MEMBRANES AND HYDROGELS IN RECONSTRUCTIVE SURGERY

摘要

The clinical requirement for artificial graft materials to promote effective wound repair is large. Examples of chronic or extensive wounds include burn injuries, post traumatic skin and soft tissue defects, pressure sores (decubitus u cers), diabetic skin ulcers, venous stasis ulcers, and defects arising following tumor excision. Especially, progress in burn care is dependent much on a suitable sophisticated skin substitute. The successful development of a permanent skin substitute will have a very strong impact on care of patients with serious burns. With regard to woundcare, the desirable final goal is that the engineered tissue becomes integrated within the patient, affording a potentially permanent and specific cure. Engineering of skin substitutes provides a prospective source of advanced therapies for treatment of acute and chronic wounds. The most common tissue engineering strategies involve the use of isolated cells or cell substitutes, tissue-inducing substances, and cells seeded on or within polymer ma rices with a three-dimensional architecture as well as appropriate biological and mechanical properties. By design and incorporation of specific therapeutic properties in skin substitutes, reduction of morbidity and mortality from full-thickness wounds can be facilitated. Several companies are investigating the use of biodegradable polymers - natural and/or synthetic as a matrix for living cells. In this regard, important properties of the materials include porosity for cell in-growth, an appropriate surface for cellular attachment, mechanical properties compatible with those of the latural tissues, and degradation rate with by-products. In case of skin substitute in the form of a membrane, the polymer matrix, may represent the device itself, or can be a scaffold for cell growth in vitro that is degraded by the growing cells prior to implantation.