Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Plast Reconstr Surg. 2010 Mar;125(3):901-9. doi: 10.1097/PRS.0b013e3181cc9665.
Prolonged healing times and hypertrophic scarring of the donor site for split-thickness-skin grafts thicker than 0.3 mm are common problems that continue to challenge plastic surgeons in the clinic. As such, a human tissue-engineered epidermal membrane was constructed to promote wound healing and reduce scar hypertrophy.
An artificial allogenic epidermis was created in vitro using human keratinocytes and chitosan-gelatin membrane. Split-thickness skin graft donor sites were divided into three treatment groups: those covered with the combined keratinocyte/chitosan-gelatin membrane, those covered with chitosan-gelatin membrane only (control group), and those covered with traditional petroleum jelly gauze (blank group). The degree of wound healing was assessed at various time points after the operation by gross observation, hematoxylin and eosin staining, immunohistochemistry, and an assay of type I collagen using the picrosirius polarization method. Reverse-transcriptase polymerase chain reaction detection of the Y chromosome was also performed to distinguish between sexes.
Over a 6-month observation period, treatment with the human tissue-engineered epidermal membrane (keratinocyte/chitosan-gelatin) appeared to decrease donor-site healing time (48 wounds in 24 cases). Average healing time was 8.1 +/- 1.3 days for the keratinocyte/chitosan-gelatin group, 16.4 +/- 1.7 days for the chitosan-gelatin group, and 22.9 +/- 4.2 days for the blank group. The artificial epidermis survived well and maintained a normal structure. Furthermore, hypertrophic scar formation was less severe for these wounds.
Keratinocyte/chitosan-gelatin membranes can be constructed in vitro and survive temporarily in vivo. They can be used to promote wound healing and reduce the severity of hypertrophic scarring of skin graft donor sites.
0.3 毫米以上的分层皮片供区愈合时间延长和增生性瘢痕是临床中持续困扰整形外科医生的常见问题。因此，构建了一种人组织工程表皮膜以促进伤口愈合并减少瘢痕增生。
在体外使用人角质形成细胞和壳聚糖-明胶膜构建人工同种异体表皮。将分层皮片供区分为三组治疗：用复合角质形成细胞/壳聚糖-明胶膜覆盖、仅用壳聚糖-明胶膜覆盖（对照组）和用传统凡士林纱布覆盖（空白组）。术后不同时间点通过大体观察、苏木精和伊红染色、免疫组织化学和天狼星红偏振法检测 I 型胶原进行伤口愈合程度评估。还进行了 Y 染色体的逆转录聚合酶链反应检测以区分性别。
在 6 个月的观察期内，用人组织工程表皮膜（角质形成细胞/壳聚糖-明胶）治疗似乎可以缩短供区愈合时间（24 例 48 个伤口）。角质形成细胞/壳聚糖-明胶组的平均愈合时间为 8.1 +/- 1.3 天，壳聚糖-明胶组为 16.4 +/- 1.7 天，空白组为 22.9 +/- 4.2 天。人工表皮存活良好并保持正常结构。此外，这些伤口的增生性瘢痕形成较轻。
可以在体外构建角质形成细胞/壳聚糖-明胶膜并在体内暂时存活。它们可用于促进伤口愈合并减轻皮肤移植供区增生性瘢痕的严重程度。
