足踝部GustiloⅢ°开放性骨折软组织缺损的显微外科治疗

目的：探讨足踝部GustiloⅢ°开放性骨折软组织缺损显微外科的治疗效果。方法：2006年8月至2010年7月收治足踝部Gustilom。开放性骨折并软组织缺损41例,其中ⅢA型18例、ⅢB型15例、ⅢC型8例;软组织缺损面积3．5cm×3．0cm-25．0cm×15．0cm,平均12．0cm×8．0cm;合并软组织感染11例,骨感染4例。均采用显微外科技术行清创和多种皮瓣移植修复术,其中小腿皮神经营养血管逆行岛状皮瓣14例,足底内侧动脉皮瓣4例,游离皮瓣移植23例。结果：本组41例,26例骨折固定的同时行一期创面皮瓣移植修复,15例先行骨折固定、软组织创面经数次清创二期行皮瓣移植修复。术后3例腓肠神经营养血管皮瓣移植失败,后经游离皮瓣手术完成创面覆盖,其余皮瓣全部成活。创面一期愈合39例,二期愈合2例。术后41例均随访3—24月,根据下肢肢体功能评定标准评定疗效,优16例、良19例、可4例、差2例,优良率为85％。结论：足踝部GustiloⅢ°开放性骨折患者的软组织缺损经清创、皮瓣移植修复可获得满意的疗效。     

皮肤持续牵张技术联合负压封闭引流技术治疗深度创面的临床观察

目的探讨皮肤持续牵张技术联合负压封闭引流(VSD)技术治疗深度创面的临床疗效。 方法选取2015年5月至2018年5月山西白求恩医院急救医学科收治的不同部位深度创面患者20例,其中外伤10例,压疮7例,感染创面3例。根据创面情况实施清创术后应用皮肤持续牵张联合VSD治疗,观察并记录患者伤口愈合时间,使用温哥华瘢痕量表评估创面愈合质量。 结果20例患者经皮肤持续牵张与VSD治疗后,创面均愈合良好,无愈合不良或不愈合。创面大小为2 cm×2 cm～3 cm×4 cm的5例患者创面平均愈合时间为20 d,创面大小为5 cm×5 cm～8 cm×10 cm的8例患者创面平均愈合时间为22 d,创面大小为10 cm×15 cm～15 cm×20 cm的7例患者创面平均愈合时间为30 d。创面愈合后3个月随访所有患者温哥华瘢痕量表评分平均为3.8分。 结论应用皮肤持续牵张技术与VSD技术联合治疗深度创面不仅可以获得满意的临床效果,而且具有操作简单、创伤小等优点,值得推广。     

Development of fungal mycelia as a skin substitute: characterization of keratinocyte proliferation and matrix metalloproteinase expression during improvement in the wound-healing process

SACCHACHITIN membranes, prepared from the waste residue of the fruiting body of Ganoderma taugae, were used in our previous study to enhance skin wound healing in animal models. In the present study, the effects of the membrane on the growth of keratinocytes and the activity of matrix metalloproteinases (MMPs), as well as on the healing of skin wounds in humans, were estimated. Fresh human foreskin was employed as the source of the keratinocyte culture, and a modified keratinocyte-SFM medium supplemented with 0.2 ng/mL of recombinant epidermal growth factor and 30 microg/mL bovine pituitary extract was used to enhance the successful growth of keratinocytes under an atmosphere of 5% CO2, at 37 degrees C. The results indicated that 0.01% SACCHACHITIN enhanced the proliferation of keratinocytes in the culture on the fourth and fifth days, and cells showed neither morphological alteration nor disordered proliferation. This evidence clearly indicated that SACCHACHITIN was not cytotoxic to and was safe for the growth of keratinocytes. Thus, SACCHACHITIN might play a positive role in the proliferation and differentiation of keratinocytes around wounds and in accelerated wound healing of epidermal tissue. In addition, microscopic observations during the growth of keratinocytes showed that normal proliferation and differentiation took place along the margin of the SACCHACHITIN membrane. This indicates that SACCHACHITIN is possibly cytocompatible with keratinocytes. Electrophoretic analysis and inhibition tests for the binding effect of SACCHACHITIN on MMPs showed that SACCHACHITIN reduced MMPs in extracellular matrix degradation and facilitated establishment of an extracellular matrix around wounds; these effects resulted in rapid wound healing. SACCHACHITIN was used as a skin dressing for patients who had skin chronicle ulcer, which had not healed for over 7 months. Preliminary clinical observations showed that the wound improved and began to heal. An analysis of MMPs by ELISA in tissue of the wound indicated a significant decrease in MMP levels.     

