真皮瓣修复口内粘膜缺损的实验研究及临床应用

Experimental study and clinical application of dermal tissue flap in intraoral defect reconstruction

目的 研究真皮瓣转移至口腔后的组织学变化并探讨毛发减少甚至消失的机制。方法 构建真皮瓣修复口内缺损的动物模型 ,常规病理观察和透射电子显微镜 (TEM)观察真皮瓣转移口内后组织瓣及毛囊的组织学变化。临床采用真皮瓣修复 13例恶性肿瘤术后所致口内粘膜组织缺损。结果 再生上皮在 2周内完全形成 ,结构近似于正常皮肤组织 ,TEM示毛囊上皮存在局部代谢障碍表现。临床 13例患者均获满意修复。结论 术后 2周内是新生上皮形成的重要时期 ,毛囊成分的破坏可能与局部组织缺氧有关。

Objective To investigate the histological changes of the dermal tissue flaps (DTFs) after being transferred into oral mucosa for intraoral reconstruction and explore the mechanism of hair diminishment or disappearance of the transported DTFs. Methods The animal model of DTFs for intraoral reconstruction were established in dogs. The histological changes of the dermal flaps transferred intraorally and the hair follicles in them were observed with HE staining and transmission electron microscope (TEM) respectively. Thirteen cases of intraoral defects caused by malignant tumor resection were reconstructed by DTFs in clinical study. Results The dermal tissue flaps were re epithelialized in 2 weeks, whose structure was similar to normal skin. There was a manifestation of disordered metabolism in the epithelium of the hair follicles under TEM. The defects of the patients were all reconstructed in satisfaction. Conclusion It is an important period for epithlializing in 2 weeks after operation in DTFs for introral reconstruction, and the destruction of hair follicles in dermal flaps may be associated with local hypoxia.