1
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Khan N, Halaseh FF, Pillai K, Zaki DP, Sayadi LR, Widgerow AD. Hyperbaric and topical oxygen therapies in thermal burn wound healing: a review. J Wound Care 2023; 32:S20-S30. [PMID: 36724086 DOI: 10.12968/jowc.2023.32.sup2.s20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This review aims to evaluate the effectiveness of the two most commonly used oxygen delivery methods for the treatment of thermal burn wound healing: hyperbaric oxygen therapy (HBOT) and topical oxygen therapy (TOT). METHOD The PubMed database was searched for articles discussing the use of HBOT or TOT in the treatment of thermal burns. RESULTS The search yielded 43,406 articles, of which 28 (23 HBOT, 5 TOT) met the inclusion criteria. Both experimental and clinical studies have demonstrated conflicting results after treating thermal burns with HBOT or TOT. Overall, 14/23 studies demonstrated positive results for HBOT on the healing of burn wounds and associated complications, such as oedema and pain. Findings from these studies showed it can reduce morbidity and mortality in certain high-risk groups such as those with diabetes or extensive burns. Although the five studies (one human and four animal trials) reviewing TOT showed promising outcomes, this therapeutic modality has not been well investigated. CONCLUSION Therapeutic use of HBOT in thermal burns has been popular in the past but its use remains controversial due to inconsistent results, serious side-effects, lack of convenience and high costs. The use of TOT in the management of burns needs further exploration by scientists and clinicians alike, in addition to the implementation of a standardised treatment protocol.
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Affiliation(s)
- Nawal Khan
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
| | - Faris F Halaseh
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
| | - Kathryn Pillai
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
| | - Daniel P Zaki
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
| | - Lohrasb R Sayadi
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
| | - Alan D Widgerow
- Center for Tissue Engineering, Department of Plastic Surgery, University of California, Irvine, US
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2
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Somani AK. Application expansion of small intestinal submucosa extracellular matrix in complex and surgical wounds. J Wound Care 2023; 32:S20-S27. [PMID: 36744601 DOI: 10.12968/jowc.2023.32.sup1a.s20] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A wound is hard-to-heal or complex when the defect fails to progress through the normal stages of wound healing in a timely fashion. Hard-to-heal wounds such as diabetic foot or venous leg ulcers can be long-lasting conditions. Alternatively, complex acute wounds that occur from trauma, burns, postoperative, necrosis and some dermatological diseases can also result in hard-to-heal wounds. This article reviews important considerations in the management of complex acute wounds, such as time to wound closure, pain, scarring, patient satisfaction and identification of options that can promote healing of grafts and flaps, while reducing donor-site morbidity. Primary research has demonstrated the inherent benefits of small intestinal submucosa extracellular matrix (SIS-ECM), a naturally occurring porcine matrix that promotes development of dermis-like tissue in both complex acute and hard-to-heal wounds. Presently, the literature provides mostly case studies demonstrating the benefits of SIS-ECM in the management of complex acute wounds. The available case series suggest emerging clinical benefits including rapid time to coverage, avoidance of donor-site complications and development of granulation tissue in locations of low circulation, which improves poor graft sites, potentially reducing dehiscence and providing support for reconstruction flaps and grafts.
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Affiliation(s)
- Ally-Khan Somani
- Assistant Professor of Clinical Dermatology, Indiana University, Indiana, US
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3
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Xiao X, Wang M, Qiu X, Ling W, Chu X, Huang Y, Li T. Construction of extracellular matrix-based 3D hydrogel and its effects on cardiomyocytes. Exp Cell Res 2021; 408:112843. [PMID: 34563515 DOI: 10.1016/j.yexcr.2021.112843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 08/03/2021] [Accepted: 09/22/2021] [Indexed: 01/26/2023]
Abstract
Some discoveries resulted from 2-dimensional (2D) cultured cardiac cells have been disqualified in animal testing and later clinical trials. Extracellular matrix (ECM) plays a vital role in cardiac homeostasis, cardiac ECM (cECM)-based 3D cell cultures can mimics the physiological and pathological conditions in vivo closely, it is hopeful of addressing this challenge. Construction of cECM-based 3-dimensional (3D) hydrogel (cECM3DH) and its effects on cell behaviors were studied here. The results indicated that cellular compartments could be efficiently removed from heart tissue via sodium dodecyl sulfonate (SDS)- and Triton X-100-mediated decellularization, remaining the natural fibrous network structure and major proteins. 3D hydrogel consisted of 1 × 107 cells/mL cells and 75% cECM could promote the proliferation and anti-apoptosis ability of human embryonic kidney (HEK)-293T cells. 0.25% trypsin or 0.20% collagenase was suitable to retrieve these cells from 3D hydrogel for further researches. Compared with 2D culture system, cECM3DH could significantly increase the proportion of GATA 4+ cardiomyocytes (CMs) derived from heart tissue of neonatal mouse or induced differentiation of embryonic stem cells (ESCs) (P < 0.05) The expression levels of mature genes including cTnT, JCN, CaV1.2, MYL2, CASQ2, NCX1, and Cx43 of these CMs in adult pig cECM-based 3D hydrogel (APcECM3DH) were significantly higher than that in 2D culture system and in newborn piglet cECM-based 3D hydrogel (NPcECM3DH), respectively (P < 0.05). Therefore, cECM3DH supports the generation of primary CMs and ESC-derived CMs, APcECM3DH was more conducive to promoting CM maturation, which contributes to building 3D model for pathogenesis exploration, drug screening, and regenerative medicine of heart diseases.
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Affiliation(s)
- Xiong Xiao
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China.
| | - Mingyu Wang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China; Institute of Laboratory Animal Science, Chongqing Academy of Chinese Materia Medica, Chongqing, 400065, China.
| | - Xiaoyan Qiu
- Department of Animal Husbandry Engineering, College of Animal Science and Technology, Southwest University, Chongqing, 400715, China.
| | - Wenhui Ling
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China.
| | - Xinyue Chu
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China.
| | - Yun Huang
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China.
| | - Tong Li
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, Southwest University, Chongqing, 400715, China.
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4
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Macrophage Response to Biomaterials in Cardiovascular Applications. Stem Cells 2021. [DOI: 10.1007/978-3-030-77052-5_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Villamil Ballesteros AC, Segura Puello HR, Lopez-Garcia JA, Bernal-Ballen A, Nieto Mosquera DL, Muñoz Forero DM, Segura Charry JS, Neira Bejarano YA. Bovine Decellularized Amniotic Membrane: Extracellular Matrix as Scaffold for Mammalian Skin. Polymers (Basel) 2020; 12:polym12030590. [PMID: 32151022 PMCID: PMC7182835 DOI: 10.3390/polym12030590] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/16/2019] [Accepted: 11/23/2019] [Indexed: 12/23/2022] Open
Abstract
Decellularized membranes (DM) were obtained from bovine amniotic membranes (BAM) using four different decellularization protocols, based on physical, chemical, and mechanical treatment. The new material was used as a biological scaffold for in vitro skin cell culture. The DM were characterized using hematoxylin-eosin assay, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR-ATR), and differential scanning calorimetry (DSC). The in vitro cytotoxicity of DM was evaluated using MTT. The efficacy of decellularization process was assessed through DNA quantification and electrophoresis. All the used protocols showed a high effectiveness in terms of elimination of native cells, confirmed by DNA extraction and quantification, electrophoresis, and SEM, although protocol IV removes the cellular contents and preserve the native extracellular matrix (ECM) architecture which it can be considered as the most effective in terms of decellularization. FTIR-ATR and DSC on the other hand, revealed the effects of decellularization on the biochemical composition of the matrices. There was no cytotoxicity and the biological matrices obtained were a source of collagen for recellularization. The matrices of protocols I, II, and III were degraded at day 21 of cell culture, forming a gel. The biocompatibility in vitro was demonstrated; hence these matrices may be deemed as potential scaffold for epithelial tissue regeneration.
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Affiliation(s)
- Andrea Catalina Villamil Ballesteros
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
- Correspondence:
| | - Hugo Ramiro Segura Puello
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
| | - Jorge Andres Lopez-Garcia
- Centre of Polymer Systems, University Institute, Tomas Bata University in Zlín, Trida Tomase Bati 5678, 76001 Zlín, Czech Republic;
| | - Andres Bernal-Ballen
- Grupo de Investigación en Ingeniería Biomédica, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia;
| | - Diana Lorena Nieto Mosquera
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
| | - Diana Milena Muñoz Forero
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
| | - Juan Sebastián Segura Charry
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
| | - Yuli Alexandra Neira Bejarano
- Laboratorio de Investigaciones en Salud, Universidad Manuela Beltrán, Avenida Circunvalar No. 60-00, Bogotá 110231, Colombia; (H.R.S.P.); (D.L.N.M.); (D.M.M.F.); (J.S.S.C.); (Y.A.N.B.)
