【Abstract】 Objective To evaluate the effect of autologous free fat particle grafting combined with bFGF to repairfacial depression. Methods From April 2004 to May 2006, 41 patients with facial depression were randomized into two groups (groups A and B). In group A, 12 cases were admitted from April 2004 to December 2004. There were 5 males and 7 females, aging 16-49 years (mean, 31 years). The pathological causes were congenital facial depression in 2 patients, hemifacial atrophy in 2, traumatic cicatrix in 5 and benign tumor removal in 3. The course of disease was 2-19 years. The concave regions were low (0.52 ± 0.13）cm compared to surrounding normal skin, concave area (16.0 ± 5.3）cm2. In group B, 29 cases were admitted from January 2005 to May 2006. There were 14 males and 15 females, aging 18-52 years (mean, 37 years). The pathological causes were: congenital facial depression in 3 patients, hemifacial atrophy in 4, traumatic cicatrix in 15 and benign tumor removal in 7. The course of disease was 2-20 years. The concave regions were low (0.58 ± 0.15）cm compared to surrounding normal skin, concave area (18.0 ± 6.2）cm2. Cases in group A were treated with pure autologous free fat particleinjection; cases in group B were treated with autologous free fat particle injection combined with bFGF(4 200 IU/10 mL). The cl inical outcome were comparatively analyzed between two groups after operation. Results The follow-up time was 6 to 24 months (mean, 12.5 months) in group A and 6 to 24 months (mean, 13 months) in group B. In group A, 6 patients achieved satisfactory cl inical effect after one injection of fat particle, the satisfactory rate of one therapy being 50%; other 6 cases were required reinjection of fat particle 6-12 months postoperatively, of which two-time injections in 3 cases, three-time injections in 3 cases. In group B, 24 patients achieved satisfactory cl inical effect after one injection of fat particle, the satisfactory rate of one therapy being 82.8%; only 5 cases were required reinjection one year postoperatively. There was statistically significant difference in the satisfactory rate of one injection between two groups (P lt; 0.05). Conclusion Autologous free fat particle grafting combined with bFGF to treat facial depression can acquire satisfactory cl inical effect, which is a safe and effective method.
Objective To review the latest research progress of full-thickness tissue engineered skin (FTTES), to thoroughly understand its current state of research and appl ication so as to lay a sol id foundation for developing new type FTTES and improving the qual ity of skin substitutes. Methods Domestical and international l iterature concerning FTTES in recent years was extensively reviewed and comprehensively analyzed. Results Some progress of FTTES had made in seedcells, scaffold materials and construction, and some therapeutic efficacy had also been achieved in cl inical appl ication. ButFTTES grafting successful rate was lower, and it had no complete skin structure and had not reached the requirements of cl inicalappl ication. Conclusion FTTES is an ideal skin substitute and has great development prospects. However, in seed cells, scaffold materials, construction and appl ications of FTTES, further studied is still needed.
Objective To summarize the research progress of biological characteristics and advantages of Wharton’s jelly-mesenchymal stem cells (WJ-MSCs). Methods The related l iterature on the biological characteristics of WJ-MSCs,umbil ical cord blood MSCs (UBMSCs) and bone marrow MSCs (BMSCs) was extensively reviewed and analyzed. Results A large number of MSCs which are able to self-repl icate, self-renew and have high prol iferation and multipotent differentiation can be isolated from the Wharton’s jelly of umbil ical cord. WJ-MSCs have many advantages in isolation time, isolation efficience, expansion time, passage capacity, expansion capacity when compared with UBMSCs and BMSCs. Conclusion WJ- MSCs have numerous advantages of convenient and abundant sources, relatively pure, non-ethical issues, and so on, which can be used for cell transplant therapy, gene therapy, and the ideal seed cells of building tissue engineered organ, so they provide new ideas for tissue regeneration repair and reconstruction.
Objective To prepare and study the biocompatibil ity of selectively decellular xenoskin which has the character of the lower antigen, continuous epidermis, and the dermal matrix without any cellular components. Methods The porcine skin was treated with glutaraldehyde solution, trypsin, and detergent solution TritonX-100 to prepare the selectivelydecellular xenoskin. The cytotoxicity was tested according to GB/T16886.5-2003 biological evaluation of medical devices for in vitro cytotoxicity, and the levels of cytotoxicity were evaluated with the United States Pharmacopeia. Subdermal implantation was tested according to GB/T16886.6-1997 biological evaluation of medical devices for local effects after implantation. Seventytwo mature Wistar rats were randomly assigned to groups A, B, and C (n=24). Three kinds of materials were implanted into subcutaneous of rats back. Selectively decellular xenoskin was transplanted into group A, fresh porcine skin was transplanted into group B, and allogeneic skin was transplanted into group C. The samples were collected to make the observation of gross and histology after 1, 2, 4, 8, 12, and 16 weeks. Results The cytotoxicity was proved to be first grade by biocompatibil ity test. The gross and histological observation of subdermal implantation: after implantation, the most severe inflammatory reactions were seen in group B which dispersion was very slow. Inflammatory reactions in groups A and C alleviated gradually. In groups A and C, there was an increased collagen fiber density and angiogenesis at late stage; the transplanted skin was gradually degraded and absorbed. In group B, no obvious degradation and absorption were observed. Conclusion Selectively decellular xenoskin, prepared with glutaraldehyde solution, trypsin, and detergent solution, possesses characteristics of integral skin structure andexcellent biocompatibil ity, so it can be used as a new type substitute to repair the burn wound.
Objective To evaluate the cl inical effect and the pathological characteristics of acellular allogeneic dermal matrix in repairing unstable burn scar. Methods From January 2007 to June 2008, 19 cases of unstable burn scars (24 parts) were treated, including 16 males (20 parts) and 3 females (4 parts) with a median age of 27 years (range, 3-58 years). Theinjury was caused by flame (14 cases, 18 parts), electricity (4 cases, 5 parts), and hot water (1 case, 1 part). The unstable burn scars located on hands (8 cases), forearms (2 cases), thighs (3 cases), legs (2 cases), feet (2 cases), chest (1 case), and abdomen (1 case). Scar formed for 3 months to 1 year. The area of defect varied from 7 cm × 5 cm to 22 cm × 15 cm after scar removal. Defects were covered with acellular allogeneic dermal matrix and autogenous spl it-thickness skin graft. At 6-18 months after operation, the pathological observations of the epidermis, the basal membrane, and structural components of the dermis were done. Results All wounds healed by first intention. Scar ulcer disappeared completely in 18 cases and the composite skin grafts all survived. Some bl isters occurred in 1 case and were cured after dressing changing. All patients were followed up 10 months to 2 years (18 months on average). The grafted-skin was excellent in the appearance, texture, and elasticity. The function recovered well. Only superficial scar was observed at skin donor sites. Pathological observation showed that the epidermis and the basal membrane of the skin grafts were similar to that of normal skin, and no significant difference was found in newly capillaries between them. Collagen fibers arranged regularly, and there were few inflammatory cells in the matrix. Conclusion Acellular allogeneic dermal matrix with autogenous spl it-thickness skin graft may effectivly repair the wound after removing the unstable burn scar, and its structure is similar to that of normal skin.