| Budget Amount *help |
¥2,400,000 (Direct Cost: ¥2,400,000)
Fiscal Year 2000: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1999: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Research Abstract |
Various types of dermal substitutes have been used for the treatment of full-thickness bum wounds to reconstruct dermal component. Acellular dermal matrix (ADM) is one of them and we reported its effectiveness as a dermal substitute (Burns 22, p182, '96). However, the mechanism of the neovascularization of grafted ADM has not been very clear. For making the ADM graft more reliable, it is important to know the factors which enhance the neovascularization of the transplanted ADM.In the present study, the factors which enhance the neovascularization process of the ADM was studied. ADM was prepared by treating human allogenic skin with Dispase and Triton X100. A split-thickness skin was harvested from Sprague-Dawley (SD) rat. Epidermal sheet was prepared by treating the split-thickness skin of SD rat with Dispase. Transplanted ADM and STSG isograft overlay were survived well. The neovascularization of the transplanted ADM was superior to that of an artificial dermal implantation. Cross-lin
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king and added serum component to ADM did not enhance the neovascularization of transplanted ADM.ADM was placed onto a rat wound and three differentt types of coverage, an epidermal sheet isograft, a split-thickness skin isograft (STIG) and a silicon sheet, were then applied to each rat. Both the overlaid epidermal sheet and the STIG successfully took on the ADM.Histologically, the ADM covered with an epidermal sheet was significantly better vascularized as compared to the ADM covered with a silicon sheet (p<0.05, by ANOVA). There were no significant differences in the degree of neovascularization between the ADM with an epidermal sheet overlay and the ADM with a STIG overlay. These results indicated that the neovascularization of the transplanted ADM was enhanced by overlaid epidermal component. According to the results, simultaneous STSG overlay and ADM implantation was studied clinically. ADM was transplanted onto debrided full thicknessbum wounds (4 cases) with STSG overlay. Both transplanted ADM and STSG were completely survived without foreign body reaction and evidence of rejection. ADM may be useful as a dermal substitute for the coverage of full thickness skin defects with thin STSG overlay. Less
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