复层人羊膜覆盖治疗深Ⅱ度烫伤创面的动物实验(英文)

Effect of double-layer human amnion on wound healing in deep second-degree burns of animals

背景:已证实单层人羊膜覆盖对浅度烧伤创面有一定的治疗作用,但仍存在很多不足。目的:观察自制复层辐射人羊膜覆盖治疗对鼠深Ⅱ度烫伤创面的效果。设计、时间及地点:随机分组,自身及组间对照动物实验,于2006-12/2007-05在哈尔滨医科大学第一临床医学院动物实验中心进行。材料:成年清洁级Wistar大鼠50只,随机分为伤后4,6,8,10,12d组5组,每组10只。复层辐射人羊膜为自制,将新鲜人羊膜去除绒毛膜后,将羊膜层干燥,制成无孔及有孔的复层薄膜,再经γ射线辐射后塑膜包装。方法:所有动物背部脱毛,麻醉后浸入沸水中8s致背部烫伤,制备深Ⅱ度烫伤模型。将每组创面积2等分,分别贴敷复层辐射人羊膜和油纱进行对照观察。主要观察指标:在伤后4,6,8,10,12d取材,观察创面大体愈合情况,光镜、扫描电镜、透射电镜观察创面组织学变化,并进行创面细菌学检查。结果:50只大鼠全部进入结果分析。①贴敷油纱的创面:可见坏死物和痂皮,伤后12d时肉眼仍见灶性小溃疡,光镜下见生真皮层少量毛囊、毛根、毛发再生,扫描电镜下见创面中心为坏死结痂,周边见少量毛发,大量炎性渗出物及白细胞存在,透射电镜显示细胞结构模糊不清。细菌学检查结果显示创面细菌生长明显。②贴敷复层辐射人羊膜创面:伤后10,12d时创面愈合,肉眼见毛发规则丛生,和正常皮肤无区别,光镜、扫描电镜、透射电镜观察均显示伤后12d时表皮各层均为正常皮肤组织。细菌学检查结果显示创面无细菌生长。结论:复层辐射人羊膜能能有效地保护鼠烫伤创面,促进创面的上皮生长,避免创面感染,缩短鼠深Ⅱ度烫伤创面的愈合时间。

BACKGROUND： Previous research reveals that, single-layer human amnion is effective to cure superficial bums, but it is still unsatisfactory. OBJECTIVE： To observe the effects of double-layer radiation-treated human amnion on the healing of deep second-degree bum wound. DESIGN, TIME AND SETTING： Randomized control study was performed at the Animal Experimental Center in the First Affiliated Hospital of Harbin Medical University （Harbin, Heilongjiang, China） from December 2006 to May 2007. MATERIALS： Fifty adult Wistar rats of clean grade were burned and then assigned into five groups at post-injury 4, 6, 8, 10 and 12 days, with ten rats in each group. Subsequent to the chorion removal, the fresh human amniotic membrane was dried and prepared into double-layer films, which were aporate or porous. Human amnion was then radiated using ~ -ray for further use. METHODS： Following dorsal skin epilation and the anesthesia, all the rats were immersed for 8 seconds in boiling water to induce rat models of deep second-degree bums. One side of the bum wound was applied human amnion, while the other side was applied oil gauze. MAIN OUTCOME MEASURES： Gross observation of the bum wound was carded out at post-injury 4, 6, 8, l0 and 12 days. Meanwhile, light microscope, scanning electron microscope and transmission electron microscope were employed to detect the histological changes of the bum wound, as well as bacteriological examination. RESULTS： Fifty rats were all involved in the result analysis. Sphacelism and crust were found in the bum wound treated with oil gauze, with the presence of focal ulcer at post-injury 12 days. Under light microscope, few hairs regenerated in dermis, especially hair follicle and hair root; Scanning electron microscope suggested a large amount of inflammatory exudates and leukocytes; Transmission electron microscope revealed an unclear structure of the cells. Bacteriological examination also indicated that the bacteria accreted on the surface of bum wound. The treatment of double-layer radiation-treated human anmion healed the bum wound at post-injury 10 and 12 days, and the hairs grew with the same manner as that of normal skin. Epidermis tissues were proved to be normal skin at post-injury 12 days by means of light microscope, scanning electron microscope and transmission electron microscope. Bacteriology was detected to be negative. CONCLUSION： Double-layer radiation-treated human amnion plays a protective role on the bum wound in rats. It may facilitate epithelial growth, avoid wound infection and accelerate the healing of deep second-degree bum.