功能化异种脱细胞真皮：从被动支架到主动修复的进化——烧伤治疗应用叙述性综述

Functionalized Xenogenic Acellular Dermal Matrix: Evolution from Passive Scaffold to Active Repair—A Narrative Review of Its Application in Burn Treatment

摘要: 烧伤是热力、化学、电力或辐射等单因素或多因素导致的皮肤及皮下组织损伤，严重时可累及深部器官并引发全身反应，发生大面积烧伤时易引发创面感染、脓毒血症等严重并发症，对患者的生命安全造成显著威胁。创面修复作为烧伤治疗的最终目标，生物材料的合理选用是提升创面修复效果的关键所在。异种脱细胞真皮(Xenogenic Acellular Dermal Matrix, XADM)经特定工艺去除免疫原性成分后，保留真皮胶原三维网状结构、基底膜、弹性蛋白、糖胺聚糖及生长因子，制成无免疫原性、可血管化、可重塑的生物支架，具有良好的生物相容性、组织再生诱导性和力学稳定性，是烧伤创面修复中提升修复质量的关键生物材料，在烧伤创面修复领域应用广泛。本文采用叙述性综述方法，以功能化XADM从被动支架到主动修复的演变过程为核心视角，总结了XADM制备工艺优化及生物学特性的研究进展，探讨了其作用机制及在烧伤创面修复中的临床疗效，并分析了当前存在的问题与未来发展方向，旨在为优化XADM的临床应用及开展相关研究提供参考依据。

Abstract: Burns are injuries to the skin and subcutaneous tissues caused by single or multiple factors such as heat, chemicals, electricity or radiation. In severe cases, they can involve deep organs and trigger systemic reactions. Extensive burns are particularly prone to serious complications such as wound infection and sepsis, posing a significant threat to patients’ lives. As the ultimate goal of burn treatment is wound repair, the rational selection of biomaterials is critical to improving wound repair outcomes. After removing immunogenic components through specific processes, xenogenic acellular dermal matrix (XADM) retains the three-dimensional reticular structure of dermal collagen, basement membrane, elastin, glycosaminoglycans and growth factors, forming a non-immunogenic, vascularizable and remodelable biological scaffold. With favorable biocompatibility, tissue regeneration-inducing property and mechanical stability, it serves as a key biomaterial for improving repair quality in burn wound repair and is widely used in this field. Adopting a narrative review approach and taking the evolution of functionalized XADM from passive scaffold to active repair as the core perspective, this paper summarizes the progress in preparation process optimization and biological characteristics of XADM, explores its action pathways and clinical efficacy in burn wound repair, and analyzes existing problems and development directions, so as to provide references for optimizing the clinical application of XADM and conducting related research.