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比较甘油保存和冷冻保存的同种异体皮肤在严重烧伤治疗中的应用:临床结果和体外组织活力的差异。

Comparing the use of glycerol preserved and cryopreserved allogenic skin for the treatment of severe burns: differences in clinical outcomes and in vitro tissue viability.

作者信息

Kua E H J, Goh C Q, Ting Y, Chua A, Song C

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.

出版信息

Cell Tissue Bank. 2012 Jun;13(2):269-79. doi: 10.1007/s10561-011-9254-4. Epub 2011 Apr 12.

Abstract

Cryopreserved (CryoPA) and Glycerol-preserved (GPA) skin allografts are commonly used in the treatment of severe burn injuries. However, comparable data on their differences in clinical outcome is scarce. This retrospective review aims to study the effect of allograft viability on clinical outcomes. The records of 48 severe burn patients who either received CryoPA or GPA were reviewed. Key burn mortality determinants were used to match the 2 groups. Clinical outcomes such as mortality rate (MR) and the length of hospital stay (LOS) were obtained. A separate in vitro comparison included histological assessments and the use of tetrazolium reductase activity to compare tissue viability. Both groups showed a comparable profile in burn mortality determinants. Patients who received CryoPA had a lower MR of 25% compared to 34.8% (P=0.250) in the GPA group and a lower LOS of 39.2-45.9 days (P=0.730), respectively. The histological structural integrity was found to be well preserved with both methods although CryoPA was confirmed to be the more viable product (P<0.05). The lower MR associated with CryoPA cannot be totally ignored. However, the mechanism through which viable skin allografts improves MR of severe burns patients remains to be elucidated.

摘要

冷冻保存(CryoPA)和甘油保存(GPA)的同种异体皮肤移植物常用于治疗严重烧伤。然而,关于它们临床结果差异的可比数据很少。这项回顾性研究旨在探讨同种异体移植物活力对临床结果的影响。回顾了48例接受CryoPA或GPA治疗的严重烧伤患者的记录。使用关键的烧伤死亡率决定因素对两组进行匹配。获得了死亡率(MR)和住院时间(LOS)等临床结果。一项单独的体外比较包括组织学评估和使用四氮唑还原酶活性来比较组织活力。两组在烧伤死亡率决定因素方面表现出相似的特征。接受CryoPA的患者死亡率较低,为25%,而GPA组为34.8%(P=0.250),住院时间也较短,分别为39.2 - 45.9天(P=0.730)。尽管CryoPA被证实是更具活力的产品(P<0.05),但两种方法的组织结构完整性均得到良好保存。与CryoPA相关的较低死亡率不容忽视。然而,有活力的同种异体皮肤移植物改善严重烧伤患者死亡率的机制仍有待阐明。

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