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[混合微粒皮移植中自体皮与异体皮最佳比例的研究]

[Study on the optimal ratio of autoskin and alloskin during mixed microskin grafting].

作者信息

Lin Heng, Peng Dai-zhi, Yan Quan, Dong Zheng-xue, Yue Hai-ling, Li Fang, Zhou Xin, Liu Jing

机构信息

Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Third Military Medical University, Chongqing 400038, PR China.

出版信息

Zhonghua Shao Shang Za Zhi. 2006 Feb;22(1):11-4.

Abstract

OBJECTIVE

To investigate the influence of different amount of allogeneic microskin in mixed grafting with certain quantity of autologous microskin on wound healing in rats. Methods Male Wistar rats served as alloskin donor rats. Forty female SD rats with full thickness skin defect were enrolled in the study, and they were randomly divided into four groups, i.e. group I (n=10, with allogeneic microskin graft at area expansion rate of 10:3); group II (n=10, with autologous microskin graft at area expansion rate of 10:1); group III (n=10, with mixed grafting of autologous and allogeneic microskin at area expansion rate of 10:1, respectively); group IV (n=10, with mixed grafting of autologous and allogeneic microskin at area expansion rate of 10:1 and 10:3, respectively). The wound healing rate, wound contraction rate and histological changes were observed at the 2, 3 and 4 post graft weeks (PGW).

RESULTS

(1) In group I, there was mainly granulation tissue with some de novo epithelial cells appearing at the wound edge along with the rejection of grafted allogenous skin in the rat wound. In group II, there was still some granulation tissue remaining at 2 PGW due to insufficient amount of microskin. However, the wounds in the mixed grafting group appeared almost totally epithelialized. (2) Various amounts of mononuclear inflammatory cell infiltration and different degrees of angiectasis were observed in the dermal layer after the skin grafting in all groups, especially in group II and IV. There was thickening of the epithelial layer in all groups except group I. (3) The wound healing rate decreased obviously along with the development of rejection in group I at 2 to 4 PGWs. The wound healing rate was (55 +/- 26)% in group II, which was obviously lower than that in group III (88 +/- 6)% and in group IV (76 +/- 10)% at 3 PGWs (P < 0.01). (4) The contraction rate of the wound in group IV (69 +/- 7)% was much higher than that in group I (58 +/- 11)% at 3 PGWs (P < 0.05), and there was no difference among all the other groups.

CONCLUSION

Wound healing can be obviously accelerated by mixing some autologous microskin with appropriate amount of alloskin. Moreover, certain amount of autologous microskin (expansion rate 10:1) mixed with the same proportion of allogeneic microskin seems to be more beneficial in promoting wound healing.

摘要

目的

探讨在一定量自体微粒皮混合移植中加入不同量异体微粒皮对大鼠创面愈合的影响。方法:雄性Wistar大鼠作为异体皮供体大鼠。选取40只雌性SD大鼠,制造全层皮肤缺损,纳入本研究,并随机分为4组,即Ⅰ组(n = 10,异体微粒皮移植,面积扩增比例为10∶3);Ⅱ组(n = 10,自体微粒皮移植,面积扩增比例为10∶1);Ⅲ组(n = 10,自体和异体微粒皮混合移植,面积扩增比例均为10∶1);Ⅳ组(n = 10,自体和异体微粒皮混合移植,面积扩增比例分别为10∶1和10∶3)。在移植后第2、3和4周观察创面愈合率、创面收缩率及组织学变化。

结果

(1)Ⅰ组大鼠创面主要为肉芽组织,创面边缘有新生上皮细胞出现,移植的异体皮肤发生排斥反应。Ⅱ组在移植后第2周时仍有一些肉芽组织残留,原因是微粒皮量不足。然而,混合移植组的创面几乎完全上皮化。(2)所有组在植皮后真皮层均观察到不同数量的单核炎性细胞浸润和不同程度的血管扩张,尤其是Ⅱ组和Ⅳ组。除Ⅰ组外,所有组的上皮层均增厚。(3)Ⅰ组在移植后第2至4周,随着排斥反应的发展,创面愈合率明显下降。Ⅱ组的创面愈合率为(55±26)%,在移植后第3周明显低于Ⅲ组(88±6)%和Ⅳ组(76±10)%(P < 0.01)。(4)在移植后第3周,Ⅳ组创面的收缩率(69±7)%明显高于Ⅰ组(58±11)%(P < 0.05),其他组之间无差异。

结论

适量异体皮与一定量自体微粒皮混合移植可明显促进创面愈合。此外,一定量的自体微粒皮(扩增比例10∶1)与相同比例的异体微粒皮混合似乎更有利于促进创面愈合。

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