CAJ | 학술논문

目的探讨外用透明质酸(HA)对异种(猪)去细胞真皮基质( PADM)复合移植皮肤组织生物力学性能的影响.方法选用10只日本大耳兔作为实验动物,每只大耳兔背部对称分4个区域,以随机数字表法随机分为4组,其中A、B、C组造成全层皮肤缺损创面,分别进行如下处理:A组:HA+ PADM+自体薄厚皮移植；B组:PADM+自体薄厚皮移植；C组:自体薄厚皮移植；D组:不作处理.术后第56天取各组标本行组织学观察,并进行应力-松弛和应力-应变力学测试.结果 A、B组标本组织学观察见真皮基质基本完整.A组标本有大量成纤维细胞与毛细血管长入真皮基质,周围有炎性细胞散在分布,纤维细胞排列均匀；B组标本真皮基质聚集成团,有少量纤维细胞长入,周围有大量炎性细胞聚集.应力-松弛力学实验结果显示:A组松弛曲线与D组最接近,B组与D组最远,C组在A组与B组之间.在一定应变下,A、B、C、D组的应力值分别为(87±8)、(115±9)、(63±7)、(81±4) kPa,A组与D组最接近,差异无统计学意义(P=0.838)；B、C组与D组差异均有统计学意义(P=0.001和P=0.009).结论外源性HA可提高真皮基质复合移植皮肤组织的生物力学性能.
목적 탐토외용투명질산(HA)대이충(저)거세포진피기질( PADM)복합이식피부조직생물역학성능적영향.방법 선용10지일본대이토작위실험동물,매지대이토배부대칭분4개구역,이수궤수자표법수궤분위4조,기중A、B、C조조성전층피부결손창면,분별진행여하처리:A조:HA+ PADM+자체박후피이식；B조:PADM+자체박후피이식；C조:자체박후피이식；D조:불작처리.술후제56천취각조표본행조직학관찰,병진행응력-송이화응력-응변역학측시.결과 A、B조표본조직학관찰견진피기질기본완정.A조표본유대량성섬유세포여모세혈관장입진피기질,주위유염성세포산재분포,섬유세포배렬균균；B조표본진피기질취집성단,유소량섬유세포장입,주위유대량염성세포취집.응력-송이역학실험결과현시:A조송이곡선여D조최접근,B조여D조최원,C조재A조여B조지간.재일정응변하,A、B、C、D조적응력치분별위(87±8)、(115±9)、(63±7)、(81±4) kPa,A조여D조최접근,차이무통계학의의(P=0.838)；B、C조여D조차이균유통계학의의(P=0.001화P=0.009).결론 외원성HA가제고진피기질복합이식피부조직적생물역학성능.
Objective To explore the effects of hyaluronic acid (HA) on biomechanical properties for porcine acellular dermal matrix (PADM) plus thin skin autograft after transplantation.Methods The dorsa of 10 Japanese white rabbits were symmetrically divided into four areas of A-D by random grouping.Full-thickness skin defects were created in Groups A-C while Group D was blank with normal skin.Operations were performed in Group A:implant with HA + PADM + thin skin autografts,Group B:implant with PADM + thin skin autografts and Group C:skin autografts group.Histological examination of specimen was performed at Day 56 postoperatively.And the biomechanical properties such as relaxation and stress-strain properties of grafts were recorded.Results The structure of PADM was found to be basically intact by hematoxylin and eosin E dyeing in Groups A and B.In Group A,dense fiber structure could be observed.Lots of regularly arranged collagenous fibers and new blood capillaries were grown into the dermal matrix with sparsely distributed inflammatory cells.In Group B,acellular dermal matrix became clustered with a small amount of invaded fibroblasts.And there was a high expression of inflammatory cells.The biomechanic pedormances of transplanted skin were:Group A's curve was mostly close to that of Group D's,Group B's curve was the most further from that of Group D's (P =0.001 ) and Group G's curve stayed between Groups A and B.Under the same strain,the stress of Groups A-D was ( 87 ± 8 ),( 115 ± 9 ),(60 ± 7 ) and (81 ± 4) kPa respectively.No significant difference of stress existed between these two groups (P=0.838).There was significant difference of stress between Groups B/C and D (P =0.001 and P =0.009).Conclusion Topical hyaluronic acid may be used to enhance the biomechanics pedormances of transplanted skin.