适用于无异体皮覆盖的大鼠全层创面抗挛缩改良模型研究

A modified model of full-thickness excision skin wound without allografts in rats

目的为克服大鼠创面容易挛缩和自咬现象,从复制创面的位置和缝合技巧的细节方面深入研究,为复制大鼠全层损伤创面模型提供可靠的技术方案。方法选取24只SD大鼠随机分为A、B、C组,每组8只。A组为传统抗挛缩创面并进行植皮;B组为改良方法制备创面并进行植皮;C组为空白对照,为改良方法制备创面但不植皮。术后7、14和21 d分析3组创面挛缩、钢丝圈暴露、线结脱落情况及所移植皮片生长情况。结果 3组术后7、14和21 d的创面收缩率有差异(P<0.05)。术后21 d时,3组创面收缩率有差异(P <0.05);A组较B组创面收缩率高(P <0.05),相对容易收缩;B组与C组的创面收缩率比较,差异无统计学意义(P>0.05)。3组创面收缩率变化趋势有差异(P <0.05)。术后21 d,A、B、C组钢丝圈脱出总长度分别为35、16和13 cm。3组术后21 d时剩余线结数比较,差异有统计学意义(P <0.05),A组剩余线结数较少。术后7 d,A、B组移植皮片成活;术后14 d,A组移植皮片无明显生长,B组移植皮片生长良好;术后21 d,A组与B组创面移植皮片覆盖面积比较,差异有统计学意义(P <0.05)。结论复制合适的大鼠创面模型与植皮修复创面的疗效关系密切,合理选择创面位置可以避免大鼠自咬创面,改良缝合方式可以使钢圈缝合更加牢固。

Objective To establish a reliable technical scheme by modifying the location of wounds and the method of sewing so as to overcome the phenomenon of easy contracture of rat wounds and self-biting.Methods Twenty-four SD rats were randomly divided into three groups with 8 in each group.For group A the anti-contracture full-thickness skin defect was established with the traditional method and then grafted by MEEK technique.For group B the same full-thickness skin defect was established with a modified method and grafted by MEEK technique.For group C the same full-thickness skin defect was established with the modified method without skin-grafts,which was a control group.The wound contraction rates were observed on days 7,14 and 21 after operation,respectively.The steel wire,suture knot and the growth of skin autografts were observed 21 days after operation.Results The wound contraction rates were significantly different among the three groups on post-operative days 7,14 and 21(P<0.05),the wound contraction rate in the group A was higher than that in the group B(P<0.05),there was no statistically significant difference in the wound contraction rate between the groups B and C(P>0.05).Meanwhile,the variation trend of the wound contraction rate was different in the three groups(P<0.05).The length of total exposed steel wire was 35 cm in the group A,16 cm in the group B and 13 cm in the group C on the 21st day after operation.There was statistically significant difference in the number of remainder line knots among the three groups on the 21st day after operation(P<0.05),the number was obviously smaller in the group A.At last,the skin autografts survived in the groups A and B,and grew better in the group B with significant difference(P<0.05).Conclusions It is more effective to establish the anti-contracture full-thickness excision skin wound model in rats through the change of wound location and suture.