皮肤移植新进展
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摘要
断层皮片移植是目前临床治疗大面积皮肤缺损的重要方法。然而,大面积烧伤患者自体皮源严重不足,取皮引起供皮区损伤甚至残留瘢痕等问题限制了断层皮片移植的临床应用。为解决上述问题,一些新的皮肤移植技术开始出现,包括负压吸疱表皮移植、自体表皮细胞悬液移植、Xpansion微粒皮移植、点阵全层皮肤移植以及新型组织工程皮肤制备与移植等。这些技术在扩大皮片覆盖面积、减少供皮区损伤等方面取得了较大进展,上述技术可以单独在临床上应用或与断层皮片移植联合使用,以减轻断层皮片移植带来的相关并发症,但上述技术仍需进一步的临床研究和实验,以更好地应用于临床实践。
Split-thickness skin grafting is currently an important method for treatment of large skin loss.However,split-thickness skin grafting is limited by donor-skin availability,especially in large burns.In addition,the donor-site wound is associated with injury and scarring.Multiple techniques have been developed to overcome these limitations,including epidermal suction blister grafting,autoepidermal suspension graft,Xpansion Micrografting System,fractional skin harvesting,tissue engineering skin,etc.Great progress has been made in enlarging the graft coverage area and alleviating the injury of the donor site.The above techniques can be used alone or in combination with split-thickness skin grafting to alleviate the complications associated with the transplantation of split-thickness skin,but the above techniques still require further clinical researchs and experiments to better apply to clinical practice.
Split-thickness skin grafting is currently an important method for treatment of large skin loss.However,split-thickness skin grafting is limited by donor-skin availability,especially in large burns.In addition,the donor-site wound is associated with injury and scarring.Multiple techniques have been developed to overcome these limitations,including epidermal suction blister grafting,autoepidermal suspension graft,Xpansion Micrografting System,fractional skin harvesting,tissue engineering skin,etc.Great progress has been made in enlarging the graft coverage area and alleviating the injury of the donor site.The above techniques can be used alone or in combination with split-thickness skin grafting to alleviate the complications associated with the transplantation of split-thickness skin,but the above techniques still require further clinical researchs and experiments to better apply to clinical practice.
引文
[1]Brusselaers N,Pirayesh A,Hoeksema H,et al.Skin replacement in burn wounds[J].J Trauma,2010,68(2):490-501.
[2]Profyris C,Tziotzios C,Do Vale I.Cutaneous scarring:Pathophysiology,molecular mechanisms,and scar reduction therapeutics Part I.The molecular basis of scar formation[J].JAm Acad Dermatol,2012,66(1):1-10.
[3]Matsumura H,Harunari N,Ikeda H.First experience using cultured epidermal autografts in Taiwan for burn victims of the Formosa Fun Coast Water Park explosion,as part of Japanese medical assistance[J].Burns,2016,42(3):697-703.
[4]Matsumura H,Matsushima A,Ueyama M,et al.Application of the cultured epidermal autograft“JACE(”)for treatment of severe burns:Results of a 6-year multicenter surveillance in Japan[J].Burns,2016,42(4):769-776.
[5]Chester DL,Balderson DS,Papini RP.A review of keratinocyte delivery to the wound bed[J].J Burn Care Rehabil,2004,25(3):266-275.
[6]Ronfard V,Rives JM,Neveux Y,et al.Long-term regeneration of human epidermis on third degree burns transplanted with autologous cultured epithelium grown on a fibrin matrix[J].Transplantation,2000,70(11):1588-1598.
[7]Hayashi M,Muramatsu H,Nakano M,et al.Changes in the Dermal Structure during Cultured Epidermal Autograft Engraftment Process[J].Plast Reconstr Surg Glob Open,2016,4(9):e870.
[8]Chiba T,Ishida N,Kohda F,et al.Air exposure may be associated with the histological differentiation of a cultured epidermal autograft(JACE)[J].Australas J Dermatol,2018,59(3):e244-246.
[9]杨素娟,曾招林,吴光宇,等.负压吸疱法自体表皮移植治疗白癜风的临床研究[J].赣南医学院学报,2015,35(4):559-560.
[10]Hu JJ,Xu AE,Wu XG,et al.Small-sized lesions of childhood vitiligo treated by autologous epidermal grafting[J].JDermatolog Treat,2012,23(3):219-223.
