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用于组织再生的人工真皮替代物:两种模板的临床结果与组织学发现比较

Artificial dermal substitutes for tissue regeneration: comparison of the clinical outcomes and histological findings of two templates.

作者信息

De Francesco Francesco, Busato Alice, Mannucci Silvia, Zingaretti Nicola, Cottone Giuseppe, Amendola Francesco, De Francesco Marialuisa, Merigo Flavia, Riccio Valentina, Vaienti Luca, Parodi Pier Camillo, Sbarbati Andrea, Riccio Michele

机构信息

Department of Reconstructive Surgery and Hand Surgery, AOU "Ospedali Riuniti", Ancona, Italy.

Accademia del Lipofilling, Research and Training Center in Regenerative Surgery, Montelabbate (PU), Italy.

出版信息

J Int Med Res. 2020 Aug;48(8):300060520945508. doi: 10.1177/0300060520945508.

Abstract

OBJECTIVE

Artificial dermal substitutes (DSs) are fundamental in physiological wound healing to ensure consistent and enduring wound closure and provide a suitable scaffold to repair tissue. We compared the clinical and histological features of two DSs, Pelnac and Integra, in the treatment of traumatic and iatrogenic skin defects.

METHODS

This prospective observational study involved 71 randomly selected patients from our hospital. Wound healing was analyzed using the Wound Surface Area Assessment, the Vancouver Scar Scale, and a visual analog scale. Histological and immunohistochemical evaluations were also performed.

RESULTS

At 2 weeks, greater regeneration with respect to proliferation of the epidermis and renewal of the dermis was observed with Pelnac than with Integra. At 4 weeks, the dermis had regenerated with both DSs. Both templates induced renewed collagen and revascularization. Differences in the Vancouver Scar Scale score were statistically significant at 4 weeks and 1 year. Pelnac produced a significant increase in contraction at 2 weeks with increasing effectiveness at 4 weeks. Integra produced a higher percentage reduction in the wound surface area and a shorter healing time than Pelnac for wounds >1.5 cm deep.

CONCLUSION

Our observational data indicate that both DSs are effective and applicable in different clinical contexts.

摘要

目的

人工真皮替代物(DSs)在生理性伤口愈合中至关重要,可确保伤口持续且持久地闭合,并为组织修复提供合适的支架。我们比较了两种DSs(Pelnac和Integra)在治疗创伤性和医源性皮肤缺损方面的临床和组织学特征。

方法

这项前瞻性观察性研究纳入了我院随机选取的71例患者。使用伤口表面积评估、温哥华瘢痕量表和视觉模拟量表对伤口愈合情况进行分析。还进行了组织学和免疫组化评估。

结果

在2周时,与Integra相比,Pelnac在表皮增殖和真皮更新方面观察到更大程度的再生。在4周时,两种DSs均使真皮再生。两种模板均诱导了新的胶原蛋白生成和血管再生。温哥华瘢痕量表评分在4周和1年时差异具有统计学意义。Pelnac在2周时收缩明显增加,在4周时效果增强。对于深度>1.5 cm的伤口,Integra比Pelnac产生更高的伤口表面积减少百分比和更短的愈合时间。

结论

我们的观察数据表明,两种DSs在不同临床情况下均有效且适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23d6/7427157/d8c38ad4dfb4/10.1177_0300060520945508-fig1.jpg

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