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Sabater González M, Mayer J. Technological Advances in Wound Treatment of Exotic Pets. Vet Clin North Am Exot Anim Pract 2019; 22:451-470. [PMID: 31395325 DOI: 10.1016/j.cvex.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although most research about the use of technological advances for wound healing was performed in laboratory animals but oriented to human medicine, recent technological advances allowed its application not only to small animals but also to exotic pets. This article reviews the literature available about some of these techniques (negative wound pressure therapy, photobiomodulation [laser therapy], electrical stimulation therapy, therapeutic ultrasonography, hyperbaric oxygen therapy), and other advances in wound management (skin expanders, xenografts, and bioengineered autologous skin substitutes) in exotic pet species.
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Affiliation(s)
| | - Jörg Mayer
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA, USA
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7
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Evaluation of decellularization protocols for production of porcine small intestine submucosa for use in abdominal wall reconstruction. Hernia 2019; 24:1221-1231. [PMID: 31041557 DOI: 10.1007/s10029-019-01954-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 04/16/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Porcine-derived acellular biologic grafts are increasingly used in abdominal wall reconstruction and other soft tissue repairs. In a previous work, we have shown porcine small intestine submucosa (PSIS) exhibits clear advantages over porcine pericardium (PPC) and porcine acellular dermal matrix (PADM) in repairing full-thickness abdominal wall defects. In the present study, we aim to determine, quantify, and compare the effects of two most commonly used decellularization protocols on biomechanical and biocompatible properties of PSIS. MATERIALS AND METHODS After mechanical preparation, PSIS was treated with either alkaline and acid (AA) protocol or sodium dodecyl sulfate (SDS) protocol. Cellular content removal, preservation of matrix components, micro- and ultra- structures, and mechanical properties were compared. The host responses were evaluated using PSIS for repairing rat abdominal wall defects. RESULTS AND CONCLUSION With regard to the absence of cellular contents, neatly arranged collagen fiber structures, better retention of growth factors, better mechanical strength, lower degrees of local and systemic inflammatory responses, higher degree of vascularization and tissue ingrowth, alkaline and acid protocol exhibits clear advantages over SDS protocol for the preparation of PSIS extracellular matrix.
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8
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Lei X, Yang Y, Shan G, Pan Y, Cheng B. Preparation of ADM/PRP freeze-dried dressing and effect of mice full-thickness skin defect model. Biomed Mater 2019; 14:035004. [DOI: 10.1088/1748-605x/ab0060] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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9
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Lu G, Ding Z, Wei Y, Lu X, Lu Q, Kaplan DL. Anisotropic Biomimetic Silk Scaffolds for Improved Cell Migration and Healing of Skin Wounds. ACS APPLIED MATERIALS & INTERFACES 2018; 10:44314-44323. [PMID: 30507148 DOI: 10.1021/acsami.8b18626] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Improved and more rapid healing of full-thickness skin wounds remains a major clinical need. Silk fibroin (SF) is a natural protein biomaterial that has been used in skin repair. However, there has been little effort aimed at improving skin healing through tuning the hierarchical microstructure of SF-based matrices and introducing multiple physical cues. Recently, enhanced vascularization was achieved with SF scaffolds with nanofibrous structures and tunable secondary conformation of the matrices. We hypothesized that anisotropic features in nanofibrous SF scaffolds would promote cell migration, neovascularization, and tissue regeneration in wounds. To address this hypothesis, SF nanofibers were aligned in an electric field to form anisotropic porous scaffolds after lyophilization. In vitro and in vivo studies indicated good cytocompatibility, and improved cell migration and vascularization than nanofibrous scaffolds without these anisotropic features. These improvements resulted in more rapid wound closure, tissue ingrowth, and the formation of new epidermis, as well as higher collagen deposition with a structure similar to the surrounding native tissue. The new epidermal layers and neovascularization were achieved by day 7, with wound healing complete by day 28. It was concluded that anisotropic SF scaffolds alone, without a need for growth factors and cells, promoted significant cell migration, vascularization, and skin regeneration and may have the potential to effectively treat dermal wounds.
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Affiliation(s)
- Guozhong Lu
- Department of Burns and Plastic Surgery , The Third Affiliated Hospital of Nantong University , Wuxi 214041 , People's Republic of China
| | - ZhaoZhao Ding
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology , Soochow University , Suzhou 215123 , People's Republic of China
| | - Yuanyuan Wei
- Department of Maternity and Child Care Hospital , Lanzhou 730050 , Gansu Province , People's Republic of China
| | - Xiaohong Lu
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology , Soochow University , Suzhou 215123 , People's Republic of China
| | - Qiang Lu
- National Engineering Laboratory for Modern Silk & Collaborative Innovation Center of Suzhou Nano Science and Technology , Soochow University , Suzhou 215123 , People's Republic of China
| | - David L Kaplan
- Department of Biomedical Engineering , Tufts University , Medford , Massachusetts 02155 , United States
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10
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Iop L, Palmosi T, Dal Sasso E, Gerosa G. Bioengineered tissue solutions for repair, correction and reconstruction in cardiovascular surgery. J Thorac Dis 2018; 10:S2390-S2411. [PMID: 30123578 PMCID: PMC6081367 DOI: 10.21037/jtd.2018.04.27] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/02/2018] [Indexed: 01/06/2023]
Abstract
The treatment of cardiac alterations is still nowadays a dramatic issue in the cardiosurgical practice. Synthetic materials applied in this surgery have failed in their long-term therapeutic efficacy due to low biocompatibility and compliance, especially when used in contractile sites. In order to overcome these treatment pitfalls, novel solutions have been developed based on biological tissues. Patches in pericardium, small intestinal submucosa, as well as engineered tissues of myocardium, heart valves and blood vessels have undergone a large preclinical investigation in regenerative medicine studies. Clinical translation has been started or reached by several of these new bioengineered treatment alternatives. This review will describe the preclinical and clinical experiences realized so far with the application of biological tissues in cardiovascular surgery. It will depict the progressive steps realized in the evolution of this research, as well as it will point out the challenges yet to face in order to generate the ideal biomaterial for cardiovascular repair, corrective and reconstructive surgery.
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Affiliation(s)
- Laura Iop
- Cardiovascular Regenerative Medicine, Department of Cardiac, Thoracic and Vascular Surgery, University of Padua and Venetian Institute of Molecular Medicine (VIMM), Padua, Italy
| | - Tiziana Palmosi
- Cardiovascular Regenerative Medicine, Department of Cardiac, Thoracic and Vascular Surgery, University of Padua and Venetian Institute of Molecular Medicine (VIMM), Padua, Italy
| | - Eleonora Dal Sasso
- Cardiovascular Regenerative Medicine, Department of Cardiac, Thoracic and Vascular Surgery, University of Padua and Venetian Institute of Molecular Medicine (VIMM), Padua, Italy
| | - Gino Gerosa
- Cardiovascular Regenerative Medicine, Department of Cardiac, Thoracic and Vascular Surgery, University of Padua and Venetian Institute of Molecular Medicine (VIMM), Padua, Italy
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11
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Spinali KL, Schmuck EG. Natural Sources of Extracellular Matrix for Cardiac Repair. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1098:115-130. [PMID: 30238368 DOI: 10.1007/978-3-319-97421-7_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Tissue engineering and regenerative medicine have adopted the use of extracellular matrix (ECM) as a cell delivery device and bioactive regenerative agent. To this end, many ECMs have been investigated for cardiac tissue engineering and regenerative medicine applications with variable success. Many sources of natural ECMs have been tested for cardiac applications. Typically, natural ECMs have been made from decellularized organs or tissues and processed into either sheets or injectable hydrogels. This chapter will review natural sources of ECM materials that have been tested as therapeutic agents in models of heart failure.
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Affiliation(s)
- Keith L Spinali
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin Madison, Madison, WI, USA
| | - Eric G Schmuck
- Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin Madison, Madison, WI, USA.