Effects of cyclophosphamide on open, granulating skin wounds in rats.

The effect of cyclophosphamide on the healing of open cutaneous wounds was studied in rats. Following intraperitoneal injections of 25 mg/kg body weight every second day for 9 days, only about 7% of the wounds were completely covered by epithelium after 15 days, whereas in the control animals 60% of the wounds were completely epithelialized. Measurements of wound diameters in circular skin wounds revealed unhealed wound areas in the drug treated animals which were significantly larger than those of the control animals. Cyclophosphamide was found to reduce the occurrence of H3-labelled cells in the granulation tissue when evaluated after 11 days. At 15 days there was no difference in the labelling frequency between treated and control animals, indicating reversal of the drug effect.     

双处截骨纵向搬移治疗长段小腿感染性复合缺损

目的探讨胫骨双处截骨纵向搬移治疗胫骨干大段感染性骨缺损复合软组织缺损的疗效及并发症情况。方法回顾性分析2009年5月至2016年5月收治的31例胫骨干大段感染性骨缺损复合软组织缺损资料,男27例,女4例,年龄2~58岁,平均33.4岁。胫前软组织缺损面积7 cm×8 cm~24 cm×12 cm,胫骨缺损长度6.5 cm~18.2 cm,平均11.4 cm。术后随访时间1~8年,平均32个月。随访观察骨及软组织愈合和并发症情况。结果31例感染均愈合,骨缺损及软组织缺损创面全部愈合。4例出现骨断端延迟愈合,植骨后愈合,3例出现骨延长区伤口感染及成骨不良,经放置万古霉素骨水泥棒2个月及"手风琴"技术处理后愈合;其余骨缺损与软组织创面均顺利愈合。软组织愈合时间为65 d~190 d,平均70 d,骨愈合的时间为14~35个月,平均21.6个月;28例患者肢体长度完全恢复,3例患者患肢较健侧短1.5 cm。结论对于8 cm以上的胫骨骨与软组织复合缺损,双处截骨纵向搬移可缩短治疗时间。主要并发症为骨会师端延迟愈合、成骨不良和胫骨力线偏移,经处理后恢复正常。     

Scar‐free cutaneous wound healing in the leopard gecko,Eublepharis macularius

Cutaneous wounds heal with two possible outcomes: scarification or near‐perfect integumentary restoration. Whereas scar formation has been intensively investigated, less is known about the tissue‐level events characterising wounds that spontaneously heal scar‐free, particularly in non‐foetal amniotes. Here, a spatiotemporal investigation of scar‐free cutaneous wound healing following full‐thickness excisional biopsies to the tail and body of leopard geckos (Eublepharis macularius) is provided. All injuries healed without scarring. Cutaneous repair involves the development of a cell‐rich aggregate within the wound bed, similar to scarring wounds. Unlike scar formation, scar‐free healing involves a more rapid closure of the wound epithelium, and a delay in blood vessel development and collagen deposition within the wound bed. It was found that, while granulation tissue of scarring wounds is hypervascular, scar‐free wound healing conspicuously does not involve a period of exuberant blood vessel formation. In addition, during scar‐free wound healing the newly formed blood vessels are typically perivascular cell‐supported. Immunohistochemistry revealed widespread expression of both the pro‐angiogenic factor vascular endothelial growth factor A and the anti‐angiogenic factor thrombospondin‐1 within the healing wound. It was found that scar‐free wound healing is an intrinsic property of leopard gecko integument, and involves a modulation of the cutaneous scar repair program. This proportional revascularisation is an important factor in scar‐free wound healing.     

Differences in second-intention wound healing of distal aspect of the limb between Caspian miniature horses and donkeys: macroscopical aspects

In this study, second-intention healing of limb wounds was studied in donkeys and Caspian miniature horses. Full-thickness, rectangular (2?×?3?cm) skin wounds were created on the lateral aspect of left metacarpi of four donkeys and four Caspian horses. Wound healing process was compared between limb wounds of donkeys and Caspian horses by clinical and geometrical assessments, over a 4-week period. At days?0, 3, 7, 10, 14, 17, 21, 24, and 28, digital photographs were taken of all wounds. The area of epithelialization and granulation tissue was measured for each wound using sigma scan software. Percentages of wound contraction, epithelialization, and healing were calculated for each wound. The clinical and geometrical evaluation revealed that there were significant differences in second-intention wound healing patterns between donkeys and Caspian horses. The donkeys limb wound healed much faster and in better condition than the limb wound of the Caspian horses. Based on results of this study, it can be concluded that although Caspian miniature horses and donkeys have same body size, it seems that due to genetic differences, considerable heterogeneity was observed in second-intention wound healing between them.     

