交联型异体脱细胞真皮基质的研制及动物复合皮移植实验

Preparation and experimental study of allogeneic acellular dermal matrix for composite skin grafting

目的：寻找适合烧伤创面移植的异体脱细胞真皮基质（ａｌｏ－ＡＤＭ）．方法：将薄中厚小猪皮采用胰蛋白酶等消化，制成含基底膜的ＡＤＭ，再作组织学等检测和猪复合移植实验．结果：①ａｌｏ－ＡＤＭ具有无细胞、无细菌、低毒性等特点．②戊二醛不同交联时间组的ＡＤＭ，与自体薄中厚皮片重叠移植于猪全层皮肤切除的创面上，皮片成活率为１００％，早期观察无排斥反应，外观平整；５ｗｋ时组织学结构完整，炎性反应轻，随交联时间延长，ａｌｏ－ＡＤＭ内浸润生长的成纤维细胞、血管内皮细胞和炎性细胞逐渐减少，而未经交联的ａｌｏ－ＡＤＭ组织内炎性反应重，组织降解迅速．结论：发挥真皮支架作用的ａｌｏ－ＡＤＭ，宜采用低浓度戊二醛等作短时间的化学交联处理．

AIM: To search for allogeneic acellular dermal matrix (allo ADM) suited to composite skin grafting in treating deep burn wound. METHODS: Thin split thickness skin harvested from juvenile white swine was treated with trypsin glutaraldehyde, EDTA, etc. to prepare ADM with intact basement membrane for the experiment of composite skin grafting on young swine wounds and histologic examination. RESULTS: ① The allo ADM, treated with glutaraldehyde for different period of time, was characterized by its aseptic, acellular and low unfavourable reaction. ② The composite skin, composed of different allo ADM overlaid with auto thin thickness skin and grafted on the full thickness defects of young swine, exhibited even appearance with 100% take and no rejection was detected in the early stage. 5 weeks after the grafting, the tissue structure was still intact with only mild inflammatory reaction histologically. The allo ADM without cross link treatment exhibited more evident inflammatory reaction, while in allo ADM treated glutaraldehyde, inflammatory reaction reduced and infiltration of fibroblast and vascular endothelia decreased with the lengthening of time of cross linkage. CONCLUSION: In order to play a framework role of dermis, the allo ADM should be treated with geutaraldehyde of low concentration for a proper time.