[Experimental study on the skeletal muscle reconstruction with autologous fascia as a scaffold]

To explore the feasibility of autologous fascia as a scaffold for the reconstruction of skeletal muscle in vivo.

Twenty-eight healthy New Zealand rabbits were employed in the study. The anterior tibial muscle in both legs were divided to create a gap of 10 mm in each muscle. One leg was used in the experiment (E, n = 28), while the contralateral as self-control (C). The legs in C group were further divided into 3 groups (C1, C2 and C3). While defects in the midportion of anterior tibial muscle in the hind legs were created in all rabbits. In E group, each defect was filled with a tubule made of autologous fascia lata, and the fascial tubule was filled with tiny muscular granules (< 1 mm x 1 mm x 1 mm). In C1 group (n = 10), the defect was also filled with fascial tubule but with no muscle filling. The defect in C2 group (n = 10) was only filled with muscle granules without fascial tubule. The defect in C3 group (n = 8) received no treatment. The survival rate of the transplantation was grossly observed, and the tissue samples were harvested for histological and ultra-structural examination and immunohistochemical identification of desmin at 2, 3, 4, 6 and 9 post-operation weeks. The expression level of alpha-actin DNA in the tissue samples from the midportion of grafted fascia was assessed by RT-PCR (reverse transcription polymerase chain reaction) in E and C1 groups.

(1) Survival rate of the transplantation: In E group, it was 93.33% with near normal tissue contour in the grafting area. The muscle defects were not completely repaired in C1, C2 and C3 groups. (2) Under light and electronic microscopy, marked proliferation of muscular cells surrounding fibrous tissue could be discerned at 2 and 3 post-operation weeks in E group, while only necrotic tissue and fibrosis were observed in C1 and C2 groups, and no definite tissue could be discernible in C3 group. (3) Immunohistochemical staining revealed that over 85% of the cells were positive for desmin in E group, while only less than 25% in C1 group. (4) The expression level of alpha-actin DNA was significantly higher in E group than that in C2 group (P < 0.05).

These results suggested that autologous fascia as a scaffold is beneficial for skeletal muscle reconstruction in vivo.