Complete horizontal skin cell resurfacing and delayed vertical cell infiltration into porcine reconstructive tissue matrix compared to bovine collagen matrix and human dermis.
BACKGROUND
Xenogenous dermal matrices are used for hernia repair and breast reconstruction. Full-thickness skin replacement is needed after burn or degloving injuries with exposure of tendons or bones. The authors used a human skin organ culture model to study whether porcine reconstructive tissue matrix (Strattice) is effective as a dermal tissue replacement.


METHODS
Skin cells or split-thickness skin grafts were seeded onto human deepidermized dermis, Strattice, and Matriderm. Cellular resurfacing and matrix infiltration were monitored by live fluorescence imaging, histology, and electron microscopy. Proliferation, apoptosis, cell differentiation, and adhesion were analyzed by immunohistochemistry.


RESULTS
Epithelial resurfacing and vertical proliferation were reduced and delayed with both bioartificial matrices compared with deepidermized dermis; however, no differences in apoptosis, cell differentiation, or basement membrane formation were found. Vertical penetration was greatest on Matriderm, whereas no matrix infiltration was found on Strattice in the first 12 days. Uncompromised horizontal resurfacing was greatest with Strattice but was absent with Matriderm. Strattice showed no stimulatory effect on cellular inflammation.


CONCLUSIONS
Matrix texture and surface properties governed cellular performance on tissues. Although dense dermal compaction delayed vertical cellular ingrowth for Strattice, it allowed uncompromised horizontal resurfacing. Dense dermal compaction may slow matrix decomposition and result in prolonged biomechanical stability of the graft. Reconstructive surgeons should choose the adequate matrix substitute depending on biomechanical requirements at the recipient site. Strattice may be suitable as a dermal replacement at recipient sites with high mechanical load requirements.
Bremen, Hannover, and Essen, Germany From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Klinikum Bremen-Mitte, Center for Biomolecular Interactions Bremen and Collaboration Center Medicine, University of Bremen; the Department of Plastic, Hand, and Reconstructive Surgery, Hannover Medical School; and the Division of Plastic and Reconstructive Surgery, Clinic for Senologie/Breast Center, Kliniken Essen-Mitte Evang. Huyssens Stiftung/Knappschaft GmbH.
Ursula
U
Mirastschijski
Corinna
C
Kerzel
Reinhild
R
Schnabel
Sarah
S
Strauss
Karl-Heinz
KH
Breuing
D000328:Adult; D000818:Animals; D017209:Apoptosis / Q000502:physiology; D001485:Basement Membrane / Q000166:cytology / Q000502:physiology; D002417:Cattle; D002454:Cell Differentiation / Q000502:physiology; D002465:Cell Movement / Q000502:physiology; D003094:Collagen / Q000502:physiology*; D020405:Dermis / Q000166:cytology* / Q000254:growth & development; D004549:Elastin / Q000502:physiology*; D005260:Female; D005347:Fibroblasts / Q000166:cytology / Q000502:physiology; D064593:Heterografts / Q000166:cytology* / Q000254:growth & development; D006801:Humans; D015603:Keratinocytes / Q000166:cytology / Q000502:physiology; D009924:Organ Culture Techniques; D061251:Primary Cell Culture; D016038:Skin Transplantation; D013552:Swine
C532298:matriderm; D003094:Collagen; D004549:Elastin