APPLICATIONS OF ECM ANALOGS IN SURGERY

The loss of tissue mass in humans has been conventionally treated as a n irreversible change. Treatments have emphasized replacement of the m issing function by use of a transplant, an autograft, tissue synthesiz ed in vitro or, most commonly, by use of engineering devices based on biomaterials. During the last few years solid progress has been made i n the area of tissue and organ regeneration. This new approach is base d on the discovery that certain simple chemical analogs of extracellul ar matrices synthesized by graft copolymerization of a glycosaminoglyc an onto type I collagen can induce synthesis of physiologic tissue in lesions which otherwise heal spontaneously by synthesis of scar tissue . This approach offers serious potential advantages over the alternati ves listed above since the graft ''grows out'' of host tissue. However , regeneration in the adult mammal has been successfully demonstrated so far only in skin (human, guinea pig), sciatic nerve (rat) and the k nee meniscus (dog). (C) 1994 Wiley-Liss, Inc.