien RD, Yang S. Natural Shaping of Acellular Dermal Matrices for Implant-Based Breast Reconstruction via Expansile Kirigami. Adv Mater 2023; 35:e2208088. [PMID: 36394177 DOI: 10.1002/adma.202208088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 10/29/2022] [Indexed: 06/16/2023]
Abstract
To complete a successful and aesthetic breast reconstruction for breast cancer survivors, tissue reinforcing acellular dermal matrices (ADMs) are widely utilized to create slings/pockets to keep breast implants or autologous tissue transfer secured against the chest wall in the desired location. However, ADM sheets are 2D and cannot completely cover the entire implant without wrinkles. Here, guided by finite element modeling, a kirigami strategy is presented to cut the ADM sheets with locally and precisely controlled stretchability, curvature, and elasticity. Upon expansion, a single kirigami ADM sheet can conformably wrap the implant regardless of the shape and size, forming a natural teardrop shape; contour cuts prescribe the topographical height and fractal cuts in the center ensures horizontal expandability and thus conformability. This kirigami ADM can provide support to the reconstructed breast in the desired regions, potentially offering optimal outcomes and patient-specific reconstruction, while minimizing operative time and cost.
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Affiliation(s)
- Young-Joo Lee
- Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Suhail K Kanchwala
- University of Pennsylvania, Division of Plastic and Reconstructive Surgery, Perelman Center of Advanced Medicine, Philadelphia, Pennsylvania, 19104, USA
| | - Hyesung Cho
- Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Jason Christopher Jolly
- Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Eric Jablonka
- University of Pennsylvania, Division of Plastic and Reconstructive Surgery, Perelman Center of Advanced Medicine, Philadelphia, Pennsylvania, 19104, USA
| | - Michael Tanis
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Randall D Kamien
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Shu Yang
- Department of Materials Science and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
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Luo J, Moss WD, Pires GR, Rhemtulla IA, Rosales M, Stoddard GJ, Agarwal JP, Kwok AC. A Nationwide Analysis Evaluating the Safety of Using Acellular Dermal Matrix with Tissue Expander-Based Breast Reconstruction. Arch Plast Surg 2022; 49:716-723. [PMID: 36523919 PMCID: PMC9747277 DOI: 10.1055/s-0042-1758638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 07/08/2022] [Indexed: 12/23/2022] Open
Abstract
Background In March 2021, the United States Food and Drug Administration (FDA) safety communication cautioned against the use of acellular dermal matrix (ADM) products in breast reconstruction and reiterated that the FDA does not approve ADM use in breast surgery. This study aims to assess the safety of ADM use in breast reconstruction. Methods Women who underwent ADM and non-ADM assisted tissue expander (TE)-based breast reconstruction were identified using the National Surgical Quality Improvement Program database (2012-2019). Trends of ADM use over time, and 30-day outcomes of surgical site infection (SSI), dehiscence, and unplanned reoperation were assessed. Results Of the 49,049 TE-based breast reconstructive cases, 42.4% were ADM assisted and 57.6% non-ADM assisted. From 2012 to 2019, the use of ADM increased from 26.1 to 55.6% (relative risk [RR] =1.10; p < 0.01). Higher rates of SSI (3.9 vs. 3.4%; p = 0.003) and reoperation (7.4 vs. 6.0%; p < 0.001) were seen in the ADM cohort. There was no significant difference seen in dehiscence rates (0.7 vs. 0.7%; p = 0.73). The most common reoperation within 30 days for the ADM group (17.6%) was removal of TE without insertion of implant (current procedural terminology: 11,971). ADM-assisted breast reconstruction was associated with increased relative risk of SSI by 10% (RR = 1.10, confidence interval [CI]: 1.01-1.21; p = 0.03) and reoperation by 15% (RR = 1.15, CI: 1.08-1.23; p < 0.001). Conclusions ADM-assisted breast reconstruction more than doubled from 2012 to 2019. There are statistically higher complication rates of SSI (0.5%) and reoperation (1.4%) with ADM use in TE-based breast reconstruction, suggesting that reconstruction without ADM is safe when comparing immediate postoperative outcomes.
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Affiliation(s)
- Jessica Luo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Whitney D. Moss
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Giovanna R. Pires
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Irfan A. Rhemtulla
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Megan Rosales
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Gregory J. Stoddard
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jayant P. Agarwal
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
| | - Alvin C. Kwok
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah
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Cong Z, Liu Y, Zhao J. Treatment of multiple adjacent gingival recessions with an acellular dermal matrix or a connective tissue graft: a Meta-analysis. Hua Xi Kou Qiang Yi Xue Za Zhi 2022; 40:690-697. [PMID: 36416322 PMCID: PMC9763956 DOI: 10.7518/hxkq.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of an acellular dermal matrix or a connective tissue autograft in the treatment of multiple adjacent gingival recessions through Meta-analysis. METHODS Randomized controlled trials were screened in four electronic databases in English according to the inclusion and exclusion criteria until April 20, 2022. The main outcome indicators were keratinized gingival tissue width, recession depth, probing depth, clinical attachment level, complete root coverage, and root coverage esthetic score. RESULTS Seven randomized controlled trials were included. After 12 months, the connective tissue graft in the control group could increase the keratinized gingival tissue width [mean difference (MD)=-0.28 (-0.47, -0.08), P=0.006], reduce the gingival recession depth [MD=0.23 (0.12, 0.35), P<0.000 1], and improve the complete root coverage [risk ratio=0.80, 95% confidence interval (0.69, 0.93), P=0.003] compared with the acellular dermal matrix in the experimental group. No significant difference was found in probing depth, clinical attachment level, and root coverage esthetic score between groups. CONCLUSIONS Connective tissue grafts have advantages in increasing the keratinized gingival tissue width, reducing the gingival recession depth, and improving the complete root coverage in surgeries for treating multiple adjacent gingival recessions. Acellular dermal matrices also have some clinical value in terms of operation simplicity and similar effectiveness.
