NERVE AND BLOOD-VESSEL GROWTH IN RESPONSE TO GRAFTED DERMIS AND CULTURED KERATINOCYTES

Citation
T. Kangesu et al., NERVE AND BLOOD-VESSEL GROWTH IN RESPONSE TO GRAFTED DERMIS AND CULTURED KERATINOCYTES, Plastic and reconstructive surgery, 101(4), 1998, pp. 1029-1038
Citations number
39
Categorie Soggetti
Surgery
ISSN journal
00321052
Volume
101
Issue
4
Year of publication
1998
Pages
1029 - 1038
Database
ISI
SICI code
0032-1052(1998)101:4<1029:NABGIR>2.0.ZU;2-K
Abstract
The aim of this study was to study innervation and angiogenesis in res ponse to grafts of dermis and cultured keratinocytes using immunohisto chemical techniques. In a porcine model, fresh autologous de-epidermal ized dermis and cultured autologous keratinocytes were combined using a two-stage technique, to produce keratodermal grafts. Wounds were enc ased within skin graft chambers that prevented the influence of the su rrounding skin. As grafts contracted, a peripheral rim of granulation tissue became exposed, allowing us to compare the wound bed beneath gr afts with that beneath the raw granulating surface. Grafts were studie d for 6 weeks. Angiogenesis was studied using antisera to von Willebra nd factor to detect endothelial cells. Nerve growth was studied using antisera to S-100, a Schwann cell marker, and to four axonal markers: protein gene product 9.5, C-flanking peptide of neuropeptide Y, calcit onin gene-related peptide, and vasoactive intestinal peptide. In kerat o-dermal grafts ( n = 28), organization of blood vessels and nerve gro wth occurred only beneath areas with epidermal cover as compared with the surrounding granulation tissue. Initially, the immunoreactivity to von Willebrand factor was high, but in areas with epidermal cover it assumed a more orderly pattern with fewer blood vessels. Innervation w as first detected by S-100 immunoreactivity seen at 1 to 2 weeks, clos ely followed by that to protein gene product 9.5 and much later to cal citonin gene-related peptide. C-flanking peptide of neuropeptide Y and vasoactive intestinal peptide immunoreactivity were detected in the w ound depth surrounding large blood vessels at 4 to 6 weeks. In control wounds that had been either grafted with de-epidermalized dermis alon e (n = 10) or allowed to granulate (n = 10), persistently there was hi gh immunoreactivity to von Willebrand factor but minimal immunoreactiv ity to the neural markers. In conclusion, kerato-dermal grafts become innervated, and beneath their surface there is also vascular organizat ion to resemble normal skin. Keratinocytes themselves may influence an giogenesis and innervation, as both processes failed to occur beneath granulating areas.