摘要
目的:探讨明胶海绵-微粒粘膜移植于皮下腔隙预制粘膜衬里的可行性。方法:将口腔粘膜剪成粘膜微粒,直径<1mm。实验组以4∶1,8∶1,16∶1,的面积比例移植,分为Ⅰ组、Ⅱ组和Ⅲ组。将微粒粘膜均匀涂抹于明胶海绵上,然后移植于皮下腔隙,中间以硅胶片分开,防止间隙闭合,关闭切口,对照组不加微粒粘膜。术后1周、2周、3周行大体观察及HE染色,免疫组织化学染色。结果:术后1周可见粘膜散在存活,上皮细胞长入明胶海绵内,各组创面未完全愈合。不同组别之间愈合率有差别。术后二周可见皮下腔隙包膜表面粘膜成活。Ⅰ组、Ⅱ组创面愈合率在80%以上,Ⅰ组、Ⅱ组优于Ⅲ组(P<0.05)。Ⅰ组、Ⅱ组间差别无统计学意义。术后3周时各实验组创面愈合率均达90%以上,上皮细胞呈极性排列。术后1周时各组明胶海绵均未见明显吸收,3周时仍见部分明胶存留。各实验组在角蛋白抗体免疫组化染色均为阳性,证实为上皮组织。不同组别上皮厚度有差别。结论:微粒粘膜-明胶海绵复合移植在皮下腔隙,可以形成粘膜衬里;微粒粘膜-明胶海绵复合移植在密闭的皮下腔隙后,3周上皮质量最好;复合移植可以增加上皮的厚度,明胶海绵的支架作用可能是上皮层数增多的原因,但是明胶降解较慢,有待寻找降解速率更快的支架材料。
Objective To investigate the possibility of prefabricated mucosal liner in subdermal cavity with micro-mucosa and gelatin sponge compound graft. Methods The free buccal mucosa was cutted into particles, the diameter of which is less than 1mm, spread onto the gelatin sponge and then transplant to the subdermal cavity, the experimental group was divided into three subgroups （Group Ⅰ , Ⅱ and Ⅲ ） with area expansion ratio of autogenous micro-mucosa 4：1,8：1 and 16：1 respectively, the skin incision was closed over a silicone sheet to prevent adhesion to the underlying mucosa. The control group was only implanted silicone sheet without mucosa graft. Macroscopy and histological samples by HE and immunohistochemical staining were examined on the 7th, 14th, 21th days after the grafting. Results All the wounds were not healed completely after one week grafting, though some of the mucosa survived and its epithelial cells grew into the gelatin sponge. And the wound healing rates were different. On the 14th day after grafting, The wound healing rates of group Ⅰ and Ⅱ were more than 80% and higher than group Ⅲ （P〈0.05）. However, there＇s no obvious difference between group Ⅰ and Ⅱ .All the wound healing rates were more than 90% on the 21th day. The CK were observed with immuneohistochemistry in wound tissue specimens so as to confirm epithelial tissue among all the experimental groups. We could find stratified squamous epithelium on 21th day and the cells presented obvious polarity. The gelatin sponge was not absorbed on the 7th day. We could also find some gelatin sponge exist 3 weeks after grafting. Conclusions The oral micro-mucosa and gelatin spongy graft can survive in the subdermal cavity. The quality of compound graft is best in 3 weeks after grafting.The stratified squamous epithelium is thick,because epithelial cells grew into the gelatin sponge.
出处
《中国美容医学》
CAS
2009年第7期893-896,共4页
Chinese Journal of Aesthetic Medicine
关键词
粘膜
硅胶
明胶海绵
微粒粘膜
mucosa
silicone sheet
gelatin sponge
micro-mucosa