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12
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Lee JS, Choi YS, Cho SW. Decellularized Tissue Matrix for Stem Cell and Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1064:161-180. [DOI: 10.1007/978-981-13-0445-3_10] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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13
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Growth Factor-Reinforced ECM Fabricated from Chemically Hypoxic MSC Sheet with Improved In Vivo Wound Repair Activity. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2578017. [PMID: 29018809 PMCID: PMC5605873 DOI: 10.1155/2017/2578017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 08/01/2017] [Indexed: 01/05/2023]
Abstract
MSC treatment can promote cutaneous wound repair through multiple mechanisms, and paracrine mediators secreted by MSC are responsible for most of its therapeutic benefits. Recently, MSC sheet composed of live MSCs and their secreted ECMs was reported to promote wound healing; however, whether its ECM alone could accelerate wound closure remained unknown. In this study, Nc-ECM and Cc-ECM were prepared from nonconditioned and CoCl2-conditioned MSC sheets, respectively, and their wound healing properties were evaluated in a mouse model of full-thickness skin defect. Our results showed that Nc-ECM can significantly promote wound repair through early adipocyte recruitment, rapid reepithelialization, enhanced granulation tissue growth, and augmented angiogenesis. Moreover, conditioning of MSC sheet with CoCl2 dramatically enriched its ECM with collagen I, collagen III, TGF-β1, VEGF, and bFGF via activation of HIF-1α and hence remarkably improved its ECM's in vivo wound healing potency. All the Cc-ECM-treated wounds completely healed on day 7, while Nc-ECM-treated wounds healed about 85.0% ± 8.6%, and no-treatment wounds only healed 69.8% ± 9.6% (p < 0.05). Therefore, we believe that such growth factor-reinforced ECM fabricated from chemically hypoxic MSC sheet has the potential for clinical translation and will lead to a MSC-derived, cost-effective, bankable biomaterial for wound management.
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Mosala Nezhad Z, Poncelet A, de Kerchove L, Gianello P, Fervaille C, El Khoury G. Small intestinal submucosa extracellular matrix (CorMatrix®) in cardiovascular surgery: a systematic review. Interact Cardiovasc Thorac Surg 2016; 22:839-50. [PMID: 26912574 DOI: 10.1093/icvts/ivw020] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 01/08/2016] [Indexed: 11/12/2022] Open
Abstract
Extracellular matrix (ECM) derived from small intestinal submucosa (SIS) is widely used in clinical applications as a scaffold for tissue repair. Recently, CorMatrix® porcine SIS-ECM (CorMatrix Cardiovascular, Inc., Roswell, GA, USA) has gained popularity for 'next-generation' cardiovascular tissue engineering due to its ease of use, remodelling properties, lack of immunogenicity, absorbability and potential to promote native tissue growth. Here, we provide an overview of the biology of porcine SIS-ECM and systematically review the preclinical and clinical literature on its use in cardiovascular surgery. CorMatrix® has been used in a variety of cardiovascular surgical applications, and since it is the most widely used SIS-ECM, this material is the focus of this review. Since CorMatrix® is a relatively new product for cardiovascular surgery, some clinical and preclinical studies published lack systematic reporting of functional and pathological findings in sufficient numbers of subjects. There are also emerging reports to suggest that, contrary to expectations, an undesirable inflammatory response may occur in CorMatrix® implants in humans and longer-term outcomes at particular sites, such as the heart valves, may be suboptimal. Large-scale clinical studies are needed driven by robust protocols that aim to quantify the pathological process of tissue repair.
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Affiliation(s)
- Zahra Mosala Nezhad
- Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium
| | - Alain Poncelet
- Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium
| | - Laurent de Kerchove
- Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium
| | - Pierre Gianello
- Institute of Experimental and Clinical Research (IREC), Division of Experimental Surgery and Transplantation (CHEX), Université catholique de Louvain, Brussels, Belgium
| | - Caroline Fervaille
- Laboratory of Anatomy Pathology, Université catholique de Louvain, Godinne University Hospital-CHU, Yvoir, Belgium
| | - Gebrine El Khoury
- Institute of Experimental and Clinical Research (IREC), Division of Cardiovascular Research (CARD), Université catholique de Louvain, Brussels, Belgium Department of Cardiovascular and Thoracic Surgery, Université catholique de Louvain, Saint-Luc University Hospital, Brussels, Belgium
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15
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Lu Y, Jia C, Bi B, Chen L, Zhou Y, Yang P, Guo Y, Zhu J, Zhu N, Liu T. Injectable SVF-loaded porcine extracellular matrix powders for adipose tissue engineering. RSC Adv 2016. [DOI: 10.1039/c6ra09543g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study provides a novel method in injectable tissue engineering which contains porcine extracellular matrix (ECM) powder scaffolds and stromal-vascular fraction (SVF) cells.
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16
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Parmaksiz M, Elcin AE, Elcin YM. Decellularization of bovine small intestinal submucosa and its use for the healing of a critical-sized full-thickness skin defect, alone and in combination with stem cells, in a small rodent model. J Tissue Eng Regen Med 2015; 11:1754-1765. [DOI: 10.1002/term.2071] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/27/2015] [Accepted: 06/12/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Mahmut Parmaksiz
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory; Ankara University Faculty of Science and Ankara University Stem Cell Institute; Ankara Turkey
| | - A. Eser Elcin
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory; Ankara University Faculty of Science and Ankara University Stem Cell Institute; Ankara Turkey
| | - Y. Murat Elcin
- Tissue Engineering, Biomaterials and Nanobiotechnology Laboratory; Ankara University Faculty of Science and Ankara University Stem Cell Institute; Ankara Turkey
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Ding JP, Fang L, Wang LZ. The use of micro-plasma radiofrequency technology in secondary skin graft contraction: 2 case reports. J COSMET LASER THER 2015; 17:301-3. [DOI: 10.3109/14764172.2015.1027230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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Acute and chronic local inflammatory reaction after implantation of different extracellular porcine dermis collagen matrices in rats. BIOMED RESEARCH INTERNATIONAL 2015; 2015:938059. [PMID: 25648958 PMCID: PMC4310316 DOI: 10.1155/2015/938059] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/08/2014] [Accepted: 10/14/2014] [Indexed: 02/04/2023]
Abstract
Two cross-linked acellular porcine dermal collagen matrices (Permacol and NRX) were implanted into rats and the acute and chronic local inflammatory tissue reactions were investigated after 7, 14, 28, and 112 days. Both membranes were stable in vivo for up to 112 days. All investigated immune cell populations (CD68+ macrophages, CD163+ macrophages, T lymphocytes, MHC class II positive cells, mast cells, and NK cells) were present. Their amount decreased significantly over time compared to day 7 after implantation. A change from an acute to a chronic inflammation and an associated shift from proinflammatory M1-like to anti-inflammatory M2-like macrophages were observed. In the early phase there was a significant correlation of T cells to CD68+ (M1-like) macrophages, whereas in the chronic phase T lymphocytes were positively correlated with CD163+ (M2-like) macrophages. The material NRX showed an enhanced inflammatory reaction in comparison to Permacol possibly caused by material characteristics such as a twofold higher thickness of the membrane, roughness, and water absorption capacity. Nevertheless, a more pronounced regenerative process as, for example, indicated by nestin expression demonstrated its possible suitability for applications as wound repair material.
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19
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Xiao S, Dan W, Dan N. Insights into the interactions between porcine collagen and a Zr–Al–Ti metal complex. RSC Adv 2015. [DOI: 10.1039/c5ra14687a] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Porcine acelluar dermal matrix (pADM), known as pure collagen with a three dimensional structure, was used to explore the interactions between porcine collagen and a metal complex in this study.
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Affiliation(s)
- Shiwei Xiao
- Department of Biomass Chemistry and Engineering
- Sichuan University
- Chengdu
- China
- Research Center of Biomedical Engineering
| | - Weihua Dan
- Department of Biomass Chemistry and Engineering
- Sichuan University
- Chengdu
- China
- Research Center of Biomedical Engineering
| | - Nianhua Dan
- Department of Biomass Chemistry and Engineering
- Sichuan University
- Chengdu
- China
- Research Center of Biomedical Engineering
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20
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Turner NJ, Pezzone D, Badylak SF. Regional variations in the histology of porcine skin. Tissue Eng Part C Methods 2014; 21:373-84. [PMID: 25205147 DOI: 10.1089/ten.tec.2014.0246] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Porcine skin is commonly used as a model for human skin injury and as a source material for biologic scaffold materials. Although remarkable similarities between porcine and human skin exist, regional anatomic variations present in human skin are also present in porcine skin. The objective of this study was to evaluate the structure of porcine skin from 11 different anatomic regions in the American Yorkshire crossbreed. Both qualitative and quantitative methods were used, with emphasis on epidermal and dermal thickness, hair follicle density, and collagen and elastin composition and distribution. The results showed that significant regional differences in skin histology exist, particularly with regard to the thickness of the dermis and epidermis and the amount of collagen and elastin within each tissue. Differences were also seen in the distribution of type I and type III collagen within the dermis. Therefore, while porcine skin shares many similarities with human skin, distinct regional differences in composition and morphology exist. This study highlights the importance of appreciating these regional differences to avoid misinterpretation of experimental results when using porcine skin as a human analogue.
