Résumé
Objective:To investigate the clinical effect of facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix.Methods:Nineteen facial depression patients (3 males and 16 females), age ranges from 16 to 56 years (average age: 29.1±10.37 years), caused by different reasons were selected in this research from Jan. 2008 to Dec. 2020. In the stage I operation, anterolateral thigh adipofascial flap was designed according to facial depression area and harvested to fill in the depression with vascular anastomosis; In the stage II operation, the human acellular dermal matrix was used to fill in the remained depression edge according to facial subunit.Results:All free anterolateral thigh adipofascial flap survived well. All patients revealed fascial subunit tissue atrophy of different degree in infraorbital, nasolabial sulcus and temporal areas which were repaired by using cellular dermal matrix and obtained satisfying effect during 1 to 8 years of follow-up with no obvious rejection. 18 of 19 patients showed flap hypertrophy and corrected by liposuction. All patients recovered well after 1 to 8 years of follow-up.Conclusions:Humana cellular dermal matrix could make up the limitations of treating fascial depression deformity when using anterolateral thigh adipofascial flap. The combination method of above approaches could obtain satisfying clinical effect, which is worthy of clinical promotion.
Résumé
Objective • To investigate the changes of skin mechanical properties after deep second-degree burn, and study the feasibility of composite transplantation by using denatured dermal acellular matrix. Methods • The deep second-degree burn models in SD rats were constructed, and then the full skins were harvested after 3 h and 3 d, respectively, to compare the skin modulus of elasticity and ultimate load with normal skins. In addition, the structural differences of the dermal matrix were also compared. The composite transplantations were conducted by using the normal or denatured dermal acellular matrix, and then the general and histological structures of living skin grafts were observed. Results • The moduli of elasticity of the normal skins and the skins 3 h and 3 d after burn in SD rats were (8.7±6.4) MPa, (7.2±2.7) MPa and (2.7±0.3) MPa, respectively. The ultimate loads were (107.1±41.7) N, (81.5±10.8) N and (42.2±7.0) N, respectively. Both indexes were significantly reduced in the skins 3 d after burn compared to the normal ones (P<0.05). In the acellular matrix of denatured dermis 3 h after burn, the pore structure was still similar to that of normal one, and the appearance and histological structure after healing from composite transplantation were similar to those of the control group. Conclusion • The early denatured skin tissue after deep second-degree burn maintains the similar mechanical properties and histological structure to the normal skin, which is a potential source of acellular dermal matrix for composite transplantation.
Résumé
Objective To compare the difference of wound healing quality of composite skin grafting consisting of xenogeneic (porcine) acellular dermal matrix (PADM) combined with micro-autograft or split-thickness autograft of skin. Methods Seventy-two Sprague-Dawley rats with full-thickness skin defect on the back were randomly divided into three groups,namely test group I with PADM with split-thickness autologous skin,test group II with HADM with autologous micro- skin and allogeneic skin graft,and control group with autologous micro-skin with allogeneic skin graft to cover the skin defect area respectively. The take rate and the condition of wound healing,and also the rates of wound contraction were calculated. Tissue samples were harvested for histological examination. Results The wound contraction was less in test group I and II than that in control group( P
Résumé
Objective To investigate the influence of composite transplantation of two kinds of acellular xeno-dermis (pigskin) and micro-autograft on wound healing. Methods Seventy-two Sprague-Dawley rats with full-thickness skin defect on the back were randomly divided into three groups, and then compositt skin I(acellular dermal xeno-matrix+autologous particulate skin +selective acellular xeno-dermis) was adopted to cover the skin defect in the experimental group I, composite skin II(acellular dermal xeno-matrix+autologous particulate skin + glutaraldehyde xeno-skin) was adopted to cover the skin defect in the experimental group II, and auto-particulate skin was adopted in the control group. The area of wound healing and the rates of wound contraction were calculated.Tissue samples were harvested and examined by means of histology, immunohistochemistry and electron microscopy. Results There were continuous epidermis and basement membrane, and the dermal matrix was a kind of matrix with normal structure and organization of collagen and without any cellular components in selective acellular xeno-dermis. There was full differentiation of epithelium, orderly collagen arrange and basal membrane of the skin could be identified by immunohistochemical stain in compound skin grafting group I. The healing effect of compound skin grafting group I was better than compound skin grafting group II and auto-particulate skin grafting group. Conclusion The composite grafts constructed by selective acellular xeno-dermis (pigskin) could be a potential new type of composite skin substitute for the repair of full-thickness skin defect.