伤后24h内削痂对深二度烧伤创面生长因子释放的影响

目的 探讨伤后24 h内削痂手术对深二度烧伤创面局部表皮生长因子(EGF)、碱性成纤维细胞生长因子(bFGF)和血小板衍生生长因子(PDGF)释放的影响。方法 12例深二度烧伤患者,伤后24 h内实施削痂手术。削痂术前先切取手术前实验区组织标本。术中部分创面保留不予手术,作为未手术实验区。伤后5～7 d行再次手术,分别切取经削痂处理和未手术区的创面组织,作为手术后和未手术实验区标本。分别检测创面组织释放生长因子EGF、FGF-2和PDGF-AB的含量,并进行组织学观察和新生肉芽形成半定量分析。结果 削痂手术创面组织局部释放EGF、FGF-2和PDGF-AB的水平较手术前和未手术创面有显著升高(P<0.05);组织形态学观察显示,削痂手术后创面新鲜肉芽组织形成较手术前和未手术创面显著(P<0.05)。结论 伤后24 h内削痂手术可以促进局部创面组织释放EGF、FGF-2和PDGF-AB,促进新生肉芽形成,有利于深二度烧伤创面愈合。

Effects of tangential excision on local cytokine release in deep partial thickness burn wound within 24 hours post-injury

Objective To evaluate the local EGF,bFGF and PDGF-AB release on deep partial thickness burn wound after tangential excision within 24 h post-injury. Methods Twelve patients with deep partial thickness burn were enrolled in our study. The tangential excision was performed within 24 h post-burn. The wound was divided into three areas: the pre-operation area, post-operation area and non-operation area. For each patient, the samples from the pre-operation area were collected before the tangential excision and those from post-operation and non- operation area were obtained 5-7 d post-burn. The samples were cultured and histopathologically examined,as well as the levels of EGF.FGF-2 and PDGF-AB release were detected. Results The results showed that compared with pre-operation and non-operation area, the level of EGF.FGF-2 and PDGF-AB released by local wound tissue was significantly increased in the post- operation area, while fresh granulation tissue formation became more by histopathological examination. Conclusion This study demonstrated that the release of EGF,FGF-2 and PDGF-AB from wound tissue could be enhanced by tangential excision within 24 hours, and thus would promote the healing process in deep partial thickness burn.