A Histological Evaluation of Artificial Dermal Scaffold Used in Micrograft Treatment: A Case Study of Micrograft and NPWT Performed on a Postoperative Ulcer Formation after Tumor Resection.
A Histological Evaluation of Artificial Dermal Scaffold Used in Micrograft Treatment: A Case Study of Micrograft and NPWT Performed on a Postoperative Ulcer Formation after Tumor Resection.
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DOI：
10.3390/medicina58010073
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发表时间：
2022-01-04
期刊：
影响因子：
--
通讯作者：
Takeda A
中科院分区：
文献类型：
--
作者：
Niimi Y;Baba K;Tsuchida M;Takeda A
背景和目标：伤口愈合（WH）是一个复杂的自然过程：有时无法通过标准疗法实现适当的 WH，并且经常在老年和糖尿病患者中观察到，导致顽固性溃疡。近年来，自体微移植（AMG）疗法已成为研究人员和临床医生一种新的、有效的、负担得起的伤口护理策略。在这项研究中，一名72岁的女性患者在背部良性肿瘤切除术后的皮肤溃疡上接受了微移植和负压伤口疗法（NPWT）的联合治疗，旨在提出一种使用AMG结合人工真皮支架和NPWT治疗皮肤溃疡的创新方法。材料和方法：在移植前对注入微移植物的人造真皮支架的切片进行取样，并在术后第 3 天和第 7 天收集切片。采用苏木精-伊红 (HE) 和免疫组织化学染色来评估细胞角蛋白 AE1/AE3、结蛋白和因子 VIII。此外，术后第 3 天，还使用 HE 染色对 NPWT 敷料进行了评估。由此产生的 HE 和免疫染色分析显示，移植前人造真皮的胶原层内存在红细胞和组织碎片。术后第3天，HE染色显示人工真皮胶原层有红细胞和中性粒细胞，免疫染色检测到细胞角蛋白AE1/AE3阳性细胞散在。术后第 7 天的 HE 染色显示，人工真皮胶原层内的红细胞和中性粒细胞比第 3 天更多，细胞角蛋白 AE1/AE3 阳性细胞增加，组织结蛋白和因子 VIII 染色呈阳性。结果：结果表明，微移植物和迁移细胞的作用可能加速了伤口愈合过程。此外，第 3 天的 NPWT 敷料显示敷料内几乎没有细胞。这表明在微移植后立即重新开始 NPWT 治疗并没有吸引支架内的细胞。结论：微移植治疗和 NPWT 可能成为复杂伤口愈合过程的有效联合疗法。
Background and Objectives: Wound healing (WH) is a complex natural process: the achieving of a proper WH with standard therapies sometimes is not fulfilled and it is often observed in aged and diabetic patients, leading to intractable ulcers. In recent years, autologous micrograft (AMG) therapies have become a new, effective, and affordable wound care strategy among both researchers and clinicians. In this study, a 72-year-old female patient underwent a combination of treatments using micrograft and negative pressure wound therapy (NPWT) on a postoperative skin ulcer after a benign tumor resection on the back with the aim to present an innovative method to treat skin ulceration using AMG combined with an artificial dermal scaffold and NPWT. Materials and Methods: A section of the artificial dermal scaffold, infused with micrografts, was sampled prior to transplant, and sections were collected postoperatively on days 3 and 7. Hematoxylin-eosin (HE) and immunohistochemical stains were employed for the evaluation of Cytokeratin AE1/AE3, desmin, and Factor VIII. Additionally, on postoperative day 3, NPWT dressing was evaluated using HE stains, as well. The resulting HE and immunostaining analysis revealed red blood cells and tissue fragments within the collagen layers of the artificial dermis prior to transplant. On postoperative day 3, collagen layers of the artificial dermis revealed red blood cells and neutrophils based on HE stains, and scattering of cytokeratin AE1/AE3-positive cells were detected by immunostaining. The HE stains on postoperative day 7 showed more red blood cells and neutrophils within the collagen layers of the artificial dermis than on day 3, an increase in cytokeratin AE1/AE3-positive cells, and tissue stained positively with desmin and Factor VIII. Results: Results suggest that the effects of both micrografts and migratory cells have likely accelerated the wound healing process. Furthermore, the NPWT dressing on day 3 showed almost no cells within the dressing. This indicated that restarting NPWT therapy immediately after micrograft transplant did not draw out cells within the scaffold. Conclusions: Micrograft treatment and NPWT may serve to be a useful combination therapy for complex processes of wound healing.
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