烫伤创面愈合后的瘢痕形成与神经支配

背景:既往研究表明神经因素在创面愈合中具有重要调控作用,但有关神经调节与创面愈合后瘢痕形成之间的关系鲜有报道。目的:观察烧伤创面愈合过程中神经支配与创面愈合质量之间的关系。方法:将30只大鼠右侧T9~L1阶段脊神经根切断,制作失神经支配皮肤模型;然后在大鼠背部右侧失神经支配皮肤区域制作直径4cm的深Ⅱ度烫伤创面,设为模型组,左侧对称正常皮肤制作同样的创面,设为对照组,伤后连续观察创面变化,于7,14,21 d采用免疫组织化学法观察Ⅰ和Ⅲ胶原分泌情况,并计算Ⅰ/Ⅲ型胶原比例的变化,探讨创面愈合速度及愈合质量。结果与结论:模型组Ⅰ,Ⅲ型胶原分泌和Ⅰ/Ⅲ型胶原比值于伤后各时间点均显著低于对照组(P<0.05)。模型组Ⅰ型胶原分泌与伤后7,14,21 d逐渐增加(P<0.05),Ⅲ型胶原于伤后21 d时分泌明显增高(P<0.05),Ⅰ/Ⅲ型胶原比值与伤后21 d时明显降低(P<0.05)。结果证实,创面早期神经支配可以促进创面愈合,创面重塑期减轻神经支配可能会改善创面重塑质量。

Effect of innervation on scar formation after burn wound healing

BACKGROUND:Previous experiments show that neural factors play important regulating roles in wound healing,however,the relationship between neural regulation and scar formation after wound healing is known little.OBJECTIVE:To observe the relationship between innervations and wound healing in the process of scalded wound healing.METHODS:Right T9-L1 stage spinal nerve roots of 30 rats were cut off and prepared for denervation skin models;and then a diameter of 4 cm and a depth ofⅡdegree scalded wound was make on the right denervated skin area of rats(model group),the same wounds were made on the left normal skin as control group.The changes of wounds were continuously observed.The secretion of type Ⅰ,Ⅲ collagens were observed by immunohistochemical method,and type Ⅰ/Ⅲ collagen ratios were calculated,the speed and quality of wound healing was explored.RESULTS AND CONCLUSION:Compared with the control group,the type I/III collagen ratio was lower in the model group(P < 0.05).Secretion of type Ⅰ collagen gradually increased in the model group at 7,14 and 21 days after injury(P < 0.05),and type III collagen was significantly increased at 21 days after injury(P < 0.05).Type Ⅰ /Ⅲcollagen ratio was significantly decreased at 21 days after injury(P < 0.05).It is revealed that early innervation of the wound may promote wound healing,and alleviating innervation on wound remodeling stage may improve the quality of wound remodeling.