Sami Khaled, Elshahat Ahmed, Moussa Manal, Abbas Alaa, Mahmoud Amr
Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Histology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Eplasty. 2015 Jan 23;15:e4. eCollection 2015.
Studies in literature on skin of patients with massive weight loss are limited and somehow conflicting in their results. The aim of this study was to quantitatively assess the skin change after massive weight loss.
This study was performed on 30 patients from whom skin biopsies were taken from the skin excised during operations, divided into 3 main groups. The first included patients who were undergoing cosmetic contouring procedures without history of massive weight loss. The second included patients with morbid obesity, who were undergoing bariatric surgery. The third included patients with massive weight loss submitted to cosmetic contouring procedures after stable weight reduction for 6 months. Biopsies were taken from the skin for histological testing. Hematoxylin and Eosin, Mallory, and Aldehyde fuchsin Stains were used to assess the skin collagen and elastic fibers. For quantitative assessment, the Image Analyzer System (Leica Q 500 MC program) was employed. Tensile tests were applied to skin samples using (Instron 5500R) Universal testing machine to measure the skin tensile strength to determine the maximum stress (Burst strength) that skin can induce before damage.
Collagen was significantly thinner in massive weight loss group in both papillary and reticular dermis and significantly less dense in reticular dermis with damage to the elastic fiber network.
The skin of the patients with massive weight loss is weak due to lower density and thickness of collagen fibers and damage to its elastic fibers.
关于大量体重减轻患者皮肤的文献研究有限,且结果在某种程度上相互矛盾。本研究的目的是定量评估大量体重减轻后的皮肤变化。
本研究对30例患者进行,这些患者在手术中切除的皮肤进行了活检,并分为3个主要组。第一组包括正在接受美容塑形手术且无大量体重减轻病史的患者。第二组包括患有病态肥胖症且正在接受减肥手术的患者。第三组包括在体重稳定减轻6个月后接受美容塑形手术的大量体重减轻患者。从皮肤取活检组织进行组织学检测。使用苏木精和伊红、马洛里染色以及醛复红染色来评估皮肤胶原蛋白和弹性纤维。为进行定量评估,采用图像分析仪系统(徕卡Q 500 MC程序)。使用(英斯特朗5500R)万能试验机对皮肤样本进行拉伸试验,以测量皮肤拉伸强度,确定皮肤在受损前可承受的最大应力(破裂强度)。
在大量体重减轻组中,乳头层和网状真皮层的胶原蛋白明显更薄,网状真皮层密度明显更低,且弹性纤维网络受损。
大量体重减轻患者的皮肤较弱,这是由于胶原纤维密度和厚度较低以及弹性纤维受损所致。