Take percentage and conditions of cultured epithelium were improved when basement membrane of the graft was maintained and anchoring mesh was added.
To achieve a higher take rate for epithelial grafts, this study investigated grafting techniques. Seventy-seven nude mice received flap grafting in which cultured human epithelium was grafted inside the flap, and 55 nude rats received transplantation of epithelium to a full-thickness skin defect. In each group, four models were studied, including model 1, in which epithelium was cultured with the conventional method; model 2, in which epithelium was cultured with fibrin gel to avoid sheet damage, then absorptive mesh was incorporated into the epithelium for anchoring to the graft bed; model 3, in which epithelium was cultured with fibrin gel and combined with absorptive mesh and artificial dermis containing fibroblasts; and model 4, in which the model 2 epithelium was grafted after artificial dermis was transplanted. The take for these models was evaluated grossly and histologically. The results show that the take percentage of models 2 and 3 was significantly higher than that of model 1 (conventional epithelium) and that there was no significant difference between model 3 (simultaneous grafting) and model 4 (two-step grafting). The difference in the take percentages of the grafts to the flap and to the full-thickness skin defect was also insignificant. In immunohistochemistry, human keratin appeared in all epidermis layers and diversification of the layer was observed in models 2, 3, and 4. In these three models, type IV collagen appeared in the basal layer and the formation of basal membrane was confirmed. These findings suggest that epithelia cultured on fibrin gel and combined with absorptive mesh could be used in a new technique for better, more stable take.
Yanaga
H
H
Department of Plastic and Reconstructive Surgery, Kurume University School of Medicine, Fukuoka, Japan. hirokoyt@med.kurume-u.ac.jp
Tai
Y
Y
Yamauchi
T
T
Mori
S
S
Udoh
Y
Y
Yamamoto
M
M
Kiyokawa
K
K
Inoue
Y
Y
D020341:Absorbable Implants; D000818:Animals; D001485:Basement Membrane / Q000166:cytology*; D021522:Bioartificial Organs; D001672:Biocompatible Materials; D003094:Collagen / Q000032:analysis; D046508:Culture Techniques / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D000078404:Epidermal Cells; D004817:Epidermis / Q000737:chemistry / Q000637:transplantation*; D004847:Epithelial Cells / Q000637:transplantation*; D005337:Fibrin; D006085:Graft Survival; D006801:Humans; D007150:Immunohistochemistry; D015603:Keratinocytes / Q000166:cytology / Q000637:transplantation; D007633:Keratins / Q000032:analysis; D008297:Male; D051379:Mice; D008819:Mice, Nude; D051381:Rats; D011923:Rats, Nude; D013524:Surgical Flaps; D013526:Surgical Mesh; D014945:Wound Healing
D001672:Biocompatible Materials; D007633:Keratins; D005337:Fibrin; D003094:Collagen