续：一篇医学英语文献Abdominal Wall ReconstructionIf tissue regeneration with AlloDerm regenerative tissue matrix (RTM) in a connective tissue defect is successful, the RTM becomes repopulated with the patient’s cells, a mature vascular ne

续：一篇医学英语文献Abdominal Wall ReconstructionIf tissue regeneration with AlloDerm regenerative tissue matrix (RTM) in a connective tissue defect is successful, the RTM becomes repopulated with the patient’s cells, a mature vascular ne
续：一篇医学英语文献
Abdominal Wall Reconstruction
If tissue regeneration with AlloDerm regenerative tissue matrix (RTM) in a connective tissue defect is successful, the RTM becomes repopulated with the patient’s cells, a mature vascular network develops and the tissue becomes well-integrated into the patient to such an extent that identification of the new tissue within a clinical biopsy becomes difficult without special histological stains. Since neither scar tissue nor fascia contains significant amounts of elastin polymer in a network organization, the Verhoeff’s Von Giessen stain for elastin is valuable tool to identify the RTM in the context of newly regenerated tissue.
Clinical biopsies have been obtained from a variety of surgical applications of RTM for tissue regeneration and the samples have been studied using differential staining with hematoxylin and eosin (H&E) and Verhoeff’s staining. Several explants of RTM-derived tissue reconstructed in a fascial plane have been performed upon revision surgery and analyzed histologically. Specimens taken by two surgeons from different patients at 8, 12, and 24 months have been studied. In the first, RTM was used to reinforce primary closure of anterior
rectus fascia following ventral hernia repair. At 8 months, the patient developed another hernia adjacent to the initial RTM repair that was unrelated to the RTM repair itself. The H&E and Verhoeff’s stain of this explant is shown in Figure 1. Grossly, the RTM was indistinguishable from the surrounding fascia, but a punch biopsy was taken at the midline of the initial repair through the suspected RTM tissue into the underlying rectus fascia. By H&E, the tissue was cellular to an apparent cell density for fascia, vascular and well-integrated with the surrounding tissue. A distinct tissue plane between RTM and fascia was not discernable.
Upon staining for elastin, it was apparent that the RTM (positive for an elastin network) was present and the elastin appeared to be in the process of remodeling away the cells within the tissue (see callouts above). This would be consistent with a dermal scaffold being transitioned into a fascia-like tissue. The collagen in this tissue appeared to remain intact and robust in the face of this elastin remodeling.
In the next case, RTM was used in a transverse rectus abdominus musculocutaneous (TRAM) flap reconstruction of a breast following mastectomy. In the TRAM donor site, RTM was used to reinforce the posterior rectus fascial sheath to minimize the risk of abdominal bulging or hernia formation. At 12 months post reconstruction, the patient required an open hysterectomy operation by another surgeon. Upon entry to the abdomen through the previous TRAM donor site, a biopsy of RTM tissue, which had the gross appearance of fascia, was taken and submitted for histological analysis.

续：一篇医学英语文献Abdominal Wall ReconstructionIf tissue regeneration with AlloDerm regenerative tissue matrix (RTM) in a connective tissue defect is successful, the RTM becomes repopulated with the patient’s cells, a mature vascular ne
腹壁重建
如果组织再生与alloderm蓄热式组织矩阵（ RTM中）在一结缔组织缺陷是成功的,RTM中成为repopulated与病人的细胞,一个成熟的血管网的发展和组织成为完善的集成到病人的这种程度鉴定新的组织内部的临床活检变得困难,无需特别学污渍.因为无论瘢痕组织,也不筋膜包含大量的弹性蛋白聚合物在一个网络组织,verhoeff的冯吉森染色弹性纤维是宝贵的工具来确定的RTM语境中的新的再生组织.
临床活检已获得来自不同的外科应用的RTM为组织再生和样本已研究了用微分染色素和曙红（在H ＆ E ）及verhoeff的染色.几个外植体的RTM衍生组织重建,在筋膜飞机已执行调整后,手术及病理分析.标本所采取的两个外科医生从不同的患者在8日,12日,24个月内进行了研究.在第一,RTM中被用来加强初级闭合前
腹直肌筋膜以下腹疝修补术.在8个月,病人发达的另一个疝毗邻初步的RTM修复,这是无关的RTM自行修复.在H ＆ E和verhoeff的染色,这是外植体,如图1所示.粗暴,RTM中是区分周围的筋膜,但力度活检采取了中线的初步修复,通过怀疑的RTM组织到背后的腹直肌筋膜.与H急症室,组织细胞,以明显的细胞密度为筋膜,血管和良好的综合与周围组织.一个独特的组织平面之间的RTM和筋膜没有分辨.
经染色弹力,很明显的RTM （正面为一弹性网络）是当前和弹性蛋白似乎是在这一过程中重塑了细胞组织（见标注段） .这将是一贯的与真皮支架被转换成筋膜样组织.胶原组织在这方面似乎维持不变,和稳健的,在面对这种弹性蛋白重塑.
在未来的情况下,RTM中,用在横向腹直肌肌abdominus （电车）皮瓣重建乳房下面的乳房.在电车捐助者的网站,RTM中被用来加强后腹直肌筋膜鞘,以尽量减少风险,腹部鼓胀或疝形成.在12个月后的重建,病人需要一个开放式子宫切除术的运作由另一外科医生.在入境时向腹部通过前电车捐助者的网站,活检组织的RTM ,其中总值的外观筋膜,被送往并提交学分析.