自、异体表皮细胞混合悬液培养在烧伤创面的临床应用

Application of the mixed suspension of self and allo-epidermal cells cultured in deep burn wounds

目的探讨自、异体表皮细胞混合悬液培养修复深度烧伤创面。方法选择10例Ⅲ度烧伤创面,面积400～600cm2,创面切痂至深筋膜下、肌膜上。切痂后复盖新鲜异体皮。同时取邮票大小自体刃厚皮片,进行消化、分离成单个表皮细胞的悬液与异体表皮细胞悬液,以1∶1的比例进行混合。混合后离心、浓缩为1×107/ml细胞浓度,与人体纤维蛋白原同时移至移植的异体皮肤下。结果混合表皮细胞悬液移植后3～4周,渐融合成片,外盖的异体皮肤脱落,伤口渐愈合。经、6个月随访,伤口平整、轻度瘢痕、无排异反应。结论在烧伤切痂创面上应用自、异体表皮细胞混合悬液培养,辅以人体纤维蛋白原为细胞培养支架可达到体内构建皮肤的目的。

Objective To repair the deep burn wound by the mixed self and allo-epiderrnal cell culturing at wound. Methods The size of burn wound was 400-600 cm^2 in the cases with three-degree deep burn. The burn wounds were excised and allo-graft was performed 3-5 days after burn. At same time, a stamp-size of normal skin was harvested, and epidermal cells suspension was made through decomposing, digesting, culturing and re-digesting in lab. The self suspension of epidermal cells were mixed with allo-suspension of epidermal cells in a 1 ： 1 proportion,which was concentrated to a cellur concentration of 1×10^7/ml. Then, it was transplanted under allo-skin with human fibrinogen as the matrix of cell. Results After mixed suspension of epidermal cells was cultured for 3-4 weeks, the new epidermal sheet covered the whole wound with the allo-skin shelling. The wounds healed gradually. The surface of healing wounds was smooth with a slight scar 3-6 months thenafter. Conclusion The self and allo-epidermal mixed cells culture used on the burn wounds is a practicable method for reconstructing human skin and healing the wounds.