中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2015年
5期
1012-1015
,共4页
王桂芳%邱学文%谭荣伟%温皇鼎%高艳彬%王甲汉
王桂芳%邱學文%譚榮偉%溫皇鼎%高豔彬%王甲漢
왕계방%구학문%담영위%온황정%고염빈%왕갑한
双层人工皮%血管化%肉芽组织%炎性反应%胶原纤维%降解
雙層人工皮%血管化%肉芽組織%炎性反應%膠原纖維%降解
쌍층인공피%혈관화%육아조직%염성반응%효원섬유%강해
Bilayer artificial skin%Vascularization%Granulation tissue%Inflammation%Collagen fibers%Degradation
目的 动态观察Lando(R)双层人工皮(以下简称双层人工皮)应用于猪皮肤全层缺损创面血管化.方法 实验以8头一级藏猪为动物模型,体质量为30 ~ 35 kg,雌雄不限,在每头猪背部正中线两侧分别切取3个边长5 cm深达肌肉筋膜的正方形全层皮肤缺损创面,采用同体自身对照,右侧创面行双层人工皮移植术(实验组),左侧创面以凡士林油纱覆盖(对照组).分别于术后第3、7、14、21天按随机数字表随机处死猪,行创面大体观察,同时取材行苏木素-伊红(HE)染色、Masson三色染色后光镜下观察创面修复细胞、炎性反应、胶原纤维排列及支架降解情况,免疫组织化学法检测标本中CD31的表达并计数新生血管数目.结果 实验组创面较对照组干燥,感染发生率较低,肉芽组织生长较平整.光镜下见实验组较对照组组织充血水肿和炎性反应轻微,肉芽组织化速度快,于14d左右支架血管化已基本完成.随时间的延长,修复细胞逐渐减少,胶原纤维排列更为规整且粗大,支架有降解趋势.免疫组织化学结果显示,CD31表达阳性的新生血管数目两组于术后第3天无明显表达,于第7天开始升高,实验组于术后第14天达到高峰,对照组于第21天达到最高.实验组于术后第7、14天高于对照组,于21 d低于对照组,组间差异有统计学意义(P<0.05).结论 双层人工皮在创面愈合过程中可快速诱导血管生成,有利于新生真皮组织的重塑,从而改善创面愈合条件,为后续联合移植自体超薄皮片奠定基础.
目的 動態觀察Lando(R)雙層人工皮(以下簡稱雙層人工皮)應用于豬皮膚全層缺損創麵血管化.方法 實驗以8頭一級藏豬為動物模型,體質量為30 ~ 35 kg,雌雄不限,在每頭豬揹部正中線兩側分彆切取3箇邊長5 cm深達肌肉觔膜的正方形全層皮膚缺損創麵,採用同體自身對照,右側創麵行雙層人工皮移植術(實驗組),左側創麵以凡士林油紗覆蓋(對照組).分彆于術後第3、7、14、21天按隨機數字錶隨機處死豬,行創麵大體觀察,同時取材行囌木素-伊紅(HE)染色、Masson三色染色後光鏡下觀察創麵脩複細胞、炎性反應、膠原纖維排列及支架降解情況,免疫組織化學法檢測標本中CD31的錶達併計數新生血管數目.結果 實驗組創麵較對照組榦燥,感染髮生率較低,肉芽組織生長較平整.光鏡下見實驗組較對照組組織充血水腫和炎性反應輕微,肉芽組織化速度快,于14d左右支架血管化已基本完成.隨時間的延長,脩複細胞逐漸減少,膠原纖維排列更為規整且粗大,支架有降解趨勢.免疫組織化學結果顯示,CD31錶達暘性的新生血管數目兩組于術後第3天無明顯錶達,于第7天開始升高,實驗組于術後第14天達到高峰,對照組于第21天達到最高.實驗組于術後第7、14天高于對照組,于21 d低于對照組,組間差異有統計學意義(P<0.05).結論 雙層人工皮在創麵愈閤過程中可快速誘導血管生成,有利于新生真皮組織的重塑,從而改善創麵愈閤條件,為後續聯閤移植自體超薄皮片奠定基礎.
목적 동태관찰Lando(R)쌍층인공피(이하간칭쌍층인공피)응용우저피부전층결손창면혈관화.방법 실험이8두일급장저위동물모형,체질량위30 ~ 35 kg,자웅불한,재매두저배부정중선량측분별절취3개변장5 cm심체기육근막적정방형전층피부결손창면,채용동체자신대조,우측창면행쌍층인공피이식술(실험조),좌측창면이범사림유사복개(대조조).분별우술후제3、7、14、21천안수궤수자표수궤처사저,행창면대체관찰,동시취재행소목소-이홍(HE)염색、Masson삼색염색후광경하관찰창면수복세포、염성반응、효원섬유배렬급지가강해정황,면역조직화학법검측표본중CD31적표체병계수신생혈관수목.결과 실험조창면교대조조간조,감염발생솔교저,육아조직생장교평정.광경하견실험조교대조조조직충혈수종화염성반응경미,육아조직화속도쾌,우14d좌우지가혈관화이기본완성.수시간적연장,수복세포축점감소,효원섬유배렬경위규정차조대,지가유강해추세.면역조직화학결과현시,CD31표체양성적신생혈관수목량조우술후제3천무명현표체,우제7천개시승고,실험조우술후제14천체도고봉,대조조우제21천체도최고.실험조우술후제7、14천고우대조조,우21 d저우대조조,조간차이유통계학의의(P<0.05).결론 쌍층인공피재창면유합과정중가쾌속유도혈관생성,유리우신생진피조직적중소,종이개선창면유합조건,위후속연합이식자체초박피편전정기출.
Objective To investigate the effects of Lando(R) bilayer artificial skin on vascularization of wounds in pigs with full-thickness loss.Methods There were eight pigs,every pig was inflicted with 6 full-thickness loss wounds on the back,which were divided into two groups for the study.The study group was covered by bilayer artificial skin,while the other received Vaseline gauze as control.For each group,at the 3,7,14 and 21 d,General situation of wounds were observed and wound specimens were obtained for hematoxylin and eosin (HE) staining,Masson staining and CD31 expression which was examined by means of immunohistochemistry method.Results Compared with the control group,wounds in study group were more dryer with lower incidence of infection.Granulation tissues in study group was relatively flat.HE staining demonstrated that granulation tissue in the study group increased faster than in control group,and less inflammation and tissue congestion and edema in the study group than in control.Collagen fibers in the study group were of more coarse and regular arrangement than in control.Dermal regeneration scaffolds were gradually of degradation with time.There was not significant expression of the CD31 at 3 d.The expression of the CD31 had an increasing tendency at 7 d in each group.The CD31 expression,in study group,reached a peak at the 14 d,while control group at the 21 d.The CD31 expression was higher in study group at the 7 d and 14 d than in control group.However,it was lower in study group at the 21 d when compared with control group.Conclusion Bilayer artificial skin can promote microvessel formation and provide favorable conditions for autologous split-thickness skin graft.