Acellular dermal matrix contributes to epithelialization in patients with chronic sinusitis

2019 ◽  
Vol 33 (8) ◽  
pp. 1053-1059
Author(s):  
Zhong Bing ◽  
Liu Feng ◽  
Chun-Shu Wu ◽  
Jin-Tao Du ◽  
Ya-Feng Liu ◽  
...  
Keyword(s):  
Chronic Sinusitis ◽  
Acellular Dermal Matrix ◽  
Gelatin Sponge ◽  
Matrix Group ◽  
Control Group ◽  
Nasal Surgery ◽  
Dermal Matrix ◽  
Mucosal Repair ◽  
Matrix Groups ◽  
Acellular Dermal

Background Nasal endoscopic surgery is widely used for nasal diseases, including sinusitis and tumors. However, scar hyperplasia, nasal irritation, scab, and nasal obstruction delay nasal mucosal recovery, with prolonged cleaning exacerbating the patient's financial burden. Here, we presented a novel approach for the treatment of nasal mucosal defects, termed acellular dermal matrix. Methods A total of 31 patients with bilateral chronic sinusitis (maxillary sinusitis and ethmoid sinusitis) underwent nasal surgery and nasal mucosal repair in September–October 2016. We divided the nasal cavities of each patient into control and acellular dermal matrix groups, randomly selected one side for nasal mucosal repair by surgery. A suitable acellular dermal matrix size was selected according to the defect in each patient. After pruning, the acellular dermal matrix was placed on the wound surface and filled with gelatin sponge. All patients were followed up for 14 weeks to compare nasal mucosal epithelialization between the control and acellular dermal matrix groups. Results：No obvious complications and adverse reactions were observed after nasal surgery. Lund-Kennedy scores in the acellular dermal matrix group were significantly decreased compared with the control group at 8 (0 (0, 1) vs. 2 (2, 4); P<0.05) weeks. Epithelialization time of eight weeks in the acellular dermal matrix groups was significantly decreased than the control group of 14 weeks. Conclusion Acellular dermal matrix provides a growth framework for the healthy mucosa on the wounded surface and reduces postoperative epithelialization time.

scholarly journals Evaluation of lymphangiogenesis in acellular dermal matrix

2014 ◽  
Vol 47 (03) ◽  
pp. 318-324 ◽  
Author(s):  
Mario Cherubino ◽  
Igor Pellegatta ◽  
Federico Tamborini ◽  
Michele Cerati ◽  
Fausto Sessa ◽  
...  
Keyword(s):  
Wound Healing ◽  
Endothelial Cells ◽  
Cell Invasion ◽  
Acellular Dermal Matrix ◽  
Wound Contraction ◽  
Control Group ◽  
Dermal Substitute ◽  
Dermal Matrix ◽  
Microscopic Evaluation ◽  
Acellular Dermal

ABSTRACT Introduction: Much attention has been directed towards understanding the phenomena of angiogenesis and lymphangiogenesis in wound healing. Thanks to the manifold dermal substitute available nowadays, wound treatment has improved greatly. Many studies have been published about angiogenesis and cell invasion in INTEGRA®. On the other hand, the development of the lymphatic network in acellular dermal matrix (ADM) is a more obscure matter. In this article, we aim to characterize the different phases of host cell invasion in ADM. Special attention was given to lymphangiogenic aspects. Materials and Methods: Among 57 rats selected to analyse the role of ADM in lymphangiogenesis, we created four groups. We performed an excision procedure on both thighs of these rats: On the left one we did not perform any action except repairing the borders of the wound; while on the right one we used INTEGRA® implant. The excision biopsy was performed at four different times: First group after 7 days, second after 14 days, third after 21 days and fourth after 28 days. For our microscopic evaluation, we used the classical staining technique of haematoxylin and eosin and a semi-quantitative method in order to evaluate cellularity counts. To assess angiogenesis and lymphangiogenesis development we employed PROX-1 Ab and CD31/PECAM for immunohistochemical analysis. Results: We found remarkable wound contraction in defects that healed by secondary intention while minor wound contraction was observed in defects treated with ADM. At day 7, optical microscopy revealed a more plentiful cellularity in the granulation tissue compared with the dermal regeneration matrix. The immunohistochemical process highlighted vascular and lymphatic cells in both groups. After 14 days a high grade of fibrosis was noticeable in the non-treated group. At day 21, both lymphatic and vascular endothelial cells were better developed in the group with a dermal matrix application. At day 28, lymphatic endothelial cells had organized themselves, engineering the pseudocylindrical structure better disposed in the ADM group than in the control group, and the lymphatic cells were detectable inside the vessels’ lumen in this group. Conclusion: This study has made it possible to demonstrate the absolute importance of an ADM in proper wound healing and has shown better definition of both the qualitative and quantitative aspects of lymphangiogenesis compared to the second intention healing. A major grade of organization of the extracellular matrix and a minor grade of fibrosclerosis in ADM allowed a well-structured morphologic and functional development of the endothelial and lymphatic vascular structures. This study hopes to represent a clinical basis for a wider use of ADM in lesions where lymphatic complications are common.

