局部纤维连接蛋白对大鼠III度烫伤创面愈合作用的研究

目的　研究混合皮肤移植对促进Ⅲ度烫伤皮肤愈合的机制。方法　在大鼠Ⅲ度烫伤及烫伤后切痂移植异体皮打洞嵌植自体皮片 (混合移植 )的模型上比较单纯Ⅲ度烫伤创面与混合移植后 3 ,5 ,7,14 ,2 1和 2 8天自体皮区、异体皮区皮肤 (包括部分皮下组织 )中纤维连接蛋白 (FN)含量的变化。结果　单纯Ⅲ度烫伤大鼠创面炎性反应明显 ,伤后 2 8天仍未愈合 ,混合移植异体皮出现排异现象 ;自体皮生长良好 ,植皮后 2 8天自体表皮相连。相应的未进行切痂混合移植的大鼠烫伤创面FN在烫伤后 17天才达到最高峰 ,混合移植异体皮区的FN在植皮后 3天即升高 ,第 7天为最高 ,第 14天降低 ,而自体皮区FN在移植后 2天即已达到最高峰。混合移植早期 ,自体皮区FN含量均高于异体皮区和烧伤创面。结论　自体皮片比异体皮片更易与创面粘连 ,建立血供 ,上皮更易扩展 ,从而有利于创面愈合。

Effect of Fibronectin on Wound Healing after Auto-and Allo-skin Intermingled Transplantation in Extensive Full Thickness Burn

Objective To study the mechanism of wound healing. Methods The fibronectin (FN) contents and morphological changes were observed in auto- and allo-skin intermingled transplantation ( a large sheet of allograft inlaid with small stamps of autoskin) in experimental extensive full-thickness burned rats on days 3, 5, 7, 14, 21, and 28 postoperatively. Results In alloskin areas of intermingled skin transplantation, the contents of FN increased on 3rd day after operation and reached the peak on the 7th day, whereas it reached the peak on the 2nd day in autoskin areas and on the 17th day in nontransplanted 3rd degree burn wound (NTW). The contents of FN in autograft were higher than those in alloskin and NTW at each time point in the early period. In pathological studies, we observed that the autoskin grew well, the alloskin rejected and NTW inflamed and even unhealed 28 days after burn. Conclusions The difference of FN contents among the areas of autoskin, alloskin and NTW may be one of the causes that autoskin is superior to alloskin in graft adhesion, epithelial cell extension and vascular network construction etc., which is essential to burn wound healing.