Therapeutic Treatment of 2A Grade Burns with Decellularized Bovine Peritoneum as a Xenograft: Multicenter Randomized Clinical Trial

An in vivo evaluation of the safety and efficacy of using decellularized bovine parietal peritoneum membranes as dural substitutes

Purpose

The reconstruction of dura matter is a challenging problem for neurosurgeons. A number of materials for dural reconstruction have recently been developed, but some of them have poor biocompatibility, poor mechanical properties, and adverse effects. Bovine parietal peritoneum is a promising natural material for regenerative medicine and reconstructive surgery. In this study, we conducted an in vivo evaluation of the safety and efficacy of using decellularized bovine peritoneum membranes (BPMs) as natural dural substitutes in a rabbit model.

Methods

The dural defects in mature New Zealand rabbits were studied. A BPM was sutured on the dural defect area of each animal. Autologous periosteum and collagen membranes (Lyoplant®) were used to facilitate a comparison with the BPMs. ELISA, histomorphological analysis, and hematological analysis were carried out to examine the safety and efficacy of using BPMs as dural substitutes.

Results

Our results showed that the BPMs demonstrated a deterioration rate that is suitable for gathering newly formed meningothelial tissue. The thickness and density of BPM fibers prevents resorption in the first few days after use as a plastic material, and the regeneration of the dura mater does not occur at an accelerated pace, meaning that the gradual formation of fibrous tissue prevents adhesion to the brain surface. It was observed that the BPM can integrate with the adjacent tissue to repair dural defects. Moreover, the transplantation of BPMs did not cause significant adverse effects or immunological responses, indicating the safety and good biocompatibility of the BPM.

Conclusion

Thus, our in vivo study in a rabbit model showed that decellularized BPMs may represent a biocompatible natural material that can be used in cases requiring dura matter repair without significant adverse effects.

Alloplastic Epidermal Skin Substitute in the Treatment of Burns

The goal of burn wound treatment is to ensure rapid epithelialization in superficial burns and the process of rebuilding the lost skin in deep burns. Topical treatment plays an important role. One of the innovations in the field of synthetic materials dedicated to the treatment of burns is epidermal skin substitutes. Since the introduction of Suprathel®, the alloplastic epidermal substitute, many research results have been published in which the authors investigated the properties and use of this substitute in the treatment of wounds of various origins, including burn wounds. Burn wounds cause both physical and psychological discomfort, which is why ensuring comfort during treatment is extremely important. Alloplastic epidermal substitute, due to its biodegradability, plasticity, no need to remove the dressing until healing, and the associated reduction in pain, is an alternative for treating burns, especially in children.

The clinical outcomes of xenografts in the treatment of burn patients: a systematic review and meta-analysis

BACKGROUND

Although autografts are not feasible in patients with extensive burn wounds, allografts and xenografts can be used for temporary coverage. In this systematic review and meta-analysis, we compared the outcomes of xenografts and the standard treatment of burn wounds.

METHODS

International online databases were searched for English articles comparing xenografts with routine treatment in the burn patients. The random-effects model was used to estimate standardized mean differences (SMD) or odds ratios (OR) with a 95% confidence interval (CI).

RESULTS

From a total of 7144 records, 14 studies were included in our review after screening by title and abstracts followed by full-texts. No significant difference in hospital stays was found between the mammalian xenografts and control groups (SMD [95% CI] = - 0.18 [- 0.54-0.18]). The mean number of dressing changes was significantly lower in both mammalian xenografts compared to the controls (SMD [95% CI] = - 1.01 [- 1.61-- 0.41]) and fish xenografts compared to controls (SMD [95% CI] = - 6.16 [- 7.65-- 4.66]). In the fish xenografts, re-epithelialization time was significantly lower compared to controls (SMD [95% CI] = - 1.18 [- 2.23-- 0.14]).

CONCLUSIONS

Xenografts showed a significantly lower number of dressing changes and fish xenografts showed significant benefit in re-epithelialization compared to routine treatment. The beneficial results of xenografts suggest further research in the use of different types of xenografts in patients with extensive burn.

[Research advances of natural biomaterials in promoting wound repair]

Acute and chronic wounds seriously threaten patients' life health and quality of life, therefore, wound repair has become a hot topic of research for scholars at home and abroad in recent years. With the development of material science and tissue engineering, more and more biomaterials prepared from natural ingredients were used in basic research and clinical treatment of wound repair. Such biomaterials can be used as templates for wound tissue regeneration to induce autologous cell adhesion and migration, and promote the deposition of extracellular matrix, which have broad clinical application prospects. This paper reviews the characteristics and application advance of natural biomaterials which are popular in the field of wound repair, aiming to provide ideas for the research and development of new wound dressing and tissue engineering skin.