皮肤应力检测系统及皮肤伸展对“皮缘”血运影响的研究

Skin stress measuring system and correlation between skin stretching force and blood circulation of “wound edge”

为了研究皮肤伸展力与预伸展时“皮缘”血运之间的关系，选取６只体重２０ｋｇ的白猪作为实验动物，在胸背标出８ｃｍ×３．５ｃｍ模拟创面，采用自制皮肤应力检测系统显示短边的受力；用激光多谱勒血流仪（ＬＤＦ）及荧光法检测不同力值短边的血运变化。结果表明，当短边受力增至６．５ｋｇ时，ＬＤＦ值虽下降，但１小时后仍可回到正常值的５０％；荧光法观察可见，当短边受力降低时，无荧光区渐缩小，当受力降至４．５ｋｇ时，无荧光区缩小到长针穿皮处。认为，行预伸展时“皮缘”可耐受６．５ｋｇ以下的作用力，而持续预伸展所施的力需低于４．５ｋｇ。因此伸展术中皮缘的受力有较大的安全范围，但作用力过大也会造成皮缘坏死。

The study was designed to investigate the relationship between skin stretching force during pre-stretching and the microcirculation of “wound edge”. The experiment was performed on six domestic pigs. An 8cm×3.5cm imitating wound was drawn on back and flank. A skin stress measuring system made by ourself was utilized to show the different skin stress. Laser doppler flowmeter(LDF) and fluorography were used to observe the circulation of the “wound edge” under different stretching force. Results showed that when stretching force was 6.5kg, the LDF value decreased less than 50% after one hour. The fluorography revealed that the area devoid of vascularity reduced while stretching force decreased. As stretching force was 4.5kg, the nonfluorescent area was just around the points that long pins were threaded through the skin. We concluded that during pre-stretching, the amount of force that could be applied safely to the skin margins was below 6.5kg for a short applying time and 4.5kg for a long applying time. The safe range of stretching force was wide. The skin wound margins would become slough with excessive closing tention.