摘要
目的:采用一步法将组织工程的支架材料猪无细胞真皮基质与薄自体皮复合移植,动态观察猪无细胞真皮基质在体移植后的稳定性。方法:动物实验于2001-01/2002-03在上海市烧伤研究所完成,指标检测在上海第二医科大学细胞生物学教研室完成。以清洁级雄性SD大鼠90只为动物模型,在其背部造成4cm×5cm的全层皮肤缺损。取模型大鼠84只随机分为薄自体皮移植组和猪无细胞真皮基质+薄自体皮移植组两组,每组各42只。复合皮移植组采用一步法将猪无细胞真皮基质与薄自体皮复合移植,在创面上先移植猪无细胞真皮基质,然后立即在无细胞真皮基质上移植薄自体皮片,缝合固定后覆盖凡士林纱布及干纱布,环形包扎。薄自体皮移植组直接将薄自体皮移植在创面上,然后固定包扎。分别于移植1,2,3,4,8,12,16周取标本,通过大体观察和组织学观察,动态观察猪无细胞真皮基质移植后创面修复效果、皮片移植成活率及猪无细胞真皮基质的稳定性和可降解性。皮片成活率=犤植皮(移片总面积-皮片坏死面积)/植皮片总面积犦×100%。另取6只大鼠进行移复合皮移植,其中3只观察至移植后24周,另外3只观察至移植后32周,分别取全层皮肤标本。结果:实验动物SD大鼠共90只,全部进入结果分析。①无细胞真皮基质与薄自体皮复合移植2周,皮片成活良好,与薄自体皮移植组比较,皮片成活率差异无显著性犤87.29±13.80)%,(88.59±10.30)%,t=0.8509,P(>0.05犦②复合皮移植后愈合创面外观平整,色泽与周围皮肤相似,柔。韧有弹性,而薄自体皮组移植区皮肤比正常皮肤薄,无弹性。③猪无细胞真皮基质与薄自体皮复合移植后皮片成活率与薄自体皮移植组无显著性差异,猪无细胞真皮基质早期完整,随着时间的推移,猪无细胞真皮基质逐渐被降解,并被自体新生的胶原所替代,直到移植后32周,在真皮的网状层仍可见到残留的猪真皮基质。在32周的观察期内未见急慢性排斥反应。结论:采用一步法将猪无细胞真皮基质与薄自体皮复合移植,并不影响覆盖其上的自体皮的成活率,且其在体内具有较好的稳定性,对于引导真皮组织的再生和减轻瘢痕形成可能具有积极的意义。
AIM： To cograft porcine acellular dermal matrix （bridge material of tissue engineering） and autologous thin split-thickness skin by using the one-step method, and dynamically observe the stability of porcine acellular dermal matrix after transplantation. METHODS： The animal experiment was carried out in Shanghai Institute of Burn from January 2001 to March 2002, and the indexes were detected in the Depanntent of Cell Biology of Shanghai Second Medical University. Ninety male SD rats of clean degree were taken as the animal models, full-thickness skin defects （4 cm×5 cm） were created on the dorsum of rats. For the first group of animals, wounds were implanted with thin split thickness skin grafts at the time of surgery. Eighty-four rat models were randomly divided into autologous thin split-thickness skin graft group （n=42） and porcine acellular dermal matrix＋autologous thin split-thickness skin graft group （n=42）, For the second group of animals, wounds were implanted with porcine acellular dermal matrix and covered with thin split-thickness skin grafts at the time of surgery, Vaseline carbasus and dry carbasus were covered after saturation and fixation, and then treated with circular bandage. For the rats in the first group, splitthickness skin was grafted on the wounds directly, and then fixed and bound up. The grafts were examined grossly at l, 2, 3, 4, 8, 12, 16, 24 and 32 weeks after grafting and evaluated histologically to dynamically observe the effect of repairing wounds, survival rate of skin graft after porcine acellular dermal matrix graft, and observe the stability and degradation of porcine acellular dermal matrix. Survival rate of skin graft=[（total area of skin graft-necrosis area of skin graft）/ total area of skin graft]×100%. Another 6 rats were treated with skin cograft, 3 of them were observed till 24 weeks after graft and the other 3 were observed till 32 weeks, and the full split-thickness skin samples were removed respectively. RESULTS： All the 90 SD rats were involved in the analysis of results. ①At 2 weeks after the cograft of porcine acellular dermal matrix and autologous thin split-thickness skin, the survival of skin graft was good, and the survival rate of skin graft had no significant difference between the two groups [（87.29±13.80）%, （88.59±10.30）%, t=0.850 9, P 〉 0.05]. ②After skin eograft, the healed skin was pliable, elastic, plane and with the same color to the around skin. In the thin split thickness skin grafts group, the healed skin was thinner than normal and without elasticity. ③The porcine acellular dermal matrix was degraded gradually but still existed at 32 weeks after transplantation. There was no rejection during the course of observation. CONCLUSION： The cograft porcine acellular dermal matrix and autologous thin split-thickness skin by using the one-step method does not affect the survival rate of autologous skin, and it has good stability in vivo, and it is of positive significance for conducting the regeneration of dermal tissue and relieving the formation of scar.
出处
《中国临床康复》
CSCD
北大核心
2006年第1期50-52,i0003,共4页
Chinese Journal of Clinical Rehabilitation