人工真皮联合负压封闭引流技术修复糖尿病足跟部骨外露15例

目的探讨人工真皮联合负压封闭引流技术对糖尿病足跟部骨外露修复的临床疗效。方法选择2012年8月至2017年8月于本院接受治疗的15例糖尿病足跟部骨外露患者为研究对象,常规手术清创后持续负压封闭引流,待肉芽组织生长良好后行人工真皮胶原支架结合自体皮片移植,观察手术时间、住院时间、术后创面愈合率、术后创面愈合时间、术后创面外观进行统计。分别于术后1个月、3个月、6个月、12个月对患者进行随访并进行优劣效评价,计算有效率。结果 15例均获得定期随访,随访12个月。所有病例跟部骨外露创面完全愈合,手术时间(67.3±14.1) min、平均住院时间(32.4±14.6) d、术后创面愈合时间(21.3±7.6) d,创面外观良好,行走无疼痛。1例植皮后皮肤部分边缘坏死,经换药1个月愈合。人工真皮修复的骨外露创面全部愈合,未发生创口感染、创口出血、神经损伤、过敏反应等并发症及不良反应;术后随访骨外露创面均完全愈合,无疤痕及形态异常,皮肤弹性及耐磨性良好,无反差色改变,无再发皮肤破损,能满足负重功能需求。结论负压封闭引流术后,人工真皮通过胶原支架诱导创面形成类真皮组织覆盖骨外露创面,促进肉芽组织增生,具有手术操作简单,创面柔韧性、耐磨性好,复发率低,疗效满意,是修复糖尿病足跟部骨外露的理想方法。     

Location of injury influences the mechanisms of both regeneration and repair within the MRL/MpJ mouse

The adult MRL/MpJ mouse regenerates all differentiated structures after through-and-through ear punch wounding in a scar-free process. We investigated whether this regenerative capacity was also shown by skin wounds. Dorsal skin wounds were created, harvested and archived from the same animals (MRL/MpJ and C57BL/6 mice) that received through-and-through ear punch wounds. Re-epithelialization was complete in dorsal wounds in both strains by day 5 and extensive granulation tissue was present by day 14 post-wounding. By day 21, wounds from both strains contained dense amounts of collagen that healed with a scar. The average wound area, as well as alpha-smooth muscle actin expression and macrophage influx were investigated during dorsal skin wound healing and did not significantly differ between strains. Thus, MRL/MpJ mice regenerate ear wounds in a scar-free manner, but heal dorsal skin wounds by simple repair with scar formation. A significant conclusion can be drawn from these data; mechanisms of regeneration and repair can occur within the same animal, potentially utilizing similar molecules and signalling pathways that subtly diverge dependent upon the microenvironment of the injury.     

综合法治疗慢性压力性创伤所致压疮的疗效观察

目的总结慢性压力性创伤所致压疮的外科治疗经验。方法1997年1月至2008年12月,郴州市第一人民医院烧伤整形科应用皮瓣、游离皮片、术后灌洗及负压吸引等外科方法治疗107例因截瘫、侧瘫、超高龄痴呆等原因导致慢性压力创伤性皮肤、软组织溃烂创面382处。其中尾骶区121处,股骨大转子区96处,坐骨结节63处,髂骨部48处,胸腰椎区22处,足跟部15处,肩胛区17处。围手术期营养不良患者予以营养代谢支持治疗,感染严重者术后持续灌洗与负压吸引,并防止再受压等。结果 382处创面一次性愈合304处,其中158处为肌瓣或肌皮瓣,轴型复合组织瓣76处,游离皮片54处,邻位皮瓣16处。延迟愈合78处,其中轴型复合组织瓣41处,肌皮瓣31处,游离皮片6处。延迟愈合创面修复方法：38处经Ⅱ期扩创后直接缝合治愈,27处经游离皮片移植治愈,13处局部换药治愈（平均17d）。随访6个月时,原位复发压力性创面17例,其中游离植皮占13例。结论改善全身营养,控制局部细菌感染,利用创面周围健康皮肤、肌肉、筋膜形成复合组织瓣修复创面,辅以创底灌洗、负压吸引,避免再受压等是提高慢性压力创伤性创面治愈率和降低复发率的较好方法。     

