Dermal substitutes for full-thickness wounds in a one-stage grafting model
Dermal substitutes for full-thickness wounds in a one-stage grafting model
复制标题
DOI：
10.1046/j.1524-475x.1993.10410.x
复制
发表时间：
1993-01-01
影响因子：
2.9
通讯作者：
Westerhof, Wiete
中科院分区：
文献类型：
--
作者：
De Vries, Henry J. C.;Mekkes, Jan R.;Westerhof, Wiete
我们在猪伤口模型中测试了不同的可生物降解基质材料作为真皮替代物。基质用裂皮网状移植物覆盖，并用微孔半透膜保护，该膜可防止水疱形成、伤口感染并提供最终愈合条件。评价参数如下：上皮形成、真皮重建、伤口收缩以及美容和功能方面。非变性胶原蛋白的微纤维基质得到了最好的结果，立即成纤维细胞向内生长和表皮生长。观察到轻微的炎症反应和极轻微的伤口收缩。与这种胶原蛋白基质结合使用的裂皮网状移植物的应用产生了比直接应用于伤口床上的裂皮网状移植物更厚的真皮层。然而，组织学真皮结构不如全层打孔移植法获得的最佳。其他基质引起炎症反应，干扰上皮形成和真皮重建。我们的结论是，非变性胶原蛋白基质，结合裂皮网状移植物，可以提供一个替代真皮在全层伤口。这种组合优于直接应用于创面的裂皮网状移植物。使用我们的微孔半透膜，真皮替代物和皮肤网状移植物的联合使用可以在单阶段手术中应用。
We tested different biodegradable matrix materials as dermal substitutes in a porcine wound model. Matrixes were covered with a split-skin mesh graft and protected with a microporous, semipermeable membrane, which prevents blister formation, wound infection and provides ultimate healing conditions. Evaluation parameters were as follows: epithelization, dermal reconstitution, wound contraction, and cosmetic and functional aspect. A microfibrillar matrix of nondenatured collagen gave the best result, with immediate fibroblast ingrowth and epidermal outgrowth. Slight inflammatory reaction and minimal wound contraction were observed. Application of a split-skin mesh graft, in combination with this collagen matrix, generated a thicker dermal layer than did a split-skin mesh graft directly applied on a wound bed. However, the histologic dermal architecture was less optimal than one obtained with a full-thickness punch graft method. Other matrixes caused inflammatory reactions, interfering with epithelization and dermal reconstitution. We conclude that a nondenatured collagen matrix, in combination with a split-skin mesh graft, can provide a substitute dermis in a full-thickness wound. This combination is preferable to a split-skin mesh graft directly applied on the wound bed. With our microporous semipermeable membrane, the combined use of a dermal substitute and a split-skin mesh graft can be applied in a single-stage operation.