大鼠皮肤碱烧伤不同时间切痂对植皮成活率的影响

目的:探讨大鼠皮肤碱烧伤不同时间切痂对植皮成活率的影响,为临床碱烧伤创面切痂植皮提供最佳时机。方法:制做Wistar大鼠皮肤碱烧伤(Ⅲ度)模型,分别于伤后(1~96 h)9个时间段切痂,行立即植皮(A组)和延迟48 h植皮(B组),测定痂下创面pH,并观察组织学变化和植皮成活率。结果:大鼠皮肤碱烧伤不同时间切痂组织结构破坏程度大致相同,痂下pH呈碱性,组织为进行性损害,但两组植皮成活率有明显不同,A组早期(1~8 h)植皮成活率大于中期(12~48 h)和晚期(72~96 h),以中期最差;B组早期植皮成活率小于中期和晚期,以早期最差。结论:早期切痂植皮可避免碱性物质和中性粒细胞对组织的继续损害,植皮效果好;而早期切痂延迟植皮也可供选择。

The effect of scab excision time on the livability of dermal grafting for the alkali burns of rats

Objective: In order to give the theoretical basis for the best scab excision and dermal grafting time of alkaline burns clinically, we explore the effect of scab excision time on the livability of dermal grafting for the alkali burns of rats experimentally.Methods: Wistar rats models of skin alkaline burn (third degree) were established. We excised scab at 9 time points (1～96h after burns) respectively. Dermal grafting was done immediately (A group) and 48 hours later (B group). Histological changes and dermal graft livability were observed. The pH values under the scab were measured.Results: The histological traumatic extent of scab were almost the same at different times after burns. The pH values under the scab were alkaline. The trauma was progressive, but the livability of dermal grafting was different obviously for group A and B. In group A, the livability of dermal grafting was higher when done early (1～8 h) than done at medium (12～48 h) and terminal (72～96 h) stages, the successful rate was lowest in medium stage group. In group B, the livability of dermal grafting was lower when done early (1～8 h) than done at medium (12～48 h) and terminal (72～96 h) stages, the successful rate was lowest in early stage group.Conclusion: The effect was better at early stages of scab excision and dermal grafting, because it could avoid the continued damage of alkali and neutrophic cells to tissues. But early scab excision and delayed dermal grafting could also be choosed.