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人类中厚皮片的神经再支配:两种不同手术方法的比较。

Reinnervation of split skin grafts in humans: comparison of two different methods of operation.

作者信息

Weiss-Becker C, Fruhstorfer H, Friederich H C, Winter H

机构信息

Institute of Physiology, Philipps-University of Marburg, Germany.

出版信息

Scand J Plast Reconstr Surg Hand Surg. 1998 Jun;32(2):157-62. doi: 10.1080/02844319850158778.

Abstract

Studies on the reinnervation of split skin grafts have produced contradictory results. As the difference in sensitivity may be caused by the method of grafting, sensory reinnervation was studied in split skin grafted by two different methods. Thirty-nine patients given split skin grafts after the excision of malignant melanoma took part in the study. In 17 patients, split skin was grafted on to the intact muscle fascia. In another 22 patients the skin was grafted directly on to the muscle after the fascia had been removed. In all patients, sensitivity (to touch, heat/cold, and pain) was tested on the grafts and the skin from the opposite side. Sensory functions on grafted skin were generally reduced. Patients with split skin grafted on to the intact muscle fascia had better reinnervation than the ones in whom the fascia had been removed. However, individual patients from both groups showed surprisingly good reinnervation of transplanted skin. The reasons for this finding are not clear, but it is quite possible that the characteristics of the grafted skin have some influence on the reinnervation.

摘要

对植皮区再神经化的研究得出了相互矛盾的结果。由于敏感性差异可能是由植皮方法引起的,因此研究了两种不同植皮方法对分裂厚皮片感觉再神经化的影响。39例恶性黑色素瘤切除术后接受分裂厚皮片移植的患者参与了本研究。17例患者的分裂厚皮片移植于完整的肌肉筋膜上。另外22例患者在去除筋膜后将皮肤直接移植于肌肉上。对所有患者移植皮片及对侧皮肤进行感觉(触觉、冷热觉和痛觉)测试。移植皮片的感觉功能普遍下降。分裂厚皮片移植于完整肌肉筋膜的患者比筋膜已被去除的患者再神经化情况更好。然而,两组中的个别患者移植皮肤的再神经化情况出人意料地良好。这一发现的原因尚不清楚,但移植皮肤的特性很可能对再神经化有一定影响。

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