Li H, Berthod F, Xu W, Damour O, Germain L, Auger F A
Laboratoire des Grands Brûlés/LOEX, Hôpital du Saint-Sacrement, 1050 chemin Sainte-Foy, G1S 4L8, Canada.
J Surg Res. 1997 Dec;73(2):143-8. doi: 10.1006/jsre.1997.5229.
The skin flap technique is widely used in reconstructive surgery for the coverage of deep burns of the face, neck, and joints. Facial deformities and joint contractures are avoided by transplanting vascularized full-thickness skin on wounds. The major drawback of this technique is the injury inflicted upon the donor site, which corresponds to a third degree burn. The usual technique to cover the flap donor site is the transplantation of split-thickness autografts. In the case of patients with deep and extensive burns, the harvesting of good quality autografts is often difficult because of multiple scars. In order to avoid additional trauma to the patient by split-thickness skin harvesting, we have experimented the use of a new model of in vitro reconstructed skin graft for flap donor site coverage in a mouse model.
The reconstructed skin was grafted on the back of nude mice at the skin flap donor site, while flap was used to cover a wound generated on joint of the posterior leg.
A 100% graft take was achieved (16 mice were used) and a limited contraction of the reconstructed skin was observed 30 days posttransplantation (78% of the initial surface area of the graft remained). Histological analysis of the graft demonstrated healing of a well differentiated epidermis laying on a dense dermis.
Since this technique would prevent additional trauma to the patient while achieving a good healing of the wound, it may be a useful approach in the coverage of skin flap donor site in humans.
皮瓣技术在重建手术中广泛用于覆盖面部、颈部和关节的深度烧伤。通过将带血管的全层皮肤移植到伤口上可避免面部畸形和关节挛缩。该技术的主要缺点是供区会受到相当于三度烧伤的损伤。覆盖皮瓣供区的常用技术是移植中厚自体皮片。对于深度和广泛烧伤的患者，由于多处瘢痕，获取高质量的自体皮片往往很困难。为了避免中厚皮片取皮给患者带来额外创伤，我们在小鼠模型中试验了一种新型体外重建皮肤移植物用于覆盖皮瓣供区。
将重建皮肤移植到裸鼠背部的皮瓣供区，同时用皮瓣覆盖后肢关节处产生的伤口。
移植成功率达100%（共使用16只小鼠），移植后30天观察到重建皮肤收缩有限（移植初始表面积的78%留存）。对移植物的组织学分析显示，在致密真皮上有分化良好的表皮愈合。
由于该技术在实现伤口良好愈合的同时可防止给患者带来额外创伤，它可能是一种用于人类皮瓣供区覆盖的有用方法。
