Wang Xue-Qing, Phillips Gael E, Wilkie Ian, Greer Ristan, Kimble Roy M
Department of Paediatrics and Child Health, University of Queensland, Royal Children's Hospital, Brisbane 4029, Australia.
J Cutan Pathol. 2010 May;37(5):530-4. doi: 10.1111/j.1600-0560.2009.01376.x. Epub 2009 Jul 15.
Hypertrophic scars in burn victims usually occur after delayed wound healing and the active phase of scar formation can persist substantially even after wound closure. Currently, the pathophysiology of the hypertrophic scar is not completely understood. This study investigated the inflammatory response in scar tissue at week 6 post-burn injury.
A porcine deep dermal partial thickness burn model was used. At week 6 post-burn, a total of 528 scar biopsies from 72 burn scars (7-8 biopsies from each scar) and 174 normal skin biopsies from 18 pigs were collected and examined histologically.
Microscopic inflammatory foci were identified in 17% (89/528) of scar biopsies. These microscopic inflammatory foci do not contain any irritant materials, are composed largely of polymorphonuclear cells with other inflammatory cells including multinucleate giant cells and show acute on chronic inflammatory response that has not been described previously in burn scars. Importantly, they are present in a significantly lower number in burns surgically debrided than in burns which have not been debrided.
This study identifies microscopic inflammatory foci in the porcine scar tissue layer and recommends thorough cleaning/debriding of burned necrotic tissue in order to minimize the formation of these inflammatory foci in scar tissue.
烧伤患者的增生性瘢痕通常在伤口愈合延迟后出现，即使伤口闭合，瘢痕形成的活跃期仍可能持续很长时间。目前，增生性瘢痕的病理生理学尚未完全明确。本研究调查了烧伤后6周瘢痕组织中的炎症反应。
采用猪深Ⅱ度部分厚度烧伤模型。烧伤后6周，从72个烧伤瘢痕中总共采集528份瘢痕活检组织（每个瘢痕7 - 8份活检组织），并从18头猪身上采集174份正常皮肤活检组织，进行组织学检查。
在17%（89/528）的瘢痕活检组织中发现了微观炎症灶。这些微观炎症灶不含任何刺激性物质，主要由多形核细胞和其他炎症细胞（包括多核巨细胞）组成，呈现出一种烧伤瘢痕中此前未被描述过的慢性炎症急性发作反应。重要的是，手术清创的烧伤创面中这些炎症灶的数量明显低于未清创的烧伤创面。
本研究在猪瘢痕组织层中识别出微观炎症灶，并建议彻底清理/清创烧伤坏死组织，以尽量减少瘢痕组织中这些炎症灶的形成。
