Treatment of full-layer skin defects using decellularized pig skin dermal matrix
Keywordsskin defects, decellularized dermal matrix
The choice of treatment methods for complex skin defects poses certain technical and medical difficulties related to the choice of material for filling the wound defect and its antigenic compatibility. A promising direction in the treatment of skin defects is the use of decellularized (celluless) pig skin, the composition and structure of which is as close as possible to the patient's dermis.
The aim of the study was to analyze the clinical case of a patient with a basal cell carcinoma in the right wing of the nose, who was treated with full-layer skin defects using a decellularized dermal matrix from pig skin.
Material and methods of investigation. Patient P., 94 years old, with a basal cell carcinoma in the area of the right wing of the nose, underwent treatment. As a material applied directly to the wound, a flap of acellular dermal matrix (ADM) of pig skin with preservation of the native structure was used.
Results. 6 weeks before the visit to the dermatologist, the patient developed a pea-sized papule on the skin in the area of the wing of the nose, which increased in size and became painful on palpation. When examining the skin in the area of the right wing of the nose, a tumor-like formation was observed, 1x1 cm in size, flesh-colored, with peeling on the surface and vascularization, firm consistency, painful. Regional lymph nodes are not enlarged. The formation is clearly separated from healthy skin. The oncologist made a diagnosis: basal cell carcinoma. The tumor was removed, resulting in a full-layer skin defect measuring 1x1.5 cm with connection to the nasal cavity. Acellular dermal matrix was used to close the defect on the 3rd day after surgery. The flap was placed so that it did not cover the skin around the wound. With the help of "Levomykol" ointment, a moist chamber was created over the dermal flap. The dressing was changed every 2-3 days. On the 14th day, the flap peeled off, a granulating wound with signs of marked marginal epithelization formed in its place. The bottom of the wound was located almost at the same level as the intact skin. On the 21st and 26th day, active marginal epithelization of the wound and wound healing under the scab were noted. The bandage was not used during this period. On the 32nd day, the wound closed.
Conclusions. Decellularized dermal matrix of pig skin when closing a full-layer postoperative skin defect creates optimal conditions for reparative wound regeneration. The effectiveness of its use is due to the presence of a collagen matrix in it, from which the nuclear elements of cells have been removed, which does not lead to immune aggression. The clinical case proves the expediency of using the decellularized dermal matrix of pig skin in the treatment of full-layer skin defects of various genesis.
Debeer S.; LeLuduec J. B.; Kaiserlian D.; Laurent P.; Nicolas J. F.; Dubois B.; Kanitakis J. Comparative histology and immunohistochemistry of porcine versus human skin. Eur. J. Dermatol.23(4): 456–466; 2013.
Summerfield A.; Meurens F.; Ricklin M. E. The immunology of the porcine skin and its valueas a model for human skin. Mol. Immunol.66(1): 14–21; 2015.
Liao J.; Joyce E. M.; Sacks M. S. Effect sofdecellularization on the mechanical and structural properties of the porcine aortic valveleaflet.Biomaterials29(8): 1065–1074; 2008.
Lee W.; Miyagawa Y.; Long C.; Cooper D. K.; Hara H. A comparison of three methods of decellularization of pig cornea store duce immunogenicity.Int. J. Opthamol.7(4): 587–593; 2014.
Hrebikova H, Diaz D, Mokry J. Chemical decellularization: a promising approach for preparation of extracellular matrix. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2015;159(1):12-7.
Crapo, P. M.; Gilbert, T. W.; Badylak, S. F. Anoverview of tissue and wholeorgan decellularization processes. Biomaterials 2011, 32 (12), 3233−3243.
Riau A. K.; Beuerman R. W.; Lim L. S.; Mehta J. S. Preservation, sterilization and de-epithelialization of human amniotic membrane for useinocular surface reconstruction.Biomaterials31(2): 216–225; 2010.
Olczyk P.; Mencner L.; Komosinska-Vassev K. The role of the extracellular matrix components in cutaneous wound healing.BioMed. Res. Int. 2014: 747584; 2014.
Volk S. W.; Iqbal S. A.; Bayat A. Interactions of the extracellular matrix and progenitor cells in cutaneous wound healing. Adv. WouldCare2(6): 261–272; 2013.
I. S. Kulyanda, L. Ya. Fedonyuk, A. I. Dovgalyuk, S. B. Kramar, O. O. Kulyanda Production of acellular dermal matrix from pig skin: morphological analysis. Achievements of clinical and experimental medicine. 2020. No. 4, pp. 107-113.
Snyder D.L., Sullivan N., Schoelles K.M. Skin substitutes for treating chronic wounds. Technology Assessment Report. – London: ECRI Institute Evidence-based Practice Center (EPC), 2012. – 290 р.
Badylak S.F., Taylor D., Uygun K. Whole-organ tissue engineering: decellularization and recellularization of three-dimensional matrix scaffolds // Annu. Rev. Biomed. – 2011. - №13. – Р. 27–53.
Ellis, C. Acellular dermal matrices in hand reconstruction / C. Ellis, D. Kulber //Plast. Reconstr. Surg. – 2012. – №130, Suppl 2. – Р. 256-269.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Number of views and downloads: 71
Number of citations: 0