口こう粘膜の創傷治ゆに関する実験的研究

Abstract

The rate of epithelialization on intraoral operative wounds was studied with special reference to the influence of blood supply disturbance on mucosa surrounding wound and of the nature of wound surface. A standardized wound was made on the rat hard palate and after various surgical treatments the epithelial extension from the wound edge was observed.Results1) Epithelial extension depended mainly on migration of the epithelial cell.2) The disturbance of blood supply to the surrounding mucosa prolonged the lag period, then the extension started. This factor did not infleunce the rate of epithelialization thereafter.3) In the groups in which the deep portion of the lamina propria was preserved on the wound surface, the rate of epithelialization was 0.19-0.21 mm/day. This value was similar to that reported previously about open skin wounds.Saliva eased dehydration of the connective tissue surface of wounds but did not accelerate epithelialization.4) In the groups in which the palatal bone was exposed to the wound surface, epithelialization was very slow because proliferation of the connective tissue was needed for the epithelial extension. But once the wound surface was covered with a new connective tissue, rate increased to half the level of the groups with the intact deep portion of the lamina propria preserved.5) When the deep portion of the lamina propria, which was suffering from blood supply disturbance, was left on the wound surface, the rate of epithelialization was half the level of groups with the intact deep portion of the lamina propria preserved.6) Edema and inflammation in the wound connective tissue decreased the rate of epithelialization.7) From these findings, it can be stated that the nature of the wound surface is a very important factor which influences epithelialization of intraoral operative wounds. To increase the rate of epithelialization, it is effective to preserve the intact lamina propria in the wound and secondarily to accelerate proliferation of the granulation tissue. It is also effective to prevent inflammation of the connective tissue in the wound.