Fan Z, Zhang D, Guan W
Department of Plastic Surgery, 9th Hospital, Shanghai.
Zhonghua Zheng Xing Shao Shang Wai Ke Za Zhi. 1995 Sep;11(5):375-8.
Nine white pigs weighing about 15 kg were divided into three groups: rapid expansion group (REG), conventional expansion group (CEG) and control group (CON). Expansion was carried out under monitoring of interal pressure of the expander and blood flow of the skin over the expander. After completion of expansion, hemodynamic, physical, histologic and ultrastructure changes of the expanded skin were measured and recorded. The study showed: (1) The immediate retraction ratios of skin of three groups were 41.37%, 20.82% and 10.01%, respectively (P < 0.01). (2) The thickness of the epidermis of the three groups was not statistically different, though the dermis of the expanded skin was thinner than that of the control (P < 0.01). (3) The density of collagen in the dermis of the three groups was 80.57 +/- 5.47, 79.49 +/- 6.31 and 82.72 +/- 2.69, respectively; the density of elastin of the three groups was 2.88 +/- 1.24, 2.77 +/- 0.74 and 2.56 +/- 0.63, respectively (P < 0.05). We concluded that the delay phenomenon of the expanded flap depends mainly on the intensity of expansion. The immediate retraction ratio of the rapidly expanded skin was greater than that of conventionally expanded skin. Rapid expansion also results in tissue hypertrophy but does not cause destruction of collagen. With proper calculating the size of the defect and estimating immediate skin retraction, rapid expansion is feasible in clinical applications.
9只体重约15千克的白色猪被分为三组：快速扩张组（REG）、传统扩张组（CEG）和对照组（CON）。在扩张器内部压力及扩张器上方皮肤血流监测下进行扩张。扩张完成后，测量并记录扩张皮肤的血流动力学、物理、组织学及超微结构变化。研究显示：（1）三组皮肤的即时回缩率分别为41.37%、20.82%和10.01%（P<0.01）。（2）三组表皮厚度无统计学差异，尽管扩张皮肤的真皮层比对照组薄（P<0.01）。（3）三组真皮层中胶原蛋白密度分别为80.57±5.47、79.49±6.31和82.72±2.69；三组弹性蛋白密度分别为2.88±1.24、2.77±0.74和2.56±0.63（P<0.05）。我们得出结论，扩张皮瓣的延迟现象主要取决于扩张强度。快速扩张皮肤的即时回缩率大于传统扩张皮肤。快速扩张还会导致组织肥大，但不会引起胶原蛋白破坏。通过适当计算缺损大小并估计皮肤即时回缩情况，快速扩张在临床应用中是可行的。
