Department of Burn and Plastic Surgery, Nanjing, Jiangsu, China.
Department of Pathology, Nanjing, Jiangsu, China.
J Burn Care Res. 2020 Jul 3;41(4):892-899. doi: 10.1093/jbcr/iraa033.
After transplantation, skin grafts contract to different degrees, thus affecting the appearance and function of the skin graft sites. The exact mechanism of contracture after skin grafting remains unclear, and reliable treatment measures are lacking; therefore, new treatment methods must be identified. Many types of centripetal contraction forces affect skin graft operation, thus leading to centripetal contracture. Therefore, antagonizing the centripetal contraction of skin grafts may be a feasible method to intervene in skin contracture. Here, the authors propose the first reported mechanical stretching method to address contracture after skin grafting. A full-thickness skin graft model was established on the backs of SD rats. The skin in the experimental group was stretched unilaterally or bidirectionally with a self-made elastic stretching device, whereas the skin was non-stretched in the control group. The rats were sacrificed 2 weeks after stretching. The area, length, and width of the skin were measured. The grafts were cut and fixed with formalin. Routine paraffin sections were stained with hematoxylin-eosin, picric acid-Sirius red, Victoria blue, and anti-alpha-smooth muscle actin (SMA). Mechanical stretching made the graft lengthen in the direction of the stress and had an important influence on collagen deposition and alpha-SMA expression in the graft. This method warrants further in-depth study to provide a basis for clinical application.
移植后，皮肤移植物会发生不同程度的收缩，从而影响移植物部位的外观和功能。皮肤移植后发生挛缩的确切机制尚不清楚，也缺乏可靠的治疗措施；因此，必须确定新的治疗方法。许多类型的向心收缩力影响皮肤移植手术，从而导致向心性挛缩。因此，拮抗皮肤移植物的向心收缩可能是干预皮肤挛缩的一种可行方法。在这里，作者提出了第一个报道的机械拉伸方法来解决皮肤移植后的挛缩问题。在 SD 大鼠的背部建立了全厚皮肤移植模型。实验组的皮肤用自制的弹性拉伸装置单向或双向拉伸，而对照组的皮肤不拉伸。拉伸 2 周后处死大鼠。测量皮肤的面积、长度和宽度。将移植物用福尔马林固定并进行常规石蜡切片，用苏木精-伊红、苦味酸-天狼星红、维多利亚蓝和抗α-平滑肌肌动蛋白（SMA）染色。机械拉伸使移植物在应力方向上变长，并对移植物中胶原沉积和α-SMA 表达有重要影响。该方法需要进一步深入研究，为临床应用提供依据。
