【摘要】 目的 探讨封闭负压引流(vacuum sealing drainage,VSD)装置用于全厚皮移植术后加压固定对全厚皮片移植成活的影响。 方法 新西兰大白兔24只,在脊柱两侧2个术区建立全厚皮片移植模型。每只兔2个术区分别采用VSD(A组)、传统缝合打包加压包扎(B组),做自身对照。第3、5、7天各随机处死8只兔,观察皮片成活情况,做移植皮片中央及边缘(指打包固定的缝线处)的外观质量评价(由1名研究者做主观评价),计算皮片成活率,并在移植皮片上取材,HE染色处理后,应用光学显微镜观察组织形态学特征。采用免疫组织化学检测各组创面血管内皮生长因子(vascular endothelial growth factor,VEGF)表达情况。 结果 两组比较,移植皮片边缘的外观质量评价显著提高(Plt;0.05),皮片中央差异无统计学意义(Pgt;0.05);皮片移植成活率差异无统计学意义(Pgt;0.05)。HE染色结果显示,A组较B组皮片边缘的细胞层次清晰、结构完整,皮片中央无差异。免疫组织化学检测显示,A组皮片边缘VEGF阳性染色部位的累积吸光度值显著高于B组(Plt;0.05),皮片中央差异无统计学意义(Pgt;0.05)。 结论 VSD用于全厚皮移植术后加压固定可提高皮片边缘的外观质量,促进创面修复和血管生成,可能减轻边缘瘢痕增生。【Abstract】 Objective To explore the influence of vacuum sealing drainage (VSD) on compression bandage of full-thickness skin grafting. Methods A model of full-thickness skin grafting in 2 operation zones was established in the two sides of spinal column of 24 New Zealand white rabbits. The wounds were deal with by VSD (group A) and conventional suture and compression bandage (group B) randomly. About 3, 5, and 7 days after operation, the assessment of the center and edge area (suture area) of skin grafting was performed by a single observer blinded to the randomization. The survival rate was calculated. Samples were selected from skin grafting and observed under a light microscope after HE staining. The expression of vascular endothelial growth factor (VEGF) was detected by immunohistochemistry method. Results The assessment of the edge area of skin grafting in group A was significantly better than that in group B (Plt;0.05); the difference in the center area was not significant (Pgt;0.05). HE staining showed that in the edge area of skin grafting, the cell layer and structure were better in group A than that in group B, the difference in the center area was not significant (Pgt;0.05). Immunohistochemistry method showed that in the edge area of skin grafting, integrated optical density of VEGF was significantly higher in group A than in group B (Plt;0.05), it was not significantly in the center area (Pgt;0.05). Conclusions VSD utilized on compression bandage of full-thickness skin grafting can significantly improve the qualitative appearance of grafting, promote wound healing and vascularization. VSD may possibly reduce scar hyperplasia.