scholarly journals The Utility of Novel Fish-Skin Derived Acellular Dermal Matrix (Kerecis) as a Wound Dressing Material

2021 ◽  
Vol 17 (1) ◽  
pp. 39-47
Author(s):  
Tae Hyung Kim ◽  
Jun Ho Park ◽  
Hyun Gyo Jeong ◽  
Syeo Young Wee
Keyword(s):  
Wound Healing ◽  
Healing Rate ◽  
Computer Software ◽  
Acellular Dermal Matrix ◽  
Control Group ◽  
Omega 3 ◽  
Dermal Matrix ◽  
Burn Wounds ◽  
Novel Material ◽  
Acellular Dermal

Background: The newly-approved Kerecis is a piscine acellular dermal xenograft. This piscine acellular dermal matrix (ADM) has specific bioactive lipid mediators, omega-3 polyunsaturated fatty acids, and has a positive effect on the process of wound healing. This study aimed to explore the utility of this novel material by comparing healing rates, and suggest the proper timing for applying Kerecis.<br/>Methods: Patients who visited the hospital with acute or chronic deep dermal wounds from June 2019 to May 2020 were enrolled in the study. A total of 48 patients were assessed. All wounds in the experimental group (n=16) were treated only once with Kerecis and a non-adherent absorptive foam material (Therasorb) to cover the ADM. In the control group, daily conventional dressings were provided. All wounds sizes were measured with mass-market computer software in a method suggested by the authors for the first time.<br/>Results: The mean healing rate proved to be faster in the Kerecis group (P<0.05) versus the control group, and no complications were observed. It was statistically proved that treating burn wounds with the ADM showed better healing rates than the conventional method (P<0.05).<br/>Conclusion: This study establishes that managing wounds with the ADM is likely to heal wounds faster than traditional dressings. In addition, for burn wounds, a prolonged application (10 days vs. 5 days after the onset) showed a better wound healing rate (98.8%±2.5% vs. 67.0%±14.3%, respectively, P=0.029).

scholarly journals Clinical and Histological Differences between Guided Tissue Regeneration with Acellular Dermal Matrix of Porcine Origin and Autologous Connective Tissue: An Animal Study

Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 272
Author(s):  
Javier Aragoneses ◽  
Ana Suárez ◽  
Cinthia Rodríguez ◽  
Juan Manuel Aragoneses
Keyword(s):  
Connective Tissue ◽  
Acellular Dermal Matrix ◽  
Control Group ◽  
Dermal Matrix ◽  
A Value ◽  
Keratinized Tissue ◽  
Sus Scrofa Domestica ◽  
Acellular Dermal ◽  
Porcine Origin ◽  
Keratin Layer

This research aims to evaluate the clinical and histological parametric differences concerning keratinized tissue that result from two regeneration techniques, the subepithelial autologous connective tissue graft (ACTG) and the acellular dermal matrix (MD) of porcine origin, performed on surgical beds on edentulous spaces in an animal model. The parameters of the MD and ACTG groups were compared with samples of the control group (CG) after 15, 45, and 90 days. Nine female white pigs (Sus scrofa domestica) were used, and each animal provided 20 study areas (12 MD and 8 ACTG). At 15 days, the keratin layer thickness in the MD group was greater than those of the ACTG (25.27 vs. 19.95 μm) and the CG (21.2 μm). After 45 days, the MD and ACTG thickness values decreased but were higher than the CG. At 90 days, MD (19.46 μm) obtained a value close to that of CG, and the ACTG decreased to CG (15.53 μm, p < 0.001). The use of an MD may be a viable alternative to the ACTG because of its ability to provide increased keratinized tissue in comparison to the ACTG.

scholarly journals Outcome Assessment According to the Thickness and Direction of the Acellular Dermal Matrix after Implant-Based Breast Reconstruction

