背景和目的:伤口愈合(WH)是一个复杂的自然过程:标准疗法有时无法实现适当的WH,并且通常在老年和糖尿病患者中观察到。导致顽固性溃疡.近年来,自体微移植(AMG)疗法已成为一种新的,有效,以及研究人员和临床医生负担得起的伤口护理策略。在这项研究中,一名72岁女性患者在背部良性肿瘤切除术后对术后皮肤溃疡进行了微移植和负压伤口治疗(NPWT)的联合治疗,目的是提出一种使用AMG联合人工真皮支架和NPWT治疗皮肤溃疡的创新方法.材料和方法:一段人工真皮支架,注入了微型移植物,在移植前取样,术后第3天和第7天收集切片。苏木精-伊红(HE)和免疫组织化学染色用于评估细胞角蛋白AE1/AE3,结蛋白,和因子VIII。此外,术后第3天,使用HE染色评估NPWT敷料,也是。所得的HE和免疫染色分析揭示了移植前人造真皮的胶原层内的红细胞和组织碎片。术后第3天,人工真皮的胶原层根据HE染色显示红细胞和中性粒细胞,免疫染色检测到细胞角蛋白AE1/AE3阳性细胞的散射。术后第7天的HE染色显示,人工真皮胶原层中的红细胞和中性粒细胞比第3天更多,细胞角蛋白AE1/AE3阳性细胞增加,和组织被结蛋白和因子VIII阳性染色。结果:结果表明,微移植物和迁移细胞的作用可能加速了伤口愈合过程。此外,第3天的NPWT敷料显示敷料内几乎没有细胞。这表明在微移植物移植后立即重新启动NPWT治疗没有抽出支架内的细胞。结论:微移植治疗和NPWT可能是复杂伤口愈合过程的有用组合疗法。
Background and Objectives: Wound healing (WH) is a complex natural process: the achieving of a proper WH with standard therapies sometimes is not fulfilled and it is often observed in aged and diabetic patients, leading to intractable ulcers. In recent years, autologous
micrograft (AMG) therapies have become a new, effective, and affordable wound care strategy among both researchers and clinicians. In this study, a 72-year-old female patient underwent a combination of treatments using
micrograft and negative pressure wound therapy (NPWT) on a postoperative skin ulcer after a benign tumor resection on the back with the aim to present an innovative method to treat skin ulceration using AMG combined with an artificial dermal scaffold and NPWT. Materials and Methods: A section of the artificial dermal scaffold, infused with micrografts, was sampled prior to transplant, and sections were collected postoperatively on days 3 and 7. Hematoxylin-eosin (HE) and immunohistochemical stains were employed for the evaluation of Cytokeratin AE1/AE3, desmin, and Factor VIII. Additionally, on postoperative day 3, NPWT dressing was evaluated using HE stains, as well. The resulting HE and immunostaining analysis revealed red blood cells and tissue fragments within the collagen layers of the artificial dermis prior to transplant. On postoperative day 3, collagen layers of the artificial dermis revealed red blood cells and neutrophils based on HE stains, and scattering of cytokeratin AE1/AE3-positive cells were detected by immunostaining. The HE stains on postoperative day 7 showed more red blood cells and neutrophils within the collagen layers of the artificial dermis than on day 3, an increase in cytokeratin AE1/AE3-positive cells, and tissue stained positively with desmin and Factor VIII. Results: Results suggest that the effects of both micrografts and migratory cells have likely accelerated the wound healing process. Furthermore, the NPWT dressing on day 3 showed almost no cells within the dressing. This indicated that restarting NPWT therapy immediately after
micrograft transplant did not draw out cells within the scaffold. Conclusions:
Micrograft treatment and NPWT may serve to be a useful combination therapy for complex processes of wound healing.