Clinical Application And Research Of Chitosan To Accelerate Tissue Expansion

Objective: On the base of predecessors'experiment that the effect of chitosan to the expanded fibro-peplos, apply chitosan to the clinical skin soft tissue expanders,explore the effect and mechanism to accelerate the soft tissue expansion with chitosan, at the same time, learn the technology of immune class and specific dyeing, be familiar with the basical operative procedure of light microscope.Method: Using the control method in same body, select thirty patients who are suitable to be embedded soft tissue expanders in the face, implant a 100ml expander in each face, one of them is the experimental group randomly, the other one is in control group. embed a negative drainage tube under the expander, then implant a silicon duct between the expander and subcutaneous tissue in the experimental group. After removing the negative drainage tube, injecting 2 ml medical chitosan by silicon duct in experimental group, and the control group is expanded under the common condition. Two teems are expanded in common method. According to hyperemia test of skin and painful feeling of patients,decide the total amount of water injection and the interval of twice. Observe the total time when expand to 100ml,record the quantity of normal sodium inside expanders after expanded two weeks and three weeks.Compare the speed of expansion.When the total amount of water in expanders is adequate for the scar, stop injecting for two weeks. Take fibropeplos from the center of the expanded skin about 1cm×1cm in the operation of taking out of the expanders from two groups,fixed by 4% paraform , then make paraffin slice and part into HE dyeing,Masson dyeing and CD34 dyeing. Observe the thickness of fibro-peplos in HE dyeing slice by light microscope in 100 times magnification, then messure the thickness of fibro-peplos by fibro-scale. Messure the gray scale of collagen in Masson dyeing slice with the pathology image analysis system. Count the quantity of blood capillaries in CD34 dyeing slice artificially. Compare the thickness of fibropeplos,the gray scale of collagen and the quantity of blood capillaries of two groups,then make statistical treatment. Observe the appearance of the fibroblasts and collagen by light microscope in 400 times magnification.Result: With the applification of chitosan in soft tissue expanders, the interval of water injection and the total time of expanding are shortened obviously. In experimental group, the average time interval is (49.55±5.93) hours, but the control group is (72.58±6.41) hours,(p<0.05).In experimental group,the average total expanding time to eighty milliliters is (24.56±5.37) days. On the contrast, the control group is (38.98±7.54) days. (p<0.05). When expanded two weeks,the total normal sodium in expanders is (67.39±8.13)ml,the control group is(48.81±7.52)ml,(p<0.05). When expanded three weeks,the total normal sodium in expanders is (89.57±8.49)ml,the control group is(67.03±9.77)ml,(p<0.05).Basal research demonstrates that the fibroblasts of fibropeplos in experimental group are more and younger than the control group.The amount of collagen around the fibroblasts is less and fibropeplos is thinner. Correspondingly, the fibroblasts are in mature period and around which is lots of compact collagen in the control group. The thickness of fibropeplos in the experimental group is(385.84±32.13)μm,the control group is (571.45±51.50)μm,(p<0.01); the average gray scale of collagen in the experimental group is(167.06±19.83), the control group is(147.74±19.92),(p<0.05);the quantity of blood capillaries per visual field in experimental group are(8.63±1.85),the control group are(8.31±2.47),(p>0.05).Conclusion: The effect of chitoson is encouraging and deserved to be recommended in tissue expansion mechanism.