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Affiliation(s)
- Zhaoxia Cong
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
| | - Yuan Liu
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
| | - Jin Zhao
- Dept. of Endodontics, The First Affiliated Hospital of Xin-;jiang Medical University, Urumqi 830000, China
- Xinjiang Oral Medical Research Institute, Urumqi 830000, China
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MIHALEČKO J, BOHÁČ M, DANIŠOVIČ Ľ, KOLLER J, VARGA I, KUNIAKOVÁ M. Acellular Dermal Matrix in Plastic and Reconstructive Surgery. Physiol Res 2022; 71:S51-S57. [PMID: 36592440 PMCID: PMC9854008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Despite significant advances in medical research, plastic surgeons still face a shortage of suitable patient tissues, and soft tissue reconstruction is no exception. In recent years, there has been a rapid boom in the use of acellular dermal matrix (ADM) in reconstructive and aesthetic surgery. ADM is incorporated into the surrounding tissue and gradually replaced by the host's collagen, thus promoting and supporting the healing process and reducing the formation of scar tissue. The main goal of this article is to provide a brief review of the current literature assessing the clinical applications of ADM across a broad spectrum of applications in plastic and reconstructive surgery.
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Affiliation(s)
- Ján MIHALEČKO
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovak Republic
| | - Martin BOHÁČ
- 2nd Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovak Republic,Centre for Tissue Engineering and Regenerative Medicine – Translational Research Unit in the Branch of Regenerative Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Ľuboš DANIŠOVIČ
- Centre for Tissue Engineering and Regenerative Medicine – Translational Research Unit in the Branch of Regenerative Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic,Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic,National Institute of Rheumatic Diseases, Piestany, Slovak Republic
| | - Ján KOLLER
- Department of Burns and Reconstructive Surgery, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic
| | - Ivan VARGA
- National Institute of Rheumatic Diseases, Piestany, Slovak Republic,Institute of Histology and Embryology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
| | - Marcela KUNIAKOVÁ
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic,National Institute of Rheumatic Diseases, Piestany, Slovak Republic
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Bual R, Labares M Jr, Valle KDD, Pague J Jr, Bantilan ZC, Ducao PG, Alimasag J, Acibar C. Characterization of Decellularized Extracellular Matrix from Milkfish (Chanos chanos) Skin. Biomimetics (Basel) 2022; 7. [PMID: 36546913 DOI: 10.3390/biomimetics7040213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/31/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
Milkfish (Chanos chanos) is an abundant fish commodity in the Philippines that generates a large number of wastes such as skin, scales, viscera, and bones, which, upon disposal, cause environmental pollution. The abundance of these wastes, such as fish skin, rich in bioactive natural products such as collagen, elicits interest in their conversion into high-market-value products. The decellularization of milkfish skin waste can extract its extracellular matrix (ECM), a potential raw material for biomedical applications such as the repair of damaged skin tissues. In particular, this study characterized the developed decellularized ECM with different concentrations (0.1%, 1.0%) of the decellularizing agents (Triton X-100, SDS) and temperature (4 °C, room temperature) using milkfish skin. The decellularized ECM structure was better preserved using Triton X-100, while SDS was more effective in cell component removal, especially at 1% concentration and 4 °C temperature. There were significant effects of varying the temperatures and concentrations on the physical and mechanical properties of the decellularized ECM. Future studies could explore more variables to further establish protocols and more analyses to better characterize the decellularized milkfish skin.
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Kim YS, Kim HS, In SK, Kim BS, Kim HY, Kim HI, Yi HS, Park JH. Correlation between acellular dermal matrix (ADM) volume and breast implant size selection among patients undergoing prepectoral direct-to-implant (DTI) breast reconstruction using complete ADM. Medicine (Baltimore) 2022; 101:e31344. [PMID: 36401398 PMCID: PMC9678633 DOI: 10.1097/md.0000000000031344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In prepectoral direct-to-implant breast reconstruction using the acellular dermal matrix (ADM)-assisted technique, breast volume asymmetry can occur. We hypothesized that ADM size influences implant size selection in prepectoral breast reconstruction with implant coverage using an ADM. We investigated factors influencing implant size selection and provide guidelines for surgeons. METHODS A retrospective chart review was performed to identify all patients who underwent prepectoral direct-to-implant breast reconstruction between January 2017 and October 2020. We assessed patient characteristics, preoperative expected implant volume, ADM size, volume of implant used in surgery, and symmetry scale of aesthetic item scale (AIS) 6 months after surgery. We compared the symmetry score of AIS between a group in which the preoperative expected silicone implant size (ES) was used and a group in which a silicone implant of a smaller size than planned (SS) was used. RESULTS Patient characteristics, including age, body mass index (BMI), and excised breast volume, were similar between the groups (P > .05). ADM size had a significant effect on implant size selection (odds ratio = 1.760, P < .01). The symmetry score of AIS was higher in the SS group. CONCLUSIONS ADM size must be considered when selecting implant size in prepectoral direct-to-implant breast reconstruction using the ADM-assisted technique.
