Department of Plastic Surgery, Specialist Medical Center, Kościelna 5/18 Str., 57-320 Polanica Zdrój, Poland.
J Biomech. 2011 Apr 29;44(7):1313-20. doi: 10.1016/j.jbiomech.2011.01.012. Epub 2011 Feb 5.
The comparative study was performed to investigate the biomechanical properties (maximum tangential stiffness, maximum tangential modulus and tensile strength) of expanded mucoperiosteal palatal tissue after rapid expansion regimen correlated with histological findings. Rabbit palatal model was used to correlate the non-operated control group, sham-operated control (subperiosteal tissue dissection) groups and 24- and 48-hour tissue expansion groups. There was no observed damage of tissue collagen network in both tissue expansion groups analyzed immediately after expansion, and biomechanical profile was not significantly different from the profile of control groups. However, rapid tissue expansion activates remodeling of mucoperiosteal tissue structure that revealed significant changes in mechanical properties during the 4-week follow-up. The 24-hour expansion induced transient increase of resilience observed 2 weeks after surgery in comparison to the control groups. As a result of maturation of newly created collagen fibers and mucoperiosteum rebuilding, there were no significant differences between any of the analyzed tensile parameters 4 weeks after the 24-hour expansion. Increased and elongated inflammatory response and connective matrix synthesis observed during healing of 48-hour expanded tissue led to a significant decrease of tensile strength value in comparison to the control groups. Even though 4 weeks after surgery, the resilience of 48-hour expanded tissue was similar to the control groups, tissue healing was not completed and limited scar formation might considerably change the final biomechanical tissue profile. These findings provide new information about tensile properties to rapid mucoperiosteal palatal tissue expansion with the use of osmotic expanders for cleft palate repair by tissue augmentation.
本对比研究旨在探讨快速扩张方案后扩张的黏骨膜腭组织的生物力学特性（最大切向刚度、最大切向模量和拉伸强度）与组织学发现之间的关系。采用兔腭模型，将未经手术的对照组、假手术对照组（骨膜下组织解剖）和 24 小时及 48 小时组织扩张组进行相关性分析。在扩张后立即分析的两个组织扩张组中，均未观察到组织胶原网络损伤，生物力学特征与对照组无显著差异。然而，快速组织扩张会激活黏骨膜组织结构的重塑，在 4 周的随访过程中，机械性能会发生显著变化。与对照组相比，24 小时扩张诱导的弹性在手术后 2 周时出现短暂增加。由于新形成的胶原纤维和黏骨膜重建的成熟，24 小时扩张后 4 周时，任何分析的拉伸参数之间均无显著差异。在 48 小时扩张组织的愈合过程中观察到的炎症反应和结缔组织基质合成增加和延长，导致与对照组相比，拉伸强度值显著降低。尽管在手术后 4 周，48 小时扩张组织的弹性与对照组相似，但组织愈合尚未完成，有限的瘢痕形成可能会极大地改变最终的生物力学组织特征。这些发现为使用渗透压扩张器进行腭裂修复的快速黏骨膜腭组织扩张提供了有关拉伸特性的新信息，以实现组织增强。
