Natural wound formation: Endodermal responses in experimental primary neural induction in the chick embryo

Natural wound formation in experimental primary neural induction has been studied by SEM and in paraffin wax sections in embryos from 0 minutes to 10 hours of re-incubation. Stage 4 host and graft embryos were removed from hen's eggs and mounted as for New culture. Graft Hensen's nodes were transplanted into “pockets” created in the host area pellucida and re-incubated for up to 10 hours. Initially the cut edges of the graft establish contact with the host ectoderm layer. After 4 hours the cut edges of the graft move from the host ectoderm to the host endoderm layer. Several small openings form in the host endoderm over the graft tissue. By 6 hours, these openings join to form a single natural wound through which the underlying graft is exposed to the external environment. At 8 hours the graft forms a head-fold and neural folds are evident. During 8 to 10 hours of re-incubation the edges of the graft which attach to the edges of the host edoderm meet in the midline and close the opening in the host endoderm; simultaneously, the graft forms a neural tube. The endodermal wounds form by cell re-arrangement and by a minor contribution from cell loss. © 1993 Wiley-Liss, Inc.     

Re-epithelialization of the rat cornea is accelerated by blockade of opioid receptors

A native opioid peptide, [Met⁵]-enkephalin, termed opioid growth factor (OGF), serves as a constitutively expressed and autocrine produced inhibitory molecule related to developing, neoplastic, renewing, and healing tissues. The present study was designed to examine the effects of interfering with opioid–receptor interaction during re-epithelialization of the cornea in the rat using both systemic injections and topical applications of the potent opioid antagonist naltrexone (NTX). A 4 mm diameter epithelial defect was made in the center of the rat cornea. NTX injected twice daily or applied as eyedrops four times daily significantly accelerated re-epithelialization compared to controls. Beginning as early as 8 h after wounding, both the systemic and topical NTX treatment groups had defects that were approximately 10% to 67% smaller than control abrasions at the time points examined. Similarly, the rate of healing for the NTX groups was 4.7- and 2.8-fold greater than controls for systemic and topical paradigms, respectively. The incidence of complete re-epithelialization in animals given systemic administration of NTX was markedly accelerated in comparison to control rats; however, differences in incidence of repair between NTX and control groups receiving topical application were not observed. These results show that native opioid peptides function in wound healing, and exert a tonically inhibitory influence at the receptor level on repair of corneal epithelial injuries.     

Kollagen-Antikörper und ihr Einfluß auf die Wundheilung

Zusammenfassung Der Einfluß von Antiseren gegen Kollagen auf die Wundheilung wurde am Modell einer standardisierten Schnittwunde bei Ratten untersucht. Die Antiseren, die sich gegen die terminalen Determinanten des Kollagenmoleküls richteten, wurden durch Immunisierung von Kaninchen mit Ratten- bzw. Schweinehautkollagen gewonnen und intraperitoneal, d. h. systemisch appliziert. Generalisierte Immunreaktionen oder Inkompatibilitätserscheinungen wurden nicht beobachtet. Die Injektion der Antiseren am 7. postoperativen Tag führte zu einer signifikanten Steigerung der Wundfestigkeit. Dieser Effekt konnte sowohl mit homologem Antiserum (p < 0,01) als auch mit heterologem Antiserum (p < 0,04) erzielt werden. Das heterologe Antiserum erzeugte ferner einen signifikanten Abfall des freien Serumhydroxyprolin (p < 0,005). Die Applikation des heterologen Antiserum am 14. postoperativen Tag verursachte eine signifikante Abnahme der Wundfestigkeit (p < 0,006). Die Befunde werden auf kollagen-spezifische Immunreaktionen und variierende Bedingungen im Wundgebiet während der verschiedenen Wundheilungsphasen zurückgeführt.

