Rudolph R
Surg Gynecol Obstet. 1976 Jan;142(1):49-56.
Both clinically and experimentally, full thickness skin grafts inhibit wound contraction better than do split thickness grafts. This occurs even if full thickness grafts are thinner than split grafts. Since inhibition of wound contraction does not depend on graft thickness alone, other differences should be sought between full and split grafts to explain this inhibition. One such difference is method of preparation. While full thickness grafts are cut with sharp dissection, split grafts are cut with mineral oil or with dermatome glue which is then stripped off. Both mineral oil and surface stripping in intact skin cause epidermal hyperplasia, more prominent in split grafts than in full thickness grafts. In this study, the effect of skin graft preparation on wound contraction and epidermal hyperplasia was tested. Seventy-four split thickness skin grafts were cut from Fischer rats with lubrication using mineral oil, Lubafax, normal saline solution or glue and a Padgett dermatome. Six full thickness grafts were treated with mineral oil. All grafts were placed on syngeneic rats; the area was measured with a planimeter, and biopsies were taken at zero, one, two, four, eight, 14 and 20 weeks. Mineral oil prepared split grafts lost 17.8 +/- 2.2 per cent area by one week, with a maximal loss of 38.8 +/- 4.8 per cent by four weeks. Split grafts cut with Lubafax, saline solution or glue plus drum dermatome lost similar area. Split grafts later enlarged as the rats grew, but in no group did split grafts surpass their original area. Full thickness grafts, even though treated with mineral oil, grew 3.9 +/- 4.3 per cent beyond their original area by four weeks and enlarged through 20 weeks. Histologic examination showed that all split skin grafts, regardless of surface preparation, had considerable epidermal hyperplasia and scarring in graft dermis and bed between one and four weeks. Thus, both skin graft contraction and epidermal hyperplasia occur independently of how grafts are prepared. The explantation of why full and split thickness grafts inhibit wound contraction differently must lie intrinsic rather than extrinsic to the skin.
在临床和实验中，全厚皮片比中厚皮片更能有效地抑制伤口收缩。即使全厚皮片比中厚皮片薄，这种情况也会发生。由于伤口收缩的抑制并不单纯取决于移植皮片的厚度，因此应在全厚皮片和中厚皮片之间寻找其他差异来解释这种抑制现象。其中一个差异就是制备方法。全厚皮片是通过锐性剥离切割而成，而中厚皮片是用矿物油或皮肤刀胶水切割，然后将胶水剥离。矿物油和在完整皮肤上进行表面剥离都会导致表皮增生，在中厚皮片中比在全厚皮片中更明显。在本研究中，测试了皮肤移植制备方法对伤口收缩和表皮增生的影响。用矿物油、Lubafax、生理盐水溶液或胶水以及Padgett皮肤刀从Fischer大鼠身上切取74片中厚皮片。6片全厚皮片用矿物油处理。所有移植皮片均置于同基因大鼠身上；用面积计测量面积，并在第0、1、2、4、8、14和20周进行活检。用矿物油制备的中厚皮片在1周时面积损失17.8±2.2%，在4周时最大损失为38.8±4.8%。用Lubafax、生理盐水溶液或胶水加鼓式皮肤刀切割的中厚皮片面积损失相似。随着大鼠生长，中厚皮片后来会扩大，但在任何一组中，中厚皮片都没有超过其原始面积。全厚皮片即使经过矿物油处理，在4周时也比其原始面积增长了3.9±4.3%，并一直扩大到20周。组织学检查显示，所有中厚皮片，无论表面处理如何，在1至4周之间，移植皮片的真皮层和创面都有相当程度的表皮增生和瘢痕形成。因此，皮肤移植的收缩和表皮增生与移植皮片的制备方式无关。关于全厚皮片和中厚皮片抑制伤口收缩方式不同的原因，其解释必定存在于皮肤的内在因素而非外在因素之中。
