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包裹性软骨膜和骨膜移植物作为新组织再生器的作用。

What wrapped perichondrial and periosteal grafts offer as regenerators of new tissue.

作者信息

Sari Alper, Tuncer Serhan, Ayhan Suhan, Elmas Cigdem, Ozogul Candan, Latifoglu Osman

机构信息

Departments of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Medical Faculty, Ankara, Turkey.

出版信息

J Craniofac Surg. 2006 Nov;17(6):1137-43. doi: 10.1097/01.scs.0000236439.82473.fe.

Abstract

The major goals in contour restoration procedures are to re-establish the desired contour with the use of resilient and durable materials that can be easily found and harvested. Cartilage grafts are commonly used for these purposes though they often possess a problem of donor site morbidity and shortage of quantity. The neo-cartilage formation capacities of both perichondrium and periosteum are well-known. We aimed to optimize both the amount and quality of the newly forming tissue from perichondrial and periosteal grafts. For this purpose the grafts were wrapped on themselves. Placement of oxidized regenerated cellulose (ORC) within graft layers was performed in two groups with the aim of giving support to the regenerating tissue, and increasing the connective tissue formation within the graft layers. Three-month-old New Zealand white rabbits were used. Group 1 ear perichondrial, and Group 2 calvarium periosteal grafts of 1.4 x 2.4 cm were harvested, folded on themselves, and sutured at the edges to create closed pockets. 0.8 x 0.8 cm sized ORC sheets were placed inside the pockets before wrapping in Group 3 perichondrial and Group 4 periosteal grafts. 0.2-mL autogenous blood was injected in each pocket. All grafts were transplanted under the abdominal muscle fascia, and harvested after 6 weeks. Volumes and weights of wrapped perichondrial grafts were higher than their periosteal counterparts either with or without the inclusion of ORC. Grafts with ORC (Groups 3 and 4) were heavier than the grafts lacking ORC (Groups 1 and 2), in a statistically significant manner (P </= 0.01). Histologically, the inclusion of ORC in both perichondrial and periosteal grafts resulted in an increased amount of fibrosis, yet did not preclude neo-cartilage formation.

摘要

轮廓修复手术的主要目标是使用易于获取和采集的弹性且耐用的材料来重新建立理想的轮廓。软骨移植常用于这些目的,尽管它们常常存在供区发病和数量不足的问题。软骨膜和骨膜的新软骨形成能力是众所周知的。我们旨在优化软骨膜和骨膜移植物新形成组织的数量和质量。为此,将移植物自身包裹起来。在两组移植物层中放置氧化再生纤维素(ORC),目的是为再生组织提供支持,并增加移植物层内结缔组织的形成。使用3个月大的新西兰白兔。采集1.4×2.4 cm大小的第1组耳软骨膜和第2组颅骨骨膜移植物,将其自身折叠,并在边缘缝合以形成封闭的袋状结构。在第3组软骨膜和第4组骨膜移植物包裹之前,将0.8×0.8 cm大小的ORC片材放入袋内。在每个袋内注射0.2 mL自体血。所有移植物均移植到腹部肌肉筋膜下,并在6周后收获。无论是否包含ORC,包裹的软骨膜移植物的体积和重量均高于其对应的骨膜移植物。含ORC的移植物(第3组和第4组)比不含ORC的移植物(第1组和第2组)更重,具有统计学意义(P≤0.01)。组织学上,软骨膜和骨膜移植物中包含ORC均导致纤维化量增加,但并不妨碍新软骨的形成。

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