Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China ; Tissue Engineering Research Unit, State Key Laboratory of Trauma, Burns and Combined Injury, Third Military Medical University, Chongqing, China.
Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, China.
PLoS One. 2014 Jan 21;9(1):e85672. doi: 10.1371/journal.pone.0085672. eCollection 2014.
The treatment of extensive thermal injuries with insufficient autologous skin remains a great challenge to burn surgeons. In this study, we investigated the influence of the ratio of autologous and allogeneic tissue in mixed microskin grafts on wound healing in order to develop an effective method for using limited donor skin to cover a large open wound. Four different mixtures were tested: autologous microskin at an area expansion ratio of 10∶1 with allogeneic microskin at an area expansion ratio of 10∶1 or 10∶3 and autologous microskin at an expansion ratio of 20∶1 with allogeneic microskin at an expansion ratio of 20∶3 or 20∶6. Wound healing, wound contraction, and integrin β1 expression were measured. Mixed microskin grafting facilitated wound healing substantially. The mixture of autologous microskin at an expansion ratio of 10∶1 with the same amount of allogeneic microskin achieved the most satisfactory wound healing among the 4 tested mixtures. Histological examination revealed the presence of obviously thickened epidermis and ectopic integrin β1 expression. Keratinocytes expressing integrin β1 were scattered in the suprabasal layer. Higher levels of integrin β1 expression were associated with faster wound healing, implying that ectopic expression of integrin β1 in keratinocytes may play a pivotal role in wound healing. In conclusion, this study proves that this new skin grafting technique may improve wound healing.
大面积热力烧伤自体皮源不足一直是烧伤外科医师面临的巨大挑战。本研究通过观察不同比例的自体与同种异体微粒皮混合移植对创面愈合的影响，旨在寻找一种有效利用有限供皮区覆盖大面积创面的方法。实验设计了 4 种不同的混合比例：① 自体微粒皮 10∶1 面积扩展比复合同种异体微粒皮 10∶1 面积扩展比；② 自体微粒皮 10∶1 面积扩展比复合同种异体微粒皮 10∶3 面积扩展比；③ 自体微粒皮 20∶1 面积扩展比复合同种异体微粒皮 20∶3 面积扩展比；④ 自体微粒皮 20∶1 面积扩展比复合同种异体微粒皮 20∶6 面积扩展比。通过观察创面愈合、收缩率及整合素β1 的表达情况来评估混合移植对创面愈合的影响。结果显示混合微粒皮移植能明显促进创面愈合，其中以自体微粒皮 10∶1 面积扩展比复合等量同种异体微粒皮 10∶1 面积扩展比的混合比例的创面愈合效果最佳。组织学观察发现实验组较对照组有明显增厚的表皮和异位整合素β1 表达，角朊细胞表达的整合素β1 散在分布于棘细胞层以上。整合素β1 表达水平越高，创面愈合越快，提示整合素β1 在角朊细胞中的异位表达可能在创面愈合过程中发挥关键作用。结论：该新型微粒皮移植技术可能会改善创面愈合。
