title: Polyurethane membrane/knitted mesh-reinforced collagen-chitosan bilayer dermal substitute for the repair of full-thickness skin defects via a two-step procedure.
abstract: The advent of dermal substitutes provides a revolutionary strategy for the repair and reconstruction of deep skin defects. Dermal substitutes form a regenerative template that provides the porous structure and mechanical support necessary to guide cell migration, deposition of the extracellular matrix (ECM) and angiogenesis. Commercially available dermal substitutes, particularly collagen-based dermal scaffolds, are widely used in clinical practice. However, the poor mechanical properties of collagen-based dermal scaffolds compromise their biological effects, as well as the repair outcomes. Here, we describe a bilayer dermal substitute prepared by integrating a hybrid dermal scaffold with a polyurethane (PU) membrane to obtain a PU membrane/knitted mesh-reinforced collagen-chitosan bilayer dermal substitute (PU-PLGAm/CCS). The morphology of PU-PLGAm/CCS was investigated and, to characterize the effects of PU-PLGAm/CCS on tissue regeneration, dermal substitutes were transplanted to repair full-thickness skin wounds in Sprague-Dawley rats using a two-step surgical procedure. These results were then compared with those obtained using the PELNAC™ Artificial Dermis. In the weeks after the first operation, wound changes were analysed based on macroscopic observations, and tissue specimens were harvested for histology, immunohistochemistry, immunofluorescence real-time quantitative PCR, and Western blotting analysis. Following the second operation (i.e., transplantation of split-thickness skin grafts), the repair outcomes were investigated based on the mechanical strength and ECM expression. PU-PLGAm/CCS significantly inhibited wound contracture, promoted angiogenesis, and facilitated the ordered arrangement of neotissue, such that the repair outcomes were improved in the PU-PLGAm/CCS group compared with the PELNAC™ group. In conclusion, the favourable microstructure and structural stability of dermal substitutes facilitated tissue regeneration. PU-PLGAm/CCS achieved a balance between porous structure, biocompatibility and mechanical properties for dermal regeneration by integrating the advantages of biological and synthetic biomaterials, which demonstrates its potential for skin tissue engineering.
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Xingang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Pan
authors.initials: P
authors.lastname: Wu
authors.affiliation: Research Institute of Medical Dressing of Zhejiang, Shaoxing 312035, China.
authors.forename: Xiuyuan
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Chuangang
authors.initials: C
authors.lastname: You
authors.affiliation: Department of Biomedical Engineering, Jinan University, Guangzhou 510632, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Guo
authors.affiliation: Department of Hand Surgery, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.
authors.forename: Haifei
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Songxue
authors.initials: S
authors.lastname: Guo
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Hanlei
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chaoheng
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China.
authors.forename: Yuanhai
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China. Electronic address: hanchunmao1@126.com.
authors.forename: Chunmao
authors.initials: C
authors.lastname: Han
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry / Q000494:pharmacology; D001696:Biomechanical Phenomena; D002417:Cattle; D048271:Chitosan / Q000737:chemistry*; D003094:Collagen / Q000737:chemistry*; D019344:Lactic Acid / Q000737:chemistry*; D008297:Male; D008567:Membranes, Artificial; D011100:Polyglycolic Acid / Q000737:chemistry*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011140:Polyurethanes / Q000737:chemistry*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012867:Skin / Q000166:cytology* / Q000187:drug effects / Q000378:metabolism; D017768:Skin, Artificial; D023822:Tissue Engineering
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011140:Polyurethanes; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D003094:Collagen; D048271:Chitosan
keywords: Angiogenesis; Dermal substitutes; Knitted mesh; Mechanical properties; Regeneration