Journal of the Chinese Medical Association
Volume 73, Issue 2 , Pages 108-112, February 2010

Novel Application of Artificial Dermis Plus Autologous Vital Epithelial Cells: Improved Wound Epithelialization

  • Li-Tzu Lee

      Affiliations

    • Department of Oral and Maxillofacial Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Po-Cheung Kwan

      Affiliations

    • Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
    • ,
  • Yong-Kie Wong

      Affiliations

    • National Yang-Ming University School of Dentistry, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Yong-Kie Wong, Department of Oral and Maxillofacial Surgery, Taichung Veterans General Hospital, 160, Section 3, Taichung-Kang Road, Taichung 407, Taiwan, R.O.C.

Received 2 April 2009; accepted 1 December 2009.

Article Outline

The purpose of this study was to evaluate artificial dermis with the simultaneous addition of autologous epithelial cells for oral lesion defect reconstruction. Surgical wounds reconstructed with artificial dermis plus scraped epithelial cells were evaluated in 5 patients with oral benign lesions or squamous cell carcinoma. Clinical follow-up indices included scar formation and tissue surface texture observation. The neomucosal layers were analyzed histologically to establish the degree of epithelialization. Clinical observation showed that the oral mucosal texture was smoother in artificial dermis with added epithelial cells at 4 weeks postoperation compared with artificial dermis alone. The wound contraction and scar formation processes were slow. Viable epithelial cells with flat rete ridges remained in the artificial dermis, and a neoepithelial layer was present in the histological findings. We showed that healthy granulation tissue and neoepithelial formation in artificial dermis with epithelial cells was beneficial for the repair of oral defects. Scraping oral epithelial cells and applying them to artificial dermis assisted in the early preparation of composite grafts and minimized requirement for donor sites. This technique may improve the treatment of patients with oral benign tumors and early-stage squamous cell carcinoma.

Key Words:  artificial dermis , epithelialization , scar contraction , squamous cell carcinoma , tissue engineering

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Chen CM, Yang CF, Huang IY, Shen TS, Shieh TY, Chen CH, et al. Clinical evaluation of a new bilayer artificial dermis for repair of oral mucosal defects: report of two cases . Kaohsiung J Med Sci . 2004;20:516–520
  2. Ophof R , Maltha JC , Von den Hoff JW , Kuijpers-Jaqtman AM . Histologic evaluation of skin-derived and collagen-based substrates implanted in palatal wounds . Wound Repair Regen . 2004;12:528–538
  3. Reid MJ , Currie LJ , James SE , Sharpe JR . Effect of artificial dermal substitute, cultured keratinocytes and split-thickness skin graft on wound contraction . Wound Repair Regen . 2007;15:889–896
  4. Lee JW , Jang YC , Oh SJ . Use of the artificial dermis for a free radial forearm flap donor site . Ann Plast Surg . 2005;55:500–502
  5. Tanihara M , Kajiwara K , Ida K , Suzuki Y , Kamitakahara M , Oqata S . The biodegradability of poly(Pro-Hyp-Gly) synthetic polypeptide and the promotion of a dermal wound epithelialization using a poly(Pro-Hyp-Gly) sponge . J Biomed Mater Res A . 2008;85:133–139
  6. Bessho K , Murakami K , Iizuka T . The use of a new bilayer artificial dermis for vestibular extension . Br J Oral Maxillofac Surg . 1998;36:457–459
  7. Hatoko M , Kuwahara M , Tanaka A , Yuruqi S , Iioka H , Niitsuma K . Correction of bone deformity after resection of dermoid cyst using artificial dermis implantation . Aesthetic Plast Surg . 2002;26:35–39
  8. Osaki K , Miura A , Koide M , Katakura T , Suqihara T . The effect of a collagenous implant on deep dermo-periosteal defects in the rabbit . J Dermatol . 1996;23:83–88
  9. Yurugi S , Hatoko M , Kuwahara M , Tanaka A , Iioka H , Niitsuma K . Usefulness and limitations of artificial dermis implantation for posttraumatic deformity . Aesthetic Plast Surg . 2002;26:360–364
  10. Soejima K , Chen X , Nozaki M , Hori K , Sakurai H , Takeuchi M . Novel application method of artificial dermis: one-step grafting procedure of artificial dermis and skin, rat experimental study . Burns . 2006;32:312–318
  11. Chung JH, Cho KH, Lee DY, Kwon OS, Sung MW, Kim KH, et al. Human oral buccal mucosa reconstructed on dermal substrates: a model for oral epithelial differentiation . Arch Dermatol Res . 1997;289:677–685
  12. Pellard S . An overview of the two widely accepted, but contradictory, theories on wound contraction . J Wound Care . 2006;15:90–92
  13. Rhee PH , Friedman CD , Ridge JA , Kusiak J . The use of processed allograft dermal matrix for intraoral resurfacing: an alternative to split-thickness skin grafts . Arch Otolaryngol Head Neck Surg . 1998;124:1201–1204
  14. Zhang W , Hu M , Wang EB , Bu JO . The clinical application of acellular dermal matrix to repair the defect of oral mucosa . Zhonghua Kou Qiang Yi Xue Za Zhi . 2005;40:241–243
  15. Wei PC , Laurell L , Lingen MW , Geivelis M . Acellular dermal matrix allografts to achieve increased attached gingiva. Part 2. A histological comparative study . J Periodontol . 2002;73:257–265
  16. Izumi K , Terashi H , Marcelo CL , Feinberg SE . Development and characterization of a tissue-engineered human oral mucosa equivalent produced in a serum-free culture system . J Dent Res . 2000;79:798–805
  17. Imaizumi F , Asahina I , Moriyama T , Ishii M , Omura K . Cultured mucosal cell sheet with a double layer of keratinocytes and fibroblasts on a collagen membrane . Tissue Eng . 2004;10:657–664
  18. Shephard P , Martin G , Smola-Hess S , Brunner G , Krieg T , Smola H . Myofibroblast differentiation is induced in keratinocyte-fibroblast co-cultures and is antagonistically regulated by endogenous transforming growth factor-beta and interleukin-1 . Am J Pathol . 2004;164:2055–2066
  19. Wong T , McGrath JA , Navasaria H . The role of fibroblasts in tissue engineering and regeneration . Br J Dermatol . 2007;156:1149–1155
  20. Park JB . Increasing the width of keratinized mucosa around endosseous implant using acellular dermal matrix allograft . Implant Dent . 2006;15:275–281
  21. Batista EL , Batista FC . Managing soft tissue fenestrations in bone grafting surgery with an acellular dermal matrix: a case report . Int J Oral Maxillofac Implants . 2001;16:875–879
  22. Ophof R , Maltha JC , Kuijper-Jagtman AM , Von Den Hoff JW . Evaluation of a collagen-glycosaminoglycan dermal substitute in the dog palate . Tissue Eng . 2007;13:2689–2698
  23. Moharamzadeh K , Brook IM , Van Noort R , Scutt AM , Thornhill MH . Tissue-engineered oral mucosa: a review of the scientific literature . J Dent Res . 2007;86:115–124

PII: S1726-4901(10)70012-5

doi:10.1016/S1726-4901(10)70012-5

Journal of the Chinese Medical Association
Volume 73, Issue 2 , Pages 108-112, February 2010

Article Tools