Smahel J
Department of Surgery, Zurich University Medical School, Switzerland.
Burns. 1991 Feb;17(1):17-24. doi: 10.1016/0305-4179(91)90005-2.
Secondary tissue loss in burn wounds (due to necrosis in the zone of stasis) is interpreted as a sequel of progressive vascular occlusion and dehydration of thermally damaged tissue. In this study on rats, delayed healing represented an additional factor in determining the fate of tissue that had sustained deep partial skin thickness burns. Early revascularization induced by excision and subsequent replantation of the burned skin resulted in survival of a large part of the corium. Replantation reduced the loss of full thickness skin seen in controls left to heal spontaneously to partial loss in treated wounds. The experiments substantiate the theory that deep partial skin thickness thermal damage is at least partly reversible and indicate that with tangential excision of dermal burns a viable part of the corium is sacrificed. This deeper part of the corium can be saved by early excision and replantation.
烧伤创面的继发性组织损失（由于淤滞区坏死）被认为是热损伤组织渐进性血管闭塞和脱水的结果。在这项针对大鼠的研究中，愈合延迟是决定遭受深Ⅱ度皮肤烧伤组织命运的一个额外因素。通过切除并随后重新移植烧伤皮肤诱导的早期血管再生，使得大部分真皮得以存活。重新移植减少了在自行愈合的对照中所见的全层皮肤损失，使治疗后的创面仅出现部分损失。这些实验证实了深Ⅱ度皮肤热损伤至少部分是可逆的这一理论，并表明在对真皮烧伤进行削痂时，一部分存活的真皮被牺牲了。通过早期切除并重新移植，可以挽救真皮的这一较深层部分。
