Matsumura Hajime, Matsushima Asako, Ueyama Masashi, Kumagai Norio
Department of Plastic and Reconstructive Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Department of Advancing Acute Medicine, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Aza Mizuhocho Mizuho-ku, Nagoya 467-8602, Japan.
Burns. 2016 Jun;42(4):769-76. doi: 10.1016/j.burns.2016.01.019. Epub 2016 Mar 2.
In the 1970s, Green et al. developed a method that involved culturing keratinocyte sheets and used for treatment of burns. Since then, the take rate of cultured epidermal autograft (CEA) onto fascia, granulation tissue, or allografts has been extensively reported, while that on an artificial dermis in a large case series is not. Moreover, the contribution of CEA to patient survival has not been analyzed in a multicenter study.
We conducted a 6-year multicenter surveillance on the application of the CEA "JACE(®") for treatment of burns >30% total body surface area (TBSA) across 118 Japanese hospitals. This surveillance included 216 patients and 718 graft sites for efficacy analysis. The CEA take rate at 4 weeks after grafting was evaluated, and safety was monitored until 52 weeks. In addition, the survival curve obtained in this study and the data obtained from the Tokyo Burn Unit Association (TBUA) were compared.
The mean CEA take rates at week 4 were 66% (sites) and 68% (patients), and the rate on the artificial dermis was 65% for 226 sites. CEA application combined with wide split-thickness auto or patch autograft increased the CEA take rate. On comparison with the data obtained from the TBUA, which included data on individuals with burns of the same severity, CEA application was found to contribute to patient survival until 7 weeks after burn.
We reported the take rate of CEA based on a 6-year multicenter surveillance. From our results, we found that the application of CEA is a useful treatment for the patients with extensive burns.
20世纪70年代，格林等人开发了一种培养角质形成细胞片的方法并用于烧伤治疗。从那时起，培养的自体表皮移植片（CEA）在筋膜、肉芽组织或同种异体移植上的成活率已有大量报道，而在大样本病例系列中其在人工真皮上的成活率报道较少。此外，尚未在多中心研究中分析CEA对患者生存的贡献。
我们对118家日本医院应用CEA“JACE(®)”治疗烧伤面积超过30%总体表面积（TBSA）的情况进行了为期6年的多中心监测。该监测包括216例患者和718个移植部位用于疗效分析。评估移植后4周时CEA的成活率，并监测安全性直至52周。此外，比较了本研究中获得的生存曲线与从东京烧伤中心协会（TBUA）获得的数据。
第4周时CEA的平均成活率为66%（移植部位）和68%（患者），226个部位在人工真皮上的成活率为65%。CEA联合广泛的中厚自体皮或点状自体皮移植可提高CEA的成活率。与TBUA获得的数据（包括相同严重程度烧伤个体的数据）相比，发现应用CEA有助于烧伤后7周内患者的生存。
我们基于6年的多中心监测报告了CEA的成活率。从我们的结果来看，我们发现CEA的应用对大面积烧伤患者是一种有效的治疗方法。
