Boyce S T, Greenhalgh D G, Kagan R J, Housinger T, Sorrell J M, Childress C P, Rieman M, Warden G D
Shriners Burns Institute, Cincinnati, Ohio.
Plast Reconstr Surg. 1993 Apr;91(4):632-41. doi: 10.1097/00006534-199304000-00010.
Closure of large skin wounds (i.e., burns, congenital giant nevus, reconstruction of traumatic injury) with split-thickness skin grafts requires extensive harvesting of autologous skin. Composite grafts consisting of collagen-glycosaminoglycan (GAG) substrates populated with cultured dermal fibroblasts and epidermal keratinocytes were tested in a pilot study on full-thickness burn wounds of three patients as an alternative to split-thickness skin. Light microscopy and transmission electron microscopy showed regeneration of epidermal and dermal tissue by 2 weeks, with degradation of the collagen-GAG implant associated with low numbers of leukocytes, and deposition of new collagen by fibroblasts. Complete basement membrane, including anchoring fibrils and anchoring plaques, is formed by 2 weeks, is mature by 3 months, and accounts for the absence of blistering of healed epidermis. All skin antigens tested (involucrin, filaggrin, laminin, collagens IV and VII, fibronectin, and chondroitin-sulfate) were expressed by 16 days after grafting. This cultured skin analogue provides an experimental alternative to split-thickness skin graft that develops histiotypic markers of skin anatomy and antigen expression after wound closure.
使用中厚皮片闭合大面积皮肤伤口（如烧伤、先天性巨痣、创伤性损伤修复）需要大量采集自体皮肤。在一项针对三名患者全层烧伤伤口的初步研究中，测试了由填充有培养的真皮成纤维细胞和表皮角质形成细胞的胶原-糖胺聚糖（GAG）基质组成的复合移植物，作为中厚皮片的替代物。光学显微镜和透射电子显微镜显示，到2周时表皮和真皮组织再生，胶原-GAG植入物降解，白细胞数量少，成纤维细胞沉积新的胶原。完整的基底膜，包括锚定纤维和锚定斑，在2周时形成，3个月时成熟，这解释了愈合表皮无水泡形成的原因。移植后16天，所有测试的皮肤抗原（兜甲蛋白、丝聚合蛋白、层粘连蛋白、IV型和VII型胶原、纤连蛋白和硫酸软骨素）均表达。这种培养的皮肤替代物为中厚皮片提供了一种实验性替代方法，在伤口闭合后能形成皮肤解剖结构和抗原表达的组织型标志物。
