Mcheik Jiad N, Barrault Christine, Levard Guillaume, Morel Franck, Bernard François-Xavier, Lecron Jean-Claude
Pediatric Department, Service de Chirurgie Pédiatrique, CHU de Poitiers, Poitiers, France; pole biologie santé, LITEC, Laboratoire Inflammation, Tissus Epithéliaux et Cytokines EA 4331, Université de Poitiers, Poitiers, France; BIOalternatives, Gençay, France; and pole biospharm, Laboratoire d'immunologie et Inflammation, CHU de Poitiers, Poitiers, France.
Plast Reconstr Surg Glob Open. 2014 Oct 7;2(9):e218. doi: 10.1097/GOX.0000000000000176. eCollection 2014 Sep.
Treatment of burned patients is a tricky clinical problem not only because of the extent of the physiologic abnormalities but also because of the limited area of normal skin available.
Literature indexed in the National Center (PubMed) has been reviewed using combinations of key words (burns, children, skin graft, tissue engineering, and keratinocyte grafts). Articles investigating the association between burns and graft therapeutic modalities have been considered. Further literature has been obtained by analysis of references listed in reviewed articles.
Severe burns are conventionally treated with split-thickness skin autografts. However, there are usually not enough skin donor sites. For years, the question of how covering the wound surface became one of the major challenges in clinical research area and several procedures were proposed. The microskin graft is one of the oldest methods to cover extensive burns. This technique of skin expansion is efficient, but results remain inconsistent. An alternative is to graft cultured human epidermal keratinocytes. However, because of several complications and labor-intensive process of preparing grafts, the initial optimism for cultured epithelial autograft has gradually declined. In an effort to solve these drawbacks, isolated epithelial cells from selecting donor site were introduced in skin transplantation.
Cell suspensions transplanted directly to the wound is an attractive process, removing the need for attachment to a membrane before transfer and avoiding one potential source of inefficiency. Choosing an optimal donor site containing cells with high proliferative capacity is essential for graft success in burns.
烧伤患者的治疗是一个棘手的临床问题，不仅因为生理异常的程度，还因为可用的正常皮肤面积有限。
使用关键词组合（烧伤、儿童、皮肤移植、组织工程和角质形成细胞移植）对美国国立医学图书馆（PubMed）索引的文献进行了综述。考虑了研究烧伤与移植治疗方式之间关联的文章。通过分析综述文章中列出的参考文献获得了更多文献。
严重烧伤传统上采用中厚自体皮移植治疗。然而，通常没有足够的皮肤供区。多年来，如何覆盖创面的问题成为临床研究领域的主要挑战之一，并提出了几种方法。微粒皮移植是覆盖大面积烧伤最古老的方法之一。这种皮肤扩张技术是有效的，但结果仍然不一致。另一种方法是移植培养的人表皮角质形成细胞。然而，由于几种并发症以及制备移植物的劳动密集型过程，对培养的上皮自体移植最初的乐观态度逐渐下降。为了解决这些缺点，在皮肤移植中引入了从选定供区分离的上皮细胞。
直接将细胞悬液移植到创面上是一个有吸引力的过程，无需在转移前附着于膜上，避免了一个潜在的低效来源。选择一个含有具有高增殖能力细胞的最佳供区对于烧伤移植的成功至关重要。
