高仿真壳聚糖支架修复腹壁缺损

Repair of abdominal wall defects by highly simulated chitosan scaffolds

背景:研究显示,壳聚糖能提高纤维细胞增殖、迁移速度,促进细胞外基质的合成,能为缺损部位营造良好的愈合环境。目的:观察高仿真壳聚糖支架修复大鼠腹壁缺损的效果。方法:取成年SD大鼠60只,建立腹壁缺损模型,随机分2组修复,实验组于缺损部位植入高仿真壳聚糖支架,对照组植入聚丙烯补片,修复后2,4周,进行修复部位大体、粘连及病理组织学观察。结果与结论:(1)大体观察:对照组修复后2周缺损部位与网膜存在粘连现象,修复4周后补片部位明显增厚,与周围组织界限比较清晰,补片区域色泽一般,整合一般;实验组修复2周后缺损部位与支架轻微粘连,修复后4周补片增厚,缺损部位未见明显隆起、红肿、感染,伤口愈合较好;(2)粘连:实验组修复后4周Kadata粘连评分低于对照组(P<0.05);(3)病理组织学观察:对照组修复4周后可见毛细血管生长,存在大量的成纤维细胞,缺损部位存在大量炎细胞浸润;实验组修复4周后可见少许炎症细胞,存在大量胶原纤维、毛细血管,肉芽组织成熟度较高;(4)结果表明:高仿真壳聚糖支架可促进缺损腹壁的修复,减轻炎性反应。

BACKGROUND： Studies have shown that chitosan can improve the proliferation and migration of fibroblasts, promote the synthesis of extracellular matrix, and create a favorable environment for defect healing.OBJECTIVE： To observe the effect of highly simulated chitosan scaffolds in repairing abdominal wall defects in rats.METHODS： Sixty adult Sprague-Dawley rats were used to make animal models of abdominal wall defects, and then model rats were randomly divided into two groups： experimental group and control group followed by implantation with the highly simulated chitosan scaffold and polypropylene mesh, respectively. At 2, 4 weeks after repair, gross, adhesion and histopathological observations of the repair part were performed.RESULTS AND CONCLUSION： Gross observation： in the control group, omental adhesion was found at 2 weeks after repair; and at 4 weeks after repair, the mesh was thickened and exhibited clear boundaries with the surrounding tissue, but common color and integration. In the experimental group, there was mild adhesion between the scaffold and the defect site at 2 weeks after repair, and the mesh was thickened, but the wound healed well with no prominence, swelling, and infection at 4 weeks after repair. Kadata adhesion score in the experimental group was lower than that the control group at 4 weeks after repair （P 〈 0.05）. Pathological observation showed that at 4 weeks after repair, there were a large number of infiltrated inflammatory cells, capillary growth, and a large number of fibroblasts at the defect site in the control group; and meanwhile, a small amount of infiltrated inflammatory cell infiltration and a large number of collagen fibers and capillaries, with better granulation tissue maturity,were found in the experimental group. To conclude, the highly simulated chitosan scaffold can promote the repair of abdominal wall defects and reduce inflammatory reactions.