膨体聚四氟乙烯覆盖创面的实验研究

目的 了解高分子材料膨体聚四氟乙烯(ePTFE)作为创面覆盖材料的可行性.方法 将45只SD大鼠背部制成全层皮肤至筋膜层损伤创面后分为:自体移植组,创面行自体皮片回植;异体移植组,以15只Wistar大鼠为供皮鼠,将皮片移植于SD大鼠创面;实验组,在创面上覆盖ePTFE.每组15只SD大鼠.肉眼观察各组大鼠创面愈合情况.于术后3、7、14 d切取各组大鼠创面组织标本行HE染色,光学显微镜下观察组织切片中巨噬细胞、Fb、淋巴细胞数量.免疫组织化学法检测γ干扰素(IFN-γ)和IL-2表达水平.结果 自体移植组、实验组大鼠创面愈合良好,未见红肿及感染征象;异体移植组大鼠术后8 d出现排斥反应,表皮有不同程度的变性坏死,创缘红肿.各时相点异体移植组镜下可见巨噬细胞、Fb、淋巴细胞数量均高于实验组和自体移植组(P＜0.01).免疫组织化学染色可见,术后7 d异体移植组IFN-γ和IL-2表达的平均灰度值分别为129±7、113.7±2.7,均明显低于自体移植组(189±6、180.3±3.7,P＜0.01)和实验组(144±8、137.3±1.9,P＜0.01).结论 ePTFE可引起较小的炎性反应及异物反应,置于受损创面上未见不良反应,可以将其作为创面覆盖材料.

Experimental study on expanded polytetrafluoroethylene as wound covering

Objective To assess the feasibility of a polymer material-expanded polytetrafluoroeth-ylene (ePTFE) as wound covering. Methods Forty-five Sprague Dawley (SD) rats inflicted with open wound on the back were divided into 3 groups, each group 15 rats. Wounds in the autograft group were cov-ered with autologous skin. Wounds in the allograft group were covered with skin from 15 Wistar rats (do-nor). Wounds in the experiment group were covered with ePTFE. Wound healing in each group was ob-served with naked eye. Tissue specimens collected on 3rd, 7th, and 14th post-operative day (POD) respec-tively were stained with HE and examined under light microscope. Macrophages, lymphocytes and fibroblasts were quantified. IL-2 and IFN-γ levels in the infiltrating mononuelear cells were assessed by immunohisto-chemistry with expression of gray value. Results Wounds in rats of autograft group and experiment group healed well without redness, swelling or infection. Rejection was evident in the allograft group rats on 8th POD, including epidermis degeneration and focal necrosis in different degree, plus red swelling on wound edge. The numbers of maerophages, fibroblasts, lymphoeytes in allograft group were significantly higher than those in autograft group and experiment group( P < 0.01 ). The average gray values of IL-2 and IFN-γ of al-lograft group on 7th POD were 129 ± 7 and 113.7 ± 2.7, which were significantly lower than those in the ex-periment group ( 144 ± 8, 137.3 ± 1.9, respectively, P < 0. 01 ) and allograft group ( 189 ± 6, 180.3± 3.7, respectively, P <0.01 ). Conclusions ePTFE will induce minimal inflammatory response and for-eign body reaction. It is unlikely to cause side effect when applied to wound surface for a prolonged period.Thus, it is suitable to use ePTFE as wound surface covering.