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Affiliation(s)
- Neill J Turner
- 1 McGowan Institute for Regenerative Medicine, University of Pittsburgh , Pittsburgh, Pennsylvania
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21
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Moon SH, Lee YJ, Rhie JW, Suh DS, Oh DY, Lee JH, Kim YJ, Kim SM, Jun YJ. Comparative study of the effectiveness and safety of porcine and bovine atelocollagen in Asian nasolabial fold correction. J Plast Surg Hand Surg 2014; 49:147-52. [PMID: 25272190 DOI: 10.3109/2000656x.2014.964725] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Bovine-derived collagen has been used for soft-tissue augmentation since 1977. However, there are issues regarding the possibility of bovine spongiform encephalopathy (BSE). Researchers discovered that the histologic structure of porcine-derived collagen is similar to that of human dermal collagen and that it is free from the risk of BSE. This study was conducted to establish the effectiveness and safety of porcine-derived collagen compared to bovine-derived collagen. The 73 patients included in this study were healthy volunteers who responded to an advertisement approved by the Institutional Review Board (IRB). They had visited the authors' hospital complaining of wrinkles on their nasolabial fold. Either porcine (TheraFill®) or bovine atelocollagen was randomly injected into each side of their nasolabial folds, and the five-grade Wrinkle Severity Rating Scale (WSRS) was used to evaluate the wrinkles before and after the injection. The average age of the 73 study patients was 46.18 years. The WSRS scores of the porcine and bovine atelocollagen-injected patients were 2.90 ± 0.71 and 2.85 ± 0.72 at the baseline and 2.15 ± 0.70 and 2.21 ± 0.67 after 6 months. There were no statistically significant differences between the two groups. Adverse effects of the porcine atelocollagen injection were seen in 12 patients, with the most common symptom being redness. This study showed that porcine atelocollagen can be used easily and without the need for the skin testing which is necessary before bovine atelocollagen injection. The efficacy of porcine atelocollagen is also similar to that of bovine atelocollagen.
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Affiliation(s)
- Suk-Ho Moon
- Department of Plastic Surgery, Catholic University of Korea , Seoul , Korea
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22
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Chatzistavrou X, Fenno JC, Faulk D, Badylak S, Kasuga T, Boccaccini AR, Papagerakis P. Fabrication and characterization of bioactive and antibacterial composites for dental applications. Acta Biomater 2014; 10:3723-32. [PMID: 24802300 DOI: 10.1016/j.actbio.2014.04.030] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 04/21/2014] [Accepted: 04/28/2014] [Indexed: 02/05/2023]
Abstract
There is an increasing clinical need to design novel dental materials that combine regenerative and antibacterial properties. In this work the characterization of a recently developed sol-gel-derived bioactive glass ceramic containing silver ions (Ag-BG) is presented. The microstructural characteristics, ion release profile, zeta potential value and changes in weight loss and pH value as a function of the immersion time of Ag-BG in Tris buffer are evaluated. Ag-BG is also incorporated into natural extracellular matrix (ECM) hydrogel to further enhance its regenerative properties. Then, the micro and macro architectures of these new composites (ECM/Ag-BG) are characterized. In addition, the antibacterial properties of these new composites are tested against Escherichia coli and Enterococcus faecalis, a bacterium commonly implicated in the pathogenesis of dental pulp infections. Cell-material interaction is also monitored in a primary culture of dental pulp cells. Our study highlights the benefits of the successful incorporation of Ag in the bioactive glass, resulting in a stable antibacterial material with long-lasting bactericidal activity. Furthermore, this work presents for the first time the fabrication of new Ag-doped composite materials, with inductive pulp-cell proliferation and antibacterial properties (ECM/Ag-BG). This advanced composite made of Ag-BG incorporated into natural ECM possesses improved properties that may facilitate potential applications in tooth regeneration approaches.
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Affiliation(s)
- Xanthippi Chatzistavrou
- Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
| | - J Christopher Fenno
- Biologic & Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Denver Faulk
- Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Stephen Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Toshihiro Kasuga
- Department of Frontier Materials, Nagoya Institute of Technology, Showa-ku, Nagoya, Japan
| | - Aldo R Boccaccini
- Institute of Biomaterials, Department of Materials Science and Engineering, University of Erlangen-Nuremberg, 91058 Erlangen, Germany
| | - Petros Papagerakis
- Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
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23
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Liu Z, Feng X, Wang H, Ma J, Liu W, Cui D, Gu Y, Tang R. Carbon nanotubes as VEGF carriers to improve the early vascularization of porcine small intestinal submucosa in abdominal wall defect repair. Int J Nanomedicine 2014; 9:1275-86. [PMID: 24648727 PMCID: PMC3956480 DOI: 10.2147/ijn.s58626] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Insufficient early vascularization in biological meshes, resulting in limited host tissue incorporation, is thought to be the primary cause for the failure of abdominal wall defect repair after implantation. The sustained release of exogenous angiogenic factors from a biocompatible nanomaterial might be a way to overcome this limitation. In the study reported here, multiwalled carbon nanotubes (MWNT) were functionalized by plasma polymerization to deliver vascular endothelial growth factor165 (VEGF165). The novel VEGF165-controlled released system was incorporated into porcine small intestinal submucosa (PSIS) to construct a composite scaffold. Scaffolds incorporating varying amounts of VEGF165-loaded functionalized MWNT were characterized in vitro. At 5 weight percent MWNT, the scaffolds exhibited optimal properties and were implanted in rats to repair abdominal wall defects. PSIS scaffolds incorporating VEGF165-loaded MWNT (VEGF–MWNT–PSIS) contributed to early vascularization from 2–12 weeks postimplantation and obtained more effective collagen deposition and exhibited improved tensile strength at 24 weeks postimplantation compared to PSIS or PSIS scaffolds, incorporating MWNT without VEGF165 loading (MWNT–PSIS).
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Affiliation(s)
- Zhengni Liu
- Department of General Surgery, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xueyi Feng
- Department of General Surgery, Lu'an People's Hospital, Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, Province Anhui, People's Republic of China
| | - Huichun Wang
- Department of General Surgery, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jun Ma
- Department of General Surgery, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Wei Liu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai, People's Republic of China
| | - Daxiang Cui
- Institute of Nano Biomedicine and Engineering, Key Laboratory for Thin Film and Microfabrication Technology of the Ministry of Education, Research Institute of Micro/Nano Science and Technology, Bio-X Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yan Gu
- Department of General Surgery, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Rui Tang
- Department of General Surgery, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Disease Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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24
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Klinge U, Binneboesel M, Kuschel S, Schuessler B. Demands and properties of alloplastic implants for the treatment of stress urinary incontinence. Expert Rev Med Devices 2014; 4:349-59. [PMID: 17488229 DOI: 10.1586/17434440.4.3.349] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Surgical treatment of stress urinary incontinence changed dramatically with the introduction of the tension-free vaginal tape. Owing to its high efficacy and minimal patient discomfort this new minimally invasive procedure quickly obtained widespread acceptance and superseded the abdominal colposuspension as the gold standard. In the course of success of the original method a number of tension-free vaginal tapes flooded the market, varying in approach and material. These variations may strongly influence the safety, efficacy and long-term results of tension-free vaginal tape and its major modification, the transobturator technique. Therefore, it is the aim of this review to closely illuminate available materials and complications associated with this procedure. An extensive Medline search of the published literature up until 2006 on the subject of stress urinary incontinence was carried out. All sources identified were reviewed with particular attention to the method applied, the properties of the mesh materials and clinical complications. Apart from several technical variations, there are marked differences between the different vaginal sling materials, ranging from absorbable collagens over polypropylene to allografts. Although performed globally in substantial and increasing numbers, minimally invasive techniques for the surgical treatment of stress urinary incontinence are lacking sufficient safety data.
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Affiliation(s)
- Uwe Klinge
- Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, and Surgical Department, University Hospital of the RWTH Aachen, Germany.