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Affiliation(s)
- Yoon Soo Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Ho Sung Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Seok Kyung In
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Byeong Seok Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Hyo Young Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Hong Il Kim
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Hyung Suk Yi
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
| | - Jin Hyung Park
- Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine Busan, Busan, Republic of Korea
- * Correspondence: Jin Hyung Park, Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 49267, Republic of Korea (e-mail: )
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35
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Kim BK, Kong DS, Nam DH, Hong SD. Comparison of Graft Materials in Multilayer Reconstruction with Nasoseptal Flap for High-Flow CSF Leak during Endoscopic Skull Base Surgery. J Clin Med 2022; 11:jcm11226711. [PMID: 36431187 PMCID: PMC9697000 DOI: 10.3390/jcm11226711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Cerebrospinal fluid (CSF) leak is a crucial complication after endoscopic skull base surgery. Therefore, multilayer reconstruction with grafts is as essential as a reconstruction with pedicled flaps. Although widely used, the multilayer technique with autologous fascia lata has drawbacks, such as additional wound and donor site complications. We compared acellular dermal graft and banked homologous fascia lata graft (alternative grafts) with autologous fascia lata graft for high-flow CSF leak repair. We retrospectively enrolled 193 subjects who underwent endoscopic skull base reconstruction with multilayer fascial grafts and nasoseptal flap for high-flow CSF leaks from November 2014 to February 2020 at a single institution. Acellular dermal matrix (ADM), banked homologous fascia lata, and autologous fascia lata were used in 48 (24.9%), 102 (52.8%), and 43 (22.3%) patients, respectively. Postoperative CSF leaks occurred in 23 (11.9%) patients and meningitis in 8 (4.1%). There was no significant difference in postoperative CSF leak (p = 0.36) and meningitis (p = 0.17) across the graft groups. Additionally, we could not find out contributing risk factors for postoperative CSF leak and meningitis. ADM and banked homologous fascia lata are non-inferior to autologous fascia lata for endoscopic skull base reconstruction in water-tight reconstruction or safety without additional donor site morbidities.
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Affiliation(s)
- Byung Kil Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu 41404, Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Do-Hyun Nam
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
- Correspondence:
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Gierek M, Łabuś W, Kitala D, Lorek A, Ochała-Gierek G, Zagórska KM, Waniczek D, Szyluk K, Niemiec P. Human Acellular Dermal Matrix in Reconstructive Surgery-A Review. Biomedicines 2022; 10:2870. [PMID: 36359387 PMCID: PMC9687949 DOI: 10.3390/biomedicines10112870] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/05/2022] [Accepted: 11/08/2022] [Indexed: 07/30/2023] Open
Abstract
Reconstructive surgery often confronts large tissue defects. This creates a need to look for materials that are immunogenic but offer the possibility of tissue filling. ADM-acellular dermal matrix-is a biological collagen matrix without immunogenicity, which is more commonly used in surgical treatment. Reconstructive surgery is still searching for various biocompatible materials that can be widely used in surgery. The available materials have their advantages and disadvantages. This paper is a literature review on the use of human acellular dermal matrix (ADM) in reconstructive surgery (surgical oncology, plastic and reconstructive surgery, and gynecologic reconstructive surgery). ADM appears to be a material of increasing use in various fields of surgery, and thus, further research in this area is required.
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Affiliation(s)
- Marcin Gierek
- Dr Stanislaw Sakiel Burn Treatment Centre in Siemianowice Slaskie, 41-100 Siemianowice Slaskie, Poland
| | - Wojciech Łabuś
- Dr Stanislaw Sakiel Burn Treatment Centre in Siemianowice Slaskie, 41-100 Siemianowice Slaskie, Poland
| | - Diana Kitala
- Dr Stanislaw Sakiel Burn Treatment Centre in Siemianowice Slaskie, 41-100 Siemianowice Slaskie, Poland
| | - Andrzej Lorek
- Department of Surgical Oncology, University Medical Center, Silesian Medical University, ul. Ceglana 35, 40-514 Katowice, Poland
| | - Gabriela Ochała-Gierek
- Dermatology Department, City Hospital in Sosnowiec, ul. Zegadłowicza 3, 41-200 Sosnowiec, Poland
| | - Karolina Mikuś Zagórska
- Dr Stanislaw Sakiel Burn Treatment Centre in Siemianowice Slaskie, 41-100 Siemianowice Slaskie, Poland
| | - Dariusz Waniczek
- Department of Surgical Oncology, University Medical Center, Silesian Medical University, ul. Ceglana 35, 40-514 Katowice, Poland
| | - Karol Szyluk
- Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- Department of Orthopaedic and Trauma Surgery, District Hospital of Orthopaedics and Trauma Surgery, 41-940 Piekary Śląskie, Poland
| | - Paweł Niemiec
- Department of Biochemistry and Medical Genetics, Faculty of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
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Overbeck N, Beierschmitt A, May BCH, Qi S, Koch J. In-Vivo Evaluation of a Reinforced Ovine Biologic for Plastic and Reconstructive Procedures in a Non-human Primate Model of Soft Tissue Repair. Eplasty 2022; 22:e43. [PMID: 36160663 PMCID: PMC9490877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Biologic matrices are used in plastic and reconstructive surgical procedures to aid in the kinetics of soft tissue repair and promote functional tissue formation. The human acellular dermal matrix AlloDerm is widely used; however, it is offered at a relatively high cost, and its dermal composition may not provide an ideal remodeling scaffold. OviTex Plastic and Reconstructive Surgery (PRS) Resorbable and Permanent are reinforced biologic matrices engineered with layers of ovine forestomach matrix embroidered with small amounts of polymer to optimize biophysical performance. This study compared the healing outcomes of these matrices in a non-human primate model of soft tissue repair. METHODS Animals were implanted with test articles in surgically created full-thickness midline abdominal wall defects and evaluated macroscopically and histologically at 2, 4, 12, and 24 weeks. RESULTS Both OviTex PRS Permanent and Resorbable matrices exhibited earlier host cell infiltration, neovascularization, and collagen deposition and also fully remodeled into the host tissue by 12 weeks post implantation. AlloDerm had less host cell infiltration and neovascularization at early time points and never fully integrated into the surrounding host tissue. There was no statistical difference in overall inflammation between AlloDerm and either OviTex PRS product at any time point, despite small amounts of polymer reinforcement in OviTex products. CONCLUSIONS In a primate soft tissue repair model, OviTex PRS Permanent and Resorbable matrices performed comparably with the leading human acellular dermal matrix. OviTex PRS Permanent and Resorbable are less expensive than alternatives like AlloDerm and may promote faster host cell proliferation and functional remodeling in some soft tissue repair applications.
