The development of a decellularized extracellular matrix–basedbiomaterial scaffold derived from human foreskin for the purpose of foreskinreconstruction in circumcised males

摘要

The circumcision of males is emphatically linked to numerous sexual dysfunctions. Many of the purported benefits do not hold up to the scrutiny of extensive literature surveys. Involuntary circumcision, particularly when not medically warranted, is also associated with many psychological and emotional traumas. Current methods to reconstruct the ablated tissue have significant drawbacks and produce a simple substitute that merely imitates the natural foreskin. Extracellular matrix–based scaffolds have been shown to be highly effective in the repair and regeneration of soft tissues; however, due to the unique nature of the foreskin tissue, commercially available biomaterial scaffolds would yield poor results. Therefore, this study discusses the development and evaluation of a tissue engineering scaffold derived from decellularized human foreskin extracellular matrix for foreskin reconstruction. A chemicophysical decellularization method was applied to human foreskin samples, sourced from consenting adult donors. The resulting foreskin dermal matrices were analyzed for their suitability for tissue engineering purposes, by biological, histological, and mechanical assessment; fresh frozen foreskin was used as a negative control. Sterility of samples at all stages was ensured bymicrobiological analysis. MTT assay was used to evaluate the absence of viablecells, and histological analysis was used to confirm the maintenance of theextracellular matrix structure and presence/integrity of collagen fibers.Bioactivity was determined by submitting tissue extracts to enzyme-linkedimmunosorbent assay and quantifying basic fibroblast growth factor content.Mechanical properties of the samples were determined using tensile stress tests.Results found foreskin dermal matrices were devoid of viable cells(p < 0.0001) and the matrix of foreskin dermal matriceswas maintained. Basic fibroblast growth factor content doubled within afterdecellularization (p < 0.0001). Tensile stress tests foundno statistically significant differences in the mechanical properties(p < 0.05). These results indicate that the derivedforeskin dermal matrix may be suitable in a regenerative approach in thereconstruction of the human foreskin.