title: Evaluation of a biodegradable matrix containing cultured human fibroblasts as a dermal replacement beneath meshed skin grafts on athymic mice.
abstract: Meshed, expanded split-thickness skin grafts (MSTSG) frequently achieve poor results when used to cover full-thickness wounds. Poor cosmetic and functional results occur in part because the epithelium that grows across the skin graft interstices lacks a dermis. We used a living dermal replacement composed of either polyglycolic acid (PGA) or polyglactin-910 (PGL) mesh containing confluent, cultured human fibroblasts. These grafts were applied to full-thickness wounds on athymic mice; widely expanded, 3:1 ratio human MSTSG was then placed over the dermal graft. Histologic examination of wounds during a 99-day period after graft placement showed that PGA/PGL-fibroblast grafts vascularized to the wound, and the MSTSG simultaneously vascularized to the PGA/PGL-fibroblast graft. Epithelialization from the MSTSG bridges proceeded rapidly across the surface of the PGA/PGL-fibroblast grafts, resulting in an epithelialized layer that covered a densely cellular substratum that resembled dermis. Basement membrane formation at the dermal-epidermal junction of the epithelialized interstices was confirmed by immunohistochemical microscopy. Minimal inflammatory reaction to the PGA/PGL-fibroblast grafts was seen. Grafts composed of PGA or PGL biodegradable meshes combined with cultured fibroblasts vascularize in full-thickness wounds, resulting in formation of organized tissue beneath the epithelialized surface that resembles dermis.
authors.affiliation: Department of Surgery, University of California, San Diego 92103.
authors.forename: J F
authors.initials: JF
authors.lastname: Hansbrough
authors.forename: M L
authors.initials: ML
authors.lastname: Cooper
authors.forename: R
authors.initials: R
authors.lastname: Cohen
authors.forename: R
authors.initials: R
authors.lastname: Spielvogel
authors.forename: G
authors.initials: G
authors.lastname: Greenleaf
authors.forename: R L
authors.initials: RL
authors.lastname: Bartel
authors.forename: G
authors.initials: G
authors.lastname: Naughton
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D001673:Biodegradation, Environmental; D005347:Fibroblasts / Q000502:physiology; D006801:Humans; D051379:Mice; D008819:Mice, Nude; D011098:Polyglactin 910; D011100:Polyglycolic Acid; D012879:Skin Physiological Phenomena; D016038:Skin Transplantation / Q000379:methods* / Q000502:physiology; D014183:Transplantation, Heterologous / Q000379:methods / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D011100:Polyglycolic Acid; D011098:Polyglactin 910