Department of Internal Medicine, Division of Dermatology, Geriatric Diseases and Nephrology, University of Bologna , Bologna , Italy.
J Dermatolog Treat. 2014 Oct;25(5):434-7. doi: 10.3109/09546634.2012.757286. Epub 2013 Feb 24.
The management of surgical wounds of the donor areas for split-thickness skin grafts might be difficult in terms of pain, risk of infection, and delayed healing.
In the period from September 2011 to June 2012, 12 patients affected by large ulcerated basal cell carcinoma (BCC) of the lower legs, 2 patients affected by squamous cell carcinoma (SCC), and 1 patient presenting malignant melanoma located on the scalp, with split-thickness skin grafts were treated. In the 12 BCC patients, the donor site areas were situated on the anterior or lateral site of the contralateral thigh and in 3 other patients on the forearms. Immediately after dermatome skin removal of 0.3 mm layer of epidermis, the donor sites were treated by applying an advanced epithelialization dressing consisting of pure cellulose film in all patients. The wound surfaces were covered by the cellulose dressing with 1 cm of excess. Bleeding was controlled with slight compression with sterile gauzes before the medication was applied. Multiple small cuts of the cellulose dressing, with a No. 11 surgical blade were made, in order to avoid hematoma formation or fluid accumulation. A mild compression bandage was used in all patients. The patients were visited after 7, 14, and 21 days. The bandage was removed after 1 week and the medical device was left at the site for other 7 days.
After 2 weeks, the medical device was partially detached on the underlying areas showing almost completely reepithelialization. Almost no pain was referred by the patients. In the authors' experience, this medical device markedly reduces the level of pain especially at the time of dressing application, after the surgical procedure, and during the healing process. No infections were observed. The healing process was fast and produced good aesthetic results.
The use of Cuticell® Epigraft BSN medical device simplifies the management and healing of the donor areas for split-thickness skin grafts.
游离刃厚皮片供皮区的外科伤口处理在疼痛、感染风险和愈合延迟方面可能存在困难。
2011 年 9 月至 2012 年 6 月期间，我们治疗了 12 例小腿基底细胞癌（BCC）大溃疡患者、2 例鳞状细胞癌（SCC）患者和 1 例头皮恶性黑色素瘤患者，这些患者均采用游离刃厚皮片移植治疗。在 12 例 BCC 患者中，供皮区位于对侧大腿的前侧或外侧，另外 3 例患者的供皮区位于前臂。在所有患者中，在表皮层 0.3mm 处用切皮机切取皮片后，立即应用含有纯纤维素膜的先进上皮化敷料处理供皮区。将纤维素敷料覆盖在伤口表面，超出 1cm。在敷药前，用无菌纱布轻轻按压以控制出血。用 No.11 手术刀片在纤维素敷料上切多个小切口，以避免血肿形成或液体积聚。所有患者均使用轻度加压绷带。患者分别在第 7、14 和 21 天进行随访。1 周后去除绷带，将医疗设备留在原处 7 天。
术后 2 周，在供皮区的底层，医疗设备部分脱落，几乎完全实现再上皮化。患者几乎没有疼痛。根据作者的经验，这种医疗设备显著降低了疼痛程度，特别是在敷药、手术和愈合过程中。未观察到感染。愈合过程快速，产生了良好的美学效果。
使用 Cuticell®Epigraft BSN 医疗设备可简化游离刃厚皮片供皮区的管理和愈合过程。
