Tran Lynn E, Berry Gerald J, Fee Willard E
Departments of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA 94305-5328, USA.
Arch Otolaryngol Head Neck Surg. 2005 Feb;131(2):124-8. doi: 10.1001/archotol.131.2.124.
To develop an animal model to investigate the survival of split-thickness skin grafts (STSGs) on bone without periosteum, to compare STSG attachment to bone with and without periosteum, and to determine the effect of fibrin glue on STSG attachment to bone.
Prospective laboratory study.
University laboratory.
Sprague-Dawley rats.
Percentage of survival of the STSGs at 2 weeks determined independently by the authors and a third, blinded head and neck surgeon.
In experiment 1, which included 40 rats, the sutured STSGs showed an average survival rate of 38% when attached to bone with periosteum, 6% when attached to bare bone, and 10% when attached to bare bone using fibrin glue. The poor survival rate was thought to be attributable to the animals scratching at their bolster dressings. In experiment 2, 18 animals underwent a posteriorly based U-shaped flap of skin and subcutaneous tissue. The grafts were placed and isolated from the overlying flap with a biosynthetic wound dressing. The sutured STSG survival rates were as follows: 87% when attached to bone with periosteum, 94% when attached to bare bone, and 74% when attached to bare bone using fibrin glue.
The survival of STSGs attached to bare bone was comparable to that of STSGs attached to bone with periosteum when grafts were protected with the skin-subcutaneous flap. The STSGs that were fixed with 0.1 cc of fibrin glue demonstrated poorer survival rates than those attached with sutures and were associated with more seromas.
建立一种动物模型，以研究无骨膜骨上的中厚皮片（STSG）的存活情况，比较有骨膜和无骨膜时STSG与骨的附着情况，并确定纤维蛋白胶对STSG与骨附着的影响。
前瞻性实验室研究。
大学实验室。
Sprague-Dawley大鼠。
由作者和第三位不知情的头颈外科医生独立测定2周时STSG的存活率。
在实验1中，包括40只大鼠，缝合的STSG附着于有骨膜的骨时平均存活率为38%，附着于裸骨时为6%，使用纤维蛋白胶附着于裸骨时为10%。存活率低被认为是由于动物抓挠其支撑敷料所致。在实验2中，18只动物接受了基于后方的皮肤和皮下组织U形皮瓣手术。用生物合成伤口敷料将移植物放置并与上方皮瓣隔离。缝合的STSG存活率如下：附着于有骨膜的骨时为87%，附着于裸骨时为94%，使用纤维蛋白胶附着于裸骨时为74%。
当用皮肤-皮下皮瓣保护移植物时，附着于裸骨的STSG的存活率与附着于有骨膜骨的STSG相当。用0.1 cc纤维蛋白胶固定的STSG存活率低于缝合固定的STSG，且血清肿更多。