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25
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Complete horizontal skin cell resurfacing and delayed vertical cell infiltration into porcine reconstructive tissue matrix compared to bovine collagen matrix and human dermis. Plast Reconstr Surg 2013; 132:861-869. [PMID: 24076679 DOI: 10.1097/prs.0b013e31829fe461] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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26
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Haifei S, Xingang W, Shoucheng W, Zhengwei M, Chuangang Y, Chunmao H. The effect of collagen-chitosan porous scaffold thickness on dermal regeneration in a one-stage grafting procedure. J Mech Behav Biomed Mater 2013; 29:114-25. [PMID: 24076783 DOI: 10.1016/j.jmbbm.2013.08.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 11/26/2022]
Abstract
Dermal substitutes are used as dermal regeneration templates to reduce scar formation and improve wound healing. Unlike autografts, dermal substitutes lack normal vascular networks. The increased distance required for diffusion of oxygen and nutrients to the autograft following interpositioning of the substitute dramatically affects graft survival. To evaluate the effect of collagen-chitosan scaffold thickness on dermal regeneration, single-layer collagen-chitosan porous scaffolds of 0.5-, 1- and 2-mm thicknesses were fabricated and used to treat full-thickness wounds in a one-stage grafting procedure in a rat model. Skin-graft viability, wound contraction, histological changes, and wound tensile strength were evaluated. The results indicated that the distance for the diffusion of oxygen and nutrients to the autograft in the 2-mm-thick scaffold provided less support for graft take, which resulted in graft necrosis, extensive inflammatory reaction, marked foreign-body reaction (FBR), rapid scaffold degradation, and abnormal collagen deposition and remodeling. In contrast, the thinner scaffolds, especially of that 0.5-mm thickness, promoted earlier angiogenesis, ensuring skin-graft viability with a mild FBR, and ordered fibroblast infiltration and better collagen remodeling. It can be concluded that collagen-chitosan porous scaffolds with a thickness of <1mm are more suitable for dermal regeneration and can be used as dermal templates for treatment of dermal defects using a one-stage grafting procedure.
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Affiliation(s)
- Shi Haifei
- Department of Hand Surgery, First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China; Department of Burns, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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27
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Kim J, Lee SM, Her SH, Lee KE, Kim JY, Ahn JH, Oh SB, Kwon JB. Newly developed porcine acellular dermal matrix (XenoDerm) for adhesion prevention and rreconstruction of aabdominal wall defect in rat. Tissue Eng Regen Med 2013. [DOI: 10.1007/s13770-013-0381-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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28
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Fundamental immunology of skin transplantation and key strategies for tolerance induction. Arch Immunol Ther Exp (Warsz) 2013; 61:397-405. [PMID: 23685832 DOI: 10.1007/s00005-013-0233-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 04/26/2013] [Indexed: 12/21/2022]
Abstract
Transplantation of allogeneic or xenogeneic skin grafts can evoke strong immune responses that lead to acute rejection of the graft tissues. In this process, donor-derived dendritic cells play crucial roles in the triggering of such immune responses. Both the innate and acquired host immune systems participate in graft rejection. At present, the rejection of skin grafts cannot be well-controlled by ordinary systemic immunosuppression therapy. Although several strategies for the long-term survival of allogeneic or xenogeneic skin grafts have been demonstrated in animal models, the induction of long-term tolerance to skin grafts is still a great challenge in clinical settings. In this article, we review the progress in the understanding of immune responses to skin grafts and discuss the possible methods that can decrease the immunogenicity of graft tissues and improve the survival of skin grafts, especially those included in preoperative pre-treatments.
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29
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Chen X, Feng X, Xie J, Ruan S, Lin Y, Lin Z, Shen R, Zhang F. Application of acellular dermal xenografts in full-thickness skin burns. Exp Ther Med 2013; 6:194-198. [PMID: 23935745 PMCID: PMC3735587 DOI: 10.3892/etm.2013.1114] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 04/11/2013] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to explore the clinical value of the porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin grafting applied in deep full-thickness burns and scar wounds. A total of 30 patients with deep burns were randomly divided into experimental and control groups following escharectomy. The patients were separately treated with porcine acellular dermal xenograft (ADX) in combination with autologous split-thickness skin and pure autologous split-thickness skin graft. The wound healing was observed routinely and the scores were evaluated using Vancouver scar scale at different times following transplant surgery. The samples of cograft regions and the control group (pure transplant split-thickness skin autograft) were observed using light microscopy and electron microscopy, and the follow-up results were recorded. No conspicuous rejections on the cograft wound surface were observed. Compared with the control group, the cograft wounds were smooth, presented no scar contracture and exhibited good skin elasticity and recovery of the joint function. The cografted skin combined well and displayed a clear and continuous basal membrane, as well as gradually combined skin structure, a mature stratum corneum, downward extended rete pegs, a mainly uniform dermal collagen fiber structure, regular alignment, and fewer blood capillaries. Clear desmosome cograft regions were identified among heckle cells, as well as a clear and continuous basal membrane. The cografted skin of the combined split-thickness autograft and the acellular heterologous (porcine) dermal matrix showed an improved shape and functional recovery compared with the pure split-thickness skin autograft. The combination of the meshed ADX and the split-thickness skin autograft applied in deep full-thickness burns and scar wounds may induce tissue regeneration via dermis aiming. This method also has superior shape and functional recovery, and has an extensive clinical application value.
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Affiliation(s)
- Xiaodong Chen
- Department of Burns Surgery, The First People's Hospital of Foshan, Foshan, Guangdong 528000
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Abstract
Although the principles of burn management are still primarily focused on survival, as advances are realized in resuscitation, nutrition, and wound management, the functional and aesthetic outcomes following burn injury have become increasingly important. Acellular dermal matrix materials, which allow surgeons to minimize skin graft donor site morbidity in the process of repairing injured areas, play a role in addressing these important issues. Many favorable reports have been published, but they are generally characterized by small sample sizes, limited objective testing, and retrospective analysis. There does appear to be some evidence for ADM application in patient populations in whom donor site availability (those with massive burns) or morbidity (children, the elderly) is a concern, but more studies are needed. In this article, the authors discuss the current applications for ADM in burn management, review the existing literature, and present opportunities for future research.
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Affiliation(s)
- David J Wainwright
- Division of Plastic Surgery, Department of Surgery, University of Texas Health Science Center, Houston, Texas 77030, USA.
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Liu Z, Tang R, Zhou Z, Song Z, Wang H, Gu Y. Comparison of two porcine-derived materials for repairing abdominal wall defects in rats. PLoS One 2011; 6:e20520. [PMID: 21637777 PMCID: PMC3102734 DOI: 10.1371/journal.pone.0020520] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 04/30/2011] [Indexed: 11/21/2022] Open
Abstract
Objective The purpose of this study was to compare the mechanical properties, host responses and incorporation of porcine small intestine submucosa (PSIS) and porcine acellular dermal matrix (PADM) in a rat model of abdominal wall defect repair. Materials and Methods Prior to implantation, PSIS and PADM were prepared and evaluated in terms of structure and mechanical properties. Full-thickness abdominal wall defects were created in 50 Sprague-Dawley rats, and were repaired using either PSIS or PADM. Rats were sacrificed 1, 2, 4, 8 and 12 weeks post-repair and examined for herniation, infection, adhesions, contraction, and changes in the thickness and strength of the tissues incorporated at the defect sites. Histopathology and immunohistochemistry were performed to analyze inflammatory responses, collagen deposition and vascularization. Results PADM showed more dense collagen deposition and stronger mechanical properties than PSIS prior to implantation (P<0.01). However, the mechanical properties observed after integration with the surrounding native tissues was similar for PADM and PSIS. Both PADM and PSIS showed significant contraction by week 12. However, PADM tissue induced less adhesion and increased in thickness more slowly, and showed less infiltration by foreign giant cells, polymorphonuclear cells, and mononuclear cells. Improved remodeling of host tissue was observed after PSIS implantation, which was apparent from the orientation of bands of fibrous connective tissue, intermixed with newly formed blood vessels by Week 12. Conclusion PSIS showed weaker mechanical properties prior to implantation. However, after implantation PSIS induced more pronounced host responses and showed better incorporation into host tissues than PADM.
