Han Hyun Ho, Jun Daiwon, Moon Suk-Ho, Kang In Sook, Kim Min Cheol
Department of Plastic and Reconstructive Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Plastic and Reconstructive Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Springerplus. 2016 Nov 2;5(1):1902. doi: 10.1186/s40064-016-3599-x. eCollection 2016.
For skin defects caused by full-thickness burns, trauma, or tumor tissue excision, skin grafting is one of the most convenient and useful treatment methods. In this situation, graft fixation is important in skin grafting. This study was performed to compare the effectiveness of skin graft fixation between high-concentration fibrin sealant and sutures. There have been numerous studies using fibrin sealant for graft fixation, but they utilized slow-clotting fibrin sealant containing less than 10 IU/mL thrombin.
Twenty-five patients underwent split-thickness skin grafting using fast-clotting fibrin sealant containing 400 IU/mL thrombin, while 30 patients underwent grafting using sutures. Rates of hematoma/seroma formation, graft dislocation, graft necrosis, and graft take were investigated postoperatively. The graft surface area was calculated using Image J software (National Institutes of Health, Bethesda, MD, USA).
After 5 days, rates of hematoma/seroma formation and graft dislocation were 7.84 and 1.29% in group I, and 9.55 and 1.45% in group II, respectively. After 30 days, rates of graft necrosis and graft take were 1.86 and 98.14% in group I, and 4.65 and 95.35% in group II. Undiluted fibrin sealant showed significantly superior results for all rates ( < 0.05) except graft dislocation.
When high-concentration fast-clotting fibrin sealant was applied to skin grafts without dilution, no difficulty was experienced during surgery. Sealant showed superior results compared with sutures and had an excellent graft take rate.
II.
对于因全层烧伤、创伤或肿瘤组织切除导致的皮肤缺损，皮肤移植是最便捷且有效的治疗方法之一。在此情况下，移植固定在皮肤移植中很重要。本研究旨在比较高浓度纤维蛋白密封剂与缝线在皮肤移植固定方面的有效性。已有众多使用纤维蛋白密封剂进行移植固定的研究，但这些研究使用的是凝血酶含量低于10 IU/mL的慢凝纤维蛋白密封剂。
25例患者使用含400 IU/mL凝血酶的快速凝血纤维蛋白密封剂进行中厚皮片移植，30例患者使用缝线进行移植。术后调查血肿/血清肿形成、移植移位、移植坏死和移植存活的发生率。使用Image J软件（美国国立卫生研究院，马里兰州贝塞斯达）计算移植表面积。
5天后，I组血肿/血清肿形成率和移植移位率分别为7.84%和1.29%，II组分别为9.55%和1.45%。30天后，I组移植坏死率和移植存活率分别为1.86%和98.14%，II组分别为4.65%和95.35%。除移植移位外，未稀释的纤维蛋白密封剂在所有发生率方面均显示出显著更好的结果（P<0.05）。
当将高浓度快速凝血纤维蛋白密封剂未稀释地应用于皮肤移植时，手术过程中未遇到困难。与缝线相比，密封剂显示出更好的结果，且移植存活率极佳。
II级。
