不同材料人工真皮支架修复猪Ⅲ度烧伤创面比较

目的 比较胶原壳聚糖真皮支架、胶原磺化羧甲基壳聚糖真皮支架及脱细胞基质真皮支架移植于Ⅲ度烧伤创面后,真皮支架的血管化及支架上表皮移植修复创面情况.方法 将3种不同真皮支架各移植于6头猪(共18头猪)Ⅲ度烧伤清创后创面,在植入后1、2、3周对真皮支架血管化、创面、支架上表皮移植愈合和修复情况进行观察,同时用免疫组织化学方法,对CD34阳性信号(新生血管数目)进行检测.以无支架植入的Ⅲ度烧伤清创后创面为对照.结果 胶原磺化羧甲基壳聚糖真皮支架植入后2周支架血管化已基本完成,而胶原壳聚糖和脱细胞基质真皮支架至少需要3周.3种不同材料支架垂直于创面的新生微血管均比无支架对照创面多;不同材料支架组与对照组2周创面比1周创面、3周创面比2周创面CD34的表达均明显增多,胶原磺化羧甲基壳聚糖真皮支架组植入后1、2、3周CD34阳性信号均明显高于相对应的其他3组;胶原磺化羧甲基壳聚糖真皮支架植入后1周,创面植表皮,移植表皮存活良好,而胶原壳聚糖和脱细胞基质真皮支架植入需要2周,其表面移植的表皮细胞才能成活.结论 3种材料的支架均可修复Ⅲ度烧伤创面,而以胶原磺化羧甲基壳聚糖真皮支架的血管化程度最好.

Comparative study on repair of full-thickness burn wound with different artificial dermal stent in pigs

Objective To compare differences of angiogenesis among collagen- chitosan, collagensulfonated carboxymethyl chitosan porous scaffolds and acellular dermal matrix after these three different scaffolds with silicone membrane were transplanted on the wounds of full thickness burn, and the wound repair of different scaffolds with epidermis grafting on. Methods Angiogenesis in different dermal scaffolds, the wound surface and epidermis survival were observed in 1, 2, and 3 weeks after the three different scaffolds were respectively transplanted on wounds of full thickness burn with debriment in 6 Bama miniature pigs (total 18 pigs in 3 groups). At the same time, CD34 positive signals (neo-forming microvessels)were detected by immunohistochemical staining. The wounds without any scaffold transplantation were studied as the control. Results Angiogenesis had been fundamentally finished in 2 weeks after implantation of collagen- sulfonated carboxymethyl chitosan porous scaffold. And fundamental angiogenesis in collagen- chitosan porous scaffolds and acellular dermal matrix needed at least 3 weeks. Neo-forming micro-vessels perpendicular to wound beds with these three different scaffolds were more than those in the control wounds without scaffold. CD34 positive signals (neo-forming micro-vessels)were significantly higher in wounds at the second week than those in wounds at the first week. And those in wounds at the third week were significantly higher than those in wounds at the second week in all wounds with differentscaffold transplantations and the control wounds. CD34 positive signals in the group of sulfonated carboxymethyl chitosan porous scaffold on the 1st, 2nd and 3rd week after the scaffold transplantation were significantly higher than those corresponding signals in the other three groups. Epidermis on the sulfonated carboxymethyl chitosan porous scaffold which had been transplanted on burn wound for 1 week could survive perfectly, however, epidermis on the collagen- chitosan porous scaffold or acellular dermal matrix could not survive until these two scaffolds had been transplanted on the burn wounds for at least 2 weeks.Conclusions These three different scaffolds could repair the full thickness skin defects caused by burn, and angiogenesis of sulfonated carboxymethyl chitosan porous scaffold is the best.