臺灣博碩士論文加值系統

傷口癒合的過程是一個複雜的生物反應，包括發炎，增生，和重塑的階段。在過去研究中，許多物理和化學治療方法被大量研究，企圖找出影響傷口癒合的機制和改善癒合的關鍵因子。然而，大部分的研究以外觀和組織觀察，來評估治療方法的效用，卻少有研究，使用抗拉強度換算的癒合指數來量化傷口癒合的品質，其中癒合指數可用來正規化不同的生長條件的老鼠。因此，我們提出了一連串的研究，在大鼠切口模型來探討縫合方法、矽凝膠、遠紅外線照射、注射生物材料（膠原蛋白，透明質酸，明膠）的影響。在Sprague-Dawley大鼠背部分4個區域，其中1處作為控制組，其他3處切2公分的傷口並縫合，作為實驗組。經過不同的治療方法干預後，在1,2,4,6週將皮膚取下作拉伸測試和H＆E染色。結果顯示，簡單的縫合方式、矽凝膠治療，對皮膚癒合過程有較佳的力學性質。而在前兩週的遠紅外線治療，可增加皮膚的抗拉強度。總而言之，其結果表明，縫線材料越穩固、縫合方法越簡單，癒合傷口的力學性能就越大。此外，矽凝膠治療組相較於較未治療組，其發炎細胞較少，表皮有更好的完整性在，以及較好的力學強度。遠紅外線能提供短期的力學強度，但其效果在較長時間則減弱。另外，玻尿酸注射組比膠原蛋白和明膠有較高的力學強度。

The wound healing process is a set of complicated and concurrent biological responses, which includes inflammation, proliferation, and remodeling phases. In the past, many physical and chemical treatments have been intensively studied in order to find the key factors that affect the mechanisms of wound healing and to improve healing. However, most of these studies used gross appearances and histology observations to evaluate the efficacy of the novel treatments. Only limited studies quantified the healing process using the mechanical recovery index (RI), which was introduced to normalize the different growth conditions of individual rats. Therefore, this study proposed a series of studies that investigated the mechanical recovery influences of suture methods, topical silicone gel, far-infrared ray (FIR) exposure, and injectable biomaterials (collagen, hyaluronic acid (HA), and gelatin) in rats used as models of incision injury. The dorsum of each the Sprague-Dawley rats was divided into four regions. The rats were randomly assigned, with one group of rats assigned to the normal group and the others to experimental groups with two centimeter long cuts and full-thickness skin suture closures. Following different treatment protocols, the skins were harvested for tensile testing and H＆E stain at 1, 2, 4, and 6 weeks of healing time. The results showed that the simple suture method, the use of silicon gel, and HA injection groups provided better mechanical properties for the healing courses. FIR increased the tensile strength (TS) 2 weeks after injury. In conclusion, the results of suture methods indicated that the more supportive the suture materials are and the simpler the suture method is, the higher the mechanical property it will have. Besides, the wound treated with topical silicone gel had fewer inflammatory cells, higher integrity in the epidermis, and better mechanical strength than untreated groups. The FIR exposure enhances the RI of skin in the short term, but its effect diminished in the longer period. HA injection groups had higher mechanical strength than collagen and gelatin groups.

ABSTRACT III
中文摘要 V
ACKNOWLEDGEMENTS VI
TABLE OF CONTENTS VII
LIST OF TABLES IX
LIST OF FIGURES X
1. BACKGROUNDS 1
1.1 WOUND HEALING PROCESS 1
1.1.1 Inflammatory phase 1
1.1.2 Proliferation phase 3
1.1.3 Remodeling phase 3
1.2 TYPES OF WOUND MODELS 3
1.3 LITERATURE REVIEWS 5
1.3.1 The Effect of Suture Methods on Wound Healing 5
1.3.2 The Effect of Silicone Gel on Wound Healing 7
1.3.3 The Effect of FIR on Wound Healing 9
1.3.4 The Effect of Biomaterial Injections on Wound Healing 10
1.4 PURPOSE OF STUDY 13
2. MATERIALS AND METHODS 15
2.1 ANIMAL EXPERIMENT 15
2.1.1 Different Suture Methods 15
2.1.2 Topical Silicone Gel 16
2.1.3 FIR 17
2.1.4 Biomaterial Injections 18
2.2 SOFT TISSUE TENSILE TEST 19
2.3 HISTOLOGY 21
2.4 STATISTICAL ANALYSIS 21
3. RESULTS 23
3.1 DIFFERENT SUTURE METHODS 23
3.2 TOPICAL SILICONE GEL 27
3.3 FIR EXPOSURE 33
3.3.1 Mechanical property of wound treated with FIR 33
3.3.2 Characteristics of Rats 36
3.3.3 TS of Unwound Skin treated with FIR 37
3.3.4 Histology 38
3.4 BIOMATERIAL INJECTIONS 41
3.5 RI FOR ALL TREATMENTS 45
4. DISCUSSION 47
4.1 DIFFERENT SUTURE METHODS 47
4.2 TOPICAL SILICONE GEL 48
4.3 FIR EXPOSURE 50
4.4 BIOMATERIAL INJECTIONS 54
4.5 LIMITATIONS 56
5. CONCLUSIONS 58
6. FUTURE WORKS 60
7. REFERENCES 61
8. BIOGRAPHY 67
9. PUBLICATION LIST 68

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