异体骨异位诱导预制骨皮瓣过程中的病理变化

Pathological changes in the preparation of bone-skin flap with allogeneic bone induction

背景:用自体骨皮瓣移植是目前修复复合组织缺损的最好方法,但其修复能力有限、创伤大、造成新的组织缺损和一定功能障碍。异体骨具有骨诱导能力,可能用来预制骨皮瓣。目的:观察异体骨异位埋植诱导预制骨皮瓣过程中异体骨的病理变化。方法:实验动物为广西巴马微型猪,将深低温冷冻异体骨埋植于旋髂浅动脉供养的皮瓣组织内,植入后在体观察局部反应情况,于植入后4,8,12,16周随机取出异体骨,行大体观察及病理切片镜下观察。结果与结论:所有异体骨植入处无明显炎症反应。病理检查可见异体骨在皮瓣组织内埋植后4周异体骨表层出现血管化,未见明显类骨母细胞;植入后8周出现异体骨不同程度的血管化、骨吸收和分布不均的类骨母细胞和类破骨细胞,有新骨形成;植入后12周新骨形成进一步增加,但骨吸收亦加重,植入骨形态改变;植入后16周异体骨碎裂吸收,新骨形成无明显增加。结果提示异体骨异位埋植预制骨皮瓣过程中,异体骨随时间不断发生病理变化,需适时移植。

BACKGROUND： Autologous bone-skin flap transplantation is the best method for the repair of composite tissue defect, but the repair ability is limited, with big trauma, new tissue defect and a certain dysfunction. AIIogeneic bone has the osteoinductive capacity, which can be used to prepare the bone-skin flap. OBJECTIVE： To research the pathological change of the allogenic bone during the prefabrication of bone-skin flap with allogeneic bone implant. METHODS： The experimental animals were Bama miniature pigs. Deepfrozen allogenic bone was implanted in iliac artery-supported tissue flap compartment of miniature pigs. After operation, the local reactions were observed, the a!logenic bone were studied by general observation and histological analysis at 4, 8, 12 and 16 weeks after implantation respectively. RESULTS AND CONCLUSION： Obvious inflammation reaction was not observed in the surgical zone. The allogeneic bone was vascularized at 4 weeks after implanted into the flap tissue without obvious osteoblast-like cells. The vascularization, bone resorption and uneven distributed osteoblast-like cells and osteoclast-like cells were observed at 8 weeks after implantation, and new bone formation was observed. At 12 weeks after implantation, new bone formation and bone absorption was strengthened, and the morphology of the bone graft was changed. At 16 weeks after implantation, allogenic bone turned into fragments and absorbed, and no newbone formation was observed. The results indicated that during the prefabrication of bone-skin flap with allogeneic bone implantation, the pathological changes of the allogeneic bone was observed with time prolonging, and the bone-skin flap should be transplanted in time.