A Potential Filling Material for Wound Healing and Shaping: Acellular Dermal Matrix Combined with Autologous Dermis

The currently used subcutaneous fillers are not effective enough. The use of autologous tissues or cells will reduce immune rejection and increase the stability of the fillers, while increasing the absorbability of filling materials. To establish a durable and safe filling material, we herein combined acellular dermal matrix (ADM) with autologous dermal cells and tested the performance of this matrix in wound healing and shaping. To prepare the ADM, stratified skin was obtained from the back of two New Zealand rabbits and decellularized to obtain ADM. The ADM was ultrasonically mixed with as-prepared autologous dermis in vitro. The mixture was injected as a subcutaneous filler into the back area of 20 New Zealand rabbits. In this procedure, different concentration ratios of the mixture were injected, and the volume change of the filler was measured and categorized into five groups. At 4 months and 8 months after filling, samples were obtained for quantitative evaluation of the thickness and vessel density, as well as qualitative evaluation of colonization. Examination of the ADM conformed that the matrix had no cells. ADM and the prepared autologous dermis were evenly mixed, and the filler was gradually absorbed. The comprehensive evaluation of ADM and autologous dermis mixture showed that group C had the best filling effect with the least infiltration of inflammatory cells and the highest vascular density compared to A, B, D and E groups in the study. When combined at the ratio of 50%:50%, the autologous dermis combined and acellular dermal matrix showed better performance compared to the other four different ratios in this study. This implies that this combination is potentially safer, effective and stable as a filling material compared to ADM or dermal matrix alone. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .