Pilot investigation into effect of an antimicrobial dressing on the cell migration effects of decellularized porcine placental extracellular matrix in viable wounded human skin ex vivo

Introduction: Decellularized extracellular matrix (ECM) medical devices can facilitate healing of hard-to-heal wounds by acting as a scaffold. A novel decellularized porcine placental ECM contains collagen, fibronectin, laminin, elastin, hyaluronic acid, and glycosaminoglycans,1 while being largely free of cells, cell debris, and DNA. However, as hard-to-heal wounds are often compromised by microbial bioburden and are at risk of infection, so the use of an antimicrobial dressing over ECM devices may be desired. The effects of this porcine placental ECM covered with an advanced antimicrobial wound dressing† on cell migration on the healing of wounded human skin in a viable ex vivo model was examined in a pilot study using immunolabeling techniques.Methods:Human skin models were treated with the ECM alone or a combined construct containing the ECM with an antimicrobial dressing and a non-adhesive wound contact layer‡ between them. Construct-treated, ECM-only-treated, antimicrobial dressing-treated, and untreated control pre-wounded skin samples were incubated for up to 6 days. Wounded skin samples were fixed and embedded before performing cross sectioning. An immunolabelling technique was used to assess cell migration to visualize the binding of a Cytokeratin 17 antibody to the wound tissue. Cytokeratin 17 was selected as a marker for wound healing as it is associated with cellular migration.Results:There was an increase in the presence of Cytokeratin 17 in construct-treated and ECM-treated wounded skin tissues compared to the antimicrobial dressing-treated and untreated control samples. These findings suggest that the wound healing potential of the decellularized porcine placental ECM is not impacted by the presence of an advanced antimicrobial dressing.     Discussion: This ex vivo pilot study suggests that the antimicrobial and physical properties of a silver-containing antimicrobial dressing, when applied over a nonadherent layer, does not affect the ability of a decellularized porcine placental ECM to encourage cell migration in an ex vivo wounded human skin model. Further studies in similarly complex models using a range of microscopic and immunological techniques may help to confirm these pilot findings.References:* InnovaMatrix AC † Aquacel Ag Advantage ‡ Mepitel 1. U.S. Food & Drug Administration. K193552 501(k) Summary. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?id=K19355