Kruse Carla R, Sakthivel Dharaniya, Sinha Indranil, Helm Douglas, Sørensen Jens A, Eriksson Elof, Nuutila Kristo
Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Plastic and Reconstructive Surgery, Odense University Hospital, Denmark.
Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
J Surg Res. 2018 Jul;227:35-43. doi: 10.1016/j.jss.2018.02.004. Epub 2018 Mar 6.
Skin grafting is the current standard of care in the treatment of full-thickness burns and other wounds. It is sometimes associated with substantial problems, such as poor quality of the healed skin, scarring, and lack of donor-site skin in large burns. To overcome these problems, alternative techniques that could provide larger expansion of a skin graft have been introduced over the years. Particularly, different cell therapies and methods to further expand skin grafts to minimize the need for donor skin have been attempted. The purpose of this study was to objectively evaluate the efficacy of cell and micrograft transplantation in the healing of full-thickness wounds.
Allogeneic cultured keratinocytes and fibroblasts, separately and together, as well as autologous and allogeneic skin micrografts were transplanted to full-thickness rat wounds, and healing was studied over time. In addition, wound fluid was collected, and the level of various cytokines and growth factors in the wound after transplantation was measured.
Our results showed that both autologous and allogeneic micrografts were efficient treatment modalities for full-thickness wound healing. Allogeneic skin cell transplantation did not result in wound closure, and no viable cells were found in the wound 10 d after transplantation.
Our study demonstrated that allogeneic micrografting is a possible treatment modality for full-thickness wound healing. The allografts stayed viable in the wound and contributed to both re-epithelialization and formation of dermis, whereas allogeneic skin cell transplantation did not result in wound closure.
皮肤移植是目前治疗全层烧伤和其他伤口的标准治疗方法。它有时会带来一些严重问题，如愈合皮肤质量差、瘢痕形成以及大面积烧伤时供皮区皮肤不足。为克服这些问题，多年来已引入了能使皮肤移植片更大程度扩张的替代技术。特别是，人们尝试了不同的细胞疗法以及进一步扩大皮肤移植片以减少对供皮需求的方法。本研究的目的是客观评估细胞和微小移植片移植在全层伤口愈合中的疗效。
将异体培养的角质形成细胞和成纤维细胞单独及联合移植，以及自体和异体皮肤微小移植片移植到大鼠全层伤口，并对愈合过程进行长期研究。此外，收集伤口渗出液，检测移植后伤口中各种细胞因子和生长因子的水平。
我们的结果表明，自体和异体微小移植片都是全层伤口愈合的有效治疗方式。异体皮肤细胞移植未导致伤口闭合，移植后10天伤口中未发现存活细胞。
我们的研究表明，异体微小移植是全层伤口愈合的一种可能治疗方式。异体移植片在伤口中保持存活，并有助于重新上皮化和真皮形成，而异体皮肤细胞移植未导致伤口闭合。
