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“移植物的初始大小是全厚皮片原发性收缩背后的真正元凶吗?”——一项横断面研究。

Is "Initial Size of the Graft the Real Culprit behind Primary Contraction of Full-Thickness Skin Graft"? - A Cross-Sectional Study.

作者信息

Vathulya Madhubari, Rao Shalinee, Malik Akanksha, Sinha Smita, Kumar Nikhilesh, Kapoor Akshay, Bahurupi Yogesh

机构信息

Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

出版信息

Arch Plast Surg. 2023 Feb 6;50(1):106-115. doi: 10.1055/s-0042-1756297. eCollection 2023 Jan.

Abstract

Primary contraction of full-thickness graft has been traditionally quoted to be 40%. There are lacunae in literature to elaborate on the factors influencing it ever since.  About 75 subjects who underwent full-thickness grafting procedures to resurface small defects were included in the study. The initial and final graft dimensions after primary contraction were traced on X-ray templates and the percentage of contraction was evaluated using the graphical method. This was further correlated with age, collagen, elastic matrix metalloproteinases-1 (MMP-1) and -2 content along with dermal thickness of the skin specimen sent from the graft.  The primary contraction of the graft had a very significant correlation only with the initial size of graft harvested with a linear regression of 33.3% and a Spearman's correlation of 0.587 significant at a -value of 0.001.  This study though preliminary tries to highlight an important factor that primary contraction of grafts is a physical phenomenon independent of its contents like collagen, elastin, or MMP-1 and -2 or age and dependent on its initial size of harvest instead.

摘要

传统观点认为,全厚皮片的初期收缩率为40%。但自那时起,文献中就存在空白,无法详细阐述影响该收缩率的因素。

该研究纳入了约75名接受全厚皮片移植手术以修复小面积缺损的受试者。通过在X线模板上描绘初期收缩后皮片的初始尺寸和最终尺寸,并采用图形法评估收缩百分比。进一步将其与年龄、胶原蛋白、弹性基质金属蛋白酶-1(MMP-1)和-2含量以及取自移植皮片的皮肤标本的真皮厚度进行关联分析。

皮片的初期收缩仅与所取皮片的初始大小具有非常显著的相关性,线性回归为33.3%,Spearman相关性为0.587,在P值为0.001时具有显著性。

本研究虽属初步,但试图强调一个重要因素,即皮片的初期收缩是一种物理现象,与其所含的胶原蛋白、弹性蛋白、MMP-1和-2或年龄无关,而是取决于其初始取材大小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20cf/9902097/8c0b1baee2e4/10-1055-s-0042-1756297-i21282-1.jpg

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