The therapeutic role of acellular dermal matrix seeded with mesenchymal stem cells versus autologous skin graft in healing of skin defect

Abstract

Background& objectives: One of the major challenges facing the surgeons is replacing a full-thickness skin loss successfully. This study aimed at seeding of bone marrow-mesenchymal stem cells (BM-MSCs) on the decellularized dermal matrix to test the efficacy of these scaffolds for the repair of skin defects in rats as well as to compare the microstructure of the skin after using autologous skin graft. Methods: A 2 × 2 cm2 size full thickness skin defect was created on the dorsum of twenty male Wister rats (200- 250g) under xylazine (5 mg/kg) and ketamine (50 mg/kg) anesthesia. The animals were then randomly divided into four equal groups: group I, the defect was left for spontaneous recovery, group II, the defect was repaired with acellular dermal matrix (ADM) alone, group III, it was repaired with ADM seeded with BM-MSCs and group IV, the defect was repaired with autologous skin graft obtained from the groin area. The healing rate of the defect of all groups were assessed by measuring size of the defect weekly. The specimens from the wound site were obtained from all groups on day 14 and day 28 post-operative for histopathological analysis for vascular density and collagen content. Results: The integrity of dermal collagen structure of ADM was retained as shown histologically. The BM-MSCs were successfully seeded on the ADM. Gross observations of the degree of wound healing revealed better implantation of seeded ADM with MSCs in group III. Furthermore, histologic analysis showed more neovascularization, keratinocyte migration, hair follicle growth, increased collagen content, and fewer inflammatory cell infiltrate in group III as compared with the other groups. Conclusion: It was concluded that stem cell seeded ADM facilitated early and better healing of skin defect in rats than the non-cell seeded ADM as well as the autograft.