扩张囊外纤维包膜的组织学结构及其意义

目的研究扩张囊外纤维包膜的组织结构和转归.方法用12只白色小家猪制作常规间断扩张(CITE)和持续恒压扩张(CPTE)动物模型,取纤维包膜做测量和组织学检查.结果CPTE纤维包膜的组织厚度和收缩率明显小于CITE组(P＜0.05).纤维包膜有4层结构,其中含大量的胶原纤维和弹力纤维,另含有发育良好的小动脉、小静脉和毛细血管.皮瓣移植后,皮瓣侧纤维包膜大部退化,弹力纤维层和纤维板层仍存.创基侧的纤维包膜则基本完全退化.结论纤维包膜具有收缩和供血能力.去纤维包膜可减轻皮瓣回缩,但制作较大的扩张皮瓣最好保留纤维包膜.扩张器底部的纤维包膜可不处理.

Histological structure of fibrous capsule around expanders and its clinical significance

Objective To study the fibrous capsule structure and its change after expansion.Methods Twelve minipigs were chosen for establishing the animal models of conventional intermittent tissue expansion (CITE) and continuous pressure tissue expansion (CPTE). The capsule samples were taken for measurement and histological examination.Results The thickness and the contraction rates of capsules in CPTE group were significantly less than those of CITE group. The capsule consisted of four layers, in which a large amount of collagen and elastic fibers existed and some small arteries, veins and capillaries were well developed. After expanded flaps were transplanted, capsules contained in flaps were partially degenerated except elastic fiber layer and fibrolaminar layer, but capsules on the wound bed almost all degenerated. Conclusion The results suggest that capsules have contractive and blood supply abilities. Capsulectomy is able to decrease flap contraction. Large expanded flaps are better to have the capsule reserved. No efforts shall be done to the capsules on wound beds.