外用罂粟碱抑制植皮片术后挛缩的实验研究

目的探讨外用罂粟碱霜对自体游离植皮片术后晚期挛缩的影响。方法在每头小型猪背部两侧皮肤制备10个2cm×2cm创面,从动物腹部正中取2cm×2cm的断层皮片并植于背部创面上,术后2周拆线,取同一动物身上100%成活且位置恰好左右侧相对的植皮片共12对,按左右侧分成A(罂粟碱治疗组)、B(空白霜剂对照组)2组,自拆线之日起,A组每日在植皮片表面外涂2%罂粟碱霜2次,B组仅涂抹空白对照霜剂,最后观察两组植皮片成活后1、2、3、4、5、6个月收缩率及植皮片成活后6个月时的组织学差异。结果A组植皮片收缩率较B组明显降低,两组之间差异有显著性意义(P<005)。组织切片显示A组植皮片成纤维细胞较B组明显减少,微血管数量较B组数量多,两组之间差异有显著性意义(P<005)。结论外用罂粟碱霜剂能够抑制自体游离植皮片术后挛缩,提高植皮效率。

Experimental study on inhibition of skin graft contraction with papaverine cream

OBJECTIVE: To evaluate the effect of exteral use of papaverine cream on enhancement of skin graft. METHODS: Five mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolstres. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the skrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxyline-eosin staining. The tissue structure was observed and the results were analyzed statistically. RESULTS: The grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers. CONCLUSIONS: External use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.