[Repair mechanisms of the wounds with exposed bone structures using an artificial dermis].

Objective: To investigate the repair mechanisms of the wounds with bone exposed by artificial dermis transplantation. Methods: Seventy two rabbits were randomly divided into 3 groups of 24 rabbits, the wound model was made on the top of head. In the skin defect group (SD group), skin was removed and skull periosteum was retained. In the periosteal defect group (PD group), the skin and skull periosteum were both removed, and the skull was exposed. In the skull burn group (SB group), after the periosteum was removed, the exposed skull bone was burned out with electric iron to cause skull surface necrosis, then the artificial dermis transplantation were performed in each group. In 1, 2, 3 and 4 weeks after transplantation, 2 specimens including artificial dermis and the underlying tissue in each group were cut for biopsy with HE staining to observe the angiogenesis in artificial dermis. Evans Blue perfusion was performed in four animals from each group to quantify angiogenesis in artificial dermis. Results: One week after transplantation, in SD group, a few microvessels can be observed in artificial dermis, but in the rest of the two groups, only a small amount of inflammatory cells can be seen. Two weeks after transplantation, in SD group, a large number of new blood vessels and fibroblasts can be seen filling in the artificial dermis, but angiogenesis delayed obviously in the PD and SB group. Three weeks after transplantation, the angiogenesis of artificial dermis in the PD and SB group accelerated obviously, and a thin layer of blood rich tissue membrane can be seen over the burned skull. The Evans Blue perfusion showed that the content of dye perfusion in the artificial dermis was closed to the peek value at 2 weeks after transplantation in the SD group, which was significantly higher than that in PD and SB group [(2 741±976) vs (1 039±590) and (403±209) µg/g, P<0.01]. Three weeks after transplantation, the content of Evans Blue in artificial dermis reached the peek value in SD and PD group, no significant difference was found between this two groups, but both significantly higher than that in SB group [(2 943±793) and (2 255±316) vs (1 125±404) µg/g, P<0.01]. Four weeks after transplantation, the content of Evans Blue in artificial dermis reached the peek value in SB group, although the value was still lower than that in SD and PD group, the difference was not significant [(1 609±787) vs (2 298±778) and (2 141±385) µg/g, P>0.05]. Conclusions: Lack or injury of periosteum can cause vascularization delay after artificial dermis transplantation. The vascularization of artificial dermis mainly originates from the normal tissues surrounding the wound when artificial dermis is transplanted on the wound with periosteum defect or bone exposed.