摘要
采用异体真皮面耕耘播种自体皮肤细胞覆盖切痂创面的方法,治疗4例烧伤病人,最大受皮区面积6～28%。术后15～25天,异体真皮表面形成新生上皮,3例于术后70～80天刨面愈合。活检表明,新生皮肤有全层表皮结构及真皮组织。最长随访1年8个月,未见愈后创面明显挛缩,功能较好。本组覆盖面积扩大30～56倍。
Using a scalpel, crisscross grooves 1-2 mm apart were made on the dermis of an allogenic skin graft. Epithelial cells in a suspension, harvested from the patient, were seeded into the dermal grooves. The allograft thus prepared was used to cover wounds resulting from excision of full thickness burns. Four patients with burn areas ranged from 5% to 28% were treated with this technic. 10-13 days after the operation, when epidermis of the allografts were lifted, epithelial growth was seen on the dermal surface. It thickened rapidly, and cornification was seen. Except in one case, in whom newly grown epithlium was rubbed away owing to poor bandage and fixation, all the other wounds healed on 70-80 days after the operation. The healed surfaces of wounds were even and smooth. With this technic, the expansion of the donor area was estimated to be as much as 30-56 fold. Biopsy sections at regular intervals after the operation showed that the auto-skin epidermal cells grew out from the grooves to more superficial portions until they reached the surface of dermis, where they extended and finally covered the whole surface of the wound. 10-14 months after the operation the epidermis assumed more or less a wavy contour, and it seemed to be firmly united with the dermis. The cellular structure was clear, and their arrangement regular. With special staining, it was demonstrated that there were eollagenous fibers, reticular fibers and elastic fibers in the dermis. However, there were no dermal appendages. One year later, the color of the new skin approximated that of the normal skin. It was soft and elastic, and no contraction was observed. No obvious signs of rejection of the allograft were noticed.