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Affiliation(s)
- Zhengni Liu
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
| | - Rui Tang
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
| | - Zhiyuan Zhou
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
| | - Zhicheng Song
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
| | - Huichun Wang
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
| | - Yan Gu
- Department of General Surgery, Shanghai Ninth Hospital affiliated to Shanghai JiaoTong University School of Medicine, and Hernia and Abdominal Wall Surgery Center of Shanghai JiaoTong University, Shanghai, China
- * E-mail:
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Johansson ML, Thomsen P, Hultén L, Halvorsen PS, Fosse E, Edwin B. Integration between a percutaneous implant and the porcine small bowel. J Biomed Mater Res B Appl Biomater 2011; 98:101-9. [PMID: 21563306 DOI: 10.1002/jbm.b.31838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 02/03/2011] [Indexed: 12/23/2022]
Abstract
Inflammatory bowel diseases, cancer or trauma may require removal of all or part of the intestines, leaving the patient with a need to wear external stoma appliances for collection of bowel contents. By connecting the small bowel to a percutaneous port, equipped with a sealing lid, a fully continent and leak proof stoma can be created without a need for permanently wearing stoma appliance. The prerequisites for a connection between a permanent, transabdominal implant and a visceral organ are largely unexplored. Stoma ports made of titanium were implanted in the abdominal wall of domestic pigs and a branch of distal ileum was inserted through the ports. After being followed for 1-3 weeks, the ports were removed and subjected to histological evaluation to study the influence of their shape, structure, and position on the tissue response. Particular focus was attended to the attachment of the ileal serosal surface to the implants inner structure consisting of a titanium mesh. Macroscopic examination revealed fistulas and formation of abscesses in 4 of 11 the retrieved implants. Histological examination revealed regenerated and well-vascularized collagenous tissue around the mesh structure inside the implant. The integration was complete or partial for 10 of 11 ports. Despite various degrees of inflammation and tissue ingrowth, it was demonstrated for the first time that the serosal surface of ileum was firmly attached to the internal structure of the implant. These experiments provide a basis for optimization of the implant and surgical procedure before long-term functional animal experiments.
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Affiliation(s)
- Martin L Johansson
- Institute of Clinical Sciences, Department of Biomaterials, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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Choi JS, Kim BS, Kim JY, Kim JD, Choi YC, Yang HJ, Park K, Lee HY, Cho YW. Decellularized extracellular matrix derived from human adipose tissue as a potential scaffold for allograft tissue engineering. J Biomed Mater Res A 2011; 97:292-9. [PMID: 21448993 DOI: 10.1002/jbm.a.33056] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 11/04/2010] [Accepted: 01/13/2011] [Indexed: 12/16/2022]
Abstract
Decellularized tissues composed of extracellular matrix (ECM) have been clinically used to support the regeneration of various human tissues and organs. Most decellularized tissues so far have been derived from animals or cadavers. Therefore, despite the many advantages of decellularized tissue, there are concerns about the potential for immunogenicity and the possible presence of infectious agents. Herein, we present a biomaterial composed of ECM derived from human adipose tissue, the most prevalent, expendable, and safely harvested tissue in the human body. The ECM was extracted by successive physical, chemical, and enzymatic treatments of human adipose tissue isolated by liposuction. Cellular components including nucleic acids were effectively removed without significant disruption of the morphology or structure of the ECM. Major ECM components were quantified, including acid/pepsin-soluble collagen, sulfated glycosaminoglycan (GAG), and soluble elastin. In an in vivo experiment using mice, the decellularized ECM graft exhibited good compatibility to surrounding tissues. Overall results suggest that the decellularized ECM containing biological and chemical cues of native human ECM could be an ideal scaffold material not only for autologous but also for allograft tissue engineering.
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Affiliation(s)
- Ji Suk Choi
- Department of Chemical Engineering and Department of Bionanotechnology, Hanyang University, Ansan, Gyeonggi-do 426-791, Republic of Korea
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Mondalek FG, Ashley RA, Roth CC, Kibar Y, Shakir N, Ihnat MA, Fung KM, Grady BP, Kropp BP, Lin HK. Enhanced angiogenesis of modified porcine small intestinal submucosa with hyaluronic acid-poly(lactide-co-glycolide) nanoparticles: from fabrication to preclinical validation. J Biomed Mater Res A 2010; 94:712-9. [PMID: 20213816 DOI: 10.1002/jbm.a.32748] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Hyaluronic acid-poly(de-co-glycolide) nanoparticles (HA-PLGA NPs) were synthesized to stabilize the porous structure of porcine small intestinal submucosa (SIS), to improve surface biocompatibility and to enhance performance in tissue regeneration. HA-PLGA NPs were characterized for size, zeta potential, surface morphology, and HA loading. Human microvascular endothelial cells responded to HA-PLGA NPs and HA-PLGA modified SIS (HA-PLGA-SIS) with elevated cell proliferation. HA-PLGA-SIS significantly enhanced neo-vascularization in an in ovo chorioallantoic membrane angiogenesis model. The angiogenic capability of the newly fabricated HA-PLGA-SIS was tested in a canine bladder augmentation model. Urinary bladder augmentation was performed in beagle dogs following hemi-cystectomy using HA-PLGA-SIS. The regenerated bladder was harvested at 10 weeks post augmentation and vascularization was evaluated using CD31 immunohistochemical staining. Bladder regenerated with HA-PLGA-SIS had significantly higher vascular ingrowth compared to unmodified SIS. This study shows that HA-PLGA NPs may represent a new approach for modifying naturally derived SIS biomaterials in regenerative medicine.
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Affiliation(s)
- Fadee G Mondalek
- Department of Chemical, Biological and Materials Engineering, University of Oklahoma, Norman, Oklahoma 73019, USA
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de Castro Brás LE, Proffitt JL, Bloor S, Sibbons PD. Effect of crosslinking on the performance of a collagen-derived biomaterial as an implant for soft tissue repair: A rodent model. J Biomed Mater Res B Appl Biomater 2010; 95:239-49. [DOI: 10.1002/jbm.b.31704] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Wainwright JM, Czajka CA, Patel UB, Freytes DO, Tobita K, Gilbert TW, Badylak SF. Preparation of cardiac extracellular matrix from an intact porcine heart. Tissue Eng Part C Methods 2010; 16:525-32. [PMID: 19702513 DOI: 10.1089/ten.tec.2009.0392] [Citation(s) in RCA: 231] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Whole organ engineering would benefit from a three-dimensional scaffold produced from intact organ-specific extracellular matrix (ECM). The microenvironment and architecture provided by such a scaffold would likely support site-appropriate cell differentiation and spatial organization. The methods to produce such scaffolds from intact organs require customized decellularization protocols. In the present study, intact adult porcine hearts were successfully decellularized in less than 10 h using pulsatile retrograde aortic perfusion. Serial perfusion of an enzymatic, nonionic detergent, ionic detergent, and acid solution with hypotonic and hypertonic rinses was used to systematically remove cellular content. The resultant cardiac ECM retained collagen, elastin, and glycosaminoglycans, and mechanical integrity. Cardiac ECM supported the formation of organized chicken cardiomyocyte sarcomere structure in vitro. The intact decellularized porcine heart provides a tissue engineering template that may be beneficial for future preclinical studies and eventual clinical applications.
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Affiliation(s)
- John M Wainwright
- Department of Surgery, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Sakurai H, Takeuchi M, Nakamori D, Kono T, Soejima K, Yamaki T, Nozaki M. Prefabricated flap for multiple facial units reconstruction using a jejunal seromuscular patch as a vascular carrier. Burns 2010; 36:e31-5. [DOI: 10.1016/j.burns.2008.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Accepted: 09/06/2008] [Indexed: 11/30/2022]
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Beattie AJ, Gilbert TW, Guyot JP, Yates AJ, Badylak SF. Chemoattraction of progenitor cells by remodeling extracellular matrix scaffolds. Tissue Eng Part A 2009; 15:1119-25. [PMID: 18837648 DOI: 10.1089/ten.tea.2008.0162] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The chemotactic properties of a biologic scaffold composed of extracellular matrix (ECM) and subjected to in vivo degradation and remodeling were evaluated in a mouse model of Achilles tendon reconstruction. Following a segmental resection of the Achilles tendon in both C57BL/6 and MRL/MpJ mice, the defect was repaired with either an ECM scaffold composed of urinary bladder matrix (UBM) or resected autologous tendon. The surgically repaired and the contralateral tendons were harvested at 3, 7, and 14 days following surgery from each animal. Chemotaxis of multipotential progenitor cells toward the harvested tissue was quantified using a fluorescent-based cell migration assay. Results showed greater migration of progenitor cells toward tendons repaired with UBM-ECM scaffold compared to both the tendons repaired with autologous tissue and the normal contralateral tendon in both the MRL/MpJ and C57BL/6 mice. The magnitude and temporal pattern of the chemotactic response differed between the two mouse strains.
