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背景:近年来,同种异体脱细胞真皮基质组织补片已在口腔组织缺损修复中广泛应用,但有关异种脱细胞真皮基质组织补片修复口腔黏膜缺损的研究较少。目的:评价异种脱细胞真皮基质在口腔黏膜组织缺损修复中的效果及生物安全性。方法:选择口腔良、恶性肿瘤手术切除后遗留的黏膜及部分软组织缺损患者71例,男37例,女34例,年龄45(20～70)岁;其中良性肿瘤42例,恶性肿瘤29例。采用异种脱细胞真皮基质组织补片修复口腔软组织浅层缺损。观察生物膜成活情况,颜色、质地,比较组织补片修复无硬组织支撑部位(颊、舌、口底)和有硬组织支撑部位(牙龈、硬腭)的收缩率。结果与结论:71例补片完全成活,未发生坏死、感染等并发症。植入后2周补片成活面积为(98.20±5.20)%,植入后3个月,补片颜色已与周围黏膜相近,大部分患者诉有不同程度的紧张感;植入后6个月补片植入区成功完成了细胞的爬行代替和血管化,生长稳定,无进一步收缩,弹性良好,患者感觉趋于正常。生物膜收缩发生在植入后2周～1个月,植入后3个月后基本稳定,术区组织形态与正常组织相比无明显差异。无硬组织支撑部位(颊、舌、口底)的收缩率较硬组织支撑部位(牙龈、硬腭)收缩率大。说明应用异种脱细胞真皮基质组织补片修复口腔黏膜具有组织相容性好、来源广泛、操作简单等优点,能够起到早期覆盖创面,促进创面愈合,减轻瘢痕生成的作用,可作为口腔黏膜缺损修复的理想材料。
BACKGROUND: In recent years, allogeneic acellular dermal matrix tissue patches have been widely used in the repair of oral tissue defects. However, there are few researches on the repair of oral mucosa defects with xenogenic acellular dermal matrix patches. OBJECTIVE: To evaluate the efficacy and biosafety of xenografted acellular dermal matrix in the repair of oral mucosal defects. Methods: A total of 71 males and 34 females, aged 45 (20-70 years) with mucosa and some soft tissue defects left after surgical resection of oral and malignant tumors, were selected. Among them, 42 were benign tumors and 29 were malignant tumors. Reconstruction of oral soft tissue superficial defects with xenogenic acellular dermal matrix. Biofilm survival, color and texture were observed. Tissue patch was used to compare the shrinkage rate of non-hard tissue support sites (buccal, lingual and floor) and hard tissue support sites (gums and hard palate). RESULTS AND CONCLUSION: Totally 71 patches survived without complication such as necrosis and infection. At 2 weeks after implantation, the survival area of the patch was (98.20 ± 5.20)%, and the color of the patch was similar to the surrounding mucosa at 3 months after implantation. Most patients complained of different degrees of tension; 6 months after implantation The patch implantation area successfully completed the cell instead of crawling and vascularization, stable growth, no further contraction, good elasticity, the patient feels normal. Biofilm shrinkage occurred 2 weeks to 1 month after implantation, and basically remained stable 3 months after implantation. There was no significant difference in histological morphology between the two groups. No hard tissue support parts (cheeks, tongue, mouth bottom) contraction rate than hard tissue support parts (gums, hard palate) shrinkage rate. It shows that the application of xenogenic acellular dermal matrix tissue patch to repair the oral mucosa has the advantages of good histocompatibility, wide range of sources, simple operation, etc. It can play an early role in covering wounds, promoting wound healing and reducing scar formation, and can be used as an oral mucosal defect The ideal material to repair.