Rogers A D, Allorto N L, Adams S, Adams K G, Hudson D A, Rode H
Division of Plastic, Reconstructive and Maxillofacial Surgery, Department of Surgery, Groote Schuur and Red Cross War Memorial Children's Hospitals and the University of Cape Town, South Africa.
Departments of General Surgery and Critical Care Medicine, Nelson R. Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa.
Ann Burns Fire Disasters. 2013 Sep 30;26(3):142-6.
Improvements in comprehensive burn care, as practiced in dedicated burns units, have reduced mortality and morbidity rates significantly. Strategies deemed most important include the application of fluid resuscitation and nutrition protocols, intensive care and antimicrobial dressings, as well as early excision and grafting. Autografting is limited, however, by availability in very extensive burns, despite the use of expanded (meshed) skin. Alternatives have therefore been required, and deceased donor allograft is considered the gold standard. Fresh allograft use is limited by supply, and legislative and cultural restrictions have significantly influenced availability, despite evidence of its efficacy. This necessitates the establishment of a deceased donor skin bank in South Africa, with a mandate to procure and store allograft for distribution to burns units when required.
在专门的烧伤治疗中心所采用的综合烧伤护理方面的改进,已显著降低了死亡率和发病率。被认为最重要的策略包括液体复苏和营养方案的应用、重症监护和抗菌敷料,以及早期切除和植皮。然而,尽管使用了扩张(网状)皮肤,但自体移植在大面积烧伤中受到供皮量的限制。因此需要其他替代方法,而尸体供体同种异体移植被认为是金标准。新鲜同种异体移植的使用受到供应的限制,尽管有其疗效的证据,但立法和文化限制已显著影响了其可获得性。这就需要在南非建立一个尸体供体皮肤库,其任务是获取和储存同种异体移植皮肤,以便在需要时分发给烧伤治疗中心。