Akita Sadanori, Akino Kozo, Tanaka Katsumi, Anraku Kuniaki, Hirano Akiyoshi
Division of Plastic and Reconstructive Surgery, Department of Developmental and Reconstructive Medicine, Nagasaki University, Graduate School of Biomedical and Sciences, Nagasaki, Japan.
J Trauma. 2008 Mar;64(3):809-15. doi: 10.1097/TA.0b013e31802c8247.
Although a number of cytokine or growth factor therapies for wound acceleration have been reported, few mentioned the quality of the outcome. The lower extremity is important in esthetics as well as in function, because it is exposed. Recently, a growth factor, namely basic growth factor (bFGF) is widely used for difficult wound healing with a porcine-derived bilayered artificial dermis for better wound closure. Thus, their combination use was tested clinically.
Sequential lower extremity reconstruction by an artificial dermis with or without bFGF administration and secondary split-thickness skin grafting was measured for hardness using a durometer, and the moisture parameters assessed such as effective contact coefficient, transepidermal water loss (TEWL), water content and thickness using a moisture meter for at least 6 months after the final procedure and compared with normal skin control.
There was significantly less skin hardness using a durometer in bFGF treatment compared with non-bFGF treatment (16.2 +/- 3.83 vs. 29.2 +/- 4.94, p < 0.01). Effective contact coefficient, TEWL, water content, and thickness in non-bFGF treatment were all significantly greater than those in bFGF treatment, whereas water content and thickness in bFGF treatment were comparable with those of the control.
The use of bFGF as artificial dermis for extensive and deeper tissue loss coverage demonstrated better reconstruction quality in terms of hardness using a durometer and the function of the stratum corneum by moisture analysis.
尽管已经报道了多种用于加速伤口愈合的细胞因子或生长因子疗法,但很少有人提及治疗结果的质量。下肢在美学和功能方面都很重要,因为它是暴露在外的。最近,一种生长因子,即碱性成纤维细胞生长因子(bFGF),被广泛用于治疗难愈合伤口,它与猪源双层人工真皮联合使用以实现更好的伤口闭合。因此,对它们的联合使用进行了临床测试。
在最终手术后至少6个月内测量使用或不使用bFGF的人工真皮进行的下肢连续重建以及二次中厚皮片移植的硬度,使用硬度计进行测量,并使用水分仪评估诸如有效接触系数、经表皮水分流失(TEWL)、含水量和厚度等水分参数,并与正常皮肤对照进行比较。
与非bFGF治疗相比,bFGF治疗组使用硬度计测量的皮肤硬度明显更低(16.2±3.83对29.2±4.94,p<0.01)。非bFGF治疗组的有效接触系数、TEWL、含水量和厚度均显著高于bFGF治疗组,而bFGF治疗组的含水量和厚度与对照组相当。
使用bFGF作为人工真皮来覆盖广泛且更深的组织缺损,在使用硬度计测量的硬度以及通过水分分析评估的角质层功能方面显示出更好的重建质量。