摘要

Objectives: Decellularized extracellular matrix (dECM) materials are widely used in reconstructive surgery because they provide structural support and promote tissue regeneration. However, conventional decellularization methods often compromise extracellular matrix integrity and bioactivity during cellular removal. Supercritical carbon dioxide (scCO₂) decellularization is a detergent-free technology that efficiently removes cellular components while preserving native tissue architecture, growth factors, and biomechanical properties, making it a promising platform for regenerative medicine. Introduction: To evaluate the regenerative potential and clinical applicability of a supercritical CO₂ decellularization platform and to present its translational applications in plastic surgery, including acellular dermal matrix (ADM), peripheral nerve grafts, and injectable extracellular matrix products for tissue reconstruction and regeneration. Materials / method: Human and porcine tissues were decellularized using a proprietary scCO₂ process. Residual DNA, extracellular matrix composition, mechanical properties, cytokine profiles, and cytotoxicity were evaluated. In vivo biocompatibility and regenerative responses were assessed using implantation and wound-healing models. Clinical outcomes were reviewed in 275 breasts reconstructed with scCO₂-derived ADM during immediate direct-to-implant breast reconstruction between 2023 and 2024. Results: The scCO₂ process achieved effective cell removal with minimal residual DNA while preserving collagen, elastin, glycosaminoglycans, and growth factors. The material maintained native-like mechanical properties and demonstrated reduced inflammatory signaling, enhanced fibroblast infiltration, increased vascularization, and accelerated wound healing. Clinical use in breast reconstruction resulted in favorable aesthetic outcomes, stable implant support, and low complication rates. Conclusion: Supercritical CO₂ decellularization enables efficient decellularization while preserving the biological and structural characteristics of native extracellular matrix. Preclinical and clinical findings support its regenerative capacity and safety. The platform has demonstrated broad applicability through ADM sheets, nerve grafts, and injectable ECM products, representing a promising next-generation biomaterial technology for reconstructive and aesthetic surgery.