烧伤变性真皮基质组织工程化改造和临床再利用

背景：大面积烧伤患者切痂术后丢弃的变性皮肤是否可再利用称为目前研究的热点。目的：通过（保留）变性真皮（基质）基础研究和临床应用进展,探讨烧伤变性真皮基质组织工程化改造和临床再利用的可行性。方法：应用计算机检索PubMed数据库、Medline database和中国期刊全文数据库（1970/2011-01）,选择文章所述内容需与烧伤变性真皮基质的获取、性质、重塑、应用、评价等方面密切相关的25篇文献,排除重复性研究文献。结果与结论：保留变性真皮治疗大面积烧伤在临床上取得较为满意的疗效;相关基础研究显示真皮细胞外基质含有功能性基质隐匿性肽,烧伤变性真皮基质及其降解物是细胞蛋白（激）酶作用的良好底物,具有细胞趋化活性。这些结果表明,烧伤变性真皮基质及其降解产物不是临床再生利用的障碍,通过体外合理改造若能成功应用于临床必将明显缓解烧伤治疗中自体皮源不足,提高复合皮移植效果和降低医疗费用。

Tissue engineering of post-burn denatured dermal matrix and clinical salvage

BACKGROUND：The dermal substitute used in composite grafting for deep burn patients can reduce the injury of donor site and improve the utilization of autologous skin and the effect of transplantation.But the treatment costs high and biological activity is limited.It is a pity that the denatured dermis which was discarded after escharectomy can not be recycled.OBJECTIVE：Through the basic research and clinical application of denatured dermis（matrix）,we studied the feasibility of denatured dermal matrix（DDM） reconstruction by tissue engineering and clinical salvage.METHODS：A computer-based online search was performed for documents on CNKI,PubMed and Medline database from 1970 to 2011.Repetitive papers were excluded.RESULTS AND CONCLUSION：The satisfactory effect was obtained for recovery of deep burn with the preservation of denatured dermis in the clinic;these results indicate that DDM is not an obstacle to the clinical recycling.The related basic researches show that dermis extracellular matrix contains functional matricryptic peptides and DDM（degradation） is the good substrate of cell protein kinase,which possesses cell chemotactic activity.If the denatured dermal matrix reconstituted in vitro is used successfully,it will help relieve the lack of autologous skin greatly,improve the effect of composite skin transplantation and reduce medical costs.