带蒂筋膜瓣促非细胞型组织工程化骨血管化及其成骨的组织学变化****

背景：目前关于带蒂筋膜瓣促组织工程骨成骨是否以早期促血管化为核心的成骨修复方式的对比研究还缺少相关报道。 目的：通过带蒂筋膜瓣在修复骨缺损各时间段中促非细胞型组织工程化骨血管化及其对成骨作用影响组织学观察,论证带蒂筋膜瓣具有较好的促血管化作用及促成骨能力。 方法：制作兔尺骨长段骨-骨膜完全缺损模型及带蒂筋膜瓣,随机分为单纯植入组、无蒂膜瓣包裹组、血管内皮生长因子组、膜瓣包裹组4组,分别于骨缺损处植入相应材料。 结果与结论：组织学显示,在各时间点无论新生血管数量,还是新生骨小梁质与量,膜瓣包裹组均明显优其他3组。血管再生面积和新生骨小梁面积测定显示,第4周血管内皮生长因子组、膜瓣包裹组明显多于单纯植入组、无蒂膜瓣包裹组        (P < 0.05);植入后第8,12,16周膜瓣包裹组骨修复区血管再生面积及对应的再生骨小梁面积明显多于其他3组(P < 0.05)。提示带蒂筋膜瓣具有显著促非细胞型组织工程化骨血管化作用,血管化增强有利于成骨作用,且可有效提高成骨质和量、缩短骨修复时间。 

Histological changes of vascularization and osteogenesis in the non-cell based tissue engineered bone promoted by the pedicle fascia flap

BACKGROUND: The pedicle fascia flap promotes the osteogenesis of tissue engineered bone. However, it is rarely reported that weather the promotion effect is achieved through the osteogenic repair process with vascularization-centric in the early stage. OBJECTIVE: To demonstrate that pedicle fascial flap has a good vascularization effect and can promote osteogenesis by observing the effects of pedicle fascial flap on the vascularization and osteogenesis at different stages of bone defect repair in non-cell based tissue engineered bone. METHODS: Full-defect rabbit models of ulna long segment bone-periosteum and pedicle fascial flap were constructed and divided into four groups: implantation group, fascia flap without pedicle group, vascular endothelial growth factor group and pedicle fascia flap group. The corresponding materials were implanted into the bone defects.. RESULTS AND CONCLUSION: According to histological observation, the pedicle fascia flap group was superior to the implantation group, fascia flap without pedicle group and vascular endothelial growth factor group not only in the quantity of the new vessels but also in the quantity and quality of the new bone trabeculae at each time point. Vascular regeneration area and new bone trabeculae area of the vascular endothelial growth factor group and pedicle fascia flap group was significantly larger than those of the implantation group and fascia flap without pedicle group in the 4th week after implantation (P < 0.05); the vascular regeneration area and the area of the corresponding new bone trabeculaes in the pedicle fascia flap group was significantly larger than those of the other three groups (P < 0.05). These findings illustrate that pedicle fascia flap has a significant promote effect on the vascularization of the non-cell based tissue engineered bone; the enhanced vascularization is helpful to the osteogenesis, it can effectively improve the quantity and quality of the regenerated bone and shorten the bone repair time.