深Ⅱ度烧伤皮肤构建复合皮移植模型的初步研究  

Initial exploration on the recycling of deep second-degree burn skin for constructing model of complex skin transplanting

作　　者：朱绪国[1,2,3] 于冠英[3] 李耀南[1,2,3] 刘磊[1] 张基勋[1] 刘振中[1] 姜笃银[1,2,3] 

机构地区：[1]山东大学第二医院整形烧伤科,山东济南250033 [2]山东大学第二医院急诊科,山东济南250033 [3]山东大学组织工程研究所,山东济南250033

出　　处：《山东大学学报（医学版）》2014年第4期53-57,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81071560;81372074;30772258;30670571);山东省科技攻关项目(2009GG10002078);山东省优秀中青年科学家科研奖励基金(BS2012YY010);山东省自然科学基金青年基金(ZR2010HQ010)

摘　　要：目的探讨利用深Ⅱ度烧伤皮肤(DBS)作为真皮替代物构建复合皮移植模型进行修复创面的可行性。方法 20只雄性Wistar大鼠随机分为深Ⅱ度烧伤真皮基质(DBDM)移植组(实验组)和无细胞真皮基质(ADM)移植组(对照组),每组10只。采用酶消化法,实验组取2只大鼠烫伤24 h后皮肤进行脱细胞等处理,制备DBDM;取新生24 h内乳鼠背部完整皮肤,修薄后与网状DBDM一次性重叠移植到大鼠背部约2 cm×2 cm全层皮肤缺损创面,14 d后观察复合皮生长情况。对照组采用Wistar大鼠正常皮肤制备的ADM替代DBDM,其他实验步骤同实验组。结果新鲜制备的DBDM呈浅黄白色,质地较柔软,有一定的韧性和伸展性,较ADM弱。镜下胶原纤维增粗和透明样变,排列紊乱、疏松,无细胞、血管和毛囊等成分存在。大鼠复合皮移植术后14 d,两组大鼠及移植物的成活率差异有统计学意义(P<0.05),双层复合皮与皮下组织紧密连接,深层DBDM或ADM呈粉红色,未见明显肿胀及炎性反应。与ADM相比,DBDM组移植物较早出现炎性细胞浸润和成纤维细胞、毛细血管长入;炎性细胞以中性粒细胞和巨噬细胞为主,新生胶原蛋白沉积较快,纤维排列规则、致密。结论 DBDM来源广泛、制备方法简单,移植物生物相容性好,无皮肤烧伤毒素样反应,可充当自体刃厚皮片的真皮替代物。本研究可为今后临床改造和利用烧伤皮肤提供新的思路。Objective To explore the feasibility of deep second-degree burn skin （ DBS） as dermal substitute for con-structing model of complex skin transplanting in repairing wounds.Methods A total of 20 Wistar rats were randomly divided into the deep second-degree burn dermal matrix （ DBDM） transplanting group （ experimental group） and acellu-lar dermal matrix （ ADM） transplanting group （ control group） , 10 rats in each group.After a second-degree scald, the skin of two rats in experimental group was treated with enzyme digestion to remove cells to prepare DBDM.The back skin of newborn rats was integrally taken and the subcutaneous and dermal tissues were removed.The thin skin over-lapped with mesh DBDM were transplanted into the back skin wound of full-thickness in size of 2 cm ＆#215;2 cm or so.Af-ter 14 days, the situatioin of composite skin growth was observed.ADM was prepared by normal skin in control group, and other experiment steps were the same as the experimental group.Results The freshly prepared DBDM was yellow-white, less soft in texture of flexibility and extensibility compared with ADM.Collagen fibers of DBDM were thickened＆amp;nbsp;unevenly with hyaline changing and arranging in disorder.No cellular, blood vessels, hair follicles and other compo-nents were observed in DBDM under light microscope.Fourteen days after the composite skin transplantation experi-ments, the survival rate of rats and transplants in the two groups had significant difference （P＆lt;0.05）.The bilayer composite skin and subcutaneous tissue connected closely.The deep DBDM or ADM was pink.The skin after operation had no significant swelling or inflammation.Infiltration of inflammatory cells and ingrowth of fibroblast and capillary appeared more earlier in DBDM group compared with those in ADM group.Inflammatory cells were mainly neutrophils and macrophages.New collagen deposition was rapid and collagen fibers arranged in a regular and dense state. Conclusion Sources of DBDM is wide and preparation method is s

关 键 词：深Ⅱ度烧伤 真皮基质 复合皮 大鼠 

分 类 号：R644[医药卫生—外科学]