自体脂肪基质血管成分改善植皮效果的初步临床实验研究

Effect of Autologous Stromal Vascular Fraction(SVF) in Adipose Tissue on Skin Grafting

目的在植皮术中辅以自体基质血管成分(stromal vascular fraction,SVF)进行治疗,观察其植皮效果的改善情况。方法于植皮术同时行脂肪抽吸术,取得患者自体脂肪组织,通过胶原酶消化后提取SVF;植皮区行患者自身对照,实验组植皮区皮下注射SVF(1×10~5 cells/cm^2),对照组注射等量生理盐水;术后1个月、3个月、6个月及12个月随访,观察皮片弹性、色泽、质地及回缩率。结果 2014年4月至2015年12月,共18例患者。SVF辅助植皮实验组和对照组均未出现皮片存活不佳、坏死(P>0.05)。随访结果显示:术后6个月和12个月,实验组较对照组色泽更接近取皮区正常皮肤(P<0.05);术后3个月和6个月,实验组含水量均明显高于对照组(P<0.05);术后3个月、6个月和12个月,实验组皮片摩擦力均明显低于对照组(P<0.05);术后3个月、6个月和12个月,实验组皮片弹性优于对照组(P<0.05);术后1个月和3个月,实验组的皮片回缩率明显低于对照组(P<0.05)。结论 SVF辅助皮片移植可有效改善皮片色泽和质地,明显减少皮片回缩,是一种安全有效的方法。

Objective To explore the improving effect of autologous stromal vascular fraction （SVF） in adipose tissue onskin grafting. Methods The adipose tissue was harvested at the same time of skin grafting, then digested and processed;SVF （1 ×10^5 cells/cm 2） was obtained and injected into the grafted skin as the treatment group, while saline was injected asself-control; The elasticity, color, texture and contracture of skin grafts were observed and measured 1 month, 3 months, 6months and 12 months after operation. Results From April 2014 to December 2015, 18 patients were enrolled. No necrosisof skin grafts was observed in both control group and treatment group （P〉0.05）. During the follow-ups, compare to the controlgroup, the skin color of the treatment group was more similar to the normal skin 6 months and 12 months after operation （P〈0.05）;The skin water content of the treatment group was higher than that of the control group 3 months and 6 months afteroperation （P〈0.05）; Compare to the control group, the frictional force and the skin elasticity of the treatment group were bothimproved 3 months, 6 months and 12 months after operation （P〈0.05）; The contracture rate of the treatment group was lowerthan that of the control group 1 month and 3 months after operation （P〈0.05）. Conclusion The transplantation of SVF is asafe and effective method for skin grafting by improving skin color, texture and reducing skin contracture.