自体微粒表皮种植上皮化再生修复大面积深度烧伤创面组织学观察

Histological observation of epithelialized regenerative repair of extensive deep burn wounds with auto micro epidermic grafting

目的:观察自体微粒表皮在深度烧伤肉芽创面上种植后上皮化再生修复刨面的临床及病理过程。方法:利用自体微粒表皮种植在深度烧伤的肉芽组织内,采用MEBT/MEBO方法进行自体微粒表皮的培养再生,在术前、术后进行病理学检查,观察创面组织的病理学和外观变化。结果:在种植自体微粒表皮后7～14天,肉眼可见肉芽创面上有新生的上皮岛,并有不断扩大生长趋势,40天相互融合封闭创面,外观平整、有弹性;病理学检查提示:自体微粒表皮种植后再生的皮肤不仅具有表皮的各层结构,而且出现了类似真皮的结构。结论:自体微粒表皮种植上皮化再生,对治疗自体皮源稀少的大面积深度烧伤患者具有良好的临床应用前景,自体微粒表皮种植上皮化再生的机制,值得深入探讨和进一步研究。

Objective： To observe the histological changes in the course of epithelialized regenerative repair of extensive deep burn granulation wounds with auto micro epidermic grafting. Method： Deep burn granulation wounds were repaired with auto micro epidermic grafting. MEBT/MEBO was applied to promote the regeneration of auto micro epidermis. Observations were made before and after operation on the changes in wound tissue and appearance. Result： In 7 to 14 days after operation, newly grown epithelial islands were seen in the granulation wounds with naked eyes and grew larger. In 44） days after operation, these islands grew to confluence to close the wounds. After wound closure, the appearance was smooth and the elasticity was good. Histological examinations showed that after auto micro epidermic grafting, the regenerated skin has complete epidermic structure in different layers and dermis -like structure also emerged. Conclusion： Auto micro epidermic grafting is very suitable for repairing extensive deep burn wound. The mechanism of its epithelialized regeneration remains to be further investigated.