皮肤伸展术后生物力学及组织学实验探究.docVIP

皮肤伸展术后生物力学及组织学实验探究周黎安　李　谆　郭树忠　艾玉峰　查元坤　鲁开化　高　岚 (1解放军451医院整形外科　西安710054　2.第四军医大学西京医院整形外科中心　西安710032) [摘　要]　目的:观察皮肤伸展作用后生物力学特性和组织学的改变。方法:取4只体重20 kg左右的猪为实验动物,采用自身对照方式进行,对伸展作用侧及对照侧皮肤标本分别进行拉伸断裂强度、拉伸断裂伸长百分率、皮肤本构关系等生物力学指标的测定及组织学的检查。结果:伸展皮肤的粘弹性下降。组织学观察可见伸展后表皮细胞层次增多,真皮层稍变薄。结论:皮肤伸展作用后,其生物力学性质及组织学均有明显变化。临床上可采用皮肤伸展术,以缩短疗程,提高疗效。 [关键词]　皮肤伸展术　生物力学特性　组织学检查 [中图分类号]R622　[文献标识码]A　[文章编号]1008-6455(2000)09-0244-03 BIOMECHANICAL AND HISTOMORPHOLOGICAL CHANGES IN STRETCHED PIG SKIN ZHOU Li-an　LI Zhun　GUO Shu-zhong et al Depart.Plastic surgery,451 Hospital,(Xian　710054) [Abstract]　Objective:The study was designed to observe the biomechanical and histomorphological changes in stretched pig skin.Methods:On 4 pigs.stretched skin was compared with non-stretched control skin from the opposite side of the animal,using a paired t-test.The biomechanical and histomorphological properties were determined in stretched and non-stretched control skin.By using tensometer,the sin was evaluated for stress strain and parameters of strength.Result:The biomechanical properties of the stretched skin were different from the control skin.Histomorphological examination revealed that the epidermis layer increase.There was thinning of dermis,the dermal collagen bundles were thicker than those of controle.Conclusion:We concluded that the biomechanical properties and histomorphological changes were different from that of the unstretched skin.It was shown that the skin stretching technique might be accepted in the practice. [Key words]　Skin stretching technique　Biomechanical property　Histomorphological examination 皮肤伸展术始于1976年,Barrer[1]等采用了固位桥装置用于关闭伤口,它是通过施加于皮缘的直接外力,线性牵引创面两侧的皮肤组织,使之产生皮肤增量,达到关闭创面的目的,作者对此已进行部分临床及实验研究[2-7],该方法近年来在国外受到普遍关注,认为是一种”有把握的关闭”(Sure-closure)[4]方法。但也有学者提醒使用该方法应防止用力过大造成真皮纤维的断裂等并发症[8]。 因此皮肤伸展术中的安全性仍是人们关心的问题,真皮决定着皮肤的生物力学性质,反之生物力学的变化也反映真皮的结构特征[9]。 本研究对伸展作用后的皮肤及对侧正常皮肤进行了生物力学特性的对比测试并观察了相应的组织形态学变化。 1　材料与方法 1.1　实验动物　选取4只体重20kg左右白色乳猪(第四军医大学实验动物中心提供),雌雄不限,3%戊巴比妥钠(美国S