Chapter 2 - Tissue repair with natural extracellular matrix (ECM) scaffolds

Abstract

Extracellular matrix (ECM) scaffolds that provide a conducive environment for normal cellular growth, differentiation and angiogenesis are important components of tissue engineered grafts for long term viability. ECM has shown to be an effective scaffold for the repair and reconstitution of several tissues, including blood vessels, skin graft, Dural repair, soft tissue grafts, hernia repair, myocardial repair, urinary tract structures, ophthalmic reconstruction and nerve tissue regeneration. These ECM scaffolds are completely degraded in vivo and induce a host cellular response that supports constructive remodeling rather than scar tissue formation. Several naturally occurring scaffold materials have been investigated, including small intestinal submucosa (SIS), acellular dermis (Allo Derm) bladder acellular matrix graft (UBM), amniotic membrane tissue (anthromatrix, ambiodry, amniograft), cadaveric fascia (Tutoplast) and porcine pericardium (IO patch). Common features of ECM-associated tissue remodeling include extensive angiogenesis, recruitment of circulating progenitor cells, rapid scaffold degradation and constructive remodeling of damaged or missing tissues. The sources, the methods of procurement and processing, and the effects of these naturally occurring, materials on angiogenesis and tissue deposition are reviewed.