Birmingham and Wolverhampton, United Kingdom From the University Hospital Birmingham National Health Service Foundation Trust and Royal Wolverhampton Hospitals National Health Service Trust.
Plast Reconstr Surg. 2011 Mar;127(3):1149-1154. doi: 10.1097/PRS.0b013e31820436e3.
This study looked at clinical and histological outcomes of patients treated with Integra more than 2 years earlier. Although previous studies have investigated the short-term clinical and histological results, there have been no studies to investigate longer-term changes.
Fourteen patients (23 sites) were assessed. Patients used a visual analogue scale to score characteristics of their scars. Objective evaluation of the reconstructions was carried out using the Cutometer MPA580. Punch biopsy specimens of the sites were stained and labeled immunohistochemically with S100, CD31, and CD34 antisera.
The highest scoring category by patients was softness (median, +45 percent). The lowest score was sweating, which all patients scored 0. The median Cutometer readings ranged from 39 to 52 percent of the control values. Histological examination showed three patterns of collagen arrangement; parallel arrangement was found in over 60 percent of specimens. Elastic fibers were identified in all specimens; however, all were of abnormal morphology. The majority of specimens showed evidence of nerve fiber regeneration although confined to the mid- or lower reticular dermis. There was no regeneration of skin adnexa.
This study showed significant improvements in patient-assessed mobility, softness, and appearance. Collagen and elastic fibrin were present in all specimens, nerve fiber regeneration was limited to the mid- or lower reticular dermis, and adnexal structures were absent. The typical wrinkled appearance of mature Integra reconstruction cannot be said to be entirely due to a lack of elastic fibers.
本研究观察了 Integra 治疗超过 2 年的患者的临床和组织学结果。尽管之前的研究已经调查了短期的临床和组织学结果，但还没有研究调查长期变化。
评估了 14 名患者（23 个部位）。患者使用视觉模拟评分法对其疤痕的特征进行评分。使用 Cutometer MPA580 对重建部位进行客观评估。对部位的活检标本进行染色，并使用 S100、CD31 和 CD34 抗血清进行免疫组织化学标记。
患者评分最高的类别是柔软度（中位数为+45%）。评分最低的是出汗，所有患者均得分为 0。Cutometer 读数的中位数范围为对照值的 39%至 52%。组织学检查显示三种胶原排列模式；超过 60%的标本为平行排列。所有标本均发现弹性纤维；然而，所有的纤维形态均异常。大多数标本显示神经纤维再生的证据，但仅限于中或下部网状真皮。没有皮肤附属物的再生。
本研究表明，患者评估的移动性、柔软度和外观有显著改善。所有标本均存在胶原和弹性纤维，神经纤维再生仅限于中或下部网状真皮，且附属结构缺失。成熟 Integra 重建的典型皱纹外观不能完全归因于缺乏弹性纤维。
