基因转染猪皮在老年顽固性皮肤溃疡自体皮片移植中的应用

Gene-transfected miniature pig skin in the treatment of refractory skin ulcer by autograft in the elderly

目的:观察基因转染猪皮在老年顽固性皮肤溃疡自体皮片移植中的干预效果。方法:选择2002-01/2006-10在成都医学院第一附属医院应用基因转染猪皮处理的老年顽固性皮肤溃疡患者20例,均知情同意。简单清创后应用基因转染猪皮(购自重庆宗申军辉生物技术有限公司,为新鲜制备全厚猪皮,然后冻存于液氮中备用,厚度为2.0～3.0mm,规格分为100mm×100mm,100mm×20mm,200mm×400mm等,存储和运输均在液氮中进行,使用前用40℃水复温)覆盖创面,培养新鲜肉芽组织,创造手术条件,后期行自体皮片移植术治疗。结果:患者全部治愈出院,其中4例出院后植皮区破溃,门诊换药数次后愈合。所有患者在治疗过程中未发生严重并发症,供皮区愈合良好,未遗留瘢痕。20例患者有16例用转基因猪皮处理创面1次,4例患者用转基因猪皮处理两次后行自体游离皮片移植,皮片成活率为90%～100%。结论:应用基因转染猪皮处理顽固性皮肤溃疡创面能有效提高自体皮移植成活率,可以提高老年顽固性皮肤溃疡的治愈率。

AIM： To explore the intervention of gene-transfected miniature pig＇s skin for the refractory skin ulcer autograft in eldedy. METHODS： From January 2002 to October 2006, we treated 20 aged patients who suffered refractory skin ulcer by transplanting free skin graft to the ulcer by gene-transfected miniature pigs＇ skin, with their informed consents. The wound was cleaned and covered with gene-transfected pig skin （purchased by Zongshen Junhui Biotechnology Co.,Ltd. Pigskin was preserved and transported in liquid nitrogen, with the thickness of 2.0-3.0 mm and specification of 100 mm× 100 mm, 100 mm×20 mm, 200 mm×400 mm. Before used, the pigskin was rewarmed by 40 % water）, Then fresh granulation tissue was cultured and conducted with autograft. RESULTS： All the 20 patients were cured without complication and discharged. There were 16 cases cured by free skin graft operation without extra treatment, the graft skin ulcerate after operation presented in 4 cases and were cured by dressing change. CONCLUSION： Using gene-transfected miniature pigs＇ skin properly can increase the survive rate of the free skin graft, thus improve the prognosis of refractory skin ulcer in elderly.