| Wound often occurs in everyday life, accidental injuries, traffic accident, natural disaster, which is an important factor that threatens people's health; severe wound can even threaten life or lead to injury or disability. In the process of repairing of wound, the affect of whole or part body factors often lead to over proliferation of fibre cell, overdeposition of extracellular matrix, decrease of collagen degradation and form hypertrophic scars, together with deformation of the body and dysfunction.Hypertrophic scars affects normal function and appearance of the body, causing a lot of mental and economic burden to patients, affecting their life quality as well. How to better improve severe wound including scar curing is still an important scientific subject in tissue repairing area.Recently, promoting methods for wound curing are mainly medicine curing, new type dressing, traditional dressing covering, skin transplantation, cell patch transplantation, external use of cytokines and gene therapy, etc. New type dressing and traditional dressing covering can only repair tissues in a certain degree, skin transplantation is an effective method for large scale defect of soft tissue. But no matter autologous or allograft skin transplantation are all affected by donor sources and bothering of immunity rejection. allograft skin and synthetic skin substitute transplantation haven't solved the problem of immunity rejection. Cell diaphragm is too thin, thus it is easy to wear and break. External use of Cell gene has the problem of short half-life period and high cure expense, and promoting curing effect is not obvious. Although gene curing conquers the deficiency of application of cell growth factor, it is not easy to solve the problem of low gene transfection rate and regulation of transfection and expression.Partial full-thickness skin, collagen fiber and blood vessel of wide full-thickness cutaneous deficiency have totally lost. Surround the wound bed, permeability of vascular wall increases, in-tube liquid extravasates, leading to local swelling. hyperemia of tissue, bleeding, blockage of blood cycle, necrosis, metabolic disorder, activates of bioactive substance such as histamine, 5-hydroxytryptamine, kinins substance, soak high pressure in local tissue and plenty of inflammatory cells. The nerve ending aches for stimulation, which affects tissue repair severely. Traditional Chinese medicine considers that the essence of soft tissue defect is blood stasis, choroid damage after wounded, blood becomes stasis isolated from nerves, blood stasis leads to qistagnation, non-dispersion of blood stasis leads to caloric, qi stagnation leads to pain. activating blood removing stasis is regarded as the most frequently used drugs in Chinese traditional medicine to cure skin ulcer and wounds, either used separately or composed, whose clinic effect is assured. Full-thickness skin ,collagen fibers and blood vessels.etc all are lost in wide full-thickness cutaneous deficiency wounds.Dragon's blood,boswellin,gum myrrh,rhubarb,angelica ,ammi majus and so on are most general drug used in skin pyocutaneous disease and trauma in Chinese traditional medicine.They are usually used alone or combination utilization,whose curative effect was confirmed [4,5]. Compendium of Materia Medica recorded that herb has some functions such as hemostasiswith astringents,promoting blood flow,detumescence and odynolysis,detoxication and gather sore,remove rotten and moistening skin and promoting granulation."meibao"is a typical traditional slurry,usually used for skin pyocutaneous,diarosis and soft tisssue injury.There were not any report about that"meibao"was used in wide full-thickness cutaneous deficiency.herb"2008"is drug compatibility slurry composed of multitude chinese crude. Modern research also consider that external usem herb can promote agglutination by regulating wound microenviroment .We assumed that to pave it on wounds, Herb"2008"could go to there without stop, play function with quaque kinds of drug and speeded up epithelization ,raise agglut quality,and inhibit cicatrization. Therefore,according to our research and correlated study trends in tissue repair hemisphere[7-8],we decided to deploy the herb"2008",which was composed by many kinds of drug produced by ourselves,to wide full-thickness cutaneous deficiency.Wound treated with"meibao"was positive control. From gross, tissue, cell and relative protein molecules to observe the curing process, trying to new curing direction of large scale difficult curing wound, providing further experimental basis and research method. key results and conlusions as follows:1. Replication of animal model of wound and wound treatmentminipigs (animal center of the third military medicine universty) ,4-6 months old and 17-45kg ,femal or male ,were used in this study. Two full-thickness cutaneous wounds(10×8.5 cm)were created on the dorsum of each side close to the vertebral column in each animal. right side wounds were treated with herb"2008", left side wounds were treated with herb"meibao"or without treating as control.2.The influence to a large scale cutaneous deficiency wounds of different treatmentright side wounds were treated with herb"2008", left side wounds were treated with herb"meibao"or without treating as control. The wound area, granulation tissue and reepithelization were observed after surgery.There were not obvious infection in wounds of three groups wounds.5~7 days after surgery, there were difficult to expose the control group as its wound was firmly adhere to gauze. In the whole course of agglutination ,all wounds coped with the herb"2008"was moist and smooth,the other two were rough,and contracted badly. Healing time of"2008"group was 32 to 34 days, and 10 to 12 days faster than that of control group, 4～6 days faster than that of meibao group after surgery. Healing time of meibao group was 36 to 38 days,and that of control group was 42 to 44 days.In addition, results of residual average area and concrecent percentage at different time in different groups indicated that Herb"2008"played an effective role in promoting wound healing of wide full-thickness cutaneous deficiency with high quality, especially has the effect of curbing formation of its cicatricle.3. To investigate partial mechanism of herb"2008"in treating wide full-thickness cutaneous deficiencycutaneous deficiency wound healing is a complicated process, the transmigration of malpighian cells play an onset and critical role.After damage to skin ,epiderm contacts and malpighian cells are stimulated firstly.Several hours later, malpighian cells-stimulating begin transmigration.The new epiderm formation essentially is the continual course of the transmigration of malpighian cells.especially 48~96 h later,overlap on wounds and formation of skin pack are independence with cell caryocinesis,but depend on the transmigration of malpighian cells[10].Our study indicated that ,herb"2008".The reepithelization rate of wide full-thickness cutaneous deficiency treating with herb"2008"was much faster than others 7 days after operation. mechanism of herb"2008"in treating wide full-thickness cutaneous deficiency possibly was that it promoted epiderm contact ,transmigration and stimulation of malpighian cells,finally speeded up epithelization.Full-thickness skin ,collagen fibers and blood vessels.etc all are lost in wide full-thickness cutaneous deficiency wounds.Compendium of Materia Medica recorded that herb has some functions such as hemostasiswith astringents,promoting blood flow,detumescence and odynolysis, detoxication and gather sore,remove rotten and moistening skin and promoting granulation.Modern research also consider that external usem herb can promote agglutination by regulating wound microenviro- ment .Herb"2008"is drug compatibility slurry composed of multitude chinese crude.To pave it on wounds, Herb"2008"can go to there without stop,and play function with quaque kinds of drug . Our study indicated ,in wide full-thickness cutaneous deficiency treating with herb"2008",compared with others , its granulation tissue grew higher,fibroblast and micrangium contents were aboundant,collagen deposition was obvious. So herb"2008"can promote the healing of wounds . TGF-βfamily is factor which regulate cell growth,differentiation, ECM composition and metabolism,etc. TGF-β1 stimulates fibroblast to produce collagen and ECM ,deposits by autocrine and paracrine. Excess collagen deposition in tissue and organ causes the hyperplasy of cicatricle.Therefore, TGF-β1 is a distinctive factor which promots cicatrization,Our study in the level of proteinum and mRNA indicated that,in the healing course of wide full-thickness cutaneous deficiency, Expression of TGF-β1 at different interval time in experimental group is lower than that of control group, and in the same group, there is no distinct difference of this expression in early, mid-term or late period. This indicates that herb"2008"has the effect of curbing scar formation. |
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