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Affiliation(s)
| | - Amy Beierschmitt
- Behavioural Science Foundation, Basseterre, Saint Kitts and Nevis
| | | | - Shijie Qi
- University of Montreal, Montreal, QC, Canada
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Simpson AM, Barrow BE, Corey SL, Kachare MD, Choo JH, Wilhelmi BJ. Red Breast Syndrome: Complete Resolution Following Replacement of Acellular Dermal Matrices With Acellular Collagen Matrices. Eplasty 2022; 22:QA1. [PMID: 36330504 PMCID: PMC9615911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
What is red breast syndrome (RBS)?What causes RBS?How often do patients present with RBS?What are effective treatments for RBS?
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Affiliation(s)
| | | | - Samuel L Corey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Milind D Kachare
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Joshua H Choo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Bradon J Wilhelmi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
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Kachare MD, Barrow BE, Corey S, Elfanagely O, Rossi AJ, Simpson AM, Kachare SD, Choo J, Wilhelmi BJ. Prevention of Implant Malposition in Latissimus Dorsi Myocutaneous Flap Breast Reconstruction Using an Acellular Dermal Matrix With Pectoralis Muscle Following Mastectomy for Breast Cancer: A Clinical Review. Eplasty 2022; 22:e39. [PMID: 36160664 PMCID: PMC9490880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Latissimus dorsi myocutaneous (LDM) pedicled flaps are a well-established method for breast reconstruction in women with inadequate soft tissue coverage following mastectomy for breast cancer. The robust nature of the latissimus blood supply can accommodate immediate implant placement to increase breast volume; however, a known risk factor with this technique is implant malposition. By utilizing an acellular dermal matrix (ADM) in subpectoral implant-based LDM reconstruction, it is hypothesized that patients will experience a lower incidence of implant malposition. This 13-year retrospective review aims to evaluate the effectiveness of breast reconstruction using this technique. METHODS A retrospective review was conducted to identify all patients who underwent breast reconstruction following mastectomy with a LDM flap, subpectoral implant, and an ADM from 2007 to 2020 by a single surgeon at a single institution. Demographic and clinical data were collected and analyzed. RESULTS A total of 40 patients (LDM flaps, N = 51) were identified. Mean participant age was 50.25 ± 9.67 years and mean body mass index (BMI) was 30.85 ± 6.15 kg/m2. Comorbidities included hypertension (40.0%), diabetes mellitus (17.5%), and current smoking (25.0%). Mean follow-up was 31.52 ± 29.51 months. The most common complication was seroma formation (9.8%). No patients experienced implant malposition or flap necrosis. CONCLUSIONS The use of a LDM flap and an ADM in implant-based breast reconstruction are each well described in the literature. This 13-year series supports the efficacy of these techniques utilized in combination to provide an aesthetic result while mitigating implant malposition during breast reconstruction of oncologic patients.
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Affiliation(s)
- Milind D Kachare
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Brooke E Barrow
- Division of Plastic, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University, Durham, NC
| | - Samuel Corey
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Omar Elfanagely
- Division of General Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Alexander J Rossi
- Division of General Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Alyssa M Simpson
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Swapnil D Kachare
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Joshua Choo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
| | - Bradon J Wilhelmi
- Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Louisville, Louisville, KY
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Gonzalez GA, Castagno C, Carter J, Chellappan B, Taupin P. Negative pressure wound therapy on complex extremity wounds requiring coverage with a meshed bilayer wound matrix: a retrospective analysis. J Wound Care 2022; 31:S8-S15. [PMID: 36113853 DOI: 10.12968/jowc.2022.31.sup9.s8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The treatment of complex extremity wounds is technically challenging. In this 5-year retrospective review, we compared the use of Integra Meshed Bilayer Wound Matrix (IMBWM; Integra LifeSciences, US) followed by a split-thickness skin graft (STSG) combined with negative pressure wound therapy (NPWT) versus IMBWM followed by STSG alone for the management of these wounds. METHOD Data from patients undergoing management using IMBWM for a complex extremity wound coverage were collected. RESULTS Among the 109 patients studied, the wounds of 62 patients were managed using IMBWM and NPWT, and 47 were managed using IMBWM alone. The most common aetiology of these injuries was trauma. Wound size and location were similar for each group, ranging in size from 2-30cm2 and being primarily on the forearm, followed by the leg and arm. There was a significantly greater take of the IMBWM+STSG with NPWT (96.8%) compared to without NPWT (85.1%, p=0.03). There were significantly fewer reapplications of the dermal matrix required in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). There were significantly fewer postoperative complications, prior to STSG, in the NPWT group (3.2%) versus the non-NPWT group (14.9%, p=0.03). CONCLUSION The combination of IMBWM with NPWT leads to a higher success rate, and can reduce the number of dermal matrix reapplications and postoperative complications, in the setting of complex extremity wounds. The use of IMBWM in combination with NPWT has the potential to improve both surgical procedures and patient outcomes in this setting.