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Antibodies to collagen and their influence on wound healing

Summary The influence of antibodies to collagen on wound healing was tested by the use of a standard incision wound in rats. The antisera —specific for the terminal determinants of the collagen molecule — were obtained from rabbits immunized with rat — or pig — skin collagen and injected intraperitoneally, i.e. systemically. Generalized immune reactions or signs of incompatibility were not observed. The injection of antisera on the 7th postoperative day led to a significant gain of tensile strength. This effect was achieved by the homologous antiserum (p < 0.01) as well as by the heterologous antiserum (p < 0.04). The heterologous antiserum further induced a significant fall of free serum hydroxyproline (p < 0.005). The application of the heterologous antiserum on the 14th postoperative day caused a significant decrease of tensile strength (p < 0.006). The results are referred to collagen-specific immune reactions and varying conditions in the wounded area during different phases of wound healing.

Auszugsweise aus der Dissertation Th. Pillukat, Köln 1984     

Experience with the skin stretching device

The skin stretching device was designed to harness the biomechanical properties of the skin in order to close large cutaneous defects by direct closure, without the need of other more complicated techniques such as skin grafts or flaps. The authors present their experience with 31 patients in whom the device was used to repair defects produced by excision of lesions of different nature, size, and body areas, six cases are presented. The main defect of the method, i.e. the increase of intraoperative time to allow for tissue stretching, should be avoidable most of the time by applying the device preoperatively under local anesthesia. The importance of not undermining during this procedure is stressed; the objective parameters to evaluate are analyzed, such as colour and tension of the skin. The complication rate was very acceptable, there was only one infection and one marginal necrosis that healed without further interventions. The described technique appears safe and easy to perform, and produces a good short-term result.     

创面愈合过程中EGF基因表达变化的研究

创面愈合是一个复杂的过程。文献中关于创面愈合过程中，上皮细胞生长因子（ｅｐｉｄｅｒｍａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＥＧＦ）基因表达变化的研究较少，为此设计了本项研究。采用Ｗｉｓｔａｒ大鼠，在脊柱两侧制作１．５ｃｍ×１．５ｃｍ中厚断层皮肤缺损创面４个，于伤后第４，８，１２和１６天取材，用地高辛标记ＥＧＦｃＤＮＡ探针原位杂交方法，观察创面愈合过程中，ＥＧＦ基因活化表达的ｍＲＮＡ在组织中的分布变化。发现：在伤口愈合的全过程中，ＥＧＦ基因均有明显表达，以伤后第８天表达最强。提示：应用某种方法促进ＥＧＦ基因表达，可能会促进伤口愈合     

增生瘢痕中转化生长因子基因的表达

目的　探讨转化生长因子 (TGF) β1和转录因子Smad 2 ,Smad 3三种基因影响增生性瘢痕形成和皮肤伤口无瘢痕愈合的调节机制。方法　 3 2份被检测标本中包括增生性瘢痕 8份 ,其自体正常皮肤组织 8份 ,胎儿和成人皮肤组织各 8份。用逆转录 多聚酶链反应方法 (RT PCR)检测上述基因在不同的组织细胞内的表达变化规律。结果　TGF β1、Smad 2和Smad 3基因在增生性瘢痕、胎儿和成人皮肤组织细胞内都有表达。在所检测 8对增生性瘢痕和其对应正常皮肤细胞中 ,这 3种不同基因在增生性瘢痕细胞中的表达量高于正常皮肤细胞的组数分别为 :TGF β1基因有 5对 ,Smad 2基因有8对 ,Smad 3基因有 5对。在胎儿皮肤细胞内 ,TGF β1的mRNA含量明显低于成人皮肤细胞 (t =2 2 0 4 ,P <0 0 5 ) ,差异有显著意义 ;Smad 3基因表达也呈相似的变化规律 ,mRNA含量显著低于成人皮肤细胞 (t=4 2 69,P <0 0 1) ,差异有非常显著意义 ;而Smad 2基因的mRNA含量却明显高于成人皮肤细胞 (t=6 685 ,P <0 0 1) ,差异亦有非常显著意义。结论　TGF β1和它的下游信号分子Smad2 ,Smad 3可能与增生性瘢痕形成密切相关。在增生性瘢痕细胞内 ,这 3种基因高表达可诱导胞外基质大量沉积 ,加速成纤维细胞增殖 ,促进组织纤维化。TGF β1和Smad 3基     