[11]方向京,朱飞滨,薛春利,等.负压吸疱术修复烧伤残余创面的临床疗效观察[J].右江民族医学院学报,2015,37(2):238-239,242.
[12]Purschke M,Asrani FA,Sabir SA,et al.Novel methods for generating fractional epidermal micrografts[J].Br J Dermatol,2015,172(4):1021-1028.
[13]Richmond NA,Lamel SA,Braun LR,et al.Epidermal grafting using a novel suction blister-harvesting system for the treatment of pyoderma gangrenosum[J].JAMA Dermatol,2014,150(9):999-1000.
[14]B9ttcher-Haberzeth S,Biedermann T,Reichmann E.Tissue engineering of skin[J].Burns,2010,36(4):450-460.
[15]Gravante G,Di Fede MC,Araco A,et al.A randomized trial comparing Re Cell system of epidermal cells delivery versus classic skin grafts for the treatment of deep partial thickness burns[J].Burns,2007,33(8):966-972.
[16]De Angelis B,Migner A,Lucarini L,et al.The use of a non cultured autologous cell suspension to repair chronic ulcers[J].Int Wound J,2015,12(1):32-39.
[17]薛宏斌,师军,武斌,等.自体点柱状微粒皮种植术的初步临床研究[J].中国烧伤创疡杂志,2016,28(6):399-402.
[18]舒承清,陈伟明,邓永高,等.微粒皮种植技术在复杂创面修复的临床应用[J].中外医疗,2014(20):71-72.
[19]郑小鹏.微粒皮方向性对移植存活率的影响及改进方法[D].上海:第二军医大学,2017.
[20]Hackl F,Bergmann J,Granter SR,et al.Epidermal regeneration by micrograft transplantation with immediate 100-fold expansion[J].Plast Reconstr Surg,2012,129(3):443e-452e.
[21]Svensj9 T,Pomahac B,Yao F,et al.Autologous skin transplantation:comparison of minced skin to other techniques[J].J Surg Res,2002,103(1):19-29.
[22]Kiwanuka E,Hackl F,Philip J,et al.Comparison of healing parameters in porcine full-thickness wounds transplanted with skin micrografts,split-thickness skin grafts,and cultured keratinocytes[J].J Am Coll Surg,2011,213(6):728-735.
[23]Manstein D,Herron GS,Sink RK,et al.Fractional photothermolysis:a new concept for cutaneous remodeling using microscopic patterns of thermal injury[J].Lasers Surg Med,2004,34(5):426-438.
[24]Tam J,Wang Y,Farinelli WA,et al.Fractional Skin Harvesting:Autologous Skin Grafting without Donor-site Morbidity[J].Plast Reconstr Surg Glob Open,2013,1(6):e47.
[25]郝文丽,张平,吴训伟.组织工程皮肤的现状和展望[J].北京生物医学工程,2016,35(1):94-99.
[26]Goodarzi P,Falahzadeh K,Nematizadeh M,et al Tissue Engineered Skin Substitutes[J].Adv Exp Med Biol,2018,1107:143-188.
[27]Zheng Y,Ji S,Wu H,et al.Topical administration of cryopreserved living micronized amnion accelerates wound healing in diabetic mice by modulating local microenvironment[J].Biomaterials,2017,113:56-67.
[2]Profyris C,Tziotzios C,Do Vale I.Cutaneous scarring:Pathophysiology,molecular mechanisms,and scar reduction therapeutics Part I.The molecular basis of scar formation[J].JAm Acad Dermatol,2012,66(1):1-10.
[3]Matsumura H,Harunari N,Ikeda H.First experience using cultured epidermal autografts in Taiwan for burn victims of the Formosa Fun Coast Water Park explosion,as part of Japanese medical assistance[J].Burns,2016,42(3):697-703.
[4]Matsumura H,Matsushima A,Ueyama M,et al.Application of the cultured epidermal autograft“JACE(”)for treatment of severe burns:Results of a 6-year multicenter surveillance in Japan[J].Burns,2016,42(4):769-776.
[5]Chester DL,Balderson DS,Papini RP.A review of keratinocyte delivery to the wound bed[J].J Burn Care Rehabil,2004,25(3):266-275.
