bFGF和硫糖铝局部应用促扩张术方法研究

The Effect of Different Dosages of bFGF and Sucralfate Local Application during Continuous Tissue Expansion

目的 探讨碱性成纤维细胞生长因子(bFGF)不同剂量、用药方法对扩张组织的影响。方法 以白色家猪为实验动物,采用持续恒压扩张技术,观察不同剂量和不同给药时间,bFGF和硫糖铝对扩张组织的影响及组织结构变化。结果 扩张术同时每日2次局部应用bFGF 9AU/cm^2+硫糖铝100μg/ml,共7 d,浸于明胶海绵上缓慢持续释放对扩张组织的影响最明显,效果最佳,扩张器内实际注液量、扩张所获得的皮肤净增面积明显增加,皮瓣回缩率降低。表皮细胞层数增多,胶原纤维、弹力纤维、成纤维细胞密度和毛细血管密度显著增高。药量增加效果未随之增加。结论持续恒压扩张术时合用bFGF 9AU/cm^2+硫糖铝100μg/ml,每日2次注药浸入明胶海绵持续缓慢释放效果最佳。

Objective To investigate the effective dosage and way of local application of basic fibroblast growth factor (bFGF) and sucralfate during continuous tissue expansion (CTE). Methods CTE was underwent in six white pigs.Normal saline, bFGF and sucralfate were perfused between tissue and tissue expander.Group 1: both bFGF (5 AU/cm^2) and sucralfate (100 μg/ml) were injected twice a day, group 2:both bFGF (9 AU/cm^2) and sucralfate (100 μg/ml) were injectad twice a day, group 3:both bFGF (18 AU/cm^2) and sucralfate (100 μg/ml) were injected twice a day, group 4:hoth bFGF (5 AU/cm^2) and sucralfate (100 μg/ml) were injected three times a day, group 5: beth bFGF (9 AU/cm^2) and sucralfate (100μg/ml) were injected three times a day group 6: both bFGF (18 AU/cm^2) and sucralfate (100 μg/ml) were injected three times a day for seven days. Normal saline was injected as control.All agents were soaked equally in Geffoam.The area of expanded skin was measured with auto-image analysis. The samples were taken from each pig or histomorphological assessment on 3rd day post-expansion.Results the tissue expansion was strikingly improved when 9 AU/cm^2 bFGF and 100μg/ml sucralfate were applied. Compared with other groups, the effect in the group 2 was more obvious:epidermal,granular,spinous and basal cell thickness increased significantly. In dermal layer, the collagen fibers became thicker and the elastic fiber significantly regenerated, the density of fibroblasts and capillaries obviously increased. The net expanded skin area of group 2 was obviously larger than that of the other groups (P<0.05). The skin contraction rate was significantly less than that of the other groups (P<0.05). The effect cannot further improve, though bFGF dosages were increased. Conclusion Local application of exogenous bFGF (9 AU/cm^2) and sucralfate (100μg/ml) during CTE twice a day could accelerate tissue expansion and improve the quality, of expanded skin flap.