Mensík I, Lamme E N, Brychta P
Department of Burns and Reconstructive Surgery, University Hospital Brno, Czech Republic.
Acta Chir Plast. 2003;45(3):105-8.
Contraction of a split-thickness skin graft used for coverage of large defects remains a great problem in plastic, burn and reconstructive surgery. In this study we evaluated healing of split-thickness skin grafts transplanted in wounds on the subcutaneous fat and muscle fascia in pigs. Four young domestic female pigs were included in the study, and the contraction was measured planimetrically during a 3-months' follow-up. At the end of the study the scar tissue was histologically assessed. From day 42 till the end of the study grafts transplanted on the muscle fascia were significantly more contracted than grafts on the subcutaneous fat without (p < 0.001) and with (p < 0.005, unpaired t-test) correction for the growth of the animal. The histological assessment showed that after 3 months the regenerated dermal tissue in the muscle fascia wounds was thicker, and less remodeled (higher tissue cellularity and thinner collagen bundles). In conclusion, in pigs, split-thickness skin grafts transplanted into deeper wounds contract more, and scar tissue maturation seems to last longer.
用于覆盖大面积缺损的中厚皮片收缩问题在整形、烧伤及重建外科领域仍然是一个重大难题。在本研究中，我们评估了移植于猪皮下脂肪和肌筋膜伤口处的中厚皮片的愈合情况。该研究纳入了4只年轻的雌性家猪，并在3个月的随访期间通过平面测量法测定皮片收缩情况。研究结束时，对瘢痕组织进行了组织学评估。从第42天直至研究结束，移植于肌筋膜上的皮片收缩程度显著大于移植于皮下脂肪上的皮片，无论是否对动物生长进行校正（未校正时p < 0.001，校正后p < 0.005，采用非配对t检验）。组织学评估显示，3个月后肌筋膜伤口处再生的真皮组织更厚，重塑程度更低（组织细胞密度更高且胶原束更细）。总之，在猪身上，移植到更深伤口的中厚皮片收缩更明显，且瘢痕组织成熟过程似乎持续更长时间。
