脱细胞真皮基质修复组织缺损研究进展

脱细胞真皮基质(ADM)是一类经过特殊方法分离皮肤表皮与真皮,去除真皮层内的朗格汉斯细胞、血管内皮细胞、成纤维细胞等附件细胞以及抗原成公主要组织相容性复合物(MHC)而仅保留胶原纤维、弹力蛋白等细胞外基质的特殊生物材料.ADM不引起机体排斥反应,为组织修复提供了良好支架,便于血管化和宿主细胞植入.其制备过程包括分离表皮与真皮、脱细胞成分及打孔、冷冻干燥等.根据分类方法的不同,ADM可分为同种异体ADM和异种ADM、补片型及注射型ADM、交联型与非交联型ADM,同时已有产品相继问世,可根据临床需要进行选择.ADM现已广泛应用于各外科领域,如深度皮肤烧伤、乳腺癌术后乳腺重建、修复口腔黏膜、腹壁疝及声带麻痹等.因其自身特点,临床应用前景广阔.就ADM近年来的研究进展作一综述.

Clinical research progress on tissue defect repairing with acellular dermal matrices

Acellular dermal matrix(ADM) is a special biological material that contains only collagen,elastin and other extracellular matrix.ADMs are made by special methods of separating skin epidermis and dermis,and removing Laugerhans cells,vascular endothelial cells,fibrohlasts cells and major histocompatibility complex (MHC)within the dermis.ADM causes no graft rejection,and provides a good scaffold for tissue reconstruction,angiogenesis and implantation of host cells.The preparation process of ADM includes the separation of epidermis and dermis,decellularization,perforation and freeze-drying.According to the classification method,ADMs can be classified into allogeneic and xenogeneic ADM,patch and injection type ADM,as well as cross-linked and non-crosslinked ADM,which can meet various clinical requirements.ADM is widely used in surgical field,such as treatment of deep burn wounds,breast reconstruction after masteetomy,oral mucosa repair,abdominal wall hernia repair,and treatment of vocal cord paralysis.Due to the characteristics ADM,its application prospect is considerable.The research progress of ADM in recent years was summarized.