title: In vitro reconstructed dermis implanted in human wounds: degradation studies of the HA-based supporting scaffold.
abstract: The objective of the present study was to demonstrate the safety and efficacy of a dermal replacement for cutaneous wounds of diverse origin. Autologous fibroblasts were cultured in fleece scaffolds made from benzyl esters of hyaluronic acid and applied onto cutaneous lesions. The cases presented are (1) skin removal for multiple epithelioma and (2) chronic deep decubitus ulcer. Dermal-like tissue applied by the surgeon elicited no adverse reactions, and was fully integrated and well-vascularized by 1-3 weeks. In Case 1, the material was fully integrated after 1 week, and after 3 weeks an epidermal autograft was overlaid which showed good take with excellent integration observed after 4 weeks. At 12 months, skin demonstrated visual normo-elastic properties and no signs of excessive scarring. In Case 2, 2-3 weeks after the dermal implant was applied, the wound was invaded with granulation tissue and healing occurred by secondary intention. The ulcer was healed by 8 weeks, with the biomaterial completely resorbed and a complete re-epithelialization over the dermal-like tissue. These results suggest that autologous fibroblast culture in hyaluronan-derived scaffolds may be successfully grafted in diverse cutaneous pathologies and constitute a suitable bed for further epidermal implantation.
authors.affiliation: Clinic of Plastic Surgery, Sant'Anna Hospital, Ferrara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Galassi
authors.forename: P
authors.initials: P
authors.lastname: Brun
authors.forename: M
authors.initials: M
authors.lastname: Radice
authors.forename: R
authors.initials: R
authors.lastname: Cortivo
authors.forename: G F
authors.initials: GF
authors.lastname: Zanon
authors.forename: P
authors.initials: P
authors.lastname: Genovese
authors.forename: G
authors.initials: G
authors.lastname: Abatangelo
mesh_terms: D020341:Absorbable Implants; D001672:Biocompatible Materials; D001673:Biodegradation, Environmental; D002277:Carcinoma / Q000601:surgery; D018929:Cell Culture Techniques / Q000295:instrumentation*; D002478:Cells, Cultured; D002921:Cicatrix / Q000517:prevention & control; D004548:Elasticity; D005109:Extracellular Matrix; D005153:Facial Neoplasms / Q000601:surgery; D005347:Fibroblasts / Q000637:transplantation; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000601:surgery; D003668:Pressure Ulcer / Q000601:surgery; D012449:Safety; D016038:Skin Transplantation; D017768:Skin, Artificial; D014182:Transplantation, Autologous; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; C086358:hyaluronic acid benzyl ester; D006820:Hyaluronic Acid