Abstract
The tissue expansion technique has been applied to obtain new skin tissue to repair large defects in clinical practice. The implantation of tissue expander could initiate a host response to foreign body (FBR), which leads to fibrotic encapsulation around the expander and prolongs the period of tissue expansion. Tanshinon IIA (Tan IIA) has been shown to have anti-inflammation and immunoregulation effect. The rat tissue expansion model was used in this study to observe whether Tan IIA injection systematically could inhibit the FBR to reduce fibrous capsule formation and accelerate the process of tissue expansion. Forty-eight rats were randomly divided into the Tan IIA group and control group with 24 rats in each group. The expansion was conducted twice a week to maintain a capsule pressure of 60 mmHg. The expansion volume and expanded area were measured. The expanded tissue in the two groups was harvested, and histological staining was performed; proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1β (IL-1β) and transforming growth factor-β (TGF-β) were examined. The expansion volume and the expanded area in the Tan IIA group were greater than that of the control group. The thickness of the fibrous capsule in the Tan IIA group was reduced with no influence on the normal skin regeneration. Decreased infiltration of macrophages, lower level of TNF-α, IL-6, IL-1β and TGF-β, less proliferating myofibroblasts and enhanced neovascularization were observed in the Tan IIA group. Our findings indicated that the Tan IIA injection reduced the formation of the fibrous capsule and accelerated the process of tissue expansion by inhibiting the FBR.
Highlights
The tissue expansion technique has been in use for many years in plastic surgery
The effect of Tanshinon IIA (Tan IIA) on the growth of the fibroblasts was examined with Cell Counting Kit-8 (CCK-8) and Annexin V/PI
The viability of fibroblasts was inhibited and the percentage of apoptosis was increased. All of these results suggested that a low concentration of Tan IIA should not influence the growth of fibroblasts (Fig. 1 B– E)
Summary
The tissue expansion technique has been in use for many years in plastic surgery. It’s a process of implanting a silicon sac subcutaneously and regularly injecting saline into the sac, in this process, new skin forms under the mechanical stretch, providing a supply of tissue similar in color, structure and adnexal distribution to the adjacent skin for a perfect repair [1]. Tissue expansion is a very useful technique and has a wide range of clinical applications, especially for repairing of large skin defect. Tissue expansion is a safe and reliable method for reconstruction; it is a time-consuming procedure. 4–6 months are usually needed to achieve adequate expansion. Such long time expansion causes distress in patients, and increases the incidence of complications such as infection, and the rupture or exposure of the tissue expander
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