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Joon Hur ◽  
Hyun Ho Han
Keyword(s):  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Surgical Outcomes ◽  
Acellular Dermal Matrix ◽  
Demographic Variables ◽  
Matrix Group ◽  
Complication Rates ◽  
Related Factors ◽  
Dermal Matrix ◽  
Acellular Dermal

Purpose. The acellular dermal matrix plays an important role in reinforcing thin mastectomy skin and repositioning the implant in prosthetic breast reconstruction. As the concept of prepectoral plane has become widespread, the role of the acellular dermal matrix has become increasingly important. However, evidences and standards for appropriate thickness and direction during placement remain insufficient. This study is aimed at testing the assumption that differences in the acellular dermal matrix thickness and orientation during placement may affect surgical outcomes including the incidence of postoperative complications. Methods. This was a retrospective single-centered analysis of 43 patients (50 breasts) who underwent implant-based reconstruction with MegaDerm® (L&C Bio, Seoul, Korea) and 23 patients (23 breasts) who underwent implant-based reconstruction with DermACELL® (LifeNet Health, Virginia Beach, VA, USA), two types of human-derived acellular dermal matrix. All surgeries were performed by a single surgeon. Demographic variables, surgery-related factors, and complications were compared between a thick matrix group (1.5–2.3 mm) and a thin matrix group (1.0–1.5 mm). The same processes were performed in the nonreverse and reverse matrix insertion groups. Results. Baseline demographics and surgery-related data were summarized according to matrix thickness and direction. There were no significant intergroup differences in the demographic variables such as history of smoking, radiation, or chemotherapy. The mean drain volume was significantly higher in the thick matrix group than that in the thin matrix group ( p = 0.0445 ). However, there were no significant differences in overall complication rates by matrix thickness ( p = 0.3139 ). Additionally, there were no significant differences in complications between the nonreverse and reverse matrix insertion groups ( p = 0.538 ). Conclusion. Our findings suggest that patients with a thick acellular dermal matrix need a prolonged period for engraftment. However, the thickness did not directly affect the surgical outcomes between the thick and thin matrix groups. Likewise, the orientation in which the acellular dermal matrix was inserted did not affect the surgical outcomes including postoperative complications.

scholarly journals Effects of acellular dermal matrix on the prevention of complications and esthetic outcome after parotidectomy: A propensity score matched analysis

2021 ◽  
pp. 014556132110581
Author(s):  
Jian-Hui Wu ◽  
Wei Zeng ◽  
Min-Yi Fu ◽  
Fei Ye
Keyword(s):  
Clinical Study ◽  
Propensity Score ◽  
Acellular Dermal Matrix ◽  
Control Group ◽  
Frey’S Syndrome ◽  
Dermal Matrix ◽  
Frey's Syndrome ◽  
Acellular Dermal

Objective The present study was designed to investigate whether acellular dermal matrix (ADM) grafts could prevent Frey’s syndrome (FS) and improve esthetic scores following parotidectomy. Methods From January 2015 to December 2019, 175 patients underwent parotidectomy. We divided the patients into two groups: the ADM group and the control group. We included in each group 30 patients according to a propensity score matched analysis. Results FS was subjective in 1 patient (3%) from the ADM group and 9 patients (30%) from the control group ( P=0.015). Patients in the ADM group had a subjective esthetic score of 6.1 + 1.7 compared with 5.2 + 1.7 in the control group. The subjective esthetic score for patients in the ADM group was higher than that for patients in the control group ( P =0.040). Conclusion The present clinical study suggests that ADM grafts are effective in preventing FS and improving esthetic scores after parotidectomy.

Xenogenic (porcine) Acellular Dermal Matrix Promotes Growth of Granulation Tissues in the Wound Healing of Fournier Gangrene

2015 ◽  
Vol 81 (1) ◽  
pp. 92-95 ◽  
Author(s):  
Zhaoxin Zhang ◽  
Lei Lv ◽  
Masut Mamat ◽  
Zhao Chen ◽  
Zhitao Zhou ◽  
...  
Keyword(s):  
Acellular Dermal Matrix ◽  
Control Group ◽  
Preparation Time ◽  
Dermal Matrix ◽  
Wound Debridement ◽  
Fournier Gangrene ◽  
Hospitalization Period ◽  
Porcine Acellular Dermal Matrix ◽  
Wound Bed Preparation ◽  
Acellular Dermal