闭式灌洗引流术治疗手部感染的治疗体会

目的：评价采用闭式灌洗引流术治疗手部感染性创口的效果。方法2011年1月至2013年12月,对吉林大学第一医院手足外科收治的57例各种原因引起的手部感染性伤口应用闭式灌洗引流术进行治疗。观察术后灌洗液的性状,创口有无炎症反应,瘢痕增生,组织粘连。结果57例患者中,53例患者伤口一期愈合,其中33例出现轻微红肿及炎症反应,20例患者未出现炎症反应。4例患者因伤口部位皮瓣部分坏死,导致伤口未愈合,二期行植皮治疗伤口愈合。随访3～12个月,35例无明显组织粘连及瘢痕增生,22例伴有不同程度组织粘连及瘢痕增生。结论应用闭式灌洗引流治疗手部感染性伤口,可以达到一期闭合伤口,保护深层的肌腱、神经、血管及骨骼组织。     

超声清创系统结合负压创面疗法在骨外露创面中的应用

目的 研究超声清创系统结合负压创面疗法治疗骨外露创面的临床效果.方法 采用超声手术系统结合负压创面疗法治疗17例患者,共18个骨外露创面,骨外露创面面积平均（10.5±6.6）cm^2.观察坏死骨组织清除速度、清除效果,清创术后3周创面愈合率,植皮成活率,创面完全愈合时间.结果 超声清创系统可以快速而有效地清除坏死骨组织以及磨除骨皮质.清创术后3周创面愈合（62.3±25.1）%,未愈合创面肉芽组织长满创面,色鲜红.植皮全部成活率88.9%,从第一次清创至创面完全愈合时间为（28.1±9.1）d.结论 超声清创系统结合负压创面疗法治疗骨外露创面可有效清除坏死骨组织,促进肉芽组织迅速生长,缩小创面面积,从而加速创面愈合,是治疗骨外露创面的一种行之有效的方法.     

南极大磷虾胰蛋白酶可促进创面的愈合

背景：胰蛋白酶已被证实具有较好的清创、促进创伤愈合作用。 目的：探讨南极大磷虾胰蛋白酶对创面的修复效果。 方法：采用全层皮肤缺损法制成新西兰大白兔背部创伤模型,将创面分为4组,分别给予从南极大磷虾中提取的粗酶液或纯化的胰蛋白酶、木瓜蛋白酶和生理盐水,每天早晚两次给药,直至伤口愈合。 结果与结论：给药5,10和15 d测量伤口愈合面积,从南极大磷虾中提取的粗酶和纯化胰蛋白酶均具有良好的促进愈合效果,但粗酶的效果更好,其各时段残余创面面积小于生理盐水组和木瓜蛋白酶组(P < 0.05);皮肤羟脯氨酸含量测定结果显示粗酶能显著促进创伤组织中胶原的合成和积累;组织学切片观察显示粗酶组愈合效果最佳。证明南极大磷虾胰蛋白酶能显著促进新西兰大白兔创口的愈合,粗酶具有最优效果。     

脂肪颗粒移植修复腔隙性软组织缺损的疗效观察

目的观察自体脂肪颗粒移植修复肢体腔隙性软组织缺损的临床效果。 方法2017年9月至2019年6月，选择武汉大学中南医院创伤与显微骨科收治的14例腔隙性软组织缺损病例，缺损面积：1.5 cm×2.0 cm ～ 4.0 cm×6.0 cm，缺损深度：3.0～7.0 cm。彻底清创后制备自体脂肪颗粒，采用Coleman法制备脂肪颗粒，将脂肪颗粒注射到缺损周围软组织内并填充于腔隙内，表面覆盖凡士林纱布，每周打开凡士林纱布观察组织缺损部位变化，连续随访了解创面修复情况至创面愈合。 结果所有患者均获得12周随访，组织缺损部位在治疗后2周观察到大量肉芽组织生长，缺损面积缩小约(47.5±5.5)%。12例在治疗后皮肤软组织缺损面积缩小直接愈合，平均愈合时间(24.2±4.5) d；1例皮肤软组缺损伴骨质缺损在治疗后1周，部分移植脂肪坏死，行局部皮瓣移植术后愈合；1例术后5 d感染脂肪液化坏死，实施清创术控制感染后换药愈合。 结论脂肪颗粒移植对肢体腔隙性软组织具有修复作用，能够促进肉芽组织生长，加速软组织缺损重建。     

