皮肤全层缺损真皮修复不同阶段对表皮再生的影响  

Effects of different dermis repairing stages on epidermis regeneration in full thickness wound

作　　者：宋宁[1] 富玲[1] 辛畅泰[1] 马世伟[1] 石岫昆[1] 

机构地区：[1]沈阳医学院奉天医院手外科,辽宁省沈阳市110024

出　　处：《中国组织工程研究与临床康复》2010年第41期7631-7634,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:当前组织工程研究多着重表皮干细胞和真皮支架材料的研究,而少有真皮新生速度和真皮修复不同时期组织结构对表皮新生和重建影响的报道。目的:观察真皮修复过程中对表皮修复和重建的影响以及是否有促进表皮修复速度的最佳阶段。方法:新西兰大耳白兔10只分别于第0,7,14天在背部制成3个直径约为3cm的创面,随机分为0,7,14d组,每组计10个创面,3组创面分别于皮肤全层损伤修复后21,14,7d植入自体表皮细胞羊膜载体复合膜。7d后取材,采用大体观察、常规组织学观察(苏木精-伊红染色,Mallory PTAH染色)、Ⅰ型胶原免疫组织化学观察等化学染色动态观察创面愈合情况。结果与结论:0d组创面与周边正常有毛皮肤齐平,与周边组织连接明显较7d组及14d组紧密,7d组尚有凹面,而14d组创面凹陷明显较7d组大而深,与周边组织分界明显,这表明0d组皮肤缺损的修复效果明显优于其他2组(P<0.05)。0d组Ⅰ型胶原阳性的成纤维细胞、血管及胶原纤维等组成的真皮网状层和乳头层较其他2组明显(P<0.05),创面愈合率高(P<0.05)。真皮修复的不同时期,对表皮再生的促进作用存在不同,全层皮肤缺损处于真皮修复的增生晚期与重建初期是促进表皮新生的最佳阶段。BACKGROUND： Presently, studies concerning tissue engineering mainly focus on epidermal stem cells and dermal scaffolds, few report the effects of generation speed and different repairing periods of dermis on neogenesis and reconstruction of epidermis. OBJECTIVE： To investigate the potential influence of dermis during repairing process on the repair and reconstruction of epithelial tissues and to reveal the possible optimum stage for repair of epithelial tissues. METHODS： Ten New Zealand rabbits were made into animal models with 3 wounds on each dorsum at 0, 7 and 14 days and were divided into 0, 7 and 14 days groups. Amnion carrier compound-membrane loaded with auto-epithelial cells was embedded into rabbits at 21, 14 and 7 days after model preparation. Samples were harvested 7 days after operation to observe the wound healing by using macroscopic and histological assessment （hematoxylin-eosin staining, Mallory PTAH staining）, and type Ⅰ collagen immunohistochemistry observation. RESULTS AND CONCLUSION： The wound in the 0 day group was closely contacted with surrounding tissues without gaps. However, there was concavity in the 7 days group, and the concavity was great and thick in the 14 days group, with a clear boundary to surrounding tissues. It demonstrated that the repairing effect was superior in the 0 day group to other 2 groups （P0.05）. Compared with other groups, the positive type Ⅰ collagen stratum reticulare dermidis and papillary layer, composed of fibroblast, blood vessel, and collagen fiber, were obviously in the 0 day group （P0.05）, with high healing rate （P0.05）. The differences of promoting action on epithelial tissue regeneration exist in different repairing stages of dermis, late stage of hyperplasia and beginning of reconstruction are the optimal periods for accelerating epidermis regeneration.

关 键 词：表皮再生 羊膜 碱性成纤维生长因子 维生素C 皮肤缺损 皮肤组织工程 

分 类 号：R318[医药卫生—生物医学工程]