Point-Counterpoint: Are Acellular Dermal Matrices More Effective Than Fibroblast-Derived Dermal Substitutes?
- Volume 26 - Issue 5 - May 2013
- 8969 reads
- 1 comments
Dr. Kimmel is a Diplomate of the American Board of Podiatric Surgery. He is the Director of Residency Training at the Department of Veterans Affairs in Cleveland, Ohio. Dr. Kimmel is the Senior Clinical Instructor in the Department of Surgery at Case Western Reserve University School of Medicine in Cleveland.
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This author says the role that fibroblasts play in facilitating the healing of chronic wounds is well established whereas questions abound for acellular dermal matrices, which lack high-quality supporting evidence.
By Alexander Reyzelman, DPM
The field of bioengineered tissue has significantly expanded during the last decade. In addition to living skin substitutes, we now have access to many acellular dermal matrices. It is becoming more and more important to have a better understanding of the role these wound healing modalities play in our treatment armamentarium.
The success of fibroblast-derived dermal substitutes is based on the premise that there are living dermal fibroblasts seeded on to a scaffold, which one then applies to the wound. These living dermal fibroblasts are able to secrete growth factors, deposit matrix proteins and facilitate epithelial cell migration.
There are multiple reasons for the failure of the wound healing process but in order to understand how fibroblast-derived dermal substitutes may help, it is important to understand the role that fibroblasts play in the non-healed wound.