Norbury William B, Jeschke Marc G, Herndon David N
Department of Surgery, Shriners Hospitals for Children, Galveston, Texas, USA.
Crit Care. 2005;9(6):533-4. doi: 10.1186/cc3881. Epub 2005 Oct 17.
The management of patients with partial thickness (second degree) burns is problematic due to the different treatments needed for varying depths of injury. A report recently published in The Lancet describes a novel treatment for deep second degree burns using a fetal skin construct (FSC). The authors included eight pediatric patients with small second degree burns. They showed that FSCs reduced the need for autografting of deep second degree burns, with little hypertrophy of new skin and no skin contraction. This technology is new and exciting, but in our opinion several issues must be addressed before FSCs can enter the clinical arena. All of the patients were included in the treatment group, and therefore no comparison with conventional skin substitutes was possible. There is no mention of the use of laser Doppler in any initial assessment of patients. The debridement carried out before application of the FSC is not elaborated upon, and the surface areas involved in the study were very small in most cases, which limits the relevance to patients with larger burns. The use of FSCs gives us an additional option in a range of possible treatments for this notoriously difficult-to-treat patient group.
由于不同深度的部分厚度（二度）烧伤患者需要不同的治疗方法，因此这类患者的管理存在问题。最近发表在《柳叶刀》上的一份报告描述了一种使用胎儿皮肤构建物（FSC）治疗深二度烧伤的新方法。作者纳入了八名患有小面积二度烧伤的儿科患者。他们表明，FSC减少了深二度烧伤自体移植的需求，新皮肤几乎没有增生，也没有皮肤挛缩。这项技术新颖且令人兴奋，但在我们看来，在FSC进入临床应用之前，必须解决几个问题。所有患者都被纳入了治疗组，因此无法与传统皮肤替代物进行比较。在对患者的任何初始评估中都没有提及使用激光多普勒。在应用FSC之前进行的清创术没有详细说明，而且在大多数情况下，研究涉及的表面积非常小，这限制了其与大面积烧伤患者的相关性。FSC的使用为这个 notoriously difficult-to-treat patient group提供了一系列可能的治疗方法中的另一种选择。 （注：原文中“notoriously difficult-to-treat patient group”直接保留英文，可能是特定表述或有误，可根据实际情况调整）
