Objective To compare the attachment and growth of fibroblasts on the different porcine accellular dermal matrix (ADM) so as to find the suitable scaffold for tissue engineering skin. Methods Fibroblasts (5×10 5) were seeded on 4 kinds of ADMs which were crosslinked with glutaraldehyde, uncrosslinked, crosslinked with glutaraldehyde and removed basement membrane, corsslinked with glutaraldehyde and then meshed. The same density fibroblasts were seeded on petri dish as a control. Cell count was done on the 1st, 3rd, 5th days after seeding. The at tachment of fibroblasts on ADM sw as observed by HE staining. Results The grow th and at tachment of fibroblasts on cro sslinked and non2meshed ADM increasedmarkedly w hen compared w ith the o thers. There w as no obvious difference betw een the group s of w ith o r w ithout basement membrane. Conclus ion The above results indicate that non2meshed and co rsslinked w ith glutaraldehyde ADM ismo re suitable fo r the at tachment and grow th of fibroblasts than the o thers and that the modified ADM can be used fo r the scaffo ld of t issue engineering skin.
【Abstract】 Objective To introduce the cl inical appl ication of heterogeneity (cattle) acellular dermal matrix(ADM)in the repair of mucosa defect otolaryngology. Methods From October 2006 to March 2007, 12 cases of mucosa defect was repaired with heterogeneity ADM after the surgery. There were 10 males and 2 females, aged 18-76 years. Defect was caused by deflection of nasal septum in 1 case, melanoma of front and midst basal is (capillary hemangioma) in 1 case, nasal vestibule angioma (T2N2M0)in 1 case, cancer of hypopharynx (T2N1M0) in 1 case, cancer of amygdale in 3 cases (2 of T2N0M0 and 1 of T3N1M0),cervical segments esophageal carcinoma in 1 case, and cancer of larynx in 4 cases (3 of T2N0M0 and 1 of T3N1M0). Results All these 12 cases were followed up for 6 months. The results of endoscope showed that heterogeneity ADM mingled with mucosa within 3 months after operation and the function was recovered. Pharynx fistula occurred in 1 case of hypopharynx cancer afterthe operation. After treatment of dressing change and antibiotics for 10 days, the wound healed, but after 2 months tumor recurred. All the patients were treated by radiation treatment. One case of amygdala cancer recurred and transferred to the neck after 2 months of radiation treatment. But 1 case of hypopharynx cancer died of massive haemorrhage after radiation treatment for 3 months. Conclusion Heterogeneity ADM can be easily obtained and it is a new method to repair mucosa defect. Theoperative procedure is easy to perform and worthwhile to be appl ied to cl inical operation.
ObjectiveTo understand the application of acellular dermal matrix (ADM) in implant-based breast reconstruction. MethodLiteratures on application of ADM in the implant-based breast reconstruction were reviewed. ResultsADM was widely used in the implant-based breast reconstruction and revisionary breast surgery. ADM could help to achieve a better reconstruction outcome by precisely locating the inferior mammary fold and strengthening the local control of the implant. However, whether ADM might increase the postoperative complications was controversial. ConclusionADM assisted implant-based breast reconstruction could achieve a better cosmetic outcome, but the large sample randomized controlled trial is needed to evaluate the application effect and risk of ADM.
Objective To evaluate the efficacy and safety of acellular dermal matrix (ADM) in preventing Frey syndrome.Methods Studies of acellular dermal matrix in preventing Frey syndrome were searched in The Cochrane Library (Issue 1, 2010), MEDLINE, EMbase, SIGLE, GreyNet, NTIS, CBMdisc, VIP, CNKI and WANFANG DATA from 1995 to 2010. All the studies were selected, extracted and evaluated by four reviewers independently, and meta-analyses were performed with RevMan 5.0.0 software. Results A total of 15 studies involving 472 participants were included in the review. The studies showed that implantation of the ADM was able to efficiently reduce the incidence of Frey syndrome, and the difference in both subjective and objective was significant between the two groups after the therapy (RR=0.11, 95%CI 0.06 to 0.18, Plt;0.01; RR=0.14, 95%CI 0.10 to 0.19, Plt;0.01). The rate of temporary facial nerve paralysis was lower than that of the control group but the difference was not significant (OR=0.78, 95%CI 0.37 to 1.66, P=0.53). The incidens of both seroma and mucocele were higher than that of the control group but the difference was not significant(OR=2.63, 95%CI 0.09 to 79.25, P=0.58) and they could be alleviated by placing drainage tube and partial pressure bandage. The incidence rate of salivary fistula was lower than that of the control group and the difference was significant (OR=0.24, 95%CI 0.08 to 0.69, P=0.009). Conclusion The result of this system review shows that, the ADM can effectively and safely reduce the incidence of Frey syndrome. To perform preoperative hypersensitivity check for iodine or iodophors, to conduct rapid frozen section for defining the character of tumor, to fix the ADM stably, to place vacuum-drainage and to make partial pressure bandage are suggested.
