Burn Treatment Center, Percy Military Teaching Hospital, 101 Avenue H. Barbusse, 92141 Clamart, France.
Burns. 2011 Sep;37(6):964-72. doi: 10.1016/j.burns.2011.03.011. Epub 2011 May 6.
Cultured epithelial autografts (CEAs) have long been used to tackle limited donor site availability and difficulty of permanent skin coverage in massive burns, but this approach still has limited documentation.
In this retrospective, single-center study, medical records of patients treated with CEAs in our burn center from 1991 until 2008 were analyzed in search of factors associated with outcome.
Out of 68 patients, 63 records were analyzable. Patients were aged 29 [17-41.5] years (seven children). Total body surface area (TBSA) burned was 81±10%, of which 69±14% TBSA full thickness. CEAs were first applied after 45±34 days, on a surface of 32±14% TBSA. Success rate at take down was 65±19%, correlating only with young age (r(2)=0.18; p=0.0006). At discharge, CEAs covered 26±15% TBSA. Infections (4.3±2 per patient), most frequently of skin, often complicated the clinical course. Mortality was 16% (10 patients). In multivariate analysis, the number of infections was the only factor associated with mortality (OR=2.05 per single infection, 95%CI 1.03-4.07, p=0.04).
Although complex and costly, CEAs can be used with reasonable success and satisfying survival results for the treatment of massive burns. In this study, favorable outcome was principally associated with young age and low number of infectious complications.
本回顾性单中心研究旨在分析本烧伤中心自 1991 年至 2008 年期间应用培养的自体上皮移植物（CEAs）治疗患者的病历资料，以寻找与预后相关的因素。
分析本烧伤中心自 1991 年至 2008 年期间应用培养的自体上皮移植物（CEAs）治疗患者的病历资料，寻找与预后相关的因素。
68 例患者中，有 63 例的病历资料可分析。患者年龄 29 岁[17-41.5]岁（7 例为儿童）。总体表烧伤面积（TBSA）为 81±10%，其中 69±14%TBSA 为全层烧伤。CEAs 首次应用于烧伤后 45±34 天，覆盖面积为 32±14%TBSA。取下 CEAs 的成功率为 65±19%，仅与年龄较小有关（r(2)=0.18；p=0.0006）。出院时，CEAs 覆盖 26±15%TBSA。感染（每位患者 4.3±2 次），通常为皮肤感染，常使临床病程复杂化。死亡率为 16%（10 例）。多变量分析显示，感染次数是与死亡率相关的唯一因素（每发生一次感染，OR=2.05，95%CI 为 1.03-4.07，p=0.04）。
尽管复杂且昂贵，但 CEAs 可用于治疗大面积烧伤，成功率合理，存活率令人满意。在本研究中，良好的预后主要与年龄较小和感染并发症较少有关。
