Standardized burn model using a multiparametric histologic analysis of burn depth
Standardized burn model using a multiparametric histologic analysis of burn depth
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DOI：
10.1111/j.1553-2712.2000.tb01881.x
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发表时间：
2000-01-01
影响因子：
4.4
通讯作者：
McClain, SA
中科院分区：
文献类型：
--
作者：
Singer, AJ;Berruti, L;McClain, SA
目的：烧伤深度和范围决定预后和治疗。目前对一度、二度和三度烧伤的分类是粗略的，使得研究之间的比较变得困难。作者标准化了一个可重复的烧伤模型和一个精确的组织病理学方法来描述猪的烧伤深度。方法：这是一项前瞻性、横断面干预性动物研究。用在水中预热至50 ℃、60 ℃、70 ℃、80 ℃、90 ℃或100 ℃的2.5 cm × 2.5 cm × 7.5 cm铝棒在两只麻醉家猪的剪下的侧腹皮肤上造成18组成对烧伤。施加该条10秒、20秒或30秒。在损伤后30分钟获得全层皮肤活检，用于使用苏木精和伊红染色的盲法组织病理学评价。两名皮肤病理学家进行了两组测量，并对彼此的评价设盲。用眼部切片机测量损伤深度的5个皮肤参数：胶原变色、胶原间嗜碱性物质、内皮细胞坏死、上皮细胞坏死和间充质细胞坏死。计算成对实验组的烧伤深度之间的相关性以评估模型的可靠性。计算观察者间和观察者内相关性以评估量表的可靠性。方差分析（ANOVA）用于评估温度和暴露时间对烧伤深度的关系。结果：所有五种皮肤成分的损伤深度与温度和暴露时间有关（ANOVA，p < 0.001）。两组烧伤患者的损伤深度高度一致（Pearson相关系数，范围= 0.88-0.95）。所有测量元素的观察者间和观察者内相关性都很好（范围分别为0.91-0.97和0.95-0.99）。结论：作者描述了一种简单且可重复的动物烧伤模型和用于测量烧伤深度的组织病理学量表，他们认为这将有助于未来烧伤研究的标准化和比较。
Objective: Burn depth and extent determine prognosis and therapy. The current classification into first-, second-, and third-degree burns is crude, making comparisons between studies difficult. The authors standardized a reproducible burn model and a precise histopathologic method for describing burn depth in swine. Methods: This was a prospective, cross-sectional interventional animal study. Eighteen paired sets of burns were inflicted on the clipped flank skin of two anesthetized domestic pigs with a 2.5 cm by 2.5 cm by 7.5 cm aluminum bar preheated in water to 50 degrees C, 60 degrees C, 70 degrees C, 80 degrees C, 90 degrees C, or 100 degrees C. The bar was applied for 10, 20, or 30 seconds. Full-thickness skin biopsies were obtained 30 minutes after injury for blinded histopathologic evaluation using hematoxylin and eosin staining. Two dermatopathologists made two sets of measurements and were masked to each other's evaluations. The depth of injury was measured with an ocular microtome for each of five dermal parameters: collagen discoloration, intercollagen basophilic material, endothelial cell necrosis, epithelial cell necrosis, and mesenchymal cell necrosis. The correlation between burn depths of the paired sets of experiments was calculated to assess the reliability of the model. Inter- and intraobserver correlations were calculated to assess the reliability of the scale. Analysis of variance (ANOVA) was used to assess the relation between temperature and exposure times on burn depth. Results: Depth of injury for all five dermal elements was related to temperature and exposure times (ANOVA, p < 0.001 for each). The depth of injury in the paired sets of burns was highly consistent (Pearson correlation, range = 0.88-0.95). Inter- and intraobserver correlations were excellent for all measured elements (range = 0.91-0.97 and 0.95-0.99, respectively). Conclusions: The authors describe a simple and reproducible animal burn model and histopathologic scale for measuring burn depth that they believe will facilitate standardization and comparison within future burn studies.