ObjectiveTo study the preparation method of acellular dermal matrix (ADM) for cartilage tissue engineering and analyze its biocompatibility. MethodsThe dermal tissues of the calf back were harvested, and decelluarized with 0.5% SDS, and the ADM was reconstructed with 0.5% trypsin, cross-linked with formaldehyde, and modified with 0.5% chondroitin sulfate which can promote the proliferation of chondrocytes. And the porosity, cytotoxicity, and biocompatibility were determined. Co-cultured 2nd passage chondrocytes and bone marrow stromal cells in a proportion of 3 to 7 were used as seed cells. The cells were seeded on ADM (experimental group) for 48 hours to observe the cell adhesion. The expressions of mRNA and protein of collagen type Ⅱ were tested by RT-PCR and Western blot methods, respectively. And the expressions were compared between the cells seeded on the scaffold and cultured in monolayer (control group). ResultsAfter modification of 0.5% trypsin, the surface of ADM was smooth and had uniform pores; the porosity (85.4%±2.8%) was significantly higher than that without modification (72.8%±5.8%) (t=-4.384, P=0.005). The cell toxicity was grade 1, which accords to the requirements for cartilage tissue engineering scaffolds. With time passing, the number of inflammatory cells decreased after implanted in the back of the rats (P<0.05). The scanning electron microscope observation showed that lots of seed cells adhered to the scaffold, the cells were well stacked, displaying surface microvilli and secretion. The expressions of mRNA and protein of collagen type Ⅱ were not significantly different between experimental and control groups (t=1.265, P=0.235;t=0.935, P=0.372). ConclusionThe ADM prepared by acellular treatment, reconstruction, cross-linking, and modification shows perfect characters. And the seed cells maintain chondrogenic phenotype on the scaffold. So it is a proper choice for cartilage tissue engineering.
ObjectiveTo evaluate the effectiveness of acellular dermal matrix (ADM) with autologous buccal micro mucosa and micro skin graft in vaginoplasty. MethodsA retrospective analysis was made on the clinical data of 67 patients with vaginal agenesis treated between July 2006 and June 2013. ADM and mixed particles were used in 20 cases (ADM group) and mixed particles graft in 47 cases (control group) in vaginoplasty. There was no significant difference in age between 2 groups (t=0.233, P=0.816). The depth, diameter, and volume of neovagina, epithelization time, stent needing time, and female sexual function index (FSFI) score were compared between 2 groups. ResultsThere was no significant difference in operation time and amount of bleeding between 2 groups (t=-1.922, P=0.059; t=0.398, P=0.692). The patients were followed up 11-38 months (mean, 16.08 months). Fifteen cases in ADM group and 29 cases in control group had sexual life after operation. Bleeding after operation occurred in 6 cases (2 in ADM group and 4 in control group). No stenosis was observed. Difference in epithelization time was not statistically significant (t=-1.938, P=0.057). However, the stent needing time of ADM group was significantly shorter than that of control group (t=7.020, P=0.000). The neovagina was ideal in wetness degree, smoothness, flexibility, and hairlessness during follow-up. The depth, diameter, and volume of vagina had no significant difference between 2 groups (P>0.05) at last follow-up, which were close to normal vagina. The other patients had normal sexual function except 1 patient whose FSFI score was less than 23; no statistically significant difference was found in FSFI score between 2 groups (P>0.05). ConclusionOn the basis of mixed particles grafting, the ADM could improve trestle structure for resisting contracture. The effectiveness is better than merely mixed particles graft. The procedure has satisfactory anatomical and functional results.
ObjectiveTo compare the half-year clinical efficacy of three different surgical root coverage methods including lateral sliding flap (LSF), subepithelial connective tissue graft (CTG) and acellular dermal matrix allograft (ADM). MethodsEighteen patients (24 teeth) with gingival recession treated in our hospital between December 2012 and July 2015 were selected and divided into three groups according to a certain sequence with 8 teeth in each group. The three groups of teeth were treated with LSF, CTG and ADM respectively. Gingival recession, probing depth and keratinized gingival width at both baseline and 6 months after surgery of all patients were recorded for inner- and inter-group comparison. ResultsAll three methods proved to be effective within 6 months with an awerage of 2.8-4.0 mm in decrease extent of gingival recession (P<0.01). LSF did not significantly change the probing depth (P>0.05) as the other two did (P<0.01). The differences among three surgical methods compared before and after surgery were all significant (P<0.05). ConclusionLSF, CTG and ADM are all effective surgical means for root coverage. Within 6 months, CTG presents better effects than ADM, and ADM better than LSF.