【文献解读】开发和测试一种皮肤牵张装置作为一种新的瘢痕治疗手段

【文献解读】开发和测试一种皮肤牵张装置作为一种新的瘢痕治疗手段
2017/10/11 创新医学网

     文章来源：欧尔意 OAE 微信号

     作者 :sofina

     原文出处

     Kanevsky J, Vorstenbosch J, Diaz-Abele J, Safran T, Prinz M, Tahiri Y, Gilardino M, Prakash S. Development and assessment of a cutaneous tissue stretch device as a novel scar therapy. Plast Aesthet Res 2016;3:351-8.

     DOI:10.20517/2347-9264.2016.27

     摘要

     目的：预防和减少瘢痕具有大量的医疗需求。由于目前没有有效的瘢痕治疗方法，患者在术后常常对外观不满和再次找到外科医生想办法，但仍没有好的解决方案。这项研究的目的是开发和测试一种在新形成瘢痕上产生间歇性平行牵张力的器械，并分析其减少瘢痕形成的作用。方法：将小鼠随机分为5个组，包含：1个对照组，1个假手术组和3个拉伸模型(0.5倍、1倍、和2倍的器械强度)，并治疗10天。使用温哥华疤痕量表评估瘢痕增生程度。比较各组瘢痕组织中组织学改变和转化生长因子β1(TGF-β1)表达情况。结果：0.5倍和1倍张力组的瘢痕评分显着低于对照组(P <0.05)。 1倍张力组的瘢痕评分也显着低于0.5倍张力组(P <0.05)。假手术组，对照组和2倍张力组与0.5倍和1倍张力组相比，具有更多的胶原沉积和更厚的瘢痕。无张力组的疤痕比0.5倍张力和2倍张力组具有较少的成纤维细胞和较多的胶原沉积。 0.5倍张力组和1倍张力组TGF-β1表达水平(分别为342.1±9.2和254.1±3.1)明显低于对照组(P <0.05)。 1倍张力组TGF-β1水平也显着低于0.5倍张力治疗组(P <0.05)。结论：在伤口愈合增生期，平行于瘢痕间断皮肤牵张治疗，在宏观，微观和生物化学水平上可降低瘢痕的纤维化程度。

     关键词：机械力，瘢痕治疗，增生性瘢痕，皮肤牵拉

     Aim: Scar prevention and reduction is an area of therapeutic opportunity and unmet medical need. With no current effective scar therapy, patients are often disappointed in their appearance post surgery and re-present to surgeons, only to be turned away. The purpose of this study was to develop and test a device that produces intermittent parallel stretch on new scars and to analyze its potential to reduce scarring. Methods: Mice were randomized into 5 scar stretch treatment groups: 1 control, 1 sham, and 3 stretch models (0.5×, 1×, or 2× device strength) and treated for 10 days. Scars were scored using the Vancouver Scar Scale. Scar tissue samples were compared by histology and transforming growth factor beta 1 (TGF-β1) expression between control and treatment groups. Results: Scar scores of 0.5× and 1× groups were significantly lower than the control group (P < 0.05). Scar scores from the 1× treatment group were also significantly lower than the 0.5× group (P < 0.05). Sham, control scar and 2× groups showed more collagen deposition and a thicker dermal scar than the 0.5× and 1× groups. Unstretched scars had fewer fibroblasts with more collagen deposition than the 0.5× and 2× groups. TGF-β1 levels were significantly lower in the 0.5× (342.1 ± 9.2) and 1× (254.1 ± 3.1) groups than in the control group (P < 0.05). TGF-β1 levels in the 1× treatment group were also significantly lower than the 0.5× treatment group (P < 0.05). Conclusion: Intermittent cutaneous tissue stretch parallel to scars during the proliferative phase of wound healing decreases fibrosis on a macroscopic, microscopic and biochemical level.

     Keywords: Mechanotransduction, scar therapy, hypertrophic scar, skin stretch

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