透明质酸对复合移植皮肤组织生物力学性能影响的实验观察  

Effects of hyaluronic acid on biomechanic performance of porcine acellular dermal matrix plus thin skin autograft after transplantation

作　　者：赵京玉[1] 柴家科[1] 宋慧锋[1] 许明火[1] 

机构地区：[1]解放军总医院第一附属医院烧伤整形科,北京100048

出　　处：《中华医学杂志》2012年第24期1719-1722,共4页National Medical Journal of China

摘　　要：目的探讨外用透明质酸（HA）对异种（猪）去细胞真皮基质（PADM）复合移植皮肤组织生物力学性能的影响。方法选用10只日本大耳兔作为实验动物，每只大耳兔背部对称分4个区域，以随机数字表法随机分为4组，其中A、B、C组造成全层皮肤缺损创面，分别进行如下处理：A组：HA＋PADM＋自体薄厚皮移植；B组：PADM＋自体薄厚皮移植；C组：自体薄厚皮移植；D组：不作处理。术后第56天取各组标本行组织学观察，并进行应力·松弛和应力-应变力学测试。结果A、B组标本组织学观察见真皮基质基本完整。A组标本有大量成纤维细胞与毛细血管长入真皮基质，周围有炎性细胞散在分布，纤维细胞排列均匀；B组标本真皮基质聚集成团，有少量纤维细胞长入，周围有大量炎性细胞聚集。应力．松弛力学实验结果显示：A组松弛曲线与D组最接近，B组与D组最远，C组在A组与B组之间。在一定应变下，A、B、C、D组的应力值分别为（87±8）、（115±9）、（63±7）、（81±4）kPa，A组与D组最接近，差异无统计学意义（P=0．838）；B、C组与D组差异均有统计学意义（P=0．001和P=0．009）。结论外源性HA可提高真皮基质复合移植皮肤组织的生物力学性能。Objective To explore the effects of hyaluronic acid （HA） on biomechanical properties for porcine acellular dermal matrix （PADM） plus thin skin autograft after transplantation. Methods The dorsa of 10 Japanese white rabbits were symmetrically divided into four areas of A-D by random grouping. Full-thickness skin defects were created in Groups A-C while Group D was blank with normal skin. Operations were performed in Group A： implant with HA ＋ PADM ＋ thin skin autografts, Group B： implant with PADM ＋ thin skin autografts and Group C： skin autografts group. Histological examination of specimen was performed at Day 56 postoperatively. And the biomechanical properties such as relaxation and stress-strain properties of grafts were recorded. Results The structure of PADM was found to be basically intact by hematoxylin and eosin E dyeing in Groups A and B. In Group A, dense fiber structure could be observed. Lots of regularly arranged collagenous fibers and new blood capillaries were grown into the dermal matrix with sparsely distributed inflammatory cells. In Group B, acellular dermal matrix became clustered with a small amount of invaded fibroblasts. And there was a high expression of inflammatory cells. The biomechanic performances of transplanted skin were： Group A＇s curve was mostly close to that of Group D＇s, Group B＇s curve was the most further from that of Group D＇s （P = 0. 001 ） and Group C＇s curve stayed between Groups A and B. Under the same strain, the stress of Groups A-D was （87 ± 8）, （115 ±9）, （63 ＋ 7 ） and （81 ± 4） kPa respectively. No significant difference of stress existed between these two groups （P=0. 838）. There was significant difference of stress between Groups B/C and D （P =0. 001 and P = 0. 009）. Conclusion Topical hyaluronic acid may be used to enhance the biomechanics performances of transplanted skin.

关 键 词：透明质酸 皮肤移植 生物力学 

分 类 号：R644[医药卫生—外科学]