鼠异体无细胞真皮基质(ADM)的制备和应用

Preparation and Application of Rat Allo-ADM (Acellular Dermal Matrix)

目的 :通过动物实验方法 ,探讨一种适合薄的自体断层皮片或培养表皮细胞膜片生长的真皮床 ,使两者结合成为复合皮 ,以期为临床应用。方法 :将异体鼠的全厚皮切制成厚 0 3mm的中厚皮片 ,先后经 1MNaCl溶液去表皮、0 1 %戊二醛交联、0 5%SDS脱真皮细胞、0 2 5%胰蛋白酶再消化及冷冻干燥处理 ,清除皮肤中具有抗原性的所有细胞成分 ,而较完整地保留了无免疫源性的细胞外基质蛋白和胶原 ,制得无细胞真皮基质 (ADM)。与薄的自体断层皮片 (厚 0 1mm)一起制成复合皮移植于创面上。结果 :术后 2周见复合皮成活率高。组织学检查证实ADM血管化良好 ,宿主细胞如成纤维细胞可长入ADM中。长期观察证实无明显瘢痕形成及挛缩畸形 ,后期收缩轻 ;表面平滑 ,质地柔软 ,有弹性 ,无水疱形成及排异反应。结论 :目前认为 ,表皮—真皮复合皮是一种较为理想的真皮替代物。

Objective: To investigate an appropriate method for the preparation of allo-ADM for clinical use. Method: Split-thickness allograft, 0.3 mm thick, was obtained from rat's full-thickness skin with a dermatome. Donor skin was treated with 1 M NaCl, 0.1% glutaraldehyde, 0.5% SDS and 0.25% trypsin successively. The resulting acellular dermal matrix was then freeze-dried in a freeze-dryer. The processing technique removed all the cellular components from the allograft, which showed antigenicity; retained non-immunogenic, extracellular tissue matrix and collagen more completely and resulted in an acellular dermal matrix. Composite skin (CS), combined ADM with thin split-thickness autograft (0.1 mm thick) was implanted on open wound. Results: 2 weeks after implantation, CS exhibited a high percentage of survival. Histological evaluation of biopsy demonstrated good neo-vascularization of ADM, infiltration of host cell (such as fibroblast) and no specific immuno response. Long-term observation showed smooth appearance, soft and elastic texture, no blister, no undesirable scarring and contracture. Conclusion: ADM is an ideal dermal substitute. [