异体去细胞真皮基质重建真皮的实验研究

Reconstruction of dermis by allogenic acellular dermal matrix

目的 通过不同形式去细胞真皮 (acellulardermalmatrix ,ADM )与单纯自体刃厚皮片移植的比较研究 ,探讨异体ADM作为真皮替代物的机制及效果。方法 猪全层皮肤缺损创面分别行颗粒状 (实验组 1)及网状异体ADM (实验组 2 )结合自体刃厚皮移植 ,以单纯自体刃厚皮移植作对照 ,观察各组移植术后皮片存活率、创面收缩率、组织学变化及血管化程度等。结果 移植术后 ,各组皮片均全部存活 ;与对照组相比 :两实验组创面收缩较小 ,弹性较好 ,创面充血程度轻 (P <0 .0 1) ,瘢痕增生程度也明显小于对照组。结论 网状及颗粒状异体ADM结合自体刃厚皮移植较好地封闭了全层皮肤缺损创面 ;其愈后功能优于单纯自体刃厚皮移植 ;颗粒状ADM制作简单 ,使用方便 ,值得进一步探索研究。

ObjectiveTo explore the mechanisms and efficiency of acellular dermal matrix(ADM) as dermal substitute in reconstruction of full-thickness skin defect by comparing two different ADMs.MethodsMeshed (experimental group 1) and granule (experimental group 2) allo-ADMs were transplanted on full-thickness skin defects on the lack of swines,covered by split auto-skin.In control group,only split auto-skin was grafted.The survive rates,contraction,histologic changes and revascularization procedure were recorded and analyzed.ResultsAll the grafts in the 3 groups survived.Compared with the control group,there were much less wound contraction,better elasticity and less scar in the two experiment groups.ConclusionMeshed and granule allo-ADMs could be used as dermal substitutes in reconstruction of full thickness skin defect.Granule allo-ADM is easy for preparation and application,and might be a new means to reconstruct dermal defects in full skin loss.