Tahir A, Webb J B, Allen G, Nancarrow J D
Department of Plastic and Reconstructive Surgery, Selly Oak Hospital, University Hospital Birmingham, Selly Oak, Birmingham B29 6JD, UK.
J Plast Reconstr Aesthet Surg. 2006;59(4):404-8. doi: 10.1016/j.bjps.2005.09.027.
EMLA cream is used in plastic surgery as a topical anaesthetic to harvest split skin grafts. It has been observed that the skin appears pale and oedematous after the application of EMLA. The aim our study was to determine the effect of EMLA with an occlusive dressing on skin thickness using a high frequency ultrasound. Twenty volunteers took part in this study after approval from the ethics committee. An area of skin was marked on both thighs and the skin thickness of each, measured using ultrasound. EMLA with an occlusive dressing was applied to one thigh. This was removed after at least 2 h of application time but at different time points and skin thickness of each thigh measured again. Data was analysed using t-test and Pearson's correlation. Mean age in years +/- SD (range) was 36.1 +/- 12.1 (23 - 61). Male:female ratio was 8:12. Mean skin thickness +/- SEM increased from 1.86 +/- 0.055 mm prior to EMLA application to 1.96 +/- 0.051 mm post-EMLA application p= 0.02. There was a significant correlation between the increase in skin thickness and duration of application of EMLA cream (p = <0.001, R2 = 0.59). The results conclude that EMLA applied under an occlusive dressing has an effect on skin tissue thickness and any surgeon who harvests split skin grafts under EMLA should be aware of this. Further research is needed to compare laser treatments performed under local anaesthetic creams against general anaesthesia as an increase in skin thickness may affect the depth of laser penetration.
EMLA乳膏在整形手术中用作局部麻醉剂以获取分层皮片移植。据观察，涂抹EMLA后皮肤会出现苍白和水肿。我们研究的目的是使用高频超声确定使用封闭敷料的EMLA对皮肤厚度的影响。在获得伦理委员会批准后，20名志愿者参与了这项研究。在双大腿上标记皮肤区域，并使用超声测量每个区域的皮肤厚度。将带有封闭敷料的EMLA应用于一侧大腿。在至少涂抹2小时后，但在不同时间点将其去除，并再次测量每个大腿的皮肤厚度。使用t检验和皮尔逊相关性分析数据。平均年龄（岁）±标准差（范围）为36.1±12.1（23 - 61）。男女比例为8:12。平均皮肤厚度±标准误从涂抹EMLA前的1.86±0.055毫米增加到涂抹EMLA后的1.96±0.051毫米，p = 0.02。皮肤厚度增加与EMLA乳膏涂抹持续时间之间存在显著相关性（p = <0.001，R2 = 0.59）。结果表明，在封闭敷料下涂抹EMLA对皮肤组织厚度有影响，任何在EMLA下获取分层皮片移植的外科医生都应意识到这一点。需要进一步研究以比较在局部麻醉乳膏下进行的激光治疗与全身麻醉，因为皮肤厚度的增加可能会影响激光穿透深度。
