自体微粒皮与异体真皮基质复合移植的实验研究

目的　观察自体微粒皮与异体真皮基质复合移植后创面的修复情况。　方法　于 6只小白猪背部制作 4 6个皮肤全层缺损创面 ,同时制作网状脱细胞异体真皮基质和自体微粒皮。创面分为实验组和对照组 ,每组 2 3个 ,分别进行自体微粒皮 异体真皮基质 (两者比例为 1∶4 ) 异体断层猪皮、自体刃厚皮 异体真皮基质的移植。　结果　实验组和对照组的移植成活率及创面收缩率差异无显著性意义 (P >0 .0 5 )。两组移植术后组织学观察无明显差别 ,术后 8～ 2 0周胶原纤维结构完整、清晰、排列规则、粗细均匀 ,可见正常的血管组织 ,炎症反应逐渐减轻 ,表 真皮间结合良好 ,钉突横跨基底膜并完好地固定于异体真皮上。移植术后 5个月皮肤均较平滑、有弹性、功能好。　结论　自体微粒皮与脱细胞异体真皮基质复合移植后皮片成活率较高 ,为大面积深度烧伤创面修复中较理想的覆盖材料。

An experimental study on the cograft of auto-microskin and allo-dermal matrix

OBJECTIVE: To explore the promoting effects of cograft of auto-microskin and allo-dermal matrix on burn wound healing. METHODS: Forty-six patches of full skin loss wounds were made in the backs of 6 small white swines. Auto-microskin and meshed acellular allo-dermal matrix were simultaneously prepared. The 46 wounds were averagely divided into test (T) and control (C) groups. The wounds in T group were covered with auto-microskin and allo-dermal matrix (1:4) and split-thick allo-porcine skin. While the wounds in C group were grafted with autoskin and allo-dermal matrix. RESULTS: The skin survival rate exhibited no difference between C and T groups (P > 0.05). There was similar histological exhibition in the two groups after skin grafting. The structure of collagen fibres appeared integrated, clear with regular arrangement and steady diameter at 8 - 20 post-operative weeks. Simultaneously, it was revealed by histological examination that normal vascular structure could be identified in the grafted skin and that inflammatory reaction ameliorated gradually and that epithelium combined well with dermis. It was also found that the epidermal papillar across the basement membrane fixed well to allo-dermis. The skin appeared smooth, elastic and functioned well at 5 months after skin grafting. CONCLUSION: The grafted skin survived well after the cograft of auto-microskin and allo-dermal matrix, which might be ideal covering material for the major deep burn wound healing.