大鼠烫伤创面愈合过程中皮肤基底膜层黏连蛋白的变化

目的：研究烫伤愈合过程中层黏连蛋白(LN)的表达。方法：采用免疫组化方法在大鼠浅Ⅱ度烫伤（伤后1,3,5,7,10,14d组）、Ⅲ度烫伤切痂混合移植模型（大张异体皮移植3,5,7,14,21,28d组）上研究了愈合过程中LN的变化。结果：正常皮肤基底膜中含有LN，而创伤后表皮细胞迁移缘LN消失，愈合后表皮下LN又出现。混合移植后7d出现异体皮排异反应，表现为异体表皮细胞铲除，而异体表皮下仍可见LN阳性表达。异体皮移植后10d，从自体皮迁移来的表皮细胞下有零星LN，而异体表皮细胞被完全铲除，异体皮基底膜处LN仍基本保持完整。异体皮移植后21d，自体表皮已基本覆盖异体皮区，此时LN表达已基本完整。结论：烫伤愈合过程中LN的变化有助于创面愈合。     

体外培养创面成纤维细胞的生物学特性及其意义

目的 研究创面成纤维细胞的生物学特性有利于揭示创面愈合过程中瘢痕形成的机理。方法 采用体外成纤维细胞培养技术，开展创面成纤维细胞的分离培养，建立细胞库；细胞的生长动力学和增殖型、合成型、收缩型等表型变化；细胞因子对不同时期来源创面成纤维细胞增殖活怀、蛋白合成及其收缩功能的影响。结果 体外培养的创面成纤维细胞保持其在体内的生物学特性；春增殖、合成、收缩等表型间转化存在着一定的规律性；不同时期来源的创面成纤维细胞对细胞因子的反应性不同。结论 体外控制条件下创面成纤维细胞的生物学活动及其影响因素在细胞水平上揭示了瘢痕形成的理论基础与调控机理，为指导临床防治烧伤后瘢痕增生或／和瘢痕挛缩提供了依据。     

两侧反向Z成形筋膜皮瓣修复创面

自1990年以来,利用深筋膜层血管网的丰富血供,结合z成形术术式,设计两侧反向Z成形筋膜皮瓣修复四肢关节、小腿胫前、头面及骶尾部有深部组织裸露的创面共已21例。可以最大限度地利用邻近皮肤形成皮瓣将创面完全修复,获得了较好外形和功能效果。     

老年人营养状况对髋部骨折术后切口愈合的影响

目的探讨老年患者营养状况对髋部手术切口愈合的影响。方法2002年7月～2004年12月我院行手术治疗老年髋部骨折患者127例,男69例,女58例;年龄65～99岁,平均72.7岁;其中股骨颈骨折60例,股骨转子间骨折67例。分别于入院时测量血清白蛋白、血清转铁蛋白、总淋巴细胞计数,并计算出RaineyMcDonald营养学指数。术后切口均住院观察2周后拆线。结果31例切口愈合出现并发症。切口延迟愈合组血清转铁蛋白明显低于正常组,对预测切口延迟愈合差异有极显著性意义(P<0.01),RaineyMcDonald营养学指数对预测切口愈合有显著性意义(P<0.05)。通过预防性应用抗生素和严格无菌操作等,切口最后均甲级愈合。结论老年患者营养不良可对髋部骨折术后结果产生影响。血清转铁蛋白和RaineyMcDonald营养学指数对预测切口愈合有意义。鼓励老年髋部骨折患者术后早期活动有助于改善营养状态。