Physical plasma therapy accelerates wound re-epithelialisation and enhances extracellular matrix formation in cutaneous skin grafts

Skin grafting is a surgical method of cutaneous reconstruction, which provides volumetric replacement in wounds unable to heal by primary intention. Clinically, full-thickness skin grafts (FTSGs) are placed in aesthetically sensitive and mechanically demanding areas such as the hands, face, and neck. Complete or partial graft failure is the primary complication associated with this surgical procedure. Strategies aimed at improving the rate of skin graft integration will reduce the incidence of graft failure. Cold atmospheric plasma (CAP) is an emerging technology offering innovative clinical applications. The aim of this study was to test the therapeutic potential of CAP to improve wound healing and skin graft integration into the recipient site. In vitro models that mimic wound healing were used to investigate the ability of CAP to enhance cellular migration, a key factor in cutaneous tissue repair. We demonstrated that CAP enhanced the migration of epidermal keratinocytes and dermal fibroblasts. This increased cellular migration was possibly induced by the low dose of reactive oxygen and nitrogen species produced by CAP. Using a mouse model of burn wound reconstructed with a full-thickness skin graft, we showed that wounds treated with CAP healed faster than did control wounds. Immunohistochemical wound analysis showed that CAP treatment enhanced the expression of the dermal–epidermal junction components, which are vital for successful skin graft integration. CAP treatment was characterised by increased levels of Tgfbr1 mRNA and collagen I protein in vivo, suggesting enhanced wound maturity and extracellular matrix deposition. Mechanistically, we show that CAP induced the activation of the canonical SMAD-dependent TGF- β 1 pathway in primary human dermal fibroblasts, which may explain the increased collagen I synthesis in vitro. These studies revealed that CAP improved wound repair and skin graft integration via mechanisms involving extracellular matrix formation. CAP offers a novel approach for treating cutaneous wounds and skin grafts. © 2020 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Characterization of bacterial communities in venous insufficiency wounds by use of conventional culture and molecular diagnostic methods

Microbial infections delay wound healing, but the effect of the composition of the wound microbiome on healing parameters is unknown. To better understand bacterial communities in chronic wounds, we analyzed debridement samples from lower-extremity venous insufficiency ulcers using the following: conventional anaerobic and aerobic bacterial cultures; the Ibis T5000 universal biosensor (Abbott Molecular); and 16S 454 FLX titanium series pyrosequencing (Roche). Wound debridement samples were obtained from 10 patients monitored clinically for at least 6 months, at which point 5 of the 10 sampled wounds had healed. Pyrosequencing data revealed significantly higher bacterial abundance and diversity in wounds that had not healed at 6 months. Additionally, Actinomycetales was increased in wounds that had not healed, and Pseudomonadaceae was increased in wounds that had healed by the 6-month follow-up. Baseline wound surface area, duration, or analysis by Ibis or conventional culture did not reveal significant differences between wounds that healed after 6 months and those that did not. Thus, pyrosequencing identified distinctive baseline characteristics of wounds that did not heal by the 6-month follow-up, furthering our understanding of potentially unique microbiome characteristics of chronic wounds.     

富血小板纤维蛋白联合姜黄素纳米颗粒水凝胶促糖尿病小鼠创面愈合

背景:糖尿病难愈性创面目前仍缺乏十分理想的治疗手段,探索促进糖尿病创面愈合的方法意义重大。目的:观察富血小板纤维蛋白联合姜黄素纳米颗粒水凝胶对糖尿病小鼠创面愈合的影响。方法:分别制备富血小板纤维蛋白与姜黄素纳米颗粒水凝胶。从100只成年C57BL/6J小鼠中随机取20只作为正常对照(A组),另外80只建立糖尿病模型。在建模成功的72只小鼠背部制作直径1 cm的圆形全层皮肤损伤创面,随机分4组处理:B组涂抹生理盐水,C组涂抹富血小板纤维蛋白与游离姜黄素溶液,D组涂抹富血小板纤维蛋白与姜黄素纳米颗粒溶液,E组涂抹富血小板纤维蛋白与姜黄素纳米颗粒水凝胶,每组18只。A组小鼠背部制作直径1 cm的圆形全层皮肤损伤创面,涂抹生理盐水。于创面造模当日即开始给药,之后隔日分别给予上述对应药物,直至伤后12 d。处理后第3,9,12天,观察创面愈合及创缘组织病理组织学变化。结果与结论:(1)处理后第12天,A、C、D、E组创面基本愈合完全,B组创面未完全愈合,E组创面愈合率高于B、C、D组(P <0.05);(2)处理后第3天苏木精-伊红染色显示,E组创面愈合情况好于B、C、D组,炎细胞浸润及肉...     

Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study

OBJECTIVE: Low-level laser therapy (LLLT) has been promoted for its beneficial effects on tissue healing and pain relief. However, according to the results of in vivo studies, the effectiveness of this modality varies. Our purpose was to assess the putative effects of LLLT on healing using an experimental wound model. DESIGN AND SETTING: We used a randomized, triple-blind, placebo-controlled design with 2 within-subjects factors (wound and time) and 1 between-subjects factor (group). Data were collected in the laboratory setting. SUBJECTS: Twenty-two healthy subjects (age = 21 +/- 1 years, height = 175.6 +/- 9.8 cm, mass = 76.2 +/- 14.2 kg). MEASUREMENTS: Two standardized 1.27-cm(2) abrasions were induced on the anterior forearm. After wound cleaning, standardized digital photos were recorded. Each subject then received LLLT (8 J/cm(2); treatment time = 2 minutes, 5 seconds; pulse rate = 700 Hz) to 1 of the 2 randomly chosen wounds from either a laser or a sham 46-diode cluster head. Subjects reported back to the laboratory on days 2 to 10 to be photographed and receive LLLT and on day 20 to be photographed. Data were analyzed for wound contraction (area), color changes (chromatic red), and luminance. RESULTS: A group x wound x time interaction was detected for area measurements. At days 6, 8, and 10, follow-up testing revealed that the laser group had smaller wounds than the sham group for both the treated and the untreated wounds (P < .05). No group x wound x time differences were detected for chromatic red or luminance. CONCLUSIONS: The LLLT resulted in enhanced healing as measured by wound contraction. The untreated wounds in subjects treated with LLLT contracted more than the wounds in the sham group, so LLLT may produce an indirect healing effect on surrounding tissues. These data indicate that LLLT is an effective modality to facilitate wound contraction of partial-thickness wounds.     

A comparative study of fibroblasts in healing freeze and burn injuries in rats.

In rats, the healing process of a full-thickness dermal freeze injury differs from that of a burn wound. Whereas burn wounds heal by wound contraction, the movement of surrounding normal skin over the defect, freeze wounds heal without wound contraction. That absence of contraction may be due to the freeze wound's lack of myofibroblasts, the cells reportedly associated with wound contraction. Myofibroblasts can be demonstrated histologically by staining the F-actin filaments of the stress fibers with NBD-phallacidin, a fluorescent reagent specific to F-actin filaments. Fibroblasts in normal dermis have no staining stress fibers. However, staining myofibroblasts are uniformly distributed in the granulation tissue of the healing burn and in the islands of granulation tissue between residual connective tissue fibers in the healing freeze wound. These residual dermal fibers were identified by their patterns of birefringence. Residual connective tissue matrix persists following cold trauma and acts like an internal splint. Burn trauma destroys cells and the connective tissue matrix, which is completely replaced with granulation tissue which undergoes wound contraction. Freeze trauma kills the cellular components of dermis, while some residual connective tissue fibers endure. This study shows that the connective tissue matrix can play an important role in the control of wound contraction.     

猪真皮与自体皮联合移植的实验研究

探讨猪真皮与自体皮联合移植修复创面的效果。21只Wistar鼠，背部切出全层皮肤。分别在移植真皮创面上于手术当天、术后7、10d移植自体皮和在打孔的真皮上于手术当天移植自体皮。通过测定创面面积和观察猪真皮与自体皮生长情况评价创面愈合效果。结果移植自体皮2周，自体皮与真皮牢固黏附。3周在打孔真皮上移植自体皮的创面已全部愈合，而其它3组仍残存小创面。4周移植的自体皮与真皮以及创面周围组织相互融和，但自体皮与真皮之间仍存在明显的分界线。各组创面面积保持在原先创面面积的51．8％～65．9％。结果提示自体皮在真皮上的移植时间和方式对创面收缩和愈合有影响。