Use of macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration of healthy dermis in humans: An in vivo study

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 63; no. 5; pp. 848 - 857
• Main Authors: Huss, Fredrik R.M., Nyman, Erika, Bolin, Johanna S.C., Kratz, Gunnar
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.05.2010; Elsevier
• Subjects: Absorbable Implants; Adult; Biological and medical sciences; Biopsy; Biotechnology; Dermis - cytology; Dermis - physiology; Fibroblasts - cytology; Fibroblasts - drug effects; Filler; Fundamental and applied biological sciences. Psychology; Gelatin - administration & dosage; Guided tissue regeneration; Health. Pharmaceutical industry; Human; Humans; Hyaluronic Acid - administration & dosage; Hyaluronic Acid - analogs & derivatives; Industrial applications and implications. Economical aspects; Injections, Intradermal; Medical sciences; MEDICIN; MEDICINE; Miscellaneous; Plastic Surgery; Porosity; Reconstructive Surgical Procedures - methods; Reference Values; Regeneration - physiology; Soft Tissue Injuries - surgery; Soft-tissue defect; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue engineering; Tissue Scaffolds; Wound Healing - drug effects; Young Adult; Soft-tissue defect; Human; Plastic surgery; Tissue engineering; Filler; Guided tissue regeneration; Soft tissue defect; Absorbable; Guided tissue; Guidance; In vivo; Regeneration; Treatment; Derm
• ISSN: 1748-6815; 1878-0539; 1878-0539
• DOI: 10.1016/j.bjps.2009.01.068

If a biodegradable scaffold is applied, the dermis can be regenerated by guided tissue regeneration. Scaffolds can stimulate in-growth of cells from the surroundings that migrate into them and start to produce autologous extracellular matrix as the scaffold is degraded. Several materials are available, but most of them are in the form of sheets and need to be laid on an open wound surface. A number of injectable fillers have been developed to correct soft-tissue defects. However, none of these has been used for guided tissue regeneration. We present a new technique that could possibly be used to correct dermal defects by using macroporous gelatine spheres as a biodegradable scaffold for guided tissue regeneration. In eight healthy volunteers, intradermal injections of macroporous gelatine spheres were compared with injections of saline and hyaluronic acid (Restylane ®). Full-thickness skin biopsy specimens of the implants and surrounding tissue were removed 2, 8, 12 and 26 weeks after injection, and the (immuno)histological results were analysed. The Restylane ® merely occupied space. It shattered the dermal tissue and compressed collagen fibres and cells at the interface between the implant and the dermis. No regeneration of tissue was found with this material at any time. The macroporous gelatine spheres were populated with fibroblasts already after 2 weeks. After 8 weeks the spheres were completely populated by fibroblasts producing dermal tissue. After 12 and 26 weeks, the gelatine spheres had been more or less completely resorbed and replaced by vascularised neodermis. There were no signs of capsular formation, rejection or adverse events in any subject. Further in vivo studies in humans are needed to evaluate the effect of the macroporous spheres fully as a matrix for guided tissue regeneration with and without cellular pre-seeding. However, the results of this study indicate the possibility of using macroporous gelatine spheres as an injectable, three-dimensional, degradable matrix for guided tissue regeneration.