[6]Ronfard V,Rives JM,Neveux Y,et al.Long-term regeneration of human epidermis on third degree burns transplanted with autologous cultured epithelium grown on a fibrin matrix[J].Transplantation,2000,70(11):1588-1598.
[7]Hayashi M,Muramatsu H,Nakano M,et al.Changes in the Dermal Structure during Cultured Epidermal Autograft Engraftment Process[J].Plast Reconstr Surg Glob Open,2016,4(9):e870.
[8]Chiba T,Ishida N,Kohda F,et al.Air exposure may be associated with the histological differentiation of a cultured epidermal autograft(JACE)[J].Australas J Dermatol,2018,59(3):e244-246.
[9]杨素娟,曾招林,吴光宇,等.负压吸疱法自体表皮移植治疗白癜风的临床研究[J].赣南医学院学报,2015,35(4):559-560.
[10]Hu JJ,Xu AE,Wu XG,et al.Small-sized lesions of childhood vitiligo treated by autologous epidermal grafting[J].JDermatolog Treat,2012,23(3):219-223.
[11]方向京,朱飞滨,薛春利,等.负压吸疱术修复烧伤残余创面的临床疗效观察[J].右江民族医学院学报,2015,37(2):238-239,242.
[12]Purschke M,Asrani FA,Sabir SA,et al.Novel methods for generating fractional epidermal micrografts[J].Br J Dermatol,2015,172(4):1021-1028.
[13]Richmond NA,Lamel SA,Braun LR,et al.Epidermal grafting using a novel suction blister-harvesting system for the treatment of pyoderma gangrenosum[J].JAMA Dermatol,2014,150(9):999-1000.
[14]B9ttcher-Haberzeth S,Biedermann T,Reichmann E.Tissue engineering of skin[J].Burns,2010,36(4):450-460.
[15]Gravante G,Di Fede MC,Araco A,et al.A randomized trial comparing Re Cell system of epidermal cells delivery versus classic skin grafts for the treatment of deep partial thickness burns[J].Burns,2007,33(8):966-972.
[16]De Angelis B,Migner A,Lucarini L,et al.The use of a non cultured autologous cell suspension to repair chronic ulcers[J].Int Wound J,2015,12(1):32-39.
[17]薛宏斌,师军,武斌,等.自体点柱状微粒皮种植术的初步临床研究[J].中国烧伤创疡杂志,2016,28(6):399-402.
[18]舒承清,陈伟明,邓永高,等.微粒皮种植技术在复杂创面修复的临床应用[J].中外医疗,2014(20):71-72.
[19]郑小鹏.微粒皮方向性对移植存活率的影响及改进方法[D].上海:第二军医大学,2017.
[20]Hackl F,Bergmann J,Granter SR,et al.Epidermal regeneration by micrograft transplantation with immediate 100-fold expansion[J].Plast Reconstr Surg,2012,129(3):443e-452e.
[21]Svensj9 T,Pomahac B,Yao F,et al.Autologous skin transplantation:comparison of minced skin to other techniques[J].J Surg Res,2002,103(1):19-29.
[22]Kiwanuka E,Hackl F,Philip J,et al.Comparison of healing parameters in porcine full-thickness wounds transplanted with skin micrografts,split-thickness skin grafts,and cultured keratinocytes[J].J Am Coll Surg,2011,213(6):728-735.
[23]Manstein D,Herron GS,Sink RK,et al.Fractional photothermolysis:a new concept for cutaneous remodeling using microscopic patterns of thermal injury[J].Lasers Surg Med,2004,34(5):426-438.
[24]Tam J,Wang Y,Farinelli WA,et al.Fractional Skin Harvesting:Autologous Skin Grafting without Donor-site Morbidity[J].Plast Reconstr Surg Glob Open,2013,1(6):e47.
[25]郝文丽,张平,吴训伟.组织工程皮肤的现状和展望[J].北京生物医学工程,2016,35(1):94-99.
[26]Goodarzi P,Falahzadeh K,Nematizadeh M,et al Tissue Engineered Skin Substitutes[J].Adv Exp Med Biol,2018,1107:143-188.
[27]Zheng Y,Ji S,Wu H,et al.Topical administration of cryopreserved living micronized amnion accelerates wound healing in diabetic mice by modulating local microenvironment[J].Biomaterials,2017,113:56-67.