Esteban-Vives Roger, Choi Myung S, Young Matthew T, Over Patrick, Ziembicki Jenny, Corcos Alain, Gerlach Jörg C
Department of Surgery and Bioengineering, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Burns. 2016 Nov;42(7):e99-e106. doi: 10.1016/j.burns.2016.02.020. Epub 2016 Aug 25.
Partial and deep partial-thickness burn wounds present a difficult diagnosis and prognosis that makes the planning for a conservative treatment versus mesh grafting problematic. A non-invasive treatment strategy avoiding mesh grafting is often chosen by practitioners based on their clinical and empirical evidence. However, a delayed re-epithelialization after conservative treatment may extend the patient's hospitalization period, increase the risk of infection, and lead to poor functional and aesthetic outcome. Early spray grafting, using non-cultured autologous cells, is under discussion for partial and deep partial-thickness wounds to accelerate the re-epithelialization process, reducing the healing time in the hospital, and minimizing complications. To address planning for future clinical studies on this technology, suitable indications will be interesting. We present case information on severe second-degree injuries after gas, chemical, electrical, gasoline, hot water, and tar scalding burns showing one patient per indication. The treatment results with autologous non-cultured cells, support rapid, uncomplicated re-epithelialization with aesthetically and functionally satisfying outcomes. Hospital stays averaged 7.6±1.6 days. Early autologous cell-spray grafting does not preclude or prevent simultaneous or subsequent traditional mesh autografting when indicated on defined areas of full-thickness injury.
部分厚度烧伤和深部部分厚度烧伤创面的诊断和预后较为困难,这使得保守治疗与网状植皮的治疗方案规划存在问题。基于临床和经验证据,从业者通常会选择避免网状植皮的非侵入性治疗策略。然而,保守治疗后上皮再形成延迟可能会延长患者的住院时间,增加感染风险,并导致功能和美观效果不佳。对于部分厚度和深部部分厚度创面,正在讨论使用非培养自体细胞的早期喷雾移植,以加速上皮再形成过程,减少住院愈合时间,并将并发症降至最低。为了规划该技术未来的临床研究,合适的适应症将很有意义。我们展示了气体、化学物质、电、汽油、热水和焦油烫伤导致的严重二度烧伤的病例信息,每个适应症展示一名患者。自体非培养细胞的治疗结果支持快速、无并发症的上皮再形成,获得美观和功能上令人满意的结果。平均住院时间为7.6±1.6天。当在全层损伤的特定区域有指征时,早期自体细胞喷雾移植并不排除或阻止同时或随后进行传统网状自体植皮。