Sun Tianjun, Han Yanfu, Chai Jiake, Yang Hongming
Department of Burns and Plastic Surgery, Burns Institute, First Hospital Affiliated to General Hospital of PLA, Haidian District, Beijing, People's Republic of China.
J Burn Care Res. 2011 May-Jun;32(3):e67-73. doi: 10.1097/BCR.0b013e318217f8e2.
Selectively decellularized split-thickness porcine skin (SDSTPS) may be an optimal alternative for allograft. This study was designed to explore the efficacy of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds and to resolve the problem of the shortage and risk of cadaver skin allografts. Full-thickness xenogenic skin was harvested from a healthy ternary pig, and SDSTPS was produced by the glutaraldehyde-trypsin-detergent method. Split-thickness autograft skin was harvested from patients and minced into microskin autografts. The microskin autografts with overlaid SDSTPS were applied to 31 patients with deep burn wounds, 4 to 6 days after injury, and comparisons with cadaver skin allograft were carried out on both sides of the torso and limbs. The cases were followed up for 18 months. The following parameters were investigated: time of rejection and exfoliation, percentage of epithelialized wound area, number of cases with wound ulcer, hypertrophic scars, pain and itching, apparent deformity, and functional impairment. The rejection and exfoliation time of the skin xenograft was 17 ± 3 days and that of the skin allograft was 14 ± 2 days (P < .05), whereas the epithelialized wound area 3 weeks postoperatively for the skin xenograft and allograft was 87 ± 21% and 83 ± 41% (P > .05), respectively. There was no significant difference in skin morphology between the two groups. The satisfactory function was observed in the follow-up visit for 18 months postoperatively. The authors' results indicate that the clinical effect of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds is similar to that of microskin autograft overlaid with frozen cadaver skin, and SDSTPS could be an optimal alternative for allograft.
选择性脱细胞的中厚猪皮（SDSTPS）可能是同种异体移植的最佳替代物。本研究旨在探讨覆盖SDSTPS的微型自体皮移植在深度烧伤创面修复中的疗效，并解决尸体皮肤同种异体移植短缺和风险的问题。从健康三元猪获取全层异种皮肤，采用戊二醛 - 胰蛋白酶 - 去污剂法制备SDSTPS。从患者身上获取中厚自体皮并切碎成微型自体皮。将覆盖SDSTPS的微型自体皮应用于31例深度烧伤患者，于伤后4至6天应用，并在躯干和四肢两侧与尸体皮肤同种异体移植进行比较。对病例进行18个月的随访。研究以下参数：排斥和脱落时间、创面上皮化面积百分比、创面溃疡病例数、增生性瘢痕、疼痛和瘙痒、明显畸形及功能障碍。皮肤异种移植的排斥和脱落时间为17±3天，皮肤同种异体移植为14±2天（P<.05），而术后3周皮肤异种移植和同种异体移植的创面上皮化面积分别为87±21%和83±41%（P>.05）。两组皮肤形态无显著差异。术后18个月随访观察到功能满意。作者的结果表明，覆盖SDSTPS的微型自体皮移植在深度烧伤创面修复中的临床效果与覆盖冷冻尸体皮肤的微型自体皮相似，且SDSTPS可作为同种异体移植的最佳替代物。