This article investigates the application values of Xenogenic (porcine) acellular dermal matrix (XADM) in preparation of a Fournier gangrene wound bed. Thirty-six consecutive cases of patients with Fournier gangrene between 2002 and 2012 were enrolled in our department of our hospital. The patients were divided into two groups according to different methods of wound bed preparation after surgical débridement, including the experimental group (17 cases) and the control group (19 cases). The wounds in the experimental group were covered with XADM after surgical wound débridement, whereas the wounds were cleaned with hydrogen peroxide and sodium hypochlorite solution (one time/day) in the control group. The wound bed preparation time and hospital stay were then compared in the two groups. The wound preparation time was 13.64 ± 1.46 days and hospitalization period was 26.06 ± 0.83 days in the experimental XADM group. In the control group, the wound bed preparation time and hospitalization period were 22.37 ± 1.38 and 38.11 ± 5.60 days, respectively. The results showed statistical differences between these two groups. When used in wound débridement after Fournier gangrene, XADM protects interecological organizations, promotes the growth of granulation tissues, and maximally retains function and morphology of the perineum and penis.

scholarly journals Effects of allogeneic mouse adipose-derived mesenchymal stem cell-microporous sheep acellular dermal matrix on healing of wound with full-thickness skin defect in mouse and the related mechanism

2019 ◽  
Vol 6 (2) ◽  
pp. 26
Author(s):  
Shengjun C ◽  
Lingfeng W ◽  
Te B ◽  
Xue F ◽  
Fang L ◽  
...  
Keyword(s):  
Wound Healing ◽  
Granulation Tissue ◽  
Acellular Dermal Matrix ◽  
Control Group ◽  
Skin Defect ◽  
Full Thickness ◽  
Dermal Matrix ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Acellular Dermal

Objective: To explore the effects of allogeneic mouse adipose-derived mesenchymal stem cell (ADSC)-microporous sheep acellular dermal matrix (ADM) on wound healing of full-thickness skin defect in mice and the related mechanism.Methods: One Kunming mouse was sacrificed by cervical dislocation to collect adipose tissue from the inguinal region. Mouse ADSCs were isolated from the adipose tissue and cultured in vitro. Cells in the third passage were identified by cell adipogenic and osteogenic differentiation. The expressions of CD34, CD73, CD90, and CD105 were analyzed by flow cytometer. After one sheep was sacrificed with the skin of its back cut off, microporous sheep ADM was prepared by using acellular processing and freeze-thaw method. A round and full-thickness skin defect wound, with a diameter of 12 mm, was made on the back of each of 36 Kunming mice. The wounds were covered by microporous sheep ADM. The mice were divided into ADSC group and control group with 18 mice in each group according to the random number table method after surgery. A volume of 0.2 ml of DMEM/F12 culture medium containing 1 × 106 ADSCs was injected between microporous sheep ADM and the wound of each mouse in ADSC group, while 0.2 ml of DMEM/F12 culture medium was injected between microporous sheep ADM and the wound of each mouse in control group. At post-surgery day (PSD) 12 and 17, the wound healing rate in each group was calculated respectively; wound vascularization in 2 groups of mice was observed under the reverse irradiation of back light; and the granulation tissue in the wound in ADSC group was observed by means of hematoxylin-eosin staining. At PSD 7, the thickness of the granulation tissue in the wound was measured in each group of mice. At PSD 12 and 17, the immunohistochemical method was used to detect the expression of VEGF in each group of mice. The number of samples was 6 in each group at each time point in the above experiments. The data obtained were processed with t-test and factorial design ANOVA.Results: (1) After 7 days of adipogenic induction, red lipid droplets were observed in the cytoplasm with oil red O staining. After 21 days of osteogenic induction, black calcium deposition was observed in the medium stained with silver nitrate. The expression levels of CD73, CD90, CD 105 and CD34 in cells were 97.82%, 99.32%, 97.35% and 5.88% respectively. The cells were identified as ADSCs. (2) The wound healing rates of ADSC group at PSD 12 and 17 [(78 ± 6)%, (98 ± 3)%] were significantly higher than those of control group at PSD 12 and 17 [(60 ± 9)%, (90 ± 4)%, t = 4.26, 4.46, p< .01]. (3) At PSD 7, no vessels obviously grew into the center of the wound in both groups of mice, while the granulation tissue already covered the wound in ADSC group. At PSD 12, the wound in ADSC group was more well-perfused than control group. At PSD 17, it was observed that large vessels were crossing through the whole wound in ADSC group, while large vessels were observed without crossing through the whole wound in control group. (4) In ADSC group, at PSD 7, the wound was covered with thin granulation tissue, and the granulation tissue was obviously thickened at PSD 12. At PSD 17, the granulation tissue was covered by epidermis. At PSD 7, the thickness of the granulation tissue in the wound in ADSC group [(0.62 ± 0.05) mm] was significantly greater than that in control group [(0.31 ± 0.04) mm, t = 12.27, p < .01]. (5) At PSD 12 and 17, the expression levels of VEGF in the wound in ADSC group [(80.7 ± 2.2), (102.8 ± 2.6)/mm2] were significantly than those in control group [(59.5 ± 2.4), (81.5 ± 2.6)/mm2, t = 15.95, 14.14, p < .01].Conclusions: Allogeneic mouse ADSC-microporous sheep ADM can promote angiogenesis and the growth of granulation tissue in the wound with full-thickness skin defect in mice, thus accelerating wound healing. The mechanism is probably related with the increase in the expression of VEGF.

