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目的了解含银异种脱细胞真皮基质(Xeno-ADM)的多项生物学性状,观察其移植效果。方法制备单纯xeno-ADM,再用2 g／L硝酸银浸泡,制成含银xeno-ADM。检测两种xeno-ADM对笔者单位烧伤患者创面常见菌的抑菌效果,并进行组织学观察;测量含银xeno-ADM的Ag+含量。在27只家兔背部制作全层皮肤缺损创面,分为A、B、C组,每组9只。A组移植自体刃厚皮,B组移植单纯xeno-ADM+自体刃厚皮,C组移植含银xeno-ADM+自体刃厚皮。术后2、4、6周取移植部位皮肤标本作形态学观察,并计算创面收缩率;术后2周计算移植皮片(未)成活率,并检测各组家兔淋巴细胞增殖活性。结果(1)含银xeno-ADM对创面常见菌的抑菌效果明显优于单纯xeno-ADM (P<0．05)。两种xeno-ADM中的表皮已完全除去,胶原纤维粗细均匀、排列规则、无明显变性,真皮中无细胞及细胞碎片。含银xeno-ADM的Ag+含量为(2．7±0．7)mg／g。(2)术后6周,A组家兔移植皮片呈暗红色,挛缩明显,易破溃,胶原纤维排列紊乱;B、C组移植皮片颜色接近周围正常皮肤,光滑无瘢痕,质地良好,胶原纤维排列有序,表皮-真皮连接结构和基底细胞桥粒、半桥粒结构以及基底膜重建明显。术后2、4、6周,A组家兔创面收缩率均明显高于B、C组(P<0．05);B、C两组创面收缩率相似(P>0．05)。术后2周,C组皮片完全成活率为91．7％,显著高于A组(77．8％)及B组(80．6％);3组家兔淋巴细胞增殖活性相似(P>0．05)。结论含银xeno-ADM脱除了基质中有免疫原性的细胞成分,保留了组织的基本结构和完整的胶原纤维支架,且具有较好的局部抗菌效果,不失为一种良好的真皮替代物。
Objective To understand the biological characteristics of Xeno-ADM and observe the effect of Xeno-ADM. Methods Pure xeno-ADM was prepared and then immersed in 2 g / L silver nitrate to make silver-containing xeno-ADM. The inhibitory effects of two xeno-ADM on the common wounds in burn wounds of patients were detected and histological observation was performed. The Ag + content of xeno-ADM containing silver was measured. Full-thickness skin defect wounds were made on the back of 27 rabbits and divided into groups A, B and C, with 9 in each group. Group A was transplanted with self-blade thickness skin, group B was xeno-ADM + autologous blade thickness skin graft, and group C was xeno-ADM + autologous blade thickness skin graft. At 2, 4, and 6 weeks after operation, the skin specimens were taken for morphological observation and the wound shrinkage was calculated. Survival rate of the transplanted skin pieces was calculated 2 weeks after the operation, and the lymphocyte proliferation activity of the rabbits in each group was also measured. Results (1) The effect of xeno-ADM containing silver on the wound surface was significantly better than that of xeno-ADM alone (P <0.05). The epidermis in both xeno-ADMs has been completely removed, the collagen fibers have uniform thickness, regular arrangement, no obvious degeneration, no dermal cells and cellular debris. Ag + content of silver-containing xeno-ADM was (2.7 ± 0.7) mg / g. (2) At 6 weeks after operation, the transplanted skin grafts of group A were dark red, the contracture was obvious and easily ruptured, and the arrangement of collagen fibers was disordered. The skin grafts of group B and C were close to the normal surrounding skin with smooth and scarless, good texture Collagen fibers arranged in order, epidermal-dermal junctional structure and basal cell desmosomal, hemidesmosome structure and basement membrane reconstruction. At 2, 4 and 6 weeks after operation, the wound shrinkage rate of rabbits in group A was significantly higher than that in rabbits in groups B and C (P <0.05). The wound shrinkage rates of rabbits in groups B and C were similar (P> 0.05). At 2 weeks after operation, the complete survival rate of group C was 91.7%, significantly higher than that of group A (77.8%) and group B (80.6%). The proliferative activity of lymphocytes in group C was similar > 0.05). CONCLUSION: Silver-containing xeno-ADM removes cellular components with immunogenicity in the matrix, retains the basic structure of the tissue and the intact collagen fiber scaffold, and has good local antibacterial effect, which is a good dermal substitute.