State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, Shanghai, People's Republic of China.
Shanghai Depeac Biotechnology Co., Ltd, Shanghai, People's Republic of China.
Updates Surg. 2024 Oct;76(6):2429-2439. doi: 10.1007/s13304-024-01850-2. Epub 2024 Aug 20.
Large-wound treatment often requires autologous skin grafting or skin flap transfer, causing iatrogenic secondary injuries. Thus, we have developed an automatic wound closure system that consists of a stretch module, microcontroller, and touch screen. Full-thickness wounds (8 × 14 cm) on Bama miniature pigs were manually closed by direct suture in control animals and with three different tension levels performed by the automatic device in the experimental animals. Wound-closure conditions, post-closure healing, and scars were evaluated. Post-operative microscopic changes in collagen fibers, local cell apoptosis, and changes in vascular density were compared between the two wound-closure techniques. In the control group and the first experimental group, which used a traction force of 15 N, primary wound closure could not be achieved. The other two experimental groups used a traction force of 30 N and 60 N and all wounds achieved primary closure. Collagen-fiber stretching was observed histologically in all groups and collagen-fiber breakdown occurred in some wounds when the traction force was 60 N. Scar hyperplasia was significantly reduced in the automatic wound closure system groups. The collagen content decreased, cell apoptosis increased, and vascular density decreased in local tissues in the early post-closure stage, but eventually recovered to normal-skin levels. In summary, we developed an automatic wound closure system that effectively and safely stretches dermal-collagen fibers under an appropriate traction force (30 N) and stretch wound-peripheral skin to cover the wound, achieve primary closure, and reduce scar hyperplasia.
大面积创伤的治疗常需要自体皮片移植或皮瓣转移，这会导致医源性的二次损伤。因此，我们研发了一种自动伤口闭合系统，该系统由拉伸模块、微控制器和触摸屏组成。我们对巴马小型猪的全层皮肤伤口（8×14 cm）进行了研究，对照组采用直接缝合的方法闭合伤口，实验组采用自动闭合装置以三种不同的张力水平闭合伤口。评估了伤口闭合情况、闭合后的愈合情况和疤痕。比较了两种闭合技术术后胶原纤维的微观变化、局部细胞凋亡和血管密度的变化。在对照组和使用 15 N 牵引力的第一实验组中，无法实现一期伤口闭合。另外两组实验均使用 30 N 和 60 N 的牵引力，所有伤口均实现了一期闭合。所有组均观察到胶原纤维的拉伸，当牵引力为 60 N 时，一些伤口出现胶原纤维断裂。疤痕增生在自动伤口闭合系统组中显著减少。在早期伤口闭合阶段，局部组织的胶原含量减少，细胞凋亡增加，血管密度降低，但最终恢复到正常皮肤水平。总之，我们开发了一种自动伤口闭合系统，该系统可在适当的牵引力（30 N）下有效且安全地拉伸真皮胶原纤维，拉伸伤口周围皮肤以覆盖伤口，实现一期闭合，并减少疤痕增生。
