自体微皮和自体上皮异体真皮混合皮浆移植修复大面积三度烧伤

目的探讨自体微粒皮和自体上皮移植方法，自体真皮混合皮浆移植术的临床应用价值缩短住院日的技术。方法105例烧伤总面积90％，三度面积70％以上烧伤患者，男89例，女16例，年龄17—52岁，平均28岁，其中86例伤后18—121h，施行了微皮移植术，19例施行了自体上皮，自、异体真皮混合皮浆移植术。从自体微皮的制备（手工和机械化）：微皮漂浮法，喷洒法和自体上皮，异体真皮皮浆3：1—5：1混合大张自体皮移植到切削的创面上，对创面愈合日、治愈率、创面瘢痕转归等进行分析。结果本组烧伤总面秽三度面积（总／三度Y±SEM）（88．2±10．5）／（76．5±8．4）。77例救治成功，平均切仰面积（58．6±32）％。供皮区面积平均（52±0．4）％。创面愈合平均（48．6±1．5）d。伤后半年到2年随访，示半年到1年，病人创面痛痒重，在关节活动部位常出现小破溃，经换药或微皮移植治愈。伤后2年，痛痒消失，功能改进。结论（1）微皮漂浮法和喷洒法以及皮浆移植是治疗大面积全层皮肤烧伤的较好方法，可扩展12—20倍；（2）碎皮机制备微皮省时省力；（3）该方法简单，容易掌握，随取随植，可缩短疗程、减少并发症、节约费用；（4）痊愈后要保护愈合后的创面，随访二年功能改善明显。     

微粒皮移植治疗大面积文身

目的：本研究的目的在于提高文身治疗的质量。方法：在削除文身皮肤、去除文身的痕迹后,将其制成约０．１～０．２ｍｍ＾３微粒皮浆,回植于创面上。结果：治疗３６例病人,显示：微粒皮生长良好,扩展迅速,创面愈合加快。随访２８例３～６个月表明,皮肤颜色、质地均匀一致、继发瘢痕轻、无明显增生瘢痕及色素沉着。结论：微粒皮回植促进了创面愈合,提高了文身治疗的效果。     

创疡再生医疗技术联合微粒皮种植治疗糖尿病患者坏死性筋膜炎疗效分析

【摘要】 目的 分析探讨创疡再生医疗技术联合微粒皮种植治疗糖尿病患者坏死性筋膜炎的临床效果。方法 给予2018年1月至2019年12月北京市丰台区中医医院收治的12例合并有糖尿病的坏死性筋膜炎患者在全身综合治疗的基础上采用创疡再生医疗技术联合微粒皮种植治疗局部创面, 观察创面愈合情况。结果 12例患者中除1例患者因合并肺部感染死亡, 1例患者因合并气性坏疽、脓毒血症、多器官功能衰竭死亡外,其余10例患者创面均完全愈合, 愈合时间为 (100.33±22.26) d。治疗结束后1年随访, 10例患者愈后创面均未复发。结论 创疡再生医疗技术联合微粒皮种植能有效促进糖尿病患者坏死性筋膜炎创面愈合,疗效满意。     

微粒皮种植对糖尿病足创面组织中AGEs、RAGE表达水平的影响

目的观察微粒皮种植治疗糖尿病足过程中创面组织中晚期糖基化终末产物(advanced glycation end products, AGEs)及晚期糖基化终末产物受体(receptor of advanced glycation end products, RAGE)的变化规律,进而探讨微粒皮种植对糖尿病足创面组织中AGEs及RAGE表达水平的影响。方法对2016年1月至2018年1月广州医科大学附属第五医院皮肤科及南方医科大学皮肤病医院皮肤外科收治的21例Wagner3～4级糖尿病足患者进行微粒皮种植治疗,分别于治疗前及治疗第7、14天测量创面面积并取创面组织进行酶联免疫吸附检测,对比观察各时间点创面组织中AGEs及RAGE的含量。结果 (1)治疗60 d后,18例患者创面完全愈合、3例患者创面明显缩小。(2)治疗过程中,21例患者创面组织中AGEs及RAGE的含量均呈逐渐下降的趋势,其中各时间点创面组织中AGEs的含量对比,P均0.01,差异具有统计学意义;RAGE的含量对比,除治疗前与治疗第7天对比,P0. 05,差异无统计学意义外,其余各时间点对比,P均0.01,差异具有统计学意义。结论微粒皮种植治疗可能能够降低糖尿病足患者创面组织中AGEs、RAGE的表达水平,促进创面愈合。     

Investigating human microskin grafting technique in a new experimental model

Background

. Microskin graft technique is a possible solution for treating major burns. The goal of this study was to investigate microskin graft techniques using a new model of grafting human skin onto athymic nude mice.

Materials and methods

Twenty female nude mice were randomly divided into a research group and a control group (14 mice in the research group, six in the control group). On the 11th day after the procedure, the following parameters were investigated: percentage of epithelial coverage, degree of contracture, thickness of the epidermis, thickness of the dermis, number of blood vessels, number of melanocytes.

Results

The healing rate (epithelial coverage) of the wounds was an average of 100% (±0%) in the control group and 97% (±5%) in the research group (P > 0.05). The average degree of wound contraction in the control group was 30% compared to 63% in the research group (P < 0.01). The average thickness of the epidermis formed at the grafted site was 8.17 (±1.94)μm in the control group compared to 4.45 (±4.17)μm in the research group, at the wound margins (P > 0.05).

Conclusion

We found that the microskin graft, created by grinding a sheet of human skin, remained vital, and tissue of human origin was present at the grafted site. Our study shows that this novel method is feasible and has the advantage of enabling investigation of human skin on an animal model. Significant contracture appears to be a drawback of this technique, and we feel that the method should be improved before its clinical application on patients.