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自体皮肤移植:碎皮移植与其他技术的比较。

Autologous skin transplantation: comparison of minced skin to other techniques.

作者信息

Svensjö Tor, Pomahac Bohdan, Yao Feng, Slama Jaromir, Wasif Nabil, Eriksson Elof

机构信息

Laboratory of Tissue Repair and Gene Transfer, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

出版信息

J Surg Res. 2002 Mar;103(1):19-29. doi: 10.1006/jsre.2001.6331.

Abstract

BACKGROUND

Skin grafting may be necessary to close nonhealing skin wounds. This report describes a fast and minimally invasive method to produce minced skin suitable for transplantation to skin wounds. The technique was evaluated in an established porcine skin wound healing model and was compared to split-thickness skin grafts and suspensions of cultured and noncultured keratinocytes.

MATERIALS AND METHODS

The study included 90 wounds on 3 pigs. Fluid-treated full-thickness skin wounds were grafted with minced skin, split-thickness skin grafts, noncultured keratinocytes, or cultured keratinocytes. Controls received either fluid or dry treatment. The wound healing process was analyzed in histologies collected at Days 8 to 43 postwounding. Wound contraction was quantified by photoplanimetry.

RESULTS

Wounds transplanted with minced skin and keratinocyte suspension contained several colonies of keratinocytes in the newly formed granulation tissue. During the healing phase, the colonies progressed upward and reepithelialization was accelerated. Minced skin and split-thickness skin grafts reduced contraction as compared to keratinocyte suspensions and saline controls. Granulation tissue formation was also reduced in split-thickness skin-grafted wounds.

CONCLUSIONS

Minced skin grafting accelerates reepithelialization of fluid-treated skin wounds. The technique is faster and less expensive than split-thickness skin grafting and keratinocyte suspension transplantation. Minced skin grafting may have implications for the treatment of chronic wounds.

摘要

背景

对于无法愈合的皮肤伤口,可能需要进行皮肤移植。本报告描述了一种快速且微创的方法来制备适合移植到皮肤伤口的碎皮。该技术在已建立的猪皮肤伤口愈合模型中进行了评估,并与中厚皮片移植以及培养和未培养的角质形成细胞悬液进行了比较。

材料与方法

该研究纳入了3头猪身上的90处伤口。对经液体处理的全层皮肤伤口移植碎皮、中厚皮片、未培养的角质形成细胞或培养的角质形成细胞。对照组接受液体或干性处理。在伤后第8天至43天收集的组织学样本中分析伤口愈合过程。通过光学平面测量法对伤口收缩进行量化。

结果

移植碎皮和角质形成细胞悬液的伤口在新形成的肉芽组织中有多个角质形成细胞集落。在愈合阶段,这些集落向上发展,上皮再形成加速。与角质形成细胞悬液和生理盐水对照组相比,碎皮和中厚皮片移植减少了伤口收缩。中厚皮片移植的伤口中肉芽组织形成也减少。

结论

碎皮移植可加速经液体处理的皮肤伤口的上皮再形成。该技术比中厚皮片移植和角质形成细胞悬液移植更快且成本更低。碎皮移植可能对慢性伤口的治疗有意义。

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