摘要
目的 探讨窄蒂真皮下血管网皮瓣 (下简称超薄皮瓣 )成活过程中成纤维细胞DNA增殖的动态变化过程。方法 采用ACAS5 70黏附式细胞仪测定皮肤组织细胞DNA荧光标记量的组织切片法 ,测定了 18块成活面积为 16cm× 8cm、蒂宽 4cm的猪背部窄蒂随意型超薄皮瓣。结果 皮瓣近段细胞DNA荧光量术后短暂轻微改变 ,中段于术后 3～ 5dDNA荧光量有显著增加 ,5～ 7d逐渐恢复正常 ,远段DNA荧光量缓慢增加 ,术后持续 3～ 7d。处于皮瓣与皮片过渡部位的中段组织细胞的活力和功能代谢最为活跃 ,该部位的皮瓣组织成活良好 ;远段组织细胞活力和功能代谢较弱 ,组织修复时间延长。说明皮瓣修薄所致的缺氧能刺激细胞DNA合成 ,在一定限度内随着缺氧程度的增加而DNA增殖含量增加 ,超过一定限度则增殖的速度减慢、持续时间延长、细胞个体间DNA增殖幅度的差异增大 ,这可能是皮瓣远段易发生灶性水疱、表层坏死的主要原因之一。结论 超薄皮瓣应着重加强皮瓣远段组织血运 。
Objective To study the dynamic changes of DNA content of the fibroblasts in narrow pedicle subdermal vascular network flap (SVNP) during their surviving. Methods Eighteen pieces of surviving skin in pig back with size of 16 cm×8 cm and pedicle wideness of 4 cm were stained with acridine orange, and their DNA contents were measured with the adherent cell analysis and sorting cytometer 570. The tissue samples were taken at 3, 4 ,5 ,and 7 days after operation from different parts of the flap.Results The DNA content of fibroblast in the proximal part of the flap was slightly changed, those in the middle portion increased from 3rd to 5th day and became normal at 7th day, and in the distal portion progressively increased after operation. The results suggested that the transitional part of the flap and skin graft in the middle portion was most active in function and metabolism, and well survived, but the distal portion of the graft was poor in surviving and had a long repairing period. These indicated that local tissue hypoxia stimulated proliferation of fibroblasts and synthesis of the DNA in a short time, but as time wert by, the proliferative speed and DNA synthesis in the individual cell were heterogeneous, probably because of the degeneration or necrosis of some epidermal cells in the graft. Conclusion The wideness and length of the pedicle as well as its vascular anastomoses should be readjusted to promote the blood circulation of the distal skin graft tissues.
出处
《中华医学美学美容杂志》
2002年第1期27-29,共3页
Chinese Journal of Medical Aesthetics and Cosmetology
