不同种属脱细胞真皮与自体皮复合移植的比较性研究

Comparison of composite grafting of autoskin with acellular dermal matrix from different sources

目的 观察不同种属脱细胞真皮基质 (acellulardermalmatrix,ADM)与自体皮复合移植的效果 ,为异种ADM的临床应用提供理论依据。 方法 本地产白色小猪 6头 ,分为异种 (人 )ADM +自体刃厚皮组 (A组 )、同种异体 (猪 )ADM +自体刃厚皮组 (B组 )、单纯自体刃厚皮组 (C组 )及单纯自体中厚皮组 (D组 )。观察术后 2、4、8、12、2 4周内移植物存活率 ,以及移植皮片收缩程度、移植区组织学变化等情况。 结果 A、B组移植后皮片外观光滑、有弹性 ;两组均获得了满意的皮片成活率 ,并可迅速诱导成纤维细胞、血管内皮细胞等宿主修复细胞的长入 ;两组移植皮片收缩面积有大于C、D组的趋势 (P <0.0 5);术后 2 4周移植区组织与单纯中厚皮移植组织结构一致。 结论 在观察期内(复合移植后 2 4周 ) ,与自体皮复合移植时 ,同、异种ADM具有相近的生物学作用 。

Objective To compare the composite grafts of acellular dermal matrix(ADM) from different sources with autoskin. Methods Six local white mini pigs were employed for the experiment. The pigs were randomly divided into four groups according to different skin grafts, i.e. A(human ADM with razor thin autoskin ), B(porcine ADM with razor thin autoskin ), C(razor thin autoskin only),and D(split thickness autoskin) as control. The survival rate, the contraction degree of the grafts, and the histological changes in grafting area were observed at 2,4,8,12#and 24 hours after the operation. Results The grafted area in both A and B groups appeared smooth and elastic with satisfactory graft survival. The ingrowth of the host reparative cells such as fibroblast and vascular endothelium could be induced by composite grafts of different ADMs with skin grafting. The contraction areas in A and B groups seemed bigger than those in C and D groups. The tissue structure of grafting areas was similar to that of split thickness skin grafting area at 24 post-operation weeks. Conclusion Combination of the homogenous and heterogenous ADMs with autografts exhibited similar biological function during the observation period(24 weeks after operation). Xenogenous ADMs might have broader clinical applications.