Gravante G, Di Fede M C, Araco A, Grimaldi M, De Angelis B, Arpino A, Cervelli V, Montone A
Department of Surgery, University of Tor Vergata in Rome, via U. Maddalena 40/a, 00043 Ciampino, and Burn Center S. Eugenio Hospital, Roma, Italy.
Burns. 2007 Dec;33(8):966-72. doi: 10.1016/j.burns.2007.04.011. Epub 2007 Sep 29.
Our purpose was to directly compare results obtained with the ReCell system and the classic skin grafting for epidermal replacement in deep partial thickness burns.
We recruited all patients with deep partial thickness burns admitted at the Burn Centre of S. Eugenio Hospital in Rome over 2 years. Enrollment was conducted with a controlled strategy--sampling chart--that allowed homogeneous groups (ReCell and skin grafting) for age, gender, type of burns and total burn surface area (TBSA). We evaluated as primary endpoints of the study the (i) time for complete epithelization (both treated area and biopsy site) and (ii) aesthetic and functional quality of the epithelization (color, joint contractures). Secondary endpoints were the assessment of infections, inflammations or any adverse effects of the ReCell procedure, particular medications assumed, postoperative pain.
Eighty-two patients were analyzed in two homogeneous groups. All of them received adequate epidermal replacement, but skin grafting was faster than ReCell (p<0.05). On the contrary, ReCell biopsy areas and postoperative pain were smaller than classic grafting (p<0.05). The aesthetic and functional outcomes were similar between procedures.
ReCell is a feasible, simple and safe technique. It gives similar results to skin grafting but, harvesting minor areas, can open possible future applications in the management of large-burns patients.
我们的目的是直接比较使用ReCell系统和传统皮肤移植术进行深Ⅱ度烧伤表皮置换的结果。
我们招募了罗马圣欧金尼奥医院烧伤中心2年内收治的所有深Ⅱ度烧伤患者。采用对照策略——抽样图表——进行入组,以确保年龄、性别、烧伤类型和烧伤总面积(TBSA)方面的分组(ReCell组和皮肤移植组)具有同质性。我们将(i)完全上皮化时间(治疗区域和活检部位)以及(ii)上皮化的美学和功能质量(颜色、关节挛缩)评估为研究的主要终点。次要终点包括对感染、炎症或ReCell手术的任何不良反应、特定用药情况以及术后疼痛的评估。
对82例患者进行了两组同质性分析。所有患者均接受了充分的表皮置换,但皮肤移植比ReCell更快(p<0.05)。相反,ReCell活检区域和术后疼痛比传统移植更小(p<0.05)。两种手术的美学和功能结果相似。
ReCell是一种可行、简单且安全的技术。它与皮肤移植术的结果相似,但取材面积较小,可能为大面积烧伤患者的治疗开辟未来的应用前景。