负压封闭引流装置用于全厚皮移植术后加压固定

【】　目的　探讨封闭负压引流（vacuumsealingdrainage，VSD）装置用于全厚皮移植术后加压固定对全厚皮片移植成活的影响。　方法　新西兰大白兔24只，在脊柱两侧2个术区建立全厚皮片移植模型。每只兔2个术区分别采用VSD（A组）、传统缝合打包加压包扎（B组），做自身对照。第3、5、7天各随机处死8只兔，观察皮片成活情况，做移植皮片中央及边缘（指打包固定的缝线处）的外观质量评价（由1名研究者做主观评价），计算皮片成活率，并在移植皮片上取材，HE染色处理后，应用光学显微镜观察组织形态学特征。采用免疫组织化学检测各组创面血管内皮生长因子（vascularendothelialgrowthfactor，VEGF）表达情况。　结果　两组比较，移植皮片边缘的外观质量评价显著提高（P0.05）；皮片移植成活率差异无统计学意义（P>0.05）。HE染色结果显示，A组较B组皮片边缘的细胞层次清晰、结构完整，皮片中央无差异。免疫组织化学检测显示，A组皮片边缘VEGF阳性染色部位的累积吸光度值显著高于B组（P0.05）。　结论　VSD用于全厚皮移植术后加压固定可提高皮片边缘的外观质量，促进创面修复和血管生成，可能减轻边缘瘢痕增生。【Abstract】　Objective　Toexploretheinfluenceofvacuumsealingdrainage(VSD)oncompressionbandageoffull-thicknessskingrafting.　Methods　Amodeloffull-thicknessskingraftingin2operationzoneswasestablishedinthetwosidesofspinalcolumnof24NewZealandwhiterabbits.ThewoundsweredealwithbyVSD(groupA)andconventionalsutureandcompressionbandage(groupB)randomly.About3,5,and7daysafteroperation,theassessmentofthecenterandedgearea(suturearea)ofskingraftingwasperformedbyasingleobserverblindedtotherandomization.Thesurvivalratewascalculated.SampleswereselectedfromskingraftingandobservedunderalightmicroscopeafterHEstaining.Theexpressionofvascularendothelialgrowthfactor(VEGF)wasdetectedbyimmunohistochemistrymethod.　Results　TheassessmentoftheedgeareaofskingraftingingroupAwassignificantlybetterthanthatingroupB(P0.05).HEstainingshowedthatintheedgeareaofskingrafting,thecelllayerandstructurewerebetteringroupAthanthatingroupB,thedifferenceinthecenterareawasnotsignificant(P>0.05).Immunohistochemistrymethodshowedthatintheedgeareaofskingrafting,integratedopticaldensityofVEGFwassignificantlyhigheringroupAthaningroupB(P0.05).　Conclusions　VSDutilizedoncompressionbandageoffull-thicknessskingraftingcansignificantlyimprovethequalitativeappearanceofgrafting,promotewoundhealingandvascularization.VSDmaypossiblyreducescarhyperplasia.