Serena Thomas, Francius Adler, Taylor Cristin, MacDonald John
Thomas Serena, MD, is CEO of the Serena Group Inc in Cambridge, Massachusetts. Adler Francius, MD, is the In-Country Medical Director of the Wound Center at the Bernard Mevs Hospital in Port-au-Prince, Haiti. Cristin Taylor, PA-C, DPT, is a Physician Assistant at the Sinai Hospital of Baltimore in Maryland. John MacDonald, MD, is a member of the Department of Dermatology and Cutaneous Surgery at the Miller School of Medicine, University of Miami, Florida.
Adv Skin Wound Care. 2015 Mar;28(3):107-12. doi: 10.1097/01.ASW.0000460839.72826.ce.
The 2010 earthquake in Port-au-Prince, Haiti, highlighted the need for wound care in resource-poor countries. Subsequently, the University of Miami in Florida established one of the first interprofessional wound care centers located at Bernard Mevs Hospital in the central portion of Port-au-Prince, caring for patients with acute and chronic wounds. In 2012, the authors used a novel epidermal harvesting system (CelluTome Epidermal Harvesting System; Kinetic Concepts Inc, San Antonio, Texas) to harvest epithelium to be grafted on 7 patients at the Mevs Hospital with longstanding wounds. Epidermal microblisters were obtained from each patient's thigh using the CelluTome Epidermal Harvesting System. After 35 minutes, microblisters were raised using the device harvester, and an adhesive dressing was inserted into the harvester for transfer to the wound site. In patients with lower-extremity wounds, a 2-layer compression dressing was placed over epidermal grafts. Six of the 7 wounds improved or achieved complete closure in 4 weeks. One of the patients with a 2-year-old thigh wound failed to demonstrate improvement; this may have been secondary to an inability to adequately secure the graft. All donor sites healed without any visible scarring. The authors were able to conclude that epidermal grafting may represent a viable reconstructive option for patients in resource-poor countries.
2010年海地太子港地震凸显了资源匮乏国家对伤口护理的需求。随后，佛罗里达州的迈阿密大学在太子港中部的贝尔纳·梅夫斯医院设立了首批跨专业伤口护理中心之一，为急性和慢性伤口患者提供护理。2012年，作者使用一种新型表皮采集系统（CelluTome表皮采集系统；得克萨斯州圣安东尼奥市的动力概念公司）采集上皮组织，用于移植到梅夫斯医院7例患有长期伤口的患者身上。使用CelluTome表皮采集系统从每位患者的大腿获取表皮微水疱。35分钟后，使用器械采集器将微水疱挑起，并将粘性敷料插入采集器中，以便转移到伤口部位。对于下肢伤口患者，在表皮移植片上放置两层加压敷料。7处伤口中有6处在4周内有所改善或完全愈合。1例患有2年大腿伤口的患者未见改善；这可能是由于无法充分固定移植片所致。所有供皮区均愈合，无明显瘢痕形成。作者能够得出结论，表皮移植对于资源匮乏国家的患者可能是一种可行的重建选择。
