联合性快速皮肤软组织扩张法的研究

Biomechanical and histologic effects of combined rapid versus conventional tissue expansion

目的 观察联合性快速扩张法应用于皮肤软组织扩张术的效果 ,并探讨其机制。方法 在 8头小猪脊柱两侧设计 48块扩张区域 ,分为 :联合组 :耗时 1周。常规组 :耗时 3周。对照组分别测定扩张前囊内压 ;测量扩张毕皮肤表面积增加幅度、皮肤即时回缩率。结果 联合组扩张后皮肤即时回缩率 (3 6.2 3± 1.0 7) %与常规组 (3 5 .89± 0 .90 ) %比较 ,差异无显著性 (P >0 .0 5 ) ;与对照组相比 ,联合组表皮层厚度显著增厚 (P <0 .0 1) ,真皮层显著变薄 (P <0 .0 1) ,真皮层内胶原纤维密度明显减低 (P <0 .0 1)。结论 联合性快速扩张法能获得额外皮肤组织 ,对皮肤超微结构无明显影响 ,具有扩张速度快 ,并发症少的优点。

Objective To evaluate the feasibility and investigate the mechanism of combined rapid tissue expansion.Methods In 8 white minipigs,3 groups were designed on each side of spine: combined rapid expansion group (n=16),conventional expansion group (n=16) and control group (n=16).Expansion was carried out under monitoring of the intraluminal pressure ranging from 40 kPa to 100 kPa.After completion of expansion,the immediate retraction rate of expanded skin and intraluminal pressure were measured,and histologic and ultrastructure changes of the expanded skin were observed.Results There was no significant difference in the immediate retraction rate of expand skin and initial intraluminal pressure between the two expansion groups (P>0.05).In combined rapid expansion group,the thickness of the epidermis was increased and the dermis was thinner than that in the control group(P<0.01).The density of elastin fibers of the three groups showed no statistical difference (P>0.05).Collagen fibers in the dermis of the combined expansion group retained the normal crossing periodicity.Conclusion The process was shown to be a safe and effective means of producing amounts of expansion similar to traditional method and preserving the structural integrity and viability of the skin.