皮肤扩张器的改造及其在构建自体复合皮中的应用

Reformation of soft tissue expander and its application in construction of autologous composite skin

背景:置入正常皮肤软组织下的皮肤软组织扩张器,通过定期向扩张囊内注入生理盐水使其不断扩张,可获得"额外"皮肤软组织。目的:对传统皮肤扩张器进行改造并应用于构建自体复合皮。方法:将传统单注射壶皮肤扩张器改造成双注射壶,原有的注射壶通向扩张囊内,添置的注射壶通向囊外,扩张囊容量10mL。将改造后的扩张器埋植于10只新西兰大耳白兔背部皮下,扩张器埋置2周后,经注射壶注入原代培养的自体表皮细胞悬液,即种植于扩张囊和纤维包囊的腔隙内。结果与结论:新西兰大耳白兔完全存活,扩张器未出现破损渗漏,伤口均愈合,无排异反应。注入表皮细胞种植1周后,纤维包囊表面可见较多的上皮细胞岛,但未形成完整的细胞层;2周后的纤维包囊表面可见完整的类似于假复层鳞状上皮的细胞层,两者结合紧密。提示经改造的新型皮肤扩张器用于体内构建自体复合皮是可行的,发挥着关键性的作用。

BACKGROUND：Periodical injection of normal saline into the capsular space of soft tissue expander implanted beneath the normal skin soft tissue can expand the capsular space to acquire supplementary skin soft tissue. OBJECTIVE：To reform the traditional soft tissue expander and then apply it to construct autologous composite skin. METHODS：One injection pot that lead to the extracapsular space was added to the traditional soft tissue expander. The modified expanders were implanted on the back of 10 New Zealand white rabbits subcutaneously. Two weeks later, the cultured autologous epidermal cell suspension was injected into the space between the fibrous cyst and expander. RESULTS AND CONCLUSION：All the animals survived with the wounds well healing until the study finished. Expander did not exhibit breakage or leakage. Gross examination showed that 1 week later, epithelial islands without complete epithelial layer appeared on the surface of fibrous cyst; 2 weeks later, complete epithelial layer similar to stratified squamous epithelium was observed on the surface of fibrous cyst. These findings suggest that it is feasible to construct autologous composite skin in vivo using the reformed soft tissue expander.