异种(猪)脱细胞真皮与自体表皮复合移植研究

The application of meshed acellular dermis xenograft (pigskin) with split thickness skin autograft in 23 patients

目的 为深度烧伤、瘢痕切除控制瘢痕增生与组织凹陷等寻求良好、廉价的覆盖与充填材料。方法 健康的白色小猪 ,活杀后剥其皮肤 ,用固定剂对异种 (猪 )皮肤细胞外基质固定交联 ,盐水法去除表皮 ,保留基底膜 ,用酶化学剂去除异种 (猪 )皮肤细胞 ,使其失去抗原性 ,保留完整的基底膜和细胞外基质的形态 ,制成网状异种 (猪 )脱细胞真皮支架。结果 对 2 3例病人进行异种(猪 )脱细胞真皮支架移植 7d左右 ,再植自体刃厚大张皮的二步法复合移植 ,成活率 ( 87 0±2 5 4 ) % ,采用一步法即异种皮脱细胞真皮支架 +自体刃厚皮同时复合移植 ,成活率 ( 60 0± 3 4 ) %。复合移植成活后的创面愈合平坦 ,颜色淡红或近似正常皮肤 ,表面光滑 ,外观平整 ,触软 ,皮肤可捏起。因病例情况不同可见无瘢痕增生或轻度瘢痕增生。结论 异种 (猪 )脱细胞真皮支架 +自体刃厚皮复合移植是覆盖深度烧伤创面、瘢痕切除创面 ,以及组织凹陷充填的廉价的较理想材料。

Objective An effective and inexpensive coverage,which can prevent scar formation and fill up scar tissue depression for full thickness skin burns in 23 patients was presented.Methods A de epithelized and acellular basement membranes of dermis from freshly harvested pigskin was obtained as meshed acellular dermis xenograft.The patients were treated in one or two stages.Two stages,7 day postoperative the meshed acellular xenograft,a split thickness skin autograft was applied.One stage,the meshed acellular xenograft and split thickness skin autograft were applied at same time.Results The take rate of two staged treatment was (87.0±25.4)% and one stage was (60.3±3.4)%.All grafts showed in pink or near normal skin color and felt soft and smooth.Conclusions The combination of meshed acellular dermis xenograft and split thickness skin autograft demonstrated an ideal way for the coverage of full thickness skin burn,which is effective and inexprensive.