摘要
目的评估A型肉毒毒素不同干预方式对移植皮片术后挛缩的影响。方法雄性SPF级SD大鼠24只,采用直接抽选法分为创缘注射组、创基注射组与皮内注射组,每组8只。在每只大鼠背部建立2个大小相同的全厚植皮模型,随机选择一侧为治疗侧,另一侧则为对照侧。各组治疗侧分别以A型肉毒毒素行创缘注射、创基注射及皮内注射进行干预,对照侧不做干预。于植皮术后2、4、6、8、10、12周测量、对比各组皮片面积。同一治疗组和不同治疗组间采用重复测量方差分析,P<0.05为差异具有统计学意义。结果术后4、6、8、10、12周,创缘注射组大鼠的治疗侧和对照侧皮片面积差异较大,除术后2周外,其他时间点2侧面积比较差异均有统计学意义(术后4、6、8、10、12周P值均<0.01;术后12周,治疗侧皮片面积为(4.106±0.320)cm^(2),对照侧为(2.885±0.264)cm^(2)。皮内注射组大鼠的治疗侧和对照侧皮片面积,在所有时间点上比较差异均无统计学意义(P值均>0.05);术后12周,治疗侧皮片面积为(3.443±0.678)cm^(2),对照侧为(3.503±0.577)cm^(2)。创基注射组大鼠在所有时间点上治疗侧皮片的面积均大于对照侧,但在术后2、4、6周时2侧比较差异无统计学意义(P值均>0.05),术后8、10、12周时2侧比较差异有统计学意义(P<0.05,<0.01,<0.05);术后12周,治疗侧皮片面积为(3.660±0.434)cm^(2),对照侧为(2.914±0.528)cm^(2)。结论初步实验表明,在创缘、创基注射A型肉毒毒素可抑制植皮片术后的挛缩,尤其是在创缘注射效果更明显。
Objective To evaluate the anticontracture effect of injecting botulinum toxin Type A(BTX-A)at different sites after skin grafting.Methods 24 SD rats of SPF grade were divided into three groups.Two full-thickness skin grafts of the same size were performed on each rat’s back.One was randomly selected as the treatment side and the other as the control side.BTX-A was used for edge injection,substrate injection and intradermal injection on the treatment side of each group.No intervention was done on the control side.The area of grafts was measured at the end of the 2nd,4th,6th,8th,10th and 12th weeks after surgery.The differences between treatment groups were analyzed by repeated measures of variance,P<0.05 was considered statistically significant.Results The area of skin grafts on the treatment side and the control side in the edge injection group was significantly different,except that there was no statistical difference at the end of the 2nd weeks(at 4,6,8,10,and 12 weeks P<0.01).In the 12th week,the average area of the experimental side in this group was(4.106±0.320)cm^(2),while the average area of the control side was(2.885±0.264)cm^(2).There was no significant difference between the two sides in the intradermal injection group at each postoperative interval(P>0.05).At the end of the 12th week,the average area of the experimental side in the intradermal injection group was(3.443±0.678)cm^(2),while the average area of the control side was(3.503±0.577)cm^(2).The results were different in the substrate injection group.The area of skin grafts on the treatment side was larger than that on the control side,but there was no statistical difference at the end of the 2nd,4th and 6th weeks after the operation(P>0.05).At the end of the 8th,10th,and 12th weeks,the differences were statistically significant(P<0.05,<0.01,<0.05).In the 12th week,the average area of the experimental side in this group was(3.660±0.434)cm^(2),while the average area of the control side was(2.914±0.528)cm^(2).Conclusions The preliminary results showed that BTX-A injection at the edge and base of the wound could inhibit the contracture after skin grafting.The injection at the edge of the wound was more effective.Use of BTX-A for anticontracture after skin graft is worthy further study.
作者
周锦烽
郝超
杨蓊勃
Zhou Jinfeng;Hao Chao;Yang Wengbo(Department of Burn and Plastic Surgery,Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing 210006,China;Department of orthopaedics,the Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing 210006,China)
出处
《中华整形外科杂志》
CSCD
2021年第11期1265-1270,共6页
Chinese Journal of Plastic Surgery
基金
南京市医学科技发展资金资助项目(YKK18100)。
