Martin R Buta, Matthew Supple, Sean Hickey, Jonathan S Friedstat, John T Schulz, Edward A Bittner, Joshua Tam, Jeremy Goverman
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引用次数: 0
摘要
本初步研究评估了劈裂厚度皮肤移植(STSGs)和微皮肤组织柱(MSTC)治疗三度全层烧伤创面的可行性。对两种移植技术的供体部位也进行了评估。年龄≥18岁,三度全层烧伤(TBSA)≤60%的患者入组。每个受试者处理一个2.5 x 2.5 cm2的伤口面积,伤口的剩余部分作为内部对照。靶创面采用MSTCs + STSG治疗,对照创面采用STSG治疗。在伤口愈合后对患者进行了长达9个月的随访。主要终点包括再上皮化率(RER)、疤痕(温哥华疤痕量表、患者和观察者疤痕评估量表)和供体部位疼痛(视觉模拟量表)。10名患者入组。总的来说,与STSG供体部位相比,MSTC供体部位疼痛更少,上皮化更快,POSAS和VSS评分也有所提高。对于所有终点,移植或不移植MSTCs的受者伤口没有差异。术中MSTC移植是可行的,且供体部位发病率最小。当MSTCs与STSGs同时应用于烧伤创面时,这项初步研究无法证明MSTCs能促进伤口愈合或减少疤痕形成。需要更大规模的临床研究来评估MSTCs与STSGs联合使用的效用。
A Pilot Study of Microcolumn Skin Grafting in Full-thickness Burns.
This pilot study evaluated the feasibility of treating third-degree, full-thickness burn wounds with both split-thickness skin grafts (STSGs) and micro skin tissue columns (MSTC). Donor sites for both grafting techniques were also assessed. Patients aged ≥18 years with ≤60% TBSA third-degree, full-thickness burns were enrolled. One 2.5 × 2.5 cm2 wound area was treated in each subject, with the remaining portion of the wound used as an internal control. The target wound was treated with MSTCs + STSG while the control site was treated with STSG. Patients were followed for up to 9 months after wound closure. Primary endpoints included re-epithelialization rate, scarring (VSS, Patient and Observer Scar Assessment Scale), and donor site pain (visual analogue scale). Ten patients were enrolled. Overall, MSTC donor sites were less painful, epithelialized faster, and resulted in improved Patient Observer Scar Assessment Scale and Vancouver Scar Scale (VSS) scores than STSG donor sites. For all endpoints, there were no differences in the recipient wounds grafted with or without MSTCs. Intraoperative MSTC grafting is feasible and results in minimal donor site morbidity. This pilot study was unable to demonstrate enhanced wound healing or reduced scar formation when MSTCs were applied simultaneously with STSGs to burn wounds. Larger clinical studies are needed to assess the utility of MSTCs in conjunction with STSGs.
期刊介绍:
Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.