无细胞异种真皮与表皮细胞膜片复合移植的研究

Study on the Composite Graft with an Acellular Xeno-dermis and Cultured Keratinocyte Sheets

目的 研究用无细胞异种真皮与体外培养的人表皮细胞膜片复合移植的方法 ,以及修复全层皮肤缺损创面的效果。方法 用猪皮制备无细胞异种真皮 ,在体外培养人表皮细胞膜片。采用裸鼠为实验动物 ,随机分两组 ,实验组于背部皮下埋藏无细胞异种真皮 ,1周后作背部全层皮肤缺损创面 ,在埋藏的无细胞异种真皮上移植表皮细胞膜片 ;对照组创面单纯移植人表皮细胞膜片。术后定期观察创面愈合情况 ,并活检行光镜、电镜及免疫组化检测。结果 与对照组相比 ,实验组创面覆盖率高 ,愈合外观好 ,创面收缩程度低。组织学检测提示实验组上皮分化充分 ,胶原增生有序 ,表皮 -真皮连接结构重建明显 ,未见明显的急性排斥反应。结论 无细胞异种真皮作为一种真皮替代品 ,可与体外培养的人表皮细胞膜片复合移植 。

Objective To study a graft method of an acellular dermis composited with cultured human keratinocyte sheets,and investigate the outcomes of the composite graft on full-thickness wounds.Methods Using porcine skins,we prepared the acellular dermis and cultured human keratinocyte sheets in vitro.Athymic null mice were divided into the experimental group and the control group,the acellular xeno-dermis was implanted into the subcutaneous of the dorsal skin in experimental group,one week after the implantation the cultured keratinocyte sheets were grafted on the full-thickness defective area of the dorsal skin in the experimental group,in control group only implanted human keratinocyte sheet on the defective area wound,healing status was regular assessed,and biopsies for histological analysis and immunohistochemistry test were performed in post-operation.Results Compared with the control group,the appearance of wound coverage in the experimental group was better.Moreover,the histologic analysis revealed that fully differentiated epidermis,organized proliferated collagen fibers and significant reconstruction of epidermis-dermis junction were seen in the experimental group which lack of the acute immuno-rejection response.Conclusion As a kind of dermal substitutes,the acellular xeno-dermis can be compositely transplanted with cultured human keratinocyte sheet and can improve the quality of wound healing.