Mustoe T A, Bartell T H, Garner W L
Division of Plastic Surgery, Washington University School of Medicine, St. Louis, Mo.
Plast Reconstr Surg. 1989 Apr;83(4):687-91. doi: 10.1097/00006534-198904000-00015.
Clinical tissue expansion has been quite successful but takes 2 to 3 months. This study compares the effects of a conventional tissue expansion regimen of 6 weeks with an accelerated regimen of 2 weeks in the dog model, which is biomechanically similar to the human. In 22 dogs, the skin expanded 34.4 percent in the 2-week and 35.8 percent in the 6-week protocol, excluding stretch and recruitment. There was thinning of the panniculus carnosus in the 6-week group and otherwise no significant decrease in dermal thickness in either group. The biomechanical properties of elasticity and creep did not differ in expanded skin from both groups, while stress/relaxation mildly decreased from a control value of 53.5 percent to 48.8 percent in the 6-week group (p less than 0.05). Collagen activity was increased in both the 6-week and the 2-week groups (p less than 0.001) over nonexpanded skin, and immunohistochemical staining with a monoclonal procollagen antibody demonstrated collagen synthesis by dermal fibroblasts in both groups. We conclude that rapid tissue expansion did not demonstrate any deleterious effects when compared with a conventional regimen.
临床组织扩张术已取得相当大的成功，但需要2至3个月时间。本研究在狗模型中比较了为期6周的传统组织扩张方案与为期2周的加速方案的效果，狗模型在生物力学上与人类相似。在22只狗中，排除拉伸和补充因素，在2周方案中皮肤扩张了34.4%，在6周方案中扩张了35.8%。6周组的肉膜变薄，而两组的真皮厚度均无显著下降。两组扩张皮肤的弹性和蠕变的生物力学特性没有差异，而6周组的应力/松弛从对照值53.5%轻度下降至48.8%（p小于0.05）。与未扩张皮肤相比，6周组和2周组的胶原蛋白活性均增加（p小于0.001），并且用单克隆前胶原抗体进行的免疫组织化学染色显示两组的真皮成纤维细胞均有胶原蛋白合成。我们得出结论，与传统方案相比，快速组织扩张未显示出任何有害影响。
