脱细胞真皮基质预制人工皮瓣的血管化研究

Vascularization of Artificial Skin Flap Fabricated by Acellular Dermal Matrix

目的ADM联合自体表皮构建人工皮瓣模型,探讨人工皮瓣血管化所需时间。方法利用F344雄性大鼠构建人工皮瓣模型,分别在术后第3、7、14、21和28天取材,HE染色、CD31+免疫组化进行血管化检测,术后7 d进行大鼠人工皮瓣模型微血管造影。结果术后各时间点人工皮瓣均成活良好,无感染或坏死;HE染色及CD31+免疫组化显示,血管样结构数量随术后时间的延长而逐渐增多,除第21、28天血管数量无显著性差异外(P>0.05),其余各时间点之间血管数量均有显著性差异(P<0.05);微血管造影显示,去除ADM的人工皮瓣血管数量明显少于ADM去除前。结论脱细胞真皮基质联合带知名血管的筋膜、自体表皮可以成功预制人工皮瓣。术后第3天人工皮瓣开始出现血管化迹象,第7天左右与筋膜组织建立相对可靠的血运,第21天左右基本完成血管化过程。

Objective To fabricated the artificial skin flap by using acellular dermal matrix, vascularized fascia and autologous epidermis and to evaluate the time of vascularization in artificial skin flap. Methods Artificial skin flap models were established with Fisher 344 male rats. The artificial skin flaps were harvested for HE staining and CD31 ~ immunohistochemistry on 3, 7, 14, 21, 28 days after operation respectively. Microangiography for artificial skin flap was carried out 7 days after operation, the shortest time to complete the process of model establishing. Results All artificial skin flaps presented a good viability without any infection or necrosis in gross observation. Angiugenesis of HE staining and CD31 ~ immunohistochemistry suggested that the total number of vessels increase when prolonging postoperative time and there is a significant difference between every two time intervals （P〈0.05） except between 21 and 28 days after operation （P〉 0.05）. Microangiography suggests less vessels after removing ADM. Conclusion Artificial skin flap could be successfully fabricated with ADM and autologous epidermis. The capillary vessels of composite skin flap begin to sprout 3 days after operation. Relatively reliable blood supply is basically established between epidermis and fascia on about 7 days after operation. Angiogenesis is completed on about 21 days after operation.