창상 환경에 따른 돼지 복합피부조직이식의 생착에 관한 연구

Abstract

Composite grafts have served as a versatile tool in plastic surgery, but their usefulness has been limited by unpredictable survival in the case of larger defects. We compared composite grafts take rates in a wet environment, known to be ideal for wound healing, a moist environment with mild compression, and a dry environment in an established porcine model. The subjects of this study were 7 female Yorkshire pigs with 54 composite grafts. These 3x3cm sized composite grafts, composed of skin and subcutaneous fat, were harvested as samples on the back of the subjects to be reimplanted based on random patterns. Group I was introduced to a wet environment with sufficient antibiotic ointment and semi-occlusive polyurethane film(Opsite(R)) coverage, while group II was introduced to a moist environment and mild compression with hydrocellular foam dressing(Allevyn(R) and Opsite(R)coverage. Meanwhile, group III was applied simply with dry. Two weeks after the grafting, the survival rates of groups I(89%) and II(83%) were significantly higher than those of group III(31%)(p<0.05). The degrees of inflammation and fibrosis in groups I and II were less than in group III. Epithelial connections between the grafts and the recipients were the fastest in group II. According to the results of this study, maintaining a wet environment and mild compression may not only increase the composite graft take rate but also increase the size of grafts that could be transferred successfully.