Pediatric Burn Center, Plastic and Reconstructive Surgery, Department of Surgery, University Children's Hospital, Steinwiesstr. 75, CH-8032 Zurich, Switzerland.
Burns. 2010 Feb;36(1):114-20. doi: 10.1016/j.burns.2009.02.023. Epub 2009 May 27.
Integra Artificial Skin, a biosynthetic dermal template, is well established in acute burn surgery. The aim of the study was to determine the role of Integra in the surgical treatment of postburn scars in a younger population. Between March 1998 and November 2004, 17 patients (n=17; mean age=13.15 years) underwent complete excision of hypertrophic scars or keloids (1-4% TBSA; extremities=47%, head/neck=35%, trunk=18%) with subsequent implantation of Integra for defect closure. Split thickness skin grafting (STSG) of the Integra-derived neodermis was performed 3 weeks after the first operation. Scar excision and primary Integra implantation was successful in all but one patient (94%) who (6%) needed reimplantation once. Integra's mean take rate was 99.7% for all primarily successful patients. Complications occurred in three patients (18%), including minor problems without long-term consequences in 12% (seroma formation), and major problems in 6% (hematoma formation). Take rate of STSG ranged from 50% to 100% (mean 94%). Functional and cosmetic long-term outcome showed results scored "excellent" in 53%, "good" in 36%, and "fair" in 11%. Comparison of pre- and postoperative findings revealed a significant functional improvement in all and a considerable cosmetic improvement in all but two patients. These results suggest that Integra is a valid new treatment modality for extensive burn scar revision in younger patients.
Integra 人造皮肤是一种生物合成的真皮模板，在急性烧伤手术中已得到广泛应用。本研究旨在确定 Integra 在年轻患者烧伤后瘢痕的外科治疗中的作用。1998 年 3 月至 2004 年 11 月，17 例患者（n=17；平均年龄 13.15 岁）接受了肥厚性瘢痕或瘢痕疙瘩的完全切除（1-4%TBSA；四肢=47%，头颈部=35%，躯干=18%），随后植入 Integra 进行缺损闭合。第一次手术后 3 周，进行 Integra 衍生的真皮的断层皮片移植（STSG）。除了 1 例患者（6%）需要再次植入外，所有患者（94%）的瘢痕切除和初次 Integra 植入均成功。所有初次成功的患者中，Integra 的平均植入率为 99.7%。3 例患者（18%）发生并发症，包括 12%（血清肿形成）无长期后果的轻微问题和 6%（血肿形成）的严重问题。STSG 的植入率为 50%至 100%（平均 94%）。功能和美容的长期结果显示，53%的患者为“优秀”，36%的患者为“良好”，11%的患者为“尚可”。术前和术后结果的比较显示，所有患者的功能均显著改善，除 2 例患者外，所有患者的美容效果均有明显改善。这些结果表明，Integra 是治疗年轻患者大面积烧伤后瘢痕的一种有效的新治疗方法。