scholarly journals The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

2021 ◽  
Author(s):  
Hossein Abdali ◽  
Mohammad Ali Hoghooghi ◽  
Shirin Fattahpour ◽  
Fatemeh Derakhshandeh ◽  
Farnoosh Mohtashampour ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Acellular Dermal Matrix ◽  
Fistula Formation ◽  
Control Group ◽  
Dermal Matrix ◽  
Surgical Infection ◽  
And Control ◽  
Acellular Dermal ◽  
Positive Results ◽  
Intravelar Veloplasty

Abstract BackgroundAcellular Dermal Matrix graft is usually used to repair fistulas following a cleft palate and has had positive results. But its use for primary palatoplasty has been less studied. Our aim was to compare the usefulness of using Acellular Dermal Matrix transplantation for primary palatoplasty with intravelar veloplasty in contrast to its lack of useMaterials and methodsA total of 72 children (6 months to 6 years old) with cleft palate were included in the study. The case-control prospective observations were conducted. A group underwent primary palatoplasty with intravelar veloplasty using Acellular Dermal Matrix and the control group had the same surgery without using Acellular Dermal Matrix. Patients were monitored for fistula formation, post-operative infection, and ulcers.ResultsNo post-surgical infection and wound opening was seen in any group. In the recipients of Acellular Dermal Matrix and control group three and six fistula was reported in which patients had soft and hard palate involvement and the cleft with length greater than 15 mm.ConclusionsConsidering the double incidence of fistulas in the control group compared to the ADM recipient, it seems that the use of ADM can be effective in reducing the incidence of fistulas. Since fistula is one of the complications of primary palatoplasty surgery and leads to secondary surgeries, the use of ADM can be helpful.

Preventing postoperative adhesions after hand tendon repair using acellular dermal matrix

2021 ◽  
Vol 30 (11) ◽  
pp. 890-895
Author(s):  
Hyung Sup Shim ◽  
Kyeong Soo Park ◽  
Sang Wha Kim
Keyword(s):  
Range Of Motion ◽  
Tendon Repair ◽  
Acellular Dermal Matrix ◽  
Tendon Injury ◽  
Interphalangeal Joint ◽  
Control Group ◽  
Dermal Matrix ◽  
Active Motion ◽  
Significant Difference ◽  
Acellular Dermal

Aims: Postoperative tendon adhesions contribute to functional disability and reconstructive failure. In this study, we present the long-term outcomes of a prospective study in which acellular dermal matrix (ADM) was used to prevent postoperative adhesion after tendon injury. Methods: The study was conducted between March 2014 and February 2017. Patients, aged 19–65 years, with an acute single flexor tendon injury in zones 1 or 2, distal to the palmar digital crease were candidates for the study. Patients were allocated to either an ADM treatment group or a control group without ADM treatment. Results: A total of 37 patients were enrolled in the study: 21 patients in the ADM group and 16 patients in the control group. At six months after surgery, the range of motion in the proximal interphalangeal joint was 81.0±5.1 degrees in the ADM group and 75.8±6.9 degrees in the control group. The range of motion in the distal interphalangeal joint was 79.9±7.1 in the ADM group and 71.2±5.7 degrees in the control group, with significant difference (p=0.03 and p<0.05, respectively). In addition, the total active motion was higher in the ADM group than in the control group. The patients' scores on the Patient Satisfaction Questionnaire were also significantly different, with higher satisfaction scores in the ADM group (p=0.02). The minimal follow-up period was six months. Conclusion: The use of ADM after tendon repair has the potential to significantly improve the outcome of tendon surgery in terms of range of motion. Declaration of interest: None of the authors has any financial interest in the products, devices, or drugs mentioned in this article.

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