Bolívar-Flores J, Poumian E, Marsch-Moreno M, Montes de Oca G, Kuri-Harcuch W
Hospital Pediátrico de Tacubaya, Mexico City Government, Col. Tacubaya.
Burns. 1990 Feb;16(1):3-8. doi: 10.1016/0305-4179(90)90197-5.
Five children who suffered burns clinically regarded as full skin thickness loss were grafted with cultured allogeneic skin from newborn prepuce. The wounds had remained open and infected without healing for about 20 days before the patients were received in the burn unit. To avoid losing surviving deep epidermal cells the wounds were débrided but not deeply excised and, a few days before allografting, they were washed with isodine solution and sterile water, and treated with silvadene cream application. All children received 76 cultured allografts of about 60 cm2 each. After allografting, the wounds were epithelized in 7-10 days and the allogeneic grafted skin began desquamation suggesting that the allograft did not 'take' permanently but was replaced by the newly formed skin. On the other hand, since allografting is an adequate therapy to provide early temporary coverage in extensively burned patients, we developed conditions for banking cultured skin to make it available for immediate use. The conditions described allow banking of the cultured grafts for 15-20 days with retention of clonal growth ability similar to that of unstored epithelia. The results show that cultured epidermal cells obtained from human newborn foreskin, when used as allografts for coverage of full skin or deep partial skin thickness burns, allow rapid epithelization of the burn wounds.
五名临床上被视为全层皮肤丧失的烧伤儿童接受了来自新生儿包皮的培养异体皮肤移植。在患者被收入烧伤病房之前，伤口一直开放且感染，未愈合约20天。为避免存活的深层表皮细胞丢失，对伤口进行了清创但未进行深度切除，并且在异体移植前几天，用碘伏溶液和无菌水冲洗伤口，并用磺胺嘧啶银乳膏处理。所有儿童均接受了76块培养异体皮移植，每块面积约60平方厘米。异体移植后，伤口在7 - 10天内上皮化，异体移植的皮肤开始脱屑，这表明异体移植皮肤并未永久“存活”，而是被新形成的皮肤所替代。另一方面，由于异体移植是为大面积烧伤患者提供早期临时覆盖的一种适当治疗方法，我们制定了储存培养皮肤的条件，使其能够立即使用。所描述的条件允许将培养的移植物储存15 - 20天，同时保留与未储存上皮相似的克隆生长能力。结果表明，从人类新生儿包皮获得的培养表皮细胞，当用作异体移植以覆盖全层皮肤或深度部分皮肤厚度烧伤时，可使烧伤创面迅速上皮化。
