Negative pressure therapy stimulates healing of critical-size calvarial defects in rabbits.
Negative pressure therapy stimulates healing of critical-size calvarial defects in rabbits.
复制标题
负压治疗刺激兔子中关键大小的钙钙缺损的愈合。
DOI：
10.1038/bonekey.2013.33
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Carnes, David L
中科院分区：
文献类型：
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作者：
Swain, Larry D;Cornet, Douglas A;Manwaring, Michael E;Collins, Barbara;Singh, Vinay K;Beniker, Dan;Carnes, David L
负压疗法(NPT)是对创面施加有控制的亚大气压力。它已被证明可以促进广泛的软组织伤口的愈合，至少部分是通过对伤口环境中的细胞和组织施加机械应力来实现的。本研究验证了应用NPT治疗骨骼成熟兔颅骨临界大小缺陷(CSD)导致骨性愈合的假说。NPT在与完整硬脑膜接触的含CSD的磷酸钙支架上放置1、4、6或10天。在12周后，NPT组显示明显更多的缺损桥接处和支架内的骨(P<；0.01)。延长NPT的使用时间并没有导致支架内的骨量增加，但确实增加了支架上半部分的骨量。在第6天去除NPT后立即出现的缺损区内的组织表明，硬脑膜压缩和扩张的交替区域表明细胞伸展。硬脑膜和邻近组织由多个细胞层组成，这些细胞层向上延伸到支架、衬里支柱和填充孔隙。细胞外基质密集填充细胞和毛细血管以及较大的血管，NPT处理的支架中有渗透的毛孔，而对照支架的毛孔内有散在的纺锤形细胞和稀疏的基质。这一兔模型数据表明，NPT在成熟的硬脑膜内激活，这是一种自然愈合的级联反应，导致骨组织的形成，而不需要添加外源因子或祖细胞。
Negative pressure therapy (NPT) is the controlled application of subatmospheric pressure to wounds. It has been shown to stimulate healing across a broad spectrum of soft-tissue wounds, at least in part from the application of mechanical stress on cells and tissues in the wound environment. This study tests the hypothesis that application of NPT to cranial critical-size defects (CSD) in skeletally mature rabbits leads to osseous healing. NPT was delivered 1, 4, 6 or 10 days over CSD-containing calcium phosphate scaffolds placed in contact with intact dura. At 12 weeks after defect creation, NPT groups exhibited significantly greater defect bridging and bone within the scaffolds (P<0.01). Increasing duration of NPT did not result in a greater amount of bone within the scaffolds, but did increase the amount of bone distributed in the upper half of the scaffolds. Appearance of tissue within defects immediately following the removal of NPT at day 6 suggests alternating regions of dural compression and distention indicative of cell stretching. Dura and adjacent tissue were composed of multiple cell layers that extended up into the scaffolds, lining struts and populating pore spaces. An extracellular matrix densely populated with cells and capillaries, as well as larger vessels, infiltrated pores of NPT-treated scaffolds, while scattered spindle-shaped cells and sparse stroma are present within pores of control scaffolds. This rabbit model data suggest that NPT activates within mature dura a natural healing cascade that results in osseous tissue formation without the addition of exogenous factors or progenitor cells.