The Experimental Study Of The Hypertrophic Scar Treated By Compound Hair Follicles Tissue Transplantation And Fractional CO₂ Laser

ObjectiveTransplant compound hair follicles tissue by trephine punch and fractional CO2 laser in hypertrophic scar, observe time of the hair shaft send forth and morphological changes of scar tissue, analysis and comparison of CK-15 and a-SMA expression in different planting mode, discusses compound hair follicles organizations promote the possible mechanisms of hypertrophic scar outcome.MethodsA total of 20 New Zealand white rabbit random assignment to four groups:Arnormal skin, B:hypertrophic scar, C:compound hair follicles tissue transplantation by trephine punch, D:compound hair follicle tissue transplantation by fractional CO2 laser.15 rabbits in group B、C and D were established hypertrophic scar. Transplanted compound hair follicle tissue in C and D. Record the hair shaft send forth time, collect 1th,3th,7th,14th Specimen. Observed under microscope by HE staining, and immunohistochernistry was used to detect the hair follicle stem cell keratin-15(CK-15),the hair follicle dermal sheath cell a-smooth muscle actin (a-SMA) expression changes of CK-15, a-SMA, analysis of the use of the expression of two kinds of different transplantation methods on the prognosis of hypertrophic scar.Results1. Observe the hair shaft send forth time:the hair shaft send forth time of C was(24.75 ±1.97)days, fractional CO2 laser drilling group new hair shaft formation time was (23.30+ 1.87)days;C、D two groups of neonatal hair shaft formation time compared with statistical significance(P=0.02< 0.05).2. HE staining:normal skin tissues (group A) of epidermis and dermis are closely connected and basal layer, granular layer, prickle cell layer and the stratum corneum, hair follicle, sebaceous gland and sweat gland, dermal glands are abundant. Collagen is bright red. loosely arranged, rules, hypertrophic scar (group B) Visible epidermis like structure, the number of basal cells are less, there is a small amount of skin appendages. A large number of fibroblasts, inflammatory cells infiltration. Collagen fibers arranged in dense, whirlpool, irregular, vascular lumen extrusion deformation, (group C) scar tissue can be seen in the huddle together like the hair follicle and sebaceous gland and sweat gland tissue around, perifollicular angiogenesis aggregation, blood vessel diameter coarse fibers were arranged loosely structured scar dermis layer thickness increases, (group D) Scar tissue memory in the hair follicle tissue, scar epidermal, dermal epidermal junction are closely connected, visible skin nail, hair follicle connective tissue and angiogenesis, vascular diameter is smaller, sebaceous glands and sweat glands are clearly visible, the dermal collagen bundles and loose, thickening. Variable width, parallel to the surface, fiber cell during the distribution of the same trend, similar to the normal dermis collagen fibers.3.immunohistochemistry:By using trephine punch and Ultrapulse CO2 laser drilling hair follicle composite tissue transplantation new hair to form a dry day 1 expression of visible CK-15 and a-SMA positive cells. CK-15 positive cells scattered in distribution around hair follicles and epidermal basal, location of a-SMA positive cells expression was fixed and the distribution in the hair follicle outer dermal tissue, (group C) of CK-15 positive expression rate in first days,3th,7 th and 14 th were 21%.32%,58%,42%; (group D) the strong positive expression rate of CK-15 were 31%,57%.78%,60%. Strong positive expression in D group was higher than that of group C; (group C) of a-SMA positive expression rate in first days,3th, 7th and 14th were 21%.34%.52%.44%; (group D) of a-SMA positive expression rates were: 39% and 69%,83%,63%. Strong positive expression in D group was higher than that of group C. the difference was statistically significant (P< 0.05).Conclusion1. The hair shaft formation time in fractional CO2 laser advance than trephine punch2. Compound hair follicles tissue transplantation is conducive to the promotion of hypertrophic scar tissue to form normal skin.3. The expression of fractional CO2 laser is more conducive to the protection of the hair follicle stem cell and hair follicle dermal sheath cells...