Dutch study: coverage of fetal skin defects with a collagen biomatrix
Thursday, 7 May 2009- Using animal models Dutch researchers have studied collagen biomatrix that is used to cover fetal skin defects in children. Their findings were presented in the poster sessions of the four-day 20th Anniversary Congress of the European Society for Pediatric Urology (ESPU) currently ongoing in Amsterdam, the Netherlands.
Lead author Dr.Luc Roelofs (Nijmegen, the Netherlands) said that patients with spina bifida suffer from severe morbidity. In former animal studies Roelofs and his team have shown that coverage of a surgically created spina bifida during the fetal period can result in decreased morbidity after birth: less incontinence and less paralysis of the hindlimbs.
He said that to enhance skin regeneration (i.e. more angiogenesis and cell attraction,) the biometric needs to be improved. Roelofs and his team aimed to evaluate the coverage of fetal skin defects with a collagen biomatrix, a biomatrix loaded with heparin and growth factors (VEGF and FGF) and wound healing without a biomatrix.
Using a sheep model, at 79 days’ gestation, three skin defects (10 mm) were created on the back of 11 fetal lambs. One defect was left uncovered, one was covered with a collagen biomatrix, and one with a biomatrix loaded with glycosaminoglycans (heparin) and growth factors (VEGF and FGF-2). Lambs were sacrificed at 93 (n=4), 107 (n=3) and 138 (n= 4) days’ gestation. The skin defects were macroscopically and histologically examined.
The results showed that macroscopic evaluation revealed wound healing mainly by wound contraction for the uncovered defects. The covered defect with plain biomatrix showed partial contraction and the covered defect with growth factor loaded biomatrix showed minor contraction. Histological evaluation revealed increased angiogenesis and keratinocyt growth in the growth-factor-loaded biomatrix.
Additionally, decreased degradation of the biomatrix was seen in these defects, that is, tat 138 days’ gestation the biomatrix was still largely present. Overall, improved maturation of the skin tissue was seen in time.
"Coverage of fetal skin defects with a VEGF and FGF-2 loaded collagen biomatrix resulted in less wound contraction, increased angiogenesis and keratinocyt growth," the researchers said. They added that this biomatrix can be useful in coverage of large spina bifida defcts to improve neonatal outcome.
Source: Luc Roelofs, et al., "Coverage of fetal skin defects with a collagen biomatrix loaded with growth factors in a sheep model," 20th Anniversary Congress, European Society for Paediatric Urology, Amsterdam, the Netherlands, 6-9 May 2009.