Wang Qian, Luan Jie, Wang Jia-qi, Tang Yong, Fan Jin-cai, Cao Yan, Zhuang Qiang, Qi Ke-ming
Plastic Surgery Hospital, Chinese Academy of Medical Science, Beijing, China.
Zhonghua Zheng Xing Wai Ke Za Zhi. 2004 Nov;20(6):461-3.
To evaluate the effect of exteral use of papaverine cream on enhancement of skin graft.
Five mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolsters. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the shrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxylin-eosin staining. The tissue structure was observed and the results were analyzed statistically.
The grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers.
External use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.
评估外用罂粟碱乳膏对皮肤移植成活的影响。
选用5只小型猪进行研究。在每只动物背部制造20个全层伤口。沿腹部中线切取一条40 cm×2 cm的全层皮肤移植物，缝合供区伤口。将全层移植物制备并修剪成2 cm×2 cm、厚度为0.6 mm的中厚皮片，用打包加压法移植到每个伤口上。术后2周拆除缝线。选取12对完全成活的皮肤移植片，分为A组（左侧）和B组（右侧），每对移植片位于相同及相对位置。从拆线日起，A组外用2%罂粟碱乳膏，B组外用空白乳膏。在拆线时以及第1、2、3、4、5、6个月观察移植片的愈合情况并测量其大小，计算收缩率。在第6个月处死动物后，取皮肤移植片样本，用10%甲醛固定，常规石蜡包埋，苏木精-伊红染色。观察组织结构并进行统计学分析。
两组移植片在拆线时无显著差异。第1至6个月的观察结果显示，两组在皮肤移植片挛缩和组织学变化方面存在显著差异。苏木精-伊红染色显示，A组皮肤移植片中成纤维细胞较少，微血管较多，胶原纤维排列有序。
外用罂粟碱乳膏可抑制皮肤移植片的收缩。该方法安全、有效、简便、可靠，具有给药方便、价格便宜、损伤小、感染少且无副作用等优点。
