摘要
目的观察对比肢体正常皮肤与脱细胞异体真皮加自体刃厚头皮复合皮移植术后中远期病理及电镜结构,为复合皮移植远期疗效提供组织学依据。方法收集2003年3月～2006年8月17例行四肢挛缩瘢痕切除,缺损皮肤创面采用脱细胞异体真皮加自体刃厚头皮复合皮移植修复术后9月～2年的组织标本。取复合皮组织标本23份为观察组,并取患者临近正常皮肤组织标本23份为对照组,分别进行HE染色及扫描电镜观察,观察表皮细胞层数、基底膜厚度、真皮结构成分、成纤维细胞及血管计数等。结果HE染色:复合皮组织结构完整,具备正常表皮及真皮各种结构成分,基底膜再生完整。复合皮及正常皮肤的表皮细胞层数分别为16.33±5.89和26.57±3.46(P=0.007);基底膜厚度(μm)分别为1.05±0.21和1.13±0.17(P=0.168)。扫描电镜观察:复合皮半桥粒、成纤维细胞及再生毛细血管计数与正常皮肤组织十分接近,分别为6.33±2.31和6.79±1.57(P=0.127),7.59±2.06和8.02±2.85(P=0.067),以及14.03±2.60和13.34±3.52(P=0.369)。结论肢体复合皮移植后中远期组织结构接近正常皮肤,移植效果满意。
Objective To observe mid- and long-term changes in the histopathology and electron microscopic characteristics of the acellular dermal matrix engrafted with thin split-thickness skin autograft. Methods Twenty-three biopsy samples were collected from 17 patients undergoing extremity scar resection, who received subsequent .grafting using allogenic dermal matrix dressed with thin split-thickness skin autografts. Six months to 2 years after the grafting, the grafts were sampled for histopathological and electron microscopic observations of the layer of the epidermis, thickness of the basal membrane, structural components of the dermis, and infiltration of fibroblasts and revascularization. The data were compared with those of the normal skin samples from the patients. Results Only the number of epidermal layers showed statistically significant difference between the skin grafts and the normal skin （16.33±5.89 vs 26.57±3.46, P=-0.007）. The thickness of the basal membrane of the skin grafts was similar to that of normal skin, and no significant difference was fotmd in the number of fibroblasts and newly generated capillaries between them. Conclusion The mid- and long-term histopathology and ultrastructures of the composite skin graft in the extremities are similar to those of normal skin, suggesting satisfactory effect of the skin grafts.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2008年第11期2041-2043,共3页
Journal of Southern Medical University
关键词
四肢
复合皮
皮肤移植
组织结构
extremities
composite skin grafts
skin transplantation
histological characteristics