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Affiliation(s)
| | | | - Jordan Carter
- Texas Tech University Health Sciences Center, El Paso, TX, US
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Kim HI, Kim BS, Park JH, Yi HS, Kim HY, Choi JH, Jung SU, Kim YS. "Tear-Drop Appearance" Wrap: A Novel Implant Coverage Method for Creating Natural Contour in Prepectoral Prosthetic-Based Breast Reconstruction. J Clin Med 2022; 11:jcm11154592. [PMID: 35956207 PMCID: PMC9370020 DOI: 10.3390/jcm11154592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Various implant wrapping methods with acellular dermal matrix (ADM) have been introduced, but most focus on random trimming and suturing aimed to maximize implant coverage. Here we present our clinical experience using a “tear-drop appearance” wrapping method to achieve natural contours through upper pole volume replacement. We retrospectively reviewed the data of 56 consecutive cases of prepectoral prosthetic-based breast reconstruction (PPBR) using this wrapping method following nipple-sparing mastectomy between March 2020 and June 2021. The “tear-drop appearance” wrapping design creates an anatomical tear-drop–shaped pocket to encourage lower pole fullness and create a natural contour through upper pole volume replacement by ADM. Patients’ baseline characteristics, operative data, and complications were analyzed. Aesthetic outcomes were measured using the BREAST-Q and Aesthetic Item Scale (AIS). A successful reconstruction was achieved without major complications and using a single ADM sheet. Four types and three sizes of ADMs were used. The mean resected breast tissue weight was 274.3 g, while the mean implant volume was 230.0 cc. The average BREAST-Q and AIS scores were 4.6 ± 0.8 and 4.5 ± 0.7, respectively. Owing to its simplicity, reproducibility, and effectivity, this method is an excellent implant coverage option that achieves a natural contour in PPBR.
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Affiliation(s)
- Hong-il Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Byeong-seok Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Jin-hyung Park
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Hyung-suk Yi
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Hyo-young Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Jin-hyuk Choi
- Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Sung-ui Jung
- Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
| | - Yoon-soo Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea
- Correspondence: ; Tel.: +82-51-990-6131
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Custer PL, Maamari RN, Ho TC, Huecker JB, Couch SM. Lower eyelid margin reconstruction: results of five different techniques. Orbit 2022:1-10. [PMID: 35893769 DOI: 10.1080/01676830.2022.2101128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE This retrospective study was performed to examine surgical results of five different techniques for lower eyelid margin reconstruction after Mohs surgery: primary closure, semicircular flap, dermal matrix graft, sliding tarsal flap, and tarsoconjunctival flap. METHODS Medical records were reviewed in 178 patients undergoing surgery between 2005 and 2020. Outcomes were evaluated (photographic review) by three oculoplastic observers masked to procedure type, both with and without knowledge of the eyelid defect. RESULTS All patients achieved a good-excellent functional result and 90.4% were asymptomatic after surgery. Tarsoconjunctival flaps were associated with greater need for subsequent interventions (p < .001) and anterior lamellar deformities (p < .001). Semicircular flaps had a higher incidence of lateral canthal deformity (p < .001), but less eyelash disruption than other flap/graft techniques (p < .001). Mean cosmetic ratings (defect masked) were similar for dermal matrix grafts, semicircular, and sliding tarsal flaps; with each grading higher than tarsoconjunctival flaps (p ≤ .05). Among patients with 9-15 mm wide defects, results were better for semicircular and sliding tarsalflaps, than dermal matrix grafts (p ≤ .005) and tarsoconjunctival flaps (p ≤ .02). CONCLUSIONS All patients achieved a good-excellent functional result and 87.1% a good-excellent cosmetic result. The semicircular flap was effective for repairing medium sized wounds that could not be closed primarily, creating a continuous lash line, although with a higher incidence of lateral canthal deformities. The sliding tarsal flap was effective for shallow wounds of varying widths. The single-staged dermal matrix graft provided similar results as the tarsoconjunctival flap. Subsequent interventions were more frequent after the tarsoconjunctival flap than other methods.
