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慢性腿部溃疡的自体皮肤移植有没有更简便的方法?一种新技术——“切碎微小移植物”

Is there an easier way to autograft skin in chronic leg ulcers? 'Minced micrografts', a new technique.

作者信息

Boggio P, Tiberio R, Gattoni M, Colombo E, Leigheb G

机构信息

Dermatologic Department, University of Piemonte Orientale, Novara, Italy.

出版信息

J Eur Acad Dermatol Venereol. 2008 Nov;22(10):1168-72. doi: 10.1111/j.1468-3083.2008.02737.x. Epub 2008 Apr 10.

Abstract

BACKGROUND

Chronic venous leg ulcers represent an urgent and increasing problem for public health. The use of skin autografts results in a greater therapeutic success in healing chronic ulcers.

OBJECTIVE

A simple method of skin autografting that could permit a wider use of skin grafts in outpatients is needed. A new technique allowing skin autografting in a simple one-step process, without complex surgical procedures or expensive technical supplies, is presented.

METHODS

A small, full-thickness skin specimen taken from the patient is finely minced and spread on his leg ulcer bed allowing to cover a surface many times wider than the sample itself.

RESULTS

This method induces faster re-epithelization of chronic leg ulcers that failed to heal despite good conservative local therapy and give the possibility to repair very large ulcers with small fragments of skin. A clinical case is shown as an example out of 20 ulcers we recently treated.

CONCLUSION

Our preliminary report shows that this technique results in a greater therapeutic success (18 of 20 cases) in healing chronic leg ulcers, a common pathology that often affects outpatients treated for very long periods at home or in the Dermatologist's office. In our experience, this new and successful reparative possibility makes 'mince grafting' a recommendable procedure.

摘要

背景

下肢慢性静脉溃疡是一个紧迫且日益严重的公共卫生问题。使用自体皮肤移植在慢性溃疡愈合方面能取得更大的治疗成功。

目的

需要一种简单的自体皮肤移植方法,以便在门诊患者中更广泛地使用皮肤移植。本文介绍了一种新技术,可通过简单的一步操作进行自体皮肤移植,无需复杂的外科手术或昂贵的技术设备。

方法

从患者身上取下一小片全层皮肤样本,精细切碎后铺展在其腿部溃疡创面上,使其覆盖的面积比样本本身大许多倍。

结果

该方法能使尽管接受了良好的保守局部治疗仍未愈合的慢性腿部溃疡更快地重新上皮化,并有可能用小皮肤碎片修复非常大的溃疡。我们展示了最近治疗的20例溃疡中的一个临床病例。

结论

我们的初步报告表明,这项技术在愈合慢性腿部溃疡方面取得了更大的治疗成功(20例中的18例),慢性腿部溃疡是一种常见病症,常影响在家中长期接受治疗或在皮肤科医生办公室接受治疗的门诊患者。根据我们的经验,这种新的且成功的修复可能性使“碎皮移植”成为一种值得推荐的手术方法。

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