Experimental Study On Skin Graft Repair Of Skull Bone

Objective Built the New Zealand white rabbit trauma model of the exposed skullbone wound with soft tissue defect, the wound treated through transplantationof full-thickness skin on skull bone wound, transfer random flap group on skullbone wound, transplantation of full-thickness skin on silicone membrane skullbone wound. To investigate the feasible of the full thickness skin graft applied to theexposed skull bone wound by the observing the healing progress including the healingtime, healing rate and the morphology in optical microscope.Method30New Zealand white rabbits(6months, weighs about2.7~3.2kg,male or female) were made the model,10rabbits in each group,30wounds inall. Randomly divided into transplantation of full-thickness skin on skull bonewound (group A), transfer random flap group on skull bone wound (group B), transplantation of full-thickness skin on silicone membrane skull bone wound (group C). On the14d after the start of the treatment, record the wound changesof6in each group, take skin tissue sample on wound for HE staining, MASSON staining and immunohistochemistry capillary count. Observed section under high optical microscope, each slice in the skin layer of randomly selected5discontinuous vision, visual counting capillary and analysis.Result1.Gross observation:14d later, removed packaged dressing, observed theskin situation on wound, A group of eight cases the majority of full-thickness skingraft survival, most of wound healing, two cases have survived not well, eye view ofthe survived full-thickness skin pale pink color, hair transplant skin no longer a softtouch texture, less skin graft activity, combined with the bone surface more closely,positive capillaries signs, showing a small amount of fresh blood after the surgicalpuncture the skin, skin warm (Figure7); group B:9flaps survived basically,1casesurvived not well, the proximal of flap survived well, but the distal of flap is purpleand black, not survived. eye view of the survived flap was pink, skin grafts showedno hair growth, texture, touch soft, grafting skin larger movable, combined with the bone surface a little tight, positive capillaries sign, after surgery area pierce the skinvisible fresh blood oozing skin warm;10wounds in group C have not healed,graftingskin black necrosis, texture touch hard, no adhesion with the base, partiallydissolved, no capillary levy, under the silicone membrane yellowish white skull, asmall amount of bone surface wound edge visible granulation tissue, skin cool.2.Rate of skin survival: After14d, the results of experiments showed that（n=10，x±s%）: skin survival rate was72.34±33.61%in group A, in group B, survivalrate was88.02±27.24%, survival rate was0.00%in group C. Statistical resultsshowed that: use of one-way AOV, compared with A, B, C three groups, P=0.000, sothe difference during group A, B, C was statistically significant (P <0.05). A groupcompared to B group, P=0.172, the difference was not statistically significant (P>0.05). A group compared to C group, P=0.000, the difference was statisticallysignificant (P <0.05). B group compared to C group, P=0.000, the difference wasstatistically significant (P <0.05).3. Histological observation under light microscope3.1HE staining: A grafting skin composed of live table clear skin and dermis layerstructure, fibroblasts and more scattered inflammatory cells; B composed of livingskin graft table clear skin and dermis layer structure, cell arrangement rules closely,more than fibroblasts, inflammatory cells infiltration; within the organizationalstructure of the group C skin graft is unclear, vague seen a lot of particles,unstructured red dye substances, showing eosinophilic bodies.3.2MASSON staining: A group of more than the number of new collagen fibers,fiber bundles thick, disorganized, inflammatory infiltration; Group B multiplenumber of collagen fibers, fiber bundles thick, disorganized, there is a small amountof inflammatory cell infiltration.3.3Immunohistochemistry capillary count: With single factor analysis ofvariance, the number of capillaries in group A was14.6±2.01, B group capillary countwas11.7±1.95, D group capillary count was8.8±1.23. The statistical results showed: with single factor analysis of variance, Compared A group with B group, P=0.001, thedifference was statistically significant (P<0.05). Compared A group with D group,P=0.000, the difference was statistically significant (P<0.05). Compared B group withD group, P=0.001, the difference was statistically significant (P<0.05).Conclusion:1. A successful model of rabbit skull bone exposed wounds was made;.2, full-thickness skin graft on fresh bone wound could survive, survival skin was ofgood shape and function, the appearance and texture ware similar to normal skin. Thatis a new viable therapeutic approach, can apply in clinical significance;3, Little difference in repairing skull wound with full-thickness skin graft or local flaptransfer in the experiment.