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Affiliation(s)
- Philip L Custer
- John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Robi N Maamari
- John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tiffany C Ho
- John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Julia B Huecker
- John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Steven M Couch
- John F. Hardesty MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
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Sisti A, Sadeghi P, Cuomo R, Alvarez SM. Pre-Pectoral One-Stage Breast Reconstruction with Anterior Coverage Using Superior Anterior Biological Acellular Dermal Matrix (ADM) and Inferior Anterior Dermal Sling Support. Medicina (Kaunas) 2022; 58:992. [PMID: 35893107 DOI: 10.3390/medicina58080992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/17/2022]
Abstract
The use of acellular dermal matrix (ADM) implants has enhanced breast reconstruction. ADM is a biotechnologically designed human tissue of bovine or porcine origin in which tissue processing removes cellular antigens. In this case report, we describe the use of ADM in one-stage prepectoral breast reconstruction. Skin-reduction breast reconstruction with a prepectoral implant was performed. We created a combined dermal pocket using the inferior dermal flap, sutured with a patch of acellular dermal matrix to continue its extension until the upper pole, to cover the implant. This technique offers single-stage immediate reconstruction, with a decreased requirement for ADM and increased use of vascularized tissue and implant support. Additionally, in the pre-pectoral space, decreased pain postoperatively and less anatomic disruption is offered.
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Sala L, Bonomi S, Ciniselli CM, Verderio P, Pastori M, Maurichi A, Cortinovis U. Patient-reported outcome measurements in post-mastectomy implant-based breast reconstruction and radiotherapy: Analysis of BREAST-Q data. Tumori 2022:3008916221107715. [PMID: 35801836 DOI: 10.1177/03008916221107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Breast reconstruction has become a standard of care in patients undergoing mastectomy, greatly improving their quality of life. An increasing number of patients-reported outcome measurements (PROMs) have been developed over the years to better analyze patients' subjective overall experience. BREAST-Q is the PROMs for breast surgery introduced in our practice to assess patients' experiences when undergoing implant-based breast reconstruction and radiotherapy along with the use of Peak Plasma Blade and acellular dermal matrix. METHODS The pre-operative version of the Reconstruction BREAST-Q was administered to all 88 patients enrolled between December 2017 and December 2018 in the Plastic Reconstructive Surgery Unit at Fondazione IRCCS Istituto Nazionale Tumori Milano through person-to-person interviews, while the post-operative version was administered to the 75 patients who completed a 12-month follow-up (four patients died during one-year follow-up and nine patients had major complications). The survey areas highlighted were: satisfaction with breast, psychosocial well-being, physical well-being and sexual well-being. RESULTS From BREAST-Q questions regarding Satisfaction With The Appearance Of The Breast and Psychosocial Well-Being outcomes showed significant improvement from pre-operative data, as well as with Satisfaction With Overall Care, with the exception of Physical Well-Being Chest. CONCLUSIONS BREAST-Q allows the assessment of patients' perception, not only for surgical results, but also for the overall experience with surgeons and medical staff.The women enrolled in our study reported an overall good patient satisfaction in most of the analyzed fields.
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Affiliation(s)
- Laura Sala
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Stefano Bonomi
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Chiara Maura Ciniselli
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori Milan, Italy
| | - Paolo Verderio
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori Milan, Italy
| | - Marta Pastori
- Unit of Bioinformatics and Biostatistics, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale Tumori Milan, Italy
| | - Andrea Maurichi
- Department of Melanoma Surgery, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Umberto Cortinovis
- Plastic and Reconstructive Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Prezzavento GE, Calvi RNJ, Rodriguez JA, Taupin P. Integra Dermal Regeneration Template in reconstructive surgery for cutaneous tumours: a two-year retrospective review. J Wound Care 2022; 31:612-619. [PMID: 35797255 DOI: 10.12968/jowc.2022.31.7.612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Integra Dermal Regeneration Template (IDRT) (Integra LifeSciences, US) is a bioengineered dermal matrix that has been widely used in burn reconstruction since its first description. However, little is reported on its use in oncologic dermatological defects. Our objective was to evaluate reconstruction using IDRT on cutaneous tumour defects. METHOD We conducted a two-year retrospective review of patients with skin tumours who had an excision surgery, followed by reconstruction with IDRT, as a mid-step towards a final autograft procedure: a split-thickness skin graft. The records of all patients at a single academic institution were queried from the electronic medical record using data obtained from the operating surgeon. RESULTS We identified 13 patients with different tumour types and locations. The mean defect size was 105.92cm². The matrix take rate was 92.3% and average postoperative day for definite autograft was 20 days. Patients were followed for a period of up to 12 months. Of the patients, one had exposed bone without periosteum; another patient showed recurrence six months after matrix placement, requiring a new second two-stage IDRT-autograft procedure before radiation therapy. Patients reported complete satisfaction with the cosmetic, functional and oncological results. No cases of infection were encountered. CONCLUSION IDRT is a valid option for the reconstruction of oncologic surgical defects of the skin and can be used in different anatomical locations. Specifically, it is an alternative to the reconstructive ladder when grafts and local flaps are not possible in those patients, and an option for patients who will eventually need adjuvant radiotherapy.
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Affiliation(s)
| | | | - Juan A Rodriguez
- German Hospital, 1640 Pueyrredón Avenue, Buenos Aires City, C1118 AAT, Argentina
| | - Philippe Taupin
- Integra LifeSciences, 1100 Campus Road, Princeton, NJ 08540, US
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Feng R, Dan N, Chen Y, Zheng X, Huang X, Yang N, Dan W. Heparinized Collagen Scaffolds Based on Schiff Base Bonds for Wound Dressings Accelerate Wound Healing without Scar. ACS Biomater Sci Eng 2022; 8:3411-3423. [PMID: 35773184 DOI: 10.1021/acsbiomaterials.2c00434] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Skin wound healing is a complex process with multiple growth factors and cytokines participating and regulating each other. It is essential to develop novel wound dressings to accelerate the wound healing process. In this study, we developed the heparinized collagen scaffold materials (OL-pA), and the cross-linking reaction was based on the Schiff base reaction between pig acellular dermal matrix (pADM) and dialdehyde low molecular weight heparin (LMWH). Compared with pADM, the OL-pA modified by cross-linking still retained the triple helix structure of native collagen. When the dosage of the OL cross-linking agent was 12 wt %, the cross-linking density of OL-pA was 49.67%, the shrinkage temperature was 75.6 °C, the tensile strength was 14.62 MPa, the elongation at break was 53.14%, and the water contact angle was 25.1°, all of which were significantly improved compared with pADM. The cytocompatibility test showed that L929 cells adhered better on the surface of OL-pA scaffolds, and the proliferation ability of primary fibroblasts was enhanced. In vivo experiments showed that the OL-pA scaffolds could better accelerate wound healing, more effectively promote the positive expression of bFGF, PDGF, and VEGF growth factors, accelerate capillary angiogenesis, and promote wound scarless healing. In summary, the OL-pA scaffolds have more excellent hygrothermal stability, mechanical properties, hydrophilicity, and cytocompatibility. Especially the scaffolds have significant pro-healing properties for the full-thickness skin wound of rats and are expected to be a potential pro-healing collagen-based wound dressing.
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Affiliation(s)
- Rongxin Feng
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China
| | - Nianhua Dan
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China.,Research Center of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Yining Chen
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China.,Research Center of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xin Zheng
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xuantao Huang
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China
| | - Na Yang
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China
| | - Weihua Dan
- Key Laboratory of Leather Chemistry and engineering of the Education Ministry, Sichuan University, Chengdu, Sichuan 610065, China.,Research Center of Biomedical Engineering, Sichuan University, Chengdu, Sichuan 610065, China
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Cottler PS, Kang H, Nash V, Salopek L, Bruce AC, Spiller KL, Campbell CA. Immunomodulation of Acellular Dermal Matrix Through Interleukin 4 Enhances Vascular Infiltration. Ann Plast Surg 2022; 88:S466-S472. [PMID: 35502953 PMCID: PMC9289891 DOI: 10.1097/sap.0000000000003163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Acellular dermal matrix (ADM) supported implant-based reconstruction remains the most commonly performed mode of reconstruction after breast cancer. Acellular dermal matrix clinical usage has reported benefits but requires rapid and efficient vascular and cellular incorporation into the recipient to have the best outcomes. Orderly transition from M1 to M2 macrophage phenotypic profile, coordinated in part by interleukin 4 (IL-4), is an important component of vascular stabilization and remodeling. Using the ADM substrate as a delivery device for immunomodulation of macrophage phenotype holds the potential to improve integration. METHODS Interleukin 4 was adsorbed onto ADM samples and drug elution curves were measured. Next, experimental groups of 8 C57BL/6 mice had 5-mm ADM discs surgically placed in a dorsal window chamber with a vascularized skin flap on one side and a plastic cover slip on the other in a model of implant-based breast reconstruction. Group 1 consisted of IL-4 (5 μg) adsorbed into the ADM preoperatively and group 2 consisted of an untreated ADM control. Serial gross examinations were performed with histology at day 21 for markers of vascularization, mesenchymal cell infiltration, and macrophage lineage. RESULTS Drug elution curves showed sustained IL-4 release for 10 days after adsorption. Serial gross examination showed similar rates of superficial vascular investment of the ADM beginning at the periphery by day 14 and increasing through day 21. Interleukin-4 treatment led to significantly increased CD31 staining of vascular endothelial cells within the ADM over the control group (P < 0.05) at 21 days. Although vimentin staining did not indicate a significant increase in fibroblasts overall, IL-4 did result in a significant increase in expression of α-smooth muscle actin. The expression of macrophage phenotype markers Arginase1 and iNOS present within the ADM were not significantly affected by IL-4 treatment at the day 21 time point. CONCLUSIONS Acellular dermal matrix has the potential to be used for immunomodulatory cytokine delivery during the timeframe of healing. Using implanted ADM as a delivery vehicle to drive IL-4 mediated angiogenesis and vascular remodeling significantly enhanced vascularity within the ADM substrate.
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Affiliation(s)
- Patrick S. Cottler
- Department of Plastic Surgery, University of Virginia, Charlottesville, VA
| | - Hannah Kang
- Department of Plastic Surgery, University of Virginia, Charlottesville, VA
| | - Victoria Nash
- School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, PA
| | - Lisa Salopek
- Department of Plastic Surgery, University of Virginia, Charlottesville, VA
| | - Anthony C. Bruce
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA
| | - Kara L. Spiller
- School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, PA
| | - Chris A. Campbell
- Department of Plastic Surgery, University of Virginia, Charlottesville, VA
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Kim HI, Kim BS, Kim YS, Yi HS, Park JH, Choi JH, Jung SU, Kim HY. Review of 107 Oncoplastic Surgeries Using an Acellular Dermal Matrix with the Round Block Technique. J Clin Med 2022; 11:jcm11113005. [PMID: 35683394 PMCID: PMC9181173 DOI: 10.3390/jcm11113005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 02/05/2023] Open
Abstract
The round block technique (RBT) is an oncoplastic surgery method that uses volume displacement techniques after partial mastectomy. However, cosmetic problems occur after tissue rearrangement in patients with small breasts or those in whom a large amount of breast tissue is excised. Therefore, we used an acellular dermal matrix (ADM) when the volume was insufficient after tissue rearrangement. Patients who underwent breast reconstruction using the ADM with the RBT after breast-conserving surgery (BCS) were included. The ADM graft was performed in two layers. First, it was placed on the glandular flap, and the patient was then seated to ascertain the degree of deformity. If the volume was insufficient, a graft was also performed under the skin flap. Overall, 107 oncoplastic surgeries were performed. Tumors were most commonly located in the upper outer quadrant of the breast, and the mean resected breast tissue was 27.1 g. Seroma was the most common complication, but it improved with several aspirations. There were no major complications or cosmetic problems requiring reoperation. Therefore, if the ADM was used for defects that could not be reconstructed with the RBT alone, safe and cosmetically good results could be obtained.
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Affiliation(s)
- Hong-Il Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
| | - Byeong-Seok Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
| | - Yoon-Soo Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
| | - Hyung-Suk Yi
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
| | - Jin-Hyung Park
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
| | - Jin-Hyuk Choi
- Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (J.-H.C.); (S.-U.J.)
| | - Sung-Ui Jung
- Department of Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (J.-H.C.); (S.-U.J.)
| | - Hyo-Young Kim
- Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan 49267, Korea; (H.-I.K.); (B.-S.K.); (Y.-S.K.); (H.-S.Y.); (J.-H.P.)
- Correspondence: ; Tel.: +82-51-990-6131
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Song L, Luo X, Tsauo C, Shi B, Liu R, Li C. Histologic characterization of orbicularis oris muscle with a new acellular dermal matrix grafts in a rabbit model. J Tissue Eng Regen Med 2022; 16:707-717. [PMID: 35524474 DOI: 10.1002/term.3310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 11/07/2022]
Abstract
Muscular dysplasia is the key factor in influencing surgical outcomes in patients with cleft lip/palate. In this research, we attempted to evaluate a new acellular dermal matrix (ADM) as a substitute for reconstruction of the orbicularis oris muscle with growth factors such as Insulin-Like Growth Factor I (IGF-I), vascular endothelial growth factor (VEGF) in a rabbit model. 30 male New Zealand Rabbits (2-3 m, 1700-2000 g) were divided into four groups as follows; a group in which the orbicularis oris muscle of the upper lip was implanted with ADM, a group in which the orbicularis oris muscle of the upper lip was implanted with ADM + IGF-I + VEGF, a group in which the upper lip was operated without implantation of an ADM scaffold, and a normal upper lip for comparison. Macroscopic observation, histological evaluation, and immunohistochemistry were employed to evaluate levels of the muscle regeneration, vascularization, and inflammation at 1, 2, 4, 6, and 12 weeks after the operation. All wounds healed well without infection, immune rejection and so on. Histological evaluation showed that ADM was totally degraded and replaced by connective tissue. The area in which the ADM scaffold was coated with growth factors show a significant increase in the formation of new myofibers after injury, and the vascularization improved compared to the control group and the normal group. In regard to the degrees of inflammation, there were no notable differences among the groups. In conclusion, Our study indicated that ADM grafts combined with IGF-I and VEGF have potential advantages in alleviating muscular dysplasia in cleft lip treatment.
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Affiliation(s)
- Lei Song
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China.,Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Chialing Tsauo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Renkai Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Chenghao Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, Chengdu, China
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Anand S, Özbey H, Sharma S. Looking beyond the dartos fascia and tunica vaginalis: reviewing the stance of common adjuvant covering biomaterials in hypospadiology. Am J Clin Exp Urol 2022; 10:111-118. [PMID: 35528465 PMCID: PMC9077145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
Hypospadias, one of the commonest congenital anomalies in boys, can have a spectrum of clinical presentation based on the location of the meatus and the presence of chordee. The surgical repair of hypospadias involves great precision, especially in proximal varieties and redo/complex cases of hypospadias. Hypospadiologists have put in tremendous efforts to improve the outcomes of these children. The utilization of adjuvant biomaterials is one such effort that has gained significant attention over the recent years. Biomaterials are used to cover the urethral suture line in instances where the ideal covering agents (dartos fascia and tunica vaginalis) are unavailable. We reviewed the mechanism of action, current stance, and advantages/disadvantages of three commonly used adjuvant agents, i.e. autologous platelet concentrates, tissue glues, and acellular dermal matrixes. Although individual studies have highlighted the therapeutic benefits of these adjuvants, the available literature has a limited level of evidence. Moreover, it is believed that the application procedure of these covering agents needs to be scrutinized in future studies. In addition, it is suggested that the application of any covering agent right up to the meatus is non-anatomical and redundant. Well-designed randomized controlled trials with a uniform application procedure and comparing different covering agents need to be conducted in the future before any definite conclusion is drawn.
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Affiliation(s)
- Sachit Anand
- Department of Pediatric Surgery, All India Institute of Medical SciencesNew Delhi 110029, India
| | - Hüseyin Özbey
- Department of Pediatric Surgery, Division of Pediatric Urology and Andrology, I.M. Sechenov First Moscow State Medical UniversityMoscow, Russia
| | - Shilpa Sharma
- Department of Pediatric Surgery, All India Institute of Medical SciencesNew Delhi 110029, India
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