机械牵张对移植皮片挛缩影响的实验研究  

Experimental Study on the Effects of Mechanical Stretch on the Skin Graft Contracture

作　　者：周锦烽[1] 杨蓊勃[2] 顾延庆[2] 郝超[1] ZHOU Jin-feng;YANG Weng-bo;GU Yan-qing;HAO Chao(Department of Burn and Plastic Surgery,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,Jiangsu,China;Department of Orthopaedics,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,Jiangsu,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)烧伤整形科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)骨科,江苏南京210006

出　　处：《中国美容医学》2019年第2期83-87,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:评估机械牵张对于移植皮片的影响,为改善植皮片术后挛缩寻找新的治疗方法。方法:SPF级SD大鼠24只,雄性,3月龄,体重300g～330g,随机分为三组,在每只大鼠背部建立两个大小相同的全厚植皮模型,各组大鼠术后随机选取一皮片,以自制弹性牵张装置分别行纵向、横向及双向牵张,另一皮片为自身对照。牵张2周后测量各治疗组与对照组皮片的面积、长度、宽度,并计算长宽比。结果:经过2周的机械牵张,各治疗组的植皮片在受力的方向上均变长了,从而造成了植皮片形态改变和面积的增加。单向牵张组的植皮术在非受力方向的长度较牵张前有所减少,而自身对照组的皮片则无此改变,说明其长度改变由机械牵张引起,而非术后挛缩引起。结论:初步实验表明,机械牵张可以有效地增加植皮片的长度与面积,全方位的机械牵张作用尤其明显,这一方法值得进一步的深入研究,从而为植皮片术后挛缩这一难题提供更好的治疗方法。Objective To evaluate the effect of mechanical stretching on skin graft and to find a new method to improve the contracture after skin graft. Methods Twenty-four SD rats of SPF grade, male, aged 3 months, weighing 300g to 330g, were divided into three groups. Two full-thickness skin grafting models of the same size were established in each rat's back. One skin graft was randomly selected from each group after operation, and the self-made elastic stretching device was used for longitudinal, transverse and bidirectional stretching, and the other skin graft was used for self-control. After 2 weeks of distraction, the area, length and width of the skin of each treatment group and the control group were measured, and the aspect ratio was calculated. Results After two weeks of mechanical stretching, the skin grafts in each treatment group were lengthened in the direction of force, resulting in the morphological changes of skin grafts and the increase of the area. The length of skin graft in unilateral distraction group was less than that before distraction, while the length of skin graft in self-control group was unchanged, indicating that the length change was caused by mechanical distraction, not by postoperative contracture. Conclusion Preliminary experiments show that mechanical stretching can effectively increase the length and area of skin graft, especially the omni-directional mechanical stretching. This method is worthy of further study, so as to provide a better treatment for contracture after skin graft.

关 键 词：SD大鼠 植皮片 机械应力 牵张 挛缩 动物实验 

分 类 号：R622[医药卫生—整形外科]