摘要:目的:總結應用自體真皮片移植疝修補術治療腹股溝疝20例的近期治療效果。方法:使用自體真皮片移植,對20例各類腹股溝疝患者進行無張力修補治療;觀察手術方法及時間、手術指征、術后患者自主能力的恢復、術后傷口疼痛、并發癥和復發率。結果:與傳統疝修補手術相比,自體真皮移植疝修補術具有方法簡便、手術指征廣、術后疼痛輕、恢復快、并發癥少和復發率低的優點。結論:自體真皮移植疝修補術是一項更符合人體解剖結構和疝的病理生理的手術方法,具有傳統方法無法比擬的優勢。尤其適于在基層醫院推廣。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.
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.