Attenuating Chronic Fibrosis: Decreasing Foreign Body Response with Acellular Dermal Matrix

Area of Science:

• Biomaterials Science
• Immunology
• Regenerative Medicine

Background:

• Surgical implants offer significant health benefits but are limited by the foreign body response (FBR), a chronic inflammation and fibrotic reaction.
• The FBR can lead to implant malfunction, infection, thrombosis, and disfigurement, increasing healthcare burdens.
• Current understanding of FBR mechanisms and cellular mediators remains limited.

Purpose of the Study:

• To review the primary literature on the biology of FBR in the context of acellular dermal matrix (ADM) use.
• To explore ADM's potential to mitigate the fibrotic reaction associated with FBR.
• To summarize shared mechanisms of ADM across diverse surgical models and anatomical applications.

Main Methods:

• Review of existing literature on FBR and ADM.
• Analysis of animal studies across various surgical models (breast reconstruction, abdominal/chest wall repair, pelvic reconstruction).
• Focus on biomimetic properties and host cell incorporation related to ADM.

Main Results:

• Acellular dermal matrix (ADM) shows promise in decreasing periprosthetic inflammation and fibrosis.
• ADM's biomimetic properties appear to facilitate improved host cell incorporation.
• Evidence suggests ADM can mitigate the fibrotic reaction seen with FBR across different surgical applications.

Conclusions:

• The foreign body response (FBR) is a critical challenge for implantable biomaterials.
• Acellular dermal matrix (ADM) demonstrates potential in reducing FBR-associated fibrosis, though mechanisms require further elucidation.
• This review consolidates understanding of ADM's efficacy across multiple surgical specialties, highlighting shared biological mechanisms.