Boekema B K H L, Boekestijn B, Breederveld R S
Association of Dutch Burn Centres, PO Box 1015, 1940 EA Beverwijk, The Netherlands.
University Medical Center, Leiden, The Netherlands.
Burns. 2015 Jun;41(4):848-52. doi: 10.1016/j.burns.2014.10.016. Epub 2014 Nov 15.
Skin grafting is standard of care for severe burn and trauma patients. Graft sites are often accompanied with more pain than the burn sites. To minimize graft site areas, excess skin remaining after harvesting, is stored in saline at 4°C to be used for transplantation up to 1 week later. However, the optimal storage solution and maximum storage time are not known. We set out to determine the storage time after which stored skin is still viable. In addition, different storage solutions were tested. Split-thickness skin from 15 donors with a thickness of 0.3 mm was stored in normal saline, in medium, RPMI or DMEM/F12, allowing pairwise comparison. Biopsies were taken up to 3 weeks for histology and for skin viability assessment using an MTT based activity assay. Activity of the saline stored control decreased to 62% at day 7 and to 27% at day 14. Activity was retained at a higher level in RPMI and was 78% at day 7 and 70% at day 14. Results with DMEM/F12 showed a similar trend as the saline control. Based on activity, RPMI was found to be superior to DMEM/F12 (on days 3 and 10) and both saline and DMEM/F12 (on days 14 and 21). Capability to proliferate (BrdU incorporation) did not differ between media, up to 7 days. Histologically, the number of apoptotic cells increased in time but differences between media were not noted. Based on these results, RPMI would be an improvement over saline in retaining viability of skin grafts during storage, and possibly in improved take rate.
皮肤移植是重度烧伤和创伤患者的标准治疗方法。移植部位通常比烧伤部位更疼。为了尽量减少移植部位面积，采集后剩余的多余皮肤保存在4℃的盐水中，可在1周后用于移植。然而，最佳的储存溶液和最长储存时间尚不清楚。我们着手确定储存皮肤仍具活力的储存时间。此外，还测试了不同的储存溶液。将来自15名供体的厚度为0.3毫米的断层皮肤分别储存在生理盐水、培养基、RPMI或DMEM/F12中，以便进行两两比较。在长达3周的时间内进行活检，用于组织学检查以及使用基于MTT的活性测定法评估皮肤活力。储存在盐水中的对照组活性在第7天降至62%，在第14天降至27%。RPMI中的活性保持在较高水平，在第7天为78%，在第14天为70%。DMEM/F12的结果显示出与盐水对照组相似的趋势。基于活性，发现RPMI在第3天和第10天优于DMEM/F12，在第14天和第21天优于盐水和DMEM/F12。在长达7天的时间内，不同培养基之间的增殖能力（BrdU掺入）没有差异。从组织学上看，凋亡细胞数量随时间增加，但未观察到不同培养基之间的差异。基于这些结果，在储存期间保持皮肤移植的活力方面，RPMI比盐水有所改进，并且可能提高移植成功率。
