猪全层创面移植皮肤微粒、刃厚皮片和培养角质细胞的愈合参数比较。
Comparison of healing parameters in porcine full-thickness wounds transplanted with skin micrografts, split-thickness skin grafts, and cultured keratinocytes.
机构信息
Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
出版信息
J Am Coll Surg. 2011 Dec;213(6):728-35. doi: 10.1016/j.jamcollsurg.2011.08.020. Epub 2011 Oct 21.
BACKGROUND
Transplantation of skin micrografts (MGs), split-thickness skin grafts (STSGs), or cultured autologous keratinocytes (CKs) enhances the healing of large full-thickness wounds. This study compares these methods in a porcine wound model, investigating the utility of micrograft transplantation in skin restoration.
STUDY DESIGN
Full-thickness wounds were created on Yorkshire pigs and assigned to one of the following treatment groups: MGs, STSGs, CKs, wet nontransplanted, or dry nontransplanted. Dry wounds were covered with gauze and the other groups' wounds were enclosed in a polyurethane chamber containing saline. Biopsies were collected 6, 12, and 18 days after wounding. Quantitative and qualitative wound healing parameters including macroscopic scar appearance, wound contraction, neoepidermal maturation, rete ridge formation, granulation tissue thickness and width, and scar tissue formation were studied.
RESULTS
Transplanted wounds scored lower on the Vancouver Scar Scale compared with nontransplanted wounds, indicating a better healing outcome. All transplanted wounds exhibited significantly lower contraction compared with nontransplanted wounds. Wounds transplanted with either MGs, STSGs, or CKs showed a significant increase in re-epithelialization compared with nontransplanted wounds. Wounds transplanted with MGs or STSGs exhibited improved epidermal healing compared with nongrafted wounds. Furthermore, transplantation with STSGs or MGs led to less scar tissue formation compared with the nontransplanted wounds. No significant impact on scar formation was observed after transplantation of CKs.
CONCLUSIONS
Qualitative and quantitative measurements collected from full-thickness porcine wounds show that transplantation of MGs improve wound healing parameters and is comparable to treatment with STSGs.
背景
皮肤微移植(MGs)、刃厚皮片(STSGs)或培养的自体角质形成细胞(CKs)移植可促进大全厚创面的愈合。本研究通过猪创面模型比较这些方法,研究微移植在皮肤修复中的应用。
研究设计
在约克夏猪身上创建全厚创面,并将其分配至以下治疗组之一:MGs、STSGs、CKs、未移植的湿性创面或未移植的干性创面。干性创面用纱布覆盖,其他组的创面用含有生理盐水的聚氨酯室封闭。在创伤后 6、12 和 18 天采集活检。研究了包括宏观瘢痕外观、伤口收缩、新生表皮成熟、网嵴形成、肉芽组织厚度和宽度以及瘢痕组织形成在内的定量和定性伤口愈合参数。
结果
与未移植创面相比,移植创面在温哥华瘢痕量表上的评分较低,表明愈合效果更好。所有移植创面的收缩程度均明显低于未移植创面。与未移植创面相比,MGs、STSGs 或 CKs 移植创面的再上皮化明显增加。MGs 或 STSGs 移植创面的表皮愈合情况明显优于未植皮创面。此外,与未移植创面相比,STSGs 或 MGs 移植导致的瘢痕组织形成减少。CKs 移植对瘢痕形成无明显影响。
结论
来自全厚猪创面的定性和定量测量结果表明,MGs 移植可改善伤口愈合参数,与 STSGs 治疗效果相当。