Collagen Matrices And Autologous Cells Suspension Differentially Influence Re-epithelialization At 2 Weeks In A Porcine Wound Model
J Genevieve Park, PhD, MD1, Sita M. Damaraju, PhD2, Benjamin R. Mintz, PhD2, Ankur S. Gandhi, PhD2, Sunil Saini, PhD2, Ronald Ingram, PhD2, Joseph A. Molnar, PhD, MD1.
1Wake Forest University School of Medicine, Winston-Salem, NC, USA, 2Integra Lifesciences, Plainsboro, NJ, USA.
The objective of this study was to evaluate if a single-stage procedure can be achieved by combining autologous cells suspension with dermal substitutes (DS) in the treatment of full thickness wounds in a porcine model. Split thickness skin grafts obtained from the pig were processed using an autologous cell harvesting device for preparation of an autologous cell suspension. Cells were seeded onto a commercially available bio-engineered matrix (DS1) or a decellularized dermal matrix (DS2). A total of twelve (4x4cm) full thickness wounds were created on the dorsum of each Yorkshire pig (n=12) and treated with: cells alone, cells+DS1, cells+DS2, DS1 alone, DS2 alone, or empty. Wound measurements and biopsies were taken on days 9, 14, 28 and 42. Histologic analyses included a combination of semi-quantitative grading scale and histomorphometry.Re-epithelialization at day 14 was significantly greater (p<.01 ANOVA, Tukey) in cells+DS1 and cells+DS2 compared to, DS1 and DS2, cells alone and the empty groups. On day 14, levels of epithelial hyperplasia significantly (p<.01 Mann-Whitney) increased in the pooled groups of cells+DS1 and cells+DS2 groups when compared to the DS1, DS2, and cells alone groups. Day 14 myofibroblast activity was markedly increased (p<.01, Mann Whitney) in the empty and cells only groups compared to DS groups and DS groups with cells.Results suggest the combination of autologous cells with DS may be promising for single-stage procedures for dermal reconstruction with marked increase in early re-epithelialization. However, additional effects of combination therapies with cells and matrices on epithelial hyperplasia emphasize the need for further investigation. Remodeling may require well over 42 days to resolve rendering possibility that longer-term studies are required to adequately assess the combined impact of autologous cells with DS on ultimate healed tissue quality.
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