Reconstructive Sciences Department, Hospital Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia.
J Reconstr Microsurg. 2011 Feb;27(2):103-8. doi: 10.1055/s-0030-1268208. Epub 2010 Oct 25.
Major reconstructive surgery may be extensive and prolonged, and it may cause edema and compromise the flap pedicle if closed under tension. Glycerol-preserved skin allograft (GPA) can provide a means for tension-free closure and temporary cover of the wound. Seven years of analysis on GPA used in conjunction with major reconstruction was undertaken to highlight its indications, results, and outcomes. Forty-seven patients were included, aged between 9 and 73 years. Majority of patients had reconstruction following tumor resection and trauma. The main indication for use of GPA was temporary, loose cover of the wound in 44% of cases; flap pedicle protection in 31% of cases; donor site wound cover in 10%; flap monitoring in one case; and management of flap-related complications in 6% of cases. Free flap reconstruction was performed in 72% of cases. In conclusion, GPA is a useful adjunct in reconstructive surgery. It can be used temporarily to allow tension-free wound closure, as well as to protect the flap pedicle until edema subsides and the pedicle becomes stable. This latter approach allows secondary wound closure and good esthetic outcome.
主要的重建手术可能范围广泛且耗时较长,如果在紧张状态下关闭,可能会导致水肿并影响皮瓣蒂。甘油保存的皮肤同种异体移植物(GPA)可以为无张力闭合和临时覆盖伤口提供一种手段。对 GPA 与主要重建联合使用 7 年的分析突显了其适应证、结果和结局。共纳入 47 例年龄在 9 至 73 岁之间的患者。大多数患者是在肿瘤切除和创伤后进行重建。使用 GPA 的主要适应证是在 44%的情况下临时、宽松地覆盖伤口;在 31%的情况下保护皮瓣蒂;10%的情况下用于供区创面覆盖;1 例用于皮瓣监测;6%的情况下用于处理皮瓣相关并发症。72%的患者进行了游离皮瓣重建。总之,GPA 是重建手术的有用辅助手段。它可以暂时用于无张力伤口闭合,以及在皮瓣蒂水肿消退和稳定之前保护皮瓣蒂。后一种方法允许二期闭合伤口,并获得良好的美容效果。