Leon-Villapalos Jorge, Eldardiri Mohamed, Dziewulski Peter
St Andrews Centre for Plastic Surgery and Burns, Court Road, Broomfield, Chelmsford, CM1 7ET, UK.
Cell Tissue Bank. 2010 Feb;11(1):99-104. doi: 10.1007/s10561-009-9152-1. Epub 2010 Jan 15.
Burns are tissue wounds caused by thermal, electrical, chemical cold or radiation injuries. Deep injuries lead to dermal damage that impairs the ability of the skin to heal and regenerate on its own. Skin autografting following burn excision is considered the current gold standard of care, but lack of patient's own donor skin or unsuitability of the wound for autografting may require the temporary use of dressings or skin substitutes to promote wound healing, reduce pain, and prevent infection and abnormal scarring. These alternatives include deceased donor skin allograft, xenograft, cultured epithelial cells and biosynthetic skin substitutes. Allotransplantation is the transplantation of cells, tissues, or organs, sourced from a genetically non-identical member of the same species as the recipient. Human deceased donor skin allografts represent a suitable and much used temporizing option for skin cover following burn injury. The main advantages for its use include dermoprotection and promotion of reepithelialisation of the wound and their ability to act as skin cover until autografting is possible or re-harvesting of donor sites becomes available. Disadvantages of its use include the limited abundance and availability of donors, possible transmission of disease, the eventual rejection by the host and its handling storing, transporting and associated costs of provision. This paper will explore the role of allograft skin in burn care, defining the indications for its use in burn management and the future potential for allograft tissue banking.
烧伤是由热、电、化学物质、寒冷或辐射损伤引起的组织创伤。深度损伤会导致真皮层受损，从而削弱皮肤自行愈合和再生的能力。烧伤切除术后进行自体皮肤移植被认为是目前的护理金标准，但缺乏患者自身的供皮或伤口不适合自体移植可能需要临时使用敷料或皮肤替代品来促进伤口愈合、减轻疼痛并预防感染和异常瘢痕形成。这些替代品包括已故供体皮肤同种异体移植、异种移植、培养的上皮细胞和生物合成皮肤替代品。同种异体移植是指将细胞、组织或器官从与受体同一物种的基因不同的成员身上移植过来。人类已故供体皮肤同种异体移植是烧伤后皮肤覆盖的一种合适且常用的临时选择。其使用的主要优点包括保护真皮、促进伤口再上皮化以及在自体移植可行或供皮区可再次取材之前作为皮肤覆盖物的能力。其使用的缺点包括供体数量有限且难以获取、可能传播疾病、最终会被宿主排斥以及其处理、储存、运输和相关供应成本。本文将探讨同种异体皮肤在烧伤护理中的作用，确定其在烧伤治疗中的使用指征以及同种异体组织库的未来潜力。
