Retained Denatured Dermis With Autologous Skin Grafts To Repair Experimental Study Of Deep Burn Wounds

Objective To supply an academic foundation considered for free skin repairing deep burn wound reserved denatured dermis in clinic. Methods Using 18 SD rats to make the burn model. After rats were burned 2-5 days cut scab, reserved denatured dermis and grafted free skin to repair deep burn wound. The denatured dermis was excised. Its cellular structure and configuration was observed through optics microscope before operation and showed hyaline degeneration. The integrate skin in operation area was excised and observed its cellular structure , configuration and its collagenous fibers through optics microscope on the seventh,ninth,fourteenth,twenty-first day after operation. Testing skin biomechanical changes on the ninth, fourteenth,twenty-first and sixtieth day after operation. Results 14 grafted skin were survived except 4 failed for fixation etc. Naked eye showed: the skin was alive with blood circulation, but could still be removed from the wound after the suture was removed on the fourth day after operation. On the seventh day after operation the skin was fused into the wound and could not be removed from the wound. Optics microscope showed: On the seventh day after operation dermic papillary and reticular layer existed, the epidermis was thinner but germinative layer cells arrayed tidily like pillar, and there were many hair follicle and sebaceous gland. On the ninth day after operation the epidermis was thicker and its four layers and hyperkeratotic ！4tissue could be seen. The dermis was thicker with papillary and reticular layer. The hair follicle and sebaceous gland were lesser. On the fourteenth day after operation the epidermic four layer structure was obviously and its thickness and configuration liked that of the normal skin and the hyperkeratotic strip was obviously. The dermic papillary and reticular layer was much thicker. There were more atrophic hair follicle and sebaceous gland. On the twenty-first day after operation the epidermis liked that of the fourteenth day. The dermic thickness and configuration was almost the same with that of the normal. The atrophic fair follicle existed. From the seventh to twenty-first day after operation the collagenous fiber became denser, fasciculus grew wider and fused at last. Biomechanics showed resistive pull intension and straining become bigger and bigger and into very similar to the normal from the ninth to sixtieth day after operation. Conclusion Grafting free skin to repair deep bum wound reserved denatured dermis survive. The denatured dermis has become the normal dermis on the seventh day after operation. On the fourteenth day after operation the structure and configuration of skin was very similar to that of the normal. On the twenty-first day after operation the appendix of skin was atrophic. The flexibility of skin is very similar to that of the normal skin on the sixtieth after operation.