烧伤创面外用人工皮肤的研究与临床应用

Clinical application of artificial skin in the treatment of burn wound

本文主要针对近年来各种用于烧伤创面外用人工皮肤的临床应用特点进行讨论。皮肤是保护机体内环境的稳定,抵御外界环境入侵,排泄水分、调节体温的重要器官,同时也是免疫系统的组成部分之一。皮肤烧伤后机体发生的各种损害均与丧失皮肤屏障有关。表皮替代物由生长在可降解基质或聚合物膜片上的表皮细胞组成;真皮替代物是含有活细菌或不含细胞成分的基质结构,用来诱导成纤维细胞的迁移、增殖和分泌细胞外基质;而全皮替代物包含以上两种成分,既有表皮结构,又有真皮结构。随着医学生物学和材料学的发展,人工皮肤产品的研究有了很大的进步,但是构建含血管与神经支配,并具有皮肤附属结构及正常皮肤生理功能的理想人工皮肤还是一项长期而艰巨的任务。

This paper reviews the clinical application characteristics of artificial skin for external used in the treatment of burn wound at recent years. Skin is the important organ to protect the environmental stability in vivo, resist the outside invasion, evacuate moisture and regulate body temperature, as well as one component of immunity system. Subsequent to the burn injury, various damages of the organism may be related to the loss of skin barrier. Epidermal substitutes comprise the epidermal cells growing on the degradable matrix or polymer film; While dermal substitutes are shaped as a matrix with active bacterium or without cells, and they can induce the migration and proliferation of fibroblasts, together with the secretion of extracellular matrix; Full skin substitutes include both epidermal ones and dermal ones. With the progress on the biomedicines and the materials, the research regarding artificial skin also develops. However, it is still a key problem to construct an ideal artificial skin, which contains vessels and innervation, skin accessory structure and physiological function of normal skin.