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Affiliation(s)
- Allison J Beattie
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Ge L, Zheng S, Wei H. Comparison of histological structure and biocompatibility between human acellular dermal matrix (ADM) and porcine ADM. Burns 2009; 35:46-50. [DOI: 10.1016/j.burns.2008.05.007] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 05/11/2008] [Indexed: 10/21/2022]
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Choi SI, Lee KY, Park SJ, Lee SH. Experience with Porcine Acellular Dermal Collagen (Permacol®) Implant in Contaminated Fascia Defects. JOURNAL OF THE KOREAN SURGICAL SOCIETY 2009. [DOI: 10.4174/jkss.2009.77.3.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sung Il Choi
- Department of Surgery, KyungHee University School of Medicine, Seoul, Korea
| | - Kil Yeon Lee
- Department of Surgery, KyungHee University School of Medicine, Seoul, Korea
| | - Sun Jin Park
- Department of Surgery, KyungHee University School of Medicine, Seoul, Korea
| | - Suk-Hwan Lee
- Department of Surgery, KyungHee University School of Medicine, Seoul, Korea
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41
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Xu H, Wan H, Sandor M, Qi S, Ervin F, Harper JR, Silverman RP, McQuillan DJ. Host Response to Human Acellular Dermal Matrix Transplantation in a Primate Model of Abdominal Wall Repair. Tissue Eng Part A 2008; 14:2009-19. [DOI: 10.1089/ten.tea.2007.0316] [Citation(s) in RCA: 118] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hui Xu
- LifeCell Corporation, Branchburg, New Jersey
| | - Hua Wan
- LifeCell Corporation, Branchburg, New Jersey
| | | | - Shijie Qi
- Laboratory of Experimental Surgery, Research Center, Centre Hospitalier de l’Université de Montréal, Notre-Dame Hospital, University of Montreal, Montreal, Canada
| | - Frank Ervin
- Behavioral Sciences Foundation, Eastern Caribbean and McGill University and Allen Memorial Institute for Psychiatric Research, Montreal, Canada
| | | | - Ronald P. Silverman
- Division of Plastic Surgery, University of Maryland School of Medicine, Baltimore, Maryland
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Papadogeorgakis N, Petsinis V, Christopoulos P, Mavrovouniotis N, Alexandridis C. Use of a porcine dermal collagen graft (Permacol) in parotid surgery. Br J Oral Maxillofac Surg 2008; 47:378-81. [PMID: 18963286 DOI: 10.1016/j.bjoms.2008.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2008] [Indexed: 11/17/2022]
Abstract
Our aim was to present the results of the use of porcine dermal collagen graft (Permacol) in the prevention of Frey's syndrome and face-contouring aesthetic deformities after operations on the parotid. We treated 19 patients with parotid tumours. After resection, a Permacol sheet was applied to the perimeter of the tissue deficit so that it was fully covered, and was sutured firmly. This technique produced satisfactory aesthetic results with good facial contouring in all patients. It also protected the exposed parotid nerve plexus, and none of the patients developed Frey's syndrome. Permacol produced good results in both postoperative facial contouring and prevention of Frey's syndrome.
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Affiliation(s)
- Nikolaos Papadogeorgakis
- Department of Oral and Maxillofacial Surgery, "Evangelismos" General Hospital of Athens, Dental School, University of Athens, Greece
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Potter MJ, Banwell P, Baldwin C, Clayton E, Irvine L, Linge C, Grobbelaar AO, Sanders R, Dye JF. In vitro optimisation of topical negative pressure regimens for angiogenesis into synthetic dermal replacements. Burns 2008; 34:164-74. [PMID: 18242874 DOI: 10.1016/j.burns.2007.06.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Accepted: 06/24/2007] [Indexed: 12/30/2022]
Abstract
BACKGROUND The use of synthetic dermal replacements (SDRs) in the treatment of large wounds, which have associated morbidity and mortality, has attracted great interest. However, because of poor outcome, SDRs have limited use. The addition of topical negative pressure (TNP) has increased their success, but little research has focused on the underlying mechanisms. This paper studies the in vitro effects of TNP on commonly used SDRs to identify the most effective TNP regimen and optimum SDR for encouraging endothelial cell ingress. METHODS Endothelial cells were co-cultured in vitro on four SDRs with or without TNP. Negative pressure (125mmHg) was applied intermittently, continuously, for 4h per day, or not at all. Endothelial ingress was measured for each condition. RESULTS In the collagen controls, cell migration was minimal. Integratrade mark gave the greatest endothelial cell migration (p<0.05, n=3). TNP increased endothelial cell migration, intermittent application being the optimum regimen. CONCLUSIONS Integratrade mark has an open sponge structure which may account for greater angiogenicity than Allodermtrade mark, Permacoltrade mark and Xenodermtrade mark. In vitro intermittent TNP stimulates the greatest angiogenic response. The majority of clinical studies investigating SDR success with TNP have used continuous regimens; this study suggests a change in clinical practice to intermittent application.
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Shevchenko RV, Sibbons PD, Sharpe JR, James SE. Use of a novel porcine collagen paste as a dermal substitute in full-thickness wounds. Wound Repair Regen 2008; 16:198-207. [PMID: 18318805 DOI: 10.1111/j.1524-475x.2008.00360.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A commercially available porcine collagen sheet material has been found previously to be useful as an implant for reconstructive surgery. However, its use as a dermal substitute has been hindered by slow cell penetration and vascularization. A novel paste formulation of this material was investigated for its potential role as a dermal substitute in full-thickness wounds. A porcine punch biopsy model was initially used to assess the integration of a wide range of material formulations. Selected formulations were then assessed further in a larger wound-chamber model. Paste formulations were compared with those of sheet and another commercially available dermal regeneration template. The porcine collagen paste became integrated into full-thickness wounds without rejection and without excessive inflammation. It was detected in wounds up to day 27 postimplantation. Porcine collagen paste was readily infiltrated by host cells by day 2 and supported migrating keratinocytes on its surface. Staining for endothelial cells indicated neovasculature formation as early as day 4 and functional newly formed microvessels were noted at day 7. This was comparable with neovascularization of an alternative and clinically proven dermal regeneration template and was significantly superior to the sheet material formulation at the same time points. Our findings suggest that porcine collagen paste may be suitable as an alternative to current dermal substitutes in full-thickness wounds.
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Affiliation(s)
- Rostislav V Shevchenko
- Blond McIndoe Research Foundation, Queen Victoria Hospital, East Grinstead, Sussex, United Kingdom
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45
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Hammond TM, Huang A, Prosser K, Frye JN, Williams NS. Parastomal hernia prevention using a novel collagen implant: a randomised controlled phase 1 study. Hernia 2008; 12:475-81. [PMID: 18484151 DOI: 10.1007/s10029-008-0383-z] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 04/25/2008] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parastomal hernias can be prevented or repaired using synthetic mesh; however, reported complications include infection, fibrosis and potential bowel erosion. The study aim was to assess the safety, feasibility and potential efficacy of using a prophylactic collagen implant. METHODS Twenty patients undergoing defunctioning stomas were randomised to a conventional procedure or reinforcement with the implant. Follow-up included regular symptom questionnaires, clinical examination, stoma site ultrasound, and serum inflammatory markers. RESULTS Ten patients (four males; mean BMI 26.3) had a conventional stoma, and ten (three males; mean BMI 26.3) received the implant. At a median of 6.5 months follow-up, a parastomal hernia was clinically evident in three of ten patients without the implant, and in none of ten patients with the implant. There were no clinical complications, ultrasound evidence of chronic seromas or serological evidence of a systemic inflammatory response. CONCLUSIONS Xenogeneic collagen has been demonstrated to aid soft tissue reinforcement. In this study, in contrast to published data relating to the use of conventional synthetic mesh, there were no complications related to infection or the implant's proximity to the bowel. This trial demonstrates that the implant is safe, feasible to use and has the potential to prevent parastomal herniation.
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Affiliation(s)
- T M Hammond
- Centre for Academic Surgery, Institute of Cellular and Molecular Science, The Royal London Hospital, Barts and The London NHS Trust, Queen Mary School of Medicine and Dentistry, University of London, London, UK.
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46
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Hammond TM, Chin-Aleong J, Navsaria H, Williams NS. Human in vivo cellular response to a cross-linked acellular collagen implant. Br J Surg 2008; 95:438-46. [PMID: 18256994 DOI: 10.1002/bjs.5883] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hernia surgery, in particular parastomal hernia mesh repair and new techniques for hernia prevention, require novel biomaterials that avoid fibrosis and potential bowel erosion, while retaining adequate strength for their intended purpose. The aim was to evaluate the human host response to an acellular porcine-derived cross-linked collagen implant. METHODS In a prospective pilot study on prevention of parastomal herniation, 15 patients undergoing loop stoma formation had an implant placed within the anterior abdominal wall. Histopathology and immunohistochemistry were performed to analyse the implant qualitatively and, where appropriate, quantitatively for biocompatibility, degradation, cellular infiltration, neo-extracellular matrix (ECM) formation and neovascularization. RESULTS At a median of 7 (range 1-8) months, 12 of 15 patients had stoma reversal and 11 implant biopsies were obtained. In biopsies from ten of the 11 patients all responses were limited to the periphery of the implant and native pores. There was a minimal inflammatory response and minimal degradation of the implant. Fibroblastic and neovascular infiltration were noted, as was matrix metalloproteinase 1 activity with organized deposition of host collagen, fibronectin and laminin. CONCLUSION The collagen implant demonstrated excellent biocompatibility and resistance to degradation in most patients. However, fibrovascular in-growth and ECM deposition were limited. This implant has excellent potential for soft tissue reinforcement.
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Affiliation(s)
- T M Hammond
- Centre for Academic Surgery, Institute of Cellular and Molecular Science, The Royal London Hospital, Barts and The London NHS Trust, Queen Mary School of Medicine and Dentistry, University of London, London, UK.
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47
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Allen KD, Athanasiou KA. Effect of passage and topography on gene expression of temporomandibular joint disc cells. ACTA ACUST UNITED AC 2007; 13:101-10. [PMID: 17518584 DOI: 10.1089/ten.2006.0094] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The temporomandibular joint (TMJ) disc is maintained by a population of fibrochondrocytes. Although articular chondrocytes exhibit zonal differences and de-differentiate in monolayer culture, such variations are unknown for fibrochondrocytic populations. This study's objective was to define topographical cellular variations in the porcine TMJ disc and investigate changes in the disc's gene expression levels over multiple passages using quantitative reverse transcriptase polymerase chain reaction. For topographical characterization, samples were acquired from posterior, anterior, lateral, medial, and intermediate zone sections and subdivided into inferior and superior halves. For passage characterization, cells were plated and passaged for 35 days, with samples acquired at every passage. The medial region had the lowest expression of genes indicative of fibroblastic activity, but in general, topographical variations were limited. Passage effects were evident; gene expression levels of aggrecan, collagen type I, and collagen type II dropped 20%, 23%, and 73% per passage, respectively. In contrast, decorin and glyseraldehyde-3-phosphate dehydrogenase gene expression increased 33% and 27% per passage, respectively. These data indicate that TMJ disc cells undergo significant changes due to monolayer expansion, experiencing losses in major chondrocytic markers (aggrecan and collagen type II) and fibroblastic markers (collagen type I) and posing a serious impediment to studies in which cell passaging is required.
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Affiliation(s)
- Kyle D Allen
- Department of Bioengineering, Rice University, Houston, Texas 77251-1892, USA
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Gratzer PF, Harrison RD, Woods T. Matrix alteration and not residual sodium dodecyl sulfate cytotoxicity affects the cellular repopulation of a decellularized matrix. ACTA ACUST UNITED AC 2007; 12:2975-83. [PMID: 17518665 DOI: 10.1089/ten.2006.12.2975] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
It has been suggested that residual cytotoxic sodium dodecyl sulfate (SDS) is responsible for the low levels of cell in-growth observed in SDS decellularized tissues. To determine whether this is the case, we used 2 washing methods to remove residual SDS and extensive biochemical, mechanical, and structural analyses to determine the effects of SDS-based decellularization on porcine anterior cruciate ligament (ACL) tissue and its propensity for cellular repopulation. The level of residual SDS in decellularized tissue was reduced using 2 different washing techniques (pH = 9 buffer, 75% ethanol). After washing in pH = 9 or 75% ethanol, residual SDS concentrations in decellularized tissues were found to be approximately 8 and 23 times less than reported SDS cytotoxic levels, respectively. It was found that SDS treatment significantly reduced glycosaminoglycan levels, increased collagen crimp amplitude and periodicity, and increased susceptibility of collagen to degradation by the gelatinase enzyme trypsin. The level of repopulation and viability of autologous ACL fibroblasts in the decellularized tissue after 28 days of culture were found to be the same regardless of the washing technique and resulting level of residual SDS in the tissue. This strongly indicates that alterations in tissue matrix biochemistry or structure from SDS treatment and not residual SDS cytotoxicity are responsible for the low cell re-population observed in SDS decellularized tissues.
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Affiliation(s)
- Paul F Gratzer
- School of Biomedical Engineering, Institute for Research in Materials, and Department of Process Engineering and Applied Science, Dalhousie University, Halifax, Nova Scotia, Canada.
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Ozeki M, Narita Y, Kagami H, Ohmiya N, Itoh A, Hirooka Y, Niwa Y, Ueda M, Goto H. Evaluation of decellularized esophagus as a scaffold for cultured esophageal epithelial cells. J Biomed Mater Res A 2007; 79:771-8. [PMID: 16871513 DOI: 10.1002/jbm.a.30885] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Recently, decellularized tissue has been reported to have the potential to regenerate a variety of tissues. However, the optimal protocol for a decellularized esophagus has not been studied. Here, we investigated the effect of different decellularization protocols on the histology and biocompatibility of decellularized esophagi in view of future applications to tissue engineering. The esophageal mucosal epithelium (EP) from 4-week-old Wistar rats was enzymatically dissociated and cultured with growth-arrested feeder cells. Two methods for decellularization using deoxycholic acid (DEOX) or Triton X-100 (TRITON) were compared on esophagi from adult Wistar rats. Those treated with DEOX showed superior mechanical properties, maintenance of extracellular matrix, and lower DNA content than those treated with TRITON. To evaluate the biocompatibility of the scaffold, cultured (passage 3) esophageal epithelial cells were seeded inside the decellularized esophagus and cultured for 7 days. The cells seeded onto the decellularized esophagus were examined histologically and immunocytochemically. Esophageal epithelial cells were stratified into three to four cellular layers in vitro inside the decellularized esophagus, to show polarity. The results from immunocytochemistry indicated that the seeded epithelial cells expressed characteristic marker proteins for native esophageal EP. Decellularized esophagus showed suitable compatibility as a scaffold material for esophageal tissue engineering.
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Affiliation(s)
- Masayasu Ozeki
- Division of Gastroenterology, Department of Therapeutic Medicine, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
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Valentin JE, Badylak JS, McCabe GP, Badylak SF. Extracellular matrix bioscaffolds for orthopaedic applications. A comparative histologic study. J Bone Joint Surg Am 2006; 88:2673-86. [PMID: 17142418 DOI: 10.2106/jbjs.e.01008] [Citation(s) in RCA: 257] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Biologic scaffold materials prepared from extracellular matrix are currently available for the surgical repair of damaged or missing musculotendinous tissue. These scaffolds differ in their species and tissue of origin, methods of processing, and methods of terminal sterilization. The purpose of the present study was to evaluate the host-tissue morphologic response to five commercially available extracellular matrix-derived biologic scaffolds used for orthopaedic soft-tissue repair in a rodent model. METHODS One hundred twenty-six Sprague-Dawley rats were divided into six groups of twenty-one animals each. A defect was created in the musculotendinous tissue of the abdominal wall of each animal and then was repaired with one of five different scaffold materials (GraftJacket, Restore, CuffPatch, TissueMend, Permacol) or with the excised autologous tissue. Three animals from each group were killed at one of seven time-points after surgery (two, four, seven, fourteen, twenty-eight, fifty-six, and 112 days), and the specimens were examined with histologic and morphologic methods. The degree of cellular infiltration, multinucleated giant cell presence, vascularity, and organization of the replacement connective tissue were evaluated with semiquantitative methods. RESULTS Each device elicited a distinct morphologic response that differed with respect to cellularity (p<0.001), vascularity (p<0.01), the presence of multinucleated giant cells (p<0.01), and organization of the remodeled tissue (p<0.01) at or after the Day 7 time-point. More rapidly degraded devices such as Restore and autologous tissue showed the greatest amount of cellular infiltration, especially at the early time-points. Devices that degraded slowly, such as CuffPatch, TissueMend, and Permacol, were associated with the presence of foreign-body giant cells, chronic inflammation, and/or the accumulation of dense, poorly organized fibrous tissue. CONCLUSIONS Biologic scaffold materials composed of extracellular matrix elicit distinct host-tissue histologic and morphologic responses, depending on species of origin, tissue of origin, processing methods, and/or method of terminal sterilization.
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Affiliation(s)
- Jolene E Valentin
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, 100 Technology Drive, Suite 200, Pittsburgh, PA 15219, USA
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