Indroduction
Fibroblasts are key players for maintaining skin homeostasis and for orchestrating physiological tissue repair.
Keratinocytes play an important role in cutaneous cell-cell communication for wound healing outcome.
A rapid vascularized tissue matrix, consisting of native collagen supplemented by an elastin hydolyzate is used since more than 20 years especially as dermal template.
We here report our - after 20-years experience - optimized setting using this tissue matrix for defect coverage and its impact in keraticocyte-fibroblast crosstalk.
Methods
Different settings of wound bed preparation with and without using this tissue matrix were compared intra-individual and to patients treated by these different settings in our level I trauma center since 2003. Outcome of tissue quality was assessed using electron microscope.
Results
Healthy human fibroblasts showed best cell proliferation and collagen synthesis when precise debridement for wound bed preparartion including complete removal of granulation tissue was performed just before application of collagen/elastin matrix.
Long follow up of these collagen-elastin matrix procedures in defect coverage showed much faster maturation of the scar and excellent functional outcome.
Conclusion
The intimate dialogue between the fibroblasts and the collagen-elastin matrix represents a fascinating domain that must be understood in order to characterize the therapeutic targets especially to prevent pathological developments of myofibroblasts but also to interfere with keraticocytes to induce cutaneous cell-cell communication.
In clinical settings precise debridement for wound bed preparartion before application of collagen-elastin matrix has shown to be the crucial key point to maximize quality and function of reconstructed tissue.