Objective To explore the expression of the vascular cell adhesion molecule 1 (VCAM1) in the acellular dermal matrix grafting in pigs. Methods Experimental models were established with 15 Inbred Strain mini pigs, 6 full-thichness skin defect wounds, 6 cm × 6 cm in size, were produced on both-side backs of the each pig, and then the pigs were randomly divided into 3 groups. In Group A (n=5, control) the thin auto-skintransplantation alone was made; in Group B (n=5), the grafting was performed in the acellular allo-dermal matrix combined with the thin auto-skins; in Group C (n=5), the grafting was performed in the acellular xeno-dermal matrixcombined with the thin auto-skins. The areas of the wounds were measured and the survival condition of the grafted skins was observed at 3, 9, 21 and 30 days after the grafting. The histological samples were harvested from the grafting area at 3, 6, 9, 12, 21 and 30 days after the procedure. The flow cytometry was employed to analyze the changes in the VCAM1 level in the sample at different time points after the grafting. Results In the 3 groups, the transplanted skin base was easily separated at 3 days after transplantation; the areas of the wound healing accounted for 94%±12%，92%±9%, and 91%±11%, respectively, at 21 days; good wound healing was achieved at 30 days. At 9 and 12 days after transplantation, there was an evidentlyincreased level of the VCAM-1 expression in the tissue samples in the composite skin grafting groups. Compared with the control group, the difference was significant (Plt;0.05); however, the VCAM-1 expression at 3 days was not statistically different between the composite skin grafting groups and the control group after transplantation. In contrast, the level of the VCAM-1 expression was significantly higher at 6 days in the control group than in the composite skin grafting groups (Plt;0.05). The levels of the VCAM-1 expression were significantly lower at 30 days than at 3 days after transplantation in all the 3 groups (plt;0.01). Conclusion The highest level of the VCAM-1 expression can be delayed in the composite skin grafting when compared with that in the thin auto-skins alone, which implies that the VCAM-1 expression may be correlated with angiogenesis and composite skin survival. The VCAM-1 expression is not different between the acellular allo-dermal matrix composite skin grafting groups and the acellular xeno-dermal matrix group.
摘要:目的:总结应用自体真皮片移植疝修补术治疗腹股沟疝20例的近期治疗效果。方法:使用自体真皮片移植,对20例各类腹股沟疝患者进行无张力修补治疗;观察手术方法及时间、手术指征、术后患者自主能力的恢复、术后伤口疼痛、并发症和复发率。结果:与传统疝修补手术相比,自体真皮移植疝修补术具有方法简便、手术指征广、术后疼痛轻、恢复快、并发症少和复发率低的优点。结论:自体真皮移植疝修补术是一项更符合人体解剖结构和疝的病理生理的手术方法,具有传统方法无法比拟的优势。尤其适于在基层医院推广。Abstract: Objective: To summarize the recently therapeutic effect of autodermis transplantation repair of inguinal hernia. Methods: Twenty patients were treated by tension free hernia repair with autodermis transplantation. The operative procedure, surgical indication,ability recovery,postoperative pain,complications and recurrence rate were studied. Results: Autodermis transplantation hernia repair was superior to the traditional because of easier performance,wider indications,blander postoperative pain,faster recovery,fewer complications and lower recurrence. Conclusion: Autodermis transplantation hernia repair is more consistent with human anatomic structure and hernial pathophysiology than the conventional method, especially suiltable for primary hospital.