The inducing effect of epidermal growth factor on acellular dermal matrix in a rat model of skin regeneration.

Objective: Tissue engineering, a novel approach in dermatology, has resulted in the development of scaffolds as skin substitutes that have accelerated wound healing. The aim of the present study was to synthesise acellular dermal matrix (ADM) as a dermal alternative and assess the effect of human epidermal growth factor (EGF) on the proliferation and migration of seeded fibroblast cells.

Method: ADM from fresh, full-thickness human skin was developed and characterised. Next, foreskin fibroblast cells were isolated, cultured and characterised. The fibroblast cells were sown into the ADM in two groups: one with EGF and one without EGF. We assessed the adhesion and proliferation of the cells on the scaffold by scanning electron microscopy, and thiazolyl blue tetrazolium bromide and 4',6-diamidino-2-phenylindole staining. For the animal study, 30 rats were divided into two equal groups at random (ADM, ADM+EGF). Wound healing was assessed macroscopically, histologically and by real-time polymerase chain reaction for Bax and Bcl-2 gene expression.

Results: The ADM characterisation results showed that the scaffold was dense and integral with good stretching. The morphology and phenotype of the isolated fibroblast cells confirmed their identity. The fibroblast cells cultured on the ADM showed proliferation, which improved with the addition of EGF. In the animal model, EGF addition caused significantly (p<0.05) improved wound healing compared with isolated ADM; it also resulted in increased Bcl-2 and reduced Bax expressions.

Conclusion: A combination of ADM, fibroblast cells and EGFs could serve as skin substitutes and represent a novel therapeutic methodology for treating burns and hard-to-heal wounds.