Bargues L, Prat M, Leclerc T, Bey E, Lataillade J-J
Centre de traitement des brûlés, hôpital d'instruction des armées Percy, 101, avenue Henri-Barbusse, 92141 Clamart, France.
Pathol Biol (Paris). 2011 Jun;59(3):e49-56. doi: 10.1016/j.patbio.2009.12.006. Epub 2010 Feb 18.
Severe burned patients need definitive and efficient wound coverage. Outcome of massive burns has been improved by using cultured epithelial autografts (CEA). Despite fragility, percentages of success take, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in few burn centres. First improvements were to combine CEA and dermis-like substitute. Cultured skin substitutes provide earlier skin closure and satisfying functional result. These methods have been used successfully in massive burns. Second improvement was to allow skin regeneration by using epidermal stem cells. Stem cells have capacity to differentiate into keratinocytes, to promote wound repair and to regenerate skin appendages. Human mesenchymal stem cells contribute to wound healing and were evaluated in cutaneous radiation syndrome. Skin regeneration and tissue engineering methods remain a complex challenge and offer the possibility of new treatment for injured and burned patients.
严重烧伤患者需要确切有效的伤口覆盖。使用培养的自体上皮移植片（CEA）改善了大面积烧伤的治疗效果。尽管存在脆弱性、成功率、治疗成本以及长期挛缩倾向等问题，但这种手术技术仅在少数烧伤中心得到发展。最初的改进是将CEA与真皮样替代物相结合。培养的皮肤替代物能更早实现皮肤闭合并取得令人满意的功能效果。这些方法已成功应用于大面积烧伤。第二个改进是通过使用表皮干细胞来促进皮肤再生。干细胞具有分化为角质形成细胞、促进伤口修复和再生皮肤附属器的能力。人间充质干细胞有助于伤口愈合，并已在皮肤辐射综合征中进行了评估。皮肤再生和组织工程方法仍然是一项复杂的挑战，但为受伤和烧伤患者提供了新的治疗可能性。
