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[不同人工真皮支架修复猪全层烧伤创面的比较研究]

[Comparative study on repair of full-thickness burn wound with different artificial dermal stent in pigs].

作者信息

Xu Shao-Jun, Ma Lie, Teng Jian-Ying, Xie Jing, Zhu Jin-Tu, Sun Dong-Jie, Ye Sheng, Ni You-Di, Wang Yong-Guang

机构信息

Department of Plastic Surgery, 1st Affiliated Hospital of Zhejiang University of Chinese Medicine, Hangzhou 310006, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2010 Sep;26(5):360-4.

Abstract

OBJECTIVE

To compare differences of angiogenesis among collagen- chitosan, collagen-sulfonated carboxymethyl chitosan porous scaffolds and acellular dermal matrix after these three different scaffolds with silicone membrane were transplanted on the wounds of full thickness burn, and the wound repair of different scaffolds with epidermis grafting on.

METHODS

Angiogenesis in different dermal scaffolds, the wound surface and epidermis survival were observed in 1, 2, and 3 weeks after the three different scaffolds were respectively transplanted on wounds of full thickness burn with debridement in 6 Bama miniature pigs (total 18 pigs in 3 groups). At the same time, CD34 positive signals (neo-forming microvessels) were detected by immunohistochemical staining. The wounds without any scaffold transplantation were studied as the control.

RESULTS

Angiogenesis had been fundamentally finished in 2 weeks after implantation of collagen- sulfonated carboxymethyl chitosan porous scaffold. And fundamental angiogenesis in collagen- chitosan porous scaffolds and acellular dermal matrix needed at least 3 weeks. Neo-forming micro-vessels perpendicular to wound beds with these three different scaffolds were more than those in the control wounds without scaffold. CD34 positive signals (neo-forming micro-vessels) were significantly higher in wounds at the second week than those in wounds at the first week. And those in wounds at the third week were significantly higher than those in wounds at the second week in all wounds with different scaffold transplantations and the control wounds. CD34 positive signals in the group of sulfonated carboxymethyl chitosan porous scaffold on the 1st, 2nd and 3rd week after the scaffold transplantation were significantly higher than those corresponding signals in the other three groups. Epidermis on the sulfonated carboxymethyl chitosan porous scaffold which had been transplanted on burn wound for 1 week could survive perfectly, however, epidermis on the collagen- chitosan porous scaffold or acellular dermal matrix could not survive until these two scaffolds had been transplanted on the burn wounds for at least 2 weeks.

CONCLUSIONS

These three different scaffolds could repair the full thickness skin defects caused by burn, and angiogenesis of sulfonated carboxymethyl chitosan porous scaffold is the best.

摘要

目的

比较胶原 - 壳聚糖、胶原 - 磺化羧甲基壳聚糖多孔支架及脱细胞真皮基质在与硅胶膜联合移植至全层烧伤创面后血管生成的差异,以及不同支架联合表皮移植后的创面修复情况。

方法

选取6只巴马小型猪(共18只,分3组),对其全层烧伤创面进行清创后,分别移植三种不同支架,于移植后1、2、3周观察不同真皮支架内的血管生成情况、创面情况及表皮存活情况。同时,采用免疫组织化学染色检测CD34阳性信号(新生微血管)。以未移植任何支架的创面作为对照。

结果

胶原 - 磺化羧甲基壳聚糖多孔支架植入后2周血管生成基本完成。胶原 - 壳聚糖多孔支架和脱细胞真皮基质的血管生成基本完成至少需要3周。这三种不同支架垂直于创面床的新生微血管均多于未移植支架的对照创面。所有移植不同支架的创面及对照创面中CD34阳性信号(新生微血管)在第2周显著高于第1周,第3周显著高于第2周。磺化羧甲基壳聚糖多孔支架组在移植后第1、2、3周的CD34阳性信号显著高于其他三组相应信号。移植于烧伤创面1周的磺化羧甲基壳聚糖多孔支架上的表皮可完美存活,而胶原 - 壳聚糖多孔支架或脱细胞真皮基质上的表皮在移植至烧伤创面至少2周后才能存活。

结论

这三种不同支架均可修复烧伤所致的全层皮肤缺损,其中磺化羧甲基壳聚糖多孔支架的血管生成情况最佳。

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