自制羊膜载体复合物植入表皮细胞修复全层皮肤缺损

Self-made amniotic carrier complex implanted with epidermal cells for full-thickness skin defects

背景:利用组织工程和细胞培养技术研制的复合皮肤距理想的人工皮肤尚有一定的差距,如局部皮肤薄弱、抗拉及抗摩擦能力差、无皮肤附属器等。目的:观察含碱性成纤维细胞生长因子和维生素C的羊膜载体复合物对皮肤缺损局部真皮组织的修复作用,寻找真皮组织修复重建促进表皮生长的最佳时期。方法:取新西兰大耳白兔36只,在每只背部建立皮肤全层缺损模型3处,分别植入含有缓释碱性成纤维细胞生长因子和维生素C羊膜载体复合物、单纯羊膜载体复合物及油纱覆盖。随机分为3组,分别于术后21,14,7d植入自体表皮细胞混合液,1周后行大体、组织学、免疫组织化学、墨汁灌注等观察。结果与结论:术后21d植入表皮细胞组皮肤缺损局部新生皮肤瘢痕轻、形态结构较满意,创面愈合速度和质量均优于术后14,7d植入表皮细胞组,并且植入含碱性成纤维细胞生长因子和维生素C羊膜载体复合物组创面皮肤新生真皮组织完全被新生的表皮覆盖,而且表皮几乎均变为复层,其生长速度及质量优于单纯羊膜载体复合物移植组和油纱覆盖组。说明含有碱性成纤维细胞生长因子和维生素C的羊膜载体复合物植入皮肤全层缺损后,能加速真皮的修复和重建;真皮组织修复增生晚期和重建初期为促进表皮生长的最佳时期。

BACKGROUND： The composite skin developed by using tissue engineering and cell culture technology is still not an ideal artificial skin, which is limited by weak local skin, poor tensile strength and resistance to friction and no skin appendages. OBJECTIVE： To observe the effect of basic fibroblast growth factor and vitamin C epidermal cell composite transplantation on full-thickness skin defects and to investigate the optimal time promoting the epidermal growth. METHODS： A total of 36 New Zealand white rabbits were prepared for three full-thickness skin defect models at the back. The self-made amnion carrying composite with basic fibroblast growth factor and vitamin C, pure amnion carrying composite, pure capping were implanted into the three defects, and were randomly divided into three groups. Epidermal cells were implanted into the site in related groups after 7, 14, and 21 days. After 7 days, general observation, histological observation, immunohistochemical observation were carried out. RESULTS AND CONCLUSION： The groups with autologuos epidermal cells implantation at 21 days had a better effect that those with autologous epidermal cells implantation at 14 and 7 days. Self-made amniotic carrier complex with basic fibroblast growth factor and vitamin C was superior to pure amnion carrying composite and pure capping. Basic fibroblast growth factor and vitamin C promoted the regeneration and renascence of the dermis. The latter of the dermis repairing and the former of the dermis restoring were the best stage which accelerates the renascence and regeneration of the epidermis.