Objective To create a method for constructing a tissue-engineered graft with self-derived bone marrow cells and heterogeneous acellular matrix.Methods The mononuclear cells were isolated from bone marrows drawn from p...Objective To create a method for constructing a tissue-engineered graft with self-derived bone marrow cells and heterogeneous acellular matrix.Methods The mononuclear cells were isolated from bone marrows drawn from piglets and cultured in different mediums including either vascular endothelial growth factor(VEGF)or platelet derived growth factor BB(PDGF-BB)to observe their expansion and differentiation.The aortas harvested from canines were processed by a multi-step decellularizing technique to erase.The bone marrow mononuclear cells cultured in the mediums without any growth factors were seeded to the acellular matrix.The cells-seeded grafts were incubated in vitro for 6 d and then implanted to the cells-donated piglets to substitute parts of their native pulmonary arteries.Results After 4 d culturing,the cells incubated in the medium including VEGF showed morphological feature of endothelial cells(ECs)and were positive to ECs-specific monoclonal antibodies of CD31,FLK-1,VE-Cadherin and vWF.The cells incubated in the medium including PDGF-BB showed morphological feature of smooth muscle cells(SMCs)and were positive to SMCs-specific monoclonal antibodies of α-SMA and Calponin.One hundred days after implantation of seeded grafts,the inner surfaces of explants were smooth without thrombosis,calcification and aneurysm.Under the microscopy,plenty of growing cells could be seen and elastic and collagen fibers were abundant.Conclusion Mesenchymal stem cells might exist in mononuclear cells isolated from bone marrow.They would differentiate into endothelial cells or smooth muscle cells in proper in vitro or in vivo environments.The bone marrow mononuclear cells might be a choice of seeding cells in constructing tissue-engineered graft.展开更多
Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined ...Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined with autoiogous展开更多
Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, t...Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.展开更多
目的探讨烧伤后期瘢痕整形儿复合植皮手术的美容效果。方法选择医院接诊的80例烧伤后期整形患儿作为研究对象,根据就诊顺序分为2组,单数为观察组,双数为对照组,各40例,均进行美容治疗,对照组使用自体中厚皮片移植治疗,观察组使用异体脱...目的探讨烧伤后期瘢痕整形儿复合植皮手术的美容效果。方法选择医院接诊的80例烧伤后期整形患儿作为研究对象,根据就诊顺序分为2组,单数为观察组,双数为对照组,各40例,均进行美容治疗,对照组使用自体中厚皮片移植治疗,观察组使用异体脱细胞真皮基质和自体中薄皮片移植治疗,术后均给予常规输液、止血、抗感染治疗。治疗3个月后,比较两组二次手术率、皮片成活率,以及两组OSAS瘢痕评价量表评分及瘢痕增生程度。结果观察组二次手术率明显低于对照组,成片成活率明显高于对照组(2.50%vs 22.50%,95.00%vs 72.50%)(P<0.05);观察组瘢痕颜色、平整度、弹性程度得分均明显优于对照组(0.47±0.07 vs 0.69±0.11,0.51±0.06 vs 0.78±0.10,0.42±0.05 vs 0.94±0.14)(P<0.05);观察组瘢痕重度增生发生率明显低于对照组(12.50%vs 42.50%(P<0.05)。结论烧伤后期瘢痕患儿使用异体脱细胞真皮基质复合自体中薄皮片的整形治疗效果显著,可有效修复瘢痕颜色、平整度、弹性程度,减轻瘢痕增生程度,恢复皮肤美观,美容效果优异。展开更多
基金Supported by Shanghai Nature Science Foundation,China(99ZB14018)
文摘Objective To create a method for constructing a tissue-engineered graft with self-derived bone marrow cells and heterogeneous acellular matrix.Methods The mononuclear cells were isolated from bone marrows drawn from piglets and cultured in different mediums including either vascular endothelial growth factor(VEGF)or platelet derived growth factor BB(PDGF-BB)to observe their expansion and differentiation.The aortas harvested from canines were processed by a multi-step decellularizing technique to erase.The bone marrow mononuclear cells cultured in the mediums without any growth factors were seeded to the acellular matrix.The cells-seeded grafts were incubated in vitro for 6 d and then implanted to the cells-donated piglets to substitute parts of their native pulmonary arteries.Results After 4 d culturing,the cells incubated in the medium including VEGF showed morphological feature of endothelial cells(ECs)and were positive to ECs-specific monoclonal antibodies of CD31,FLK-1,VE-Cadherin and vWF.The cells incubated in the medium including PDGF-BB showed morphological feature of smooth muscle cells(SMCs)and were positive to SMCs-specific monoclonal antibodies of α-SMA and Calponin.One hundred days after implantation of seeded grafts,the inner surfaces of explants were smooth without thrombosis,calcification and aneurysm.Under the microscopy,plenty of growing cells could be seen and elastic and collagen fibers were abundant.Conclusion Mesenchymal stem cells might exist in mononuclear cells isolated from bone marrow.They would differentiate into endothelial cells or smooth muscle cells in proper in vitro or in vivo environments.The bone marrow mononuclear cells might be a choice of seeding cells in constructing tissue-engineered graft.
文摘Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined with autoiogous
文摘Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.
文摘目的探讨烧伤后期瘢痕整形儿复合植皮手术的美容效果。方法选择医院接诊的80例烧伤后期整形患儿作为研究对象,根据就诊顺序分为2组,单数为观察组,双数为对照组,各40例,均进行美容治疗,对照组使用自体中厚皮片移植治疗,观察组使用异体脱细胞真皮基质和自体中薄皮片移植治疗,术后均给予常规输液、止血、抗感染治疗。治疗3个月后,比较两组二次手术率、皮片成活率,以及两组OSAS瘢痕评价量表评分及瘢痕增生程度。结果观察组二次手术率明显低于对照组,成片成活率明显高于对照组(2.50%vs 22.50%,95.00%vs 72.50%)(P<0.05);观察组瘢痕颜色、平整度、弹性程度得分均明显优于对照组(0.47±0.07 vs 0.69±0.11,0.51±0.06 vs 0.78±0.10,0.42±0.05 vs 0.94±0.14)(P<0.05);观察组瘢痕重度增生发生率明显低于对照组(12.50%vs 42.50%(P<0.05)。结论烧伤后期瘢痕患儿使用异体脱细胞真皮基质复合自体中薄皮片的整形治疗效果显著,可有效修复瘢痕颜色、平整度、弹性程度,减轻瘢痕增生程度,恢复皮肤美观,美容效果优异。
