Empirical study of autogenous dermal grafts in the prevention of epidoral fiSrosis and adhesions / 中华骨科杂志

ABSTRACT

Objective To investigate the ability of auto-dermis grafts in the prevention of epidural fibrosis and adhesions, and provide reference for clinical application. Methods Five Tibet mini-pigs were used and laminectomy was performed in lumbar 2 and 4 segment. Dura was exposed and covered with auto-genous dermis grafts in lumbar 2 (the experimental group), without grafts in lumbar 4 (the autogeoous blank group). The specimens were observed grossly and histologically at 2, 4, 6, 8 and 10 weeks postoperatively. Epidural scar amount and adhere range was evaluated by modified Robertson scoring method and analyzed by SPSS 13.0. No sear and adhesion, 0 point; small amount scar and light-range adhesion, 1 point; medium sear and midrange adhesion, 2 pionts; bulk scar ang high-range adhesion, 3 pionts. Results All grafted dermis survived and thicken obviously than dermis in body surface (P< 0.05). Hair growth, sebaceous gland cyst and sweat cystogenesis were not observed. A larvaceous dissection abruption plane, little cicatricial tis-sue and adhesions rarefaction between dermis and dura were observed in the experimental group. Massive ei-catricial tissue from erector spinae filled in cavitas epiduralis was observed and dura was separated difficult-ly from cicatricial tissue in the autogeous blank group. Epidural scar amount and adhesion range in the ex-perimental group was significantly lower than the blank group (P< 0.05). Conclusion Dermis is a kind of favourable biomaterial with restraining cicatrisation and isolation barrier. Autogenous dermis grafts has the best effect on preventing peridural cicatrisation and adhesion after laminectomy.