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Wei-Cherng Hsu, Mark H. Spilker, Ioannis V. Yannas, Peter A. D. Rubin; Inhibition of Conjunctival Scarring and Contraction by a Porous Collagen-Glycosaminoglycan Implant. Invest. Ophthalmol. Vis. Sci. 2000;41(9):2404-2411.
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purpose. To study the healing processes of full-thickness wounds in the adult
rabbit conjunctiva after grafting with a porous
collagen-glycosaminoglycan (CG) copolymer matrix.
methods. A 7-mm trephine was used to produce lesions of the bulbar conjunctiva
down to the level of the bare sclera. Full-thickness removal of the
conjunctiva and Tenon’s capsule created a reproducible wound bed.
Wounds either remained ungrafted (control) or were grafted with CG
matrix. In previous studies, this CG matrix has induced partial
regeneration of the dermis in the human, the swine, and the guinea pig.
Healing of the conjunctival epithelium and underlying stroma was
evaluated by histology, immunohistochemistry, and measurement of wound
results. By 28 days, ungrafted wounds had closed by contraction (26.4% ± 5.0%
fornix shortening) and the formation of scarlike tissue comprising an
aligned array of dense collagen populated with occasional fibroblasts.
Grafting of identical defects with CG copolymer matrix resulted in
inhibition of wound contraction (6.8% ± 3.2% fornix shortening) and
the formation of a tissue that resembled normal conjunctival stroma,
being composed of a loose network of collagen fibers and fibroblasts.
Contractile fibroblasts (myofibroblasts) were identified at the edge of
both ungrafted and grafted wounds during the period of active
contraction. Both ungrafted and grafted wounds were completely
re-epithelialized by 28 days.
conclusions. Implantation of CG copolymer matrix drastically reduced contraction and
promoted the formation of a nearly normal subconjunctival
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