Kürklü Ömer, Soylu Sinan
Department of General Surgery, Sivas Cumhuriyet University Faculty of Medicine, Sivas, Türkiye.
Turk J Surg. 2025 May 30;41(2):135-140. doi: 10.47717/turkjsurg.2025.6684. Epub 2025 Mar 19.
This study investigates the effects of adipose tissue-derived mesenchymal stem cell (MSC), human recombinant epidermal growth factor (EGF) and silver sulfadiazine (SSD) on wound healing in the burn stasis zone by applying the comb burn model in rats.
A comb burn model was used for the burns and 32 Wistar albino female rats were randomly divided into four groups (control, SSD, SSD+MSC, SSD+EGF). On the 1 day and the 21 day, the total burn area on the 1 day and the healed, healing, and non-healing burn area on the 21 day were calculated with the Image-J program. At the end of the 21 day, the pathology samples taken after euthanasia were scored semiquantitatively in terms of epithelization, inflammatory cell density, fibroblast density, collagen amount, and angiogenesis after hematoxylin-eosin staining.
Histopathological analysis demonstrated that epithelialization scores were highest in the MSC (3.88±0.35, p<0.001) and EGF (3.63±0.52) groups, while the control group had the lowest values (1.50±0.53). Inflammatory cell density was significantly lower in the MSC (1.50±0.53, p<0.001) and EGF (1.88±0.64) groups than in the control group (3.75±0.46). Similarly, fibroblast density was lowest in the MSC (1.38±0.52, p<0.001) and EGF (1.75±0.71) groups, while the control group had the highest values (3.63±0.52). Collagen fibril density was significantly increased in the MSC (3.88±0.35, p<0.001) and EGF (3.50±0.53) groups compared to the control (1.63±0.74). Angiogenesis was highest in the EGF group (3.75±0.46, p<0.001), followed by the MSC group (3.00±0.53), while the control group had the lowest values (1.25±0.46). These results suggest that MSC and EGF play a significant role in wound healing, with MSC demonstrating superior epithelialization and EGF exhibiting the greatest angiogenic effect. Photo-analytical measurements showed that on day 1, burn area sizes were similar among all groups (p>0.05). By day 21, the healing burn area was significantly smaller in the MSC (3.19±0.98 cm², p<0.001) and EGF (4.33±0.48 cm²) groups compared to the control (8.43±2.35 cm²). The non-healing area was smallest in the EGF group (0.67±0.49 cm²), followed by the MSC (1.06±0.49 cm², p<0.001) and SSD (1.91±0.75 cm²) groups, whereas the control group had the largest non-healing area (7.29±2.20 cm²). These findings suggest that MSC was the most effective treatment for promoting wound healing, followed by EGF and SSD.
We determined that both histologically and photo analytically, MSC and EGF provided faster wound healing in the burn stasis zone EGF gave better results than all groups in preventing necrosis.
本研究通过在大鼠中应用梳状烧伤模型，研究脂肪组织来源的间充质干细胞（MSC）、人重组表皮生长因子（EGF）和磺胺嘧啶银（SSD）对烧伤淤滞区伤口愈合的影响。
采用梳状烧伤模型进行烧伤，将32只雌性Wistar白化大鼠随机分为四组（对照组、SSD组、SSD + MSC组、SSD + EGF组）。在第1天和第21天，使用Image-J程序计算第1天的总烧伤面积以及第21天的愈合、正在愈合和未愈合的烧伤面积。在第21天结束时，对安乐死后采集的病理样本进行苏木精-伊红染色，然后根据上皮化、炎症细胞密度、成纤维细胞密度、胶原含量和血管生成进行半定量评分。
组织病理学分析表明，MSC组（3.88±0.35，p<0.001）和EGF组（3.63±0.52）的上皮化评分最高，而对照组的值最低（1.50±0.53）。MSC组（1.50±0.53，p<0.001）和EGF组（1.88±0.64）的炎症细胞密度明显低于对照组（3.75±0.46）。同样，MSC组（1.38±0.52，p<0.001）和EGF组（1.75±0.71）的成纤维细胞密度最低，而对照组的值最高（3.63±0.52）。与对照组（1.63±0.74）相比，MSC组（3.88±0.35，p<0.001）和EGF组（3.50±0.53）的胶原纤维密度显著增加。EGF组的血管生成最高（3.75±0.46，p<0.001），其次是MSC组（3.00±0.53），而对照组的值最低（1.25±0.46）。这些结果表明，MSC和EGF在伤口愈合中起重要作用；MSC表现出卓越的上皮化能力，而EGF表现出最大的血管生成作用。光分析测量显示第1天所有组的烧伤面积大小相似（p>0.05）。到第21天，与对照组（8.43±2.35 cm²）相比，MSC组（3.19±0.98 cm²，p<0.001）和EGF组（4.33±0.48 cm²）的正在愈合的烧伤面积明显较小。EGF组的未愈合面积最小（0.67±0.49 cm²），其次是MSC组（1.06±0.49 cm²，p<0.001）和SSD组（1.91±0.75 cm²），而对照组的未愈合面积最大（7.29±2.20 cm²）。这些发现表明，MSC是促进伤口愈合最有效的治疗方法，其次是EGF和SSD。
我们通过组织学和光分析确定，MSC和EGF均可使烧伤淤滞区的伤口愈合更快；在预防坏死方面，EGF比所有组的效果都更好。
