Miyanaga Toru, Haseda Yasuo, Sakagami Akihiko
Department of Plastic Surgery, Kouseiren Takaoka Hospital, Toyama, Japan.
Department of Plastic Surgery, Kouseiren Takaoka Hospital, Toyama, Japan.
Burns. 2017 Jun;43(4):819-823. doi: 10.1016/j.burns.2016.10.011. Epub 2016 Dec 29.
It is important to minimize time to healing in the donor site after split-thickness skin grafting (STSG). It has been shown that minced skin grafting improves the appearance of the STSG donor site. The objective of this study was to investigate whether mincing the leftover harvested skin and grafting it back onto the donor site during minced grafting (MG) reduces healing time of the donor site. Normal healing time of the donor site after STSG is 10-20 days; therefore, healing time more than a month is abnormal. Out of the 96 patients (MG: controls=48:48) initially selected for this study, 7 patients (1 in the MG group and 6 in the control group) with abnormal wound healing (healing time >1 month) were excluded because their healing times were too long (from 1.5 to 6 months). All donor sites were on the lateral thigh. A part of the skin was minced and uniformly spread on the entire surface of the donor site. A calcium alginate dressing was applied and covered with a protective gauze dressing. Patients in the control group were treated identically, except that MG was not performed. MG of the STSG donor site reduced the average time to healing by approximately 4days (9.1 vs. 13.2). This effect was independent from the size of the donor site and MG/STSG mass ratio. This procedure, which makes use of skin leftovers after skin grafting, should be performed prior to applying wound