Kanapathy Muholan, Hachach-Haram Nadine, Bystrzonowski Nicola, Harding Keith, Mosahebi Afshin, Richards Toby
Division of Surgery & Interventional Science, University College London, London, UK.
Royal Free Hospital Wound Healing Group, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
Trials. 2016 May 17;17(1):245. doi: 10.1186/s13063-016-1352-y.
Split-thickness skin grafting (SSG) is an important modality for wound closure. However, the donor site becomes a second, often painful wound, which may take more time to heal than the graft site itself and holds the risk of infection and scarring. Epidermal grafting (EG) is an alternative method of autologous skin grafting that harvests only the epidermal layer of the skin by applying continuous negative pressure on the normal skin to raise blisters. This procedure has minimal donor site morbidity and is relatively pain-free, allowing autologous skin grafting in an outpatient setting. We plan to compare EG to SSG and to further investigate the cellular mechanism by which each technique achieves wound healing.
METHODS/DESIGN: EPIGRAAFT is a multicentre, randomised, controlled trial that compares the efficacy and wound-healing mechanism of EG with SSG for wound healing. The primary outcome measures are the proportion of wounds healed in 6 weeks and the donor site healing time. The secondary outcome measures include the mean time for complete wound healing, pain score, patient satisfaction, health care utilisation, cost analysis, and incidence of adverse events.
This study is expected to define the efficacy of EG and promote further understanding of the mechanism of wound healing by EG compared to SSG. The results of this study can be used to inform the current best practise for wound care.
Clinicaltrials.gov identifier, NCT02535481 . Registered on 11 August 2015.
断层皮片移植(SSG)是伤口闭合的一种重要方式。然而,供皮区会形成第二个往往很疼痛的伤口,其愈合时间可能比植皮区本身更长,且存在感染和瘢痕形成的风险。表皮移植(EG)是自体皮肤移植的一种替代方法,通过对正常皮肤施加持续负压以形成水疱,仅采集皮肤的表皮层。该手术供皮区发病率极低且相对无痛,可在门诊进行自体皮肤移植。我们计划比较EG和SSG,并进一步研究每种技术实现伤口愈合的细胞机制。
方法/设计:EPIGRAAFT是一项多中心、随机、对照试验,比较EG和SSG在伤口愈合方面的疗效及伤口愈合机制。主要结局指标为6周内愈合的伤口比例和供皮区愈合时间。次要结局指标包括伤口完全愈合的平均时间、疼痛评分、患者满意度、医疗保健利用情况、成本分析及不良事件发生率。
本研究有望明确EG的疗效,并促进对EG与SSG相比伤口愈合机制的进一步理解。本研究结果可用于为当前伤口护理的最佳实践提供参考。
Clinicaltrials.gov标识符,NCT02535481。于2015年8月11日注册。