Neural Control of Blood Flow in Grafted Skin

描述(申请人提供)：增加皮肤血液流动对人类 适当调节运动和/或高温暴露期间的体内温度。烧伤等伤口会损害皮肤，需要移除受损组织并随后进行皮肤移植。尽管移植的皮肤可以血运重建，但目前尚不清楚这种血管床是否通过神经介导的皮肤血管扩张和收缩来控制体内温度。有证据表明烧伤/移植皮肤的温度控制受损，因为有研究发现，在热挑战期间，烧伤面积超过40%的人的直肠温度高于未烧伤的受试者。然而，在这些研究中，植皮的存在或缺失以及移植物的成熟度都没有得到控制。鉴于缺乏关于 关于皮肤移植对移植皮肤自主控制的短期和长期影响，这项建议的主要目的是检验这样一种假设，即人类中厚移植物对皮肤血流的神经控制最初是受损的，但随着移植物的成熟而恢复正常。这些目标将通过执行新的实验来评估神经控制皮肤血流，这些受试者在测试前5-9个月、26-38个月、50-62个月和72-86个月进行了中厚皮片移植。从拟议的研究中获得的信息将对理解这种外科手术的短期和长期影响是有价值的。此外，这些信息将提供一个有价值的基准，根据这些基准来评估由于新兴技术(如人造皮肤、培养皮肤、生长因子等)而产生的生理反应。可以进行比较，以确定这些技术在移植皮肤的再神经支配和血运重建方面是否对患者有益。

DESCRIPTION (provided by applicant): Increasing skin blood flow is critical for humans to appropriately regulate internal temperature during exercise and/or hyperthermic exposure. Wounds, such as burns, can damage skin, requiring removal of damaged tissue and subsequent skin grafting. Although grafted skin becomes revascularized, it remains unclear whether this vascular bed contributes to the control of internal temperature through neurally mediated cutaneous vasodilation and constriction. Evidence of impaired temperature control in burned/grafted skin has been suggested given findings that individuals with burns over 40 percent of their body have higher rectal temperatures during a thermal challenge relative to non-burned subjects. However, the presence or absence of skin grafting, as well as the maturity of the graft, was not controlled in those studies. Given the lack of information regarding the short and long term consequences of skin grafting on autonomic control of grafted skin, the primary objective of this proposal is to test the hypothesis that neural control of skin blood flow in human split-thickness grafts is initially impaired, but returns towards normal as the graft matures. These objectives will be accomplished by performing novel experiments to assess neural control of skin blood flow from subjects who had split-thickness skin grafts 5-9, 26-38, 50-62, and 72-86 months prior to testing. The information gained from the proposed studies will be valuable in understanding the short and long-term ramifications of this surgical procedure. Moreover, this information will provide a valuable benchmark from which physiological responses as a result of emerging technologies (i.e. synthetic skin, cultured skin, growth factors, etc.) could be compared, to identify if those technologies are beneficial to the patient with respect to reinnervation and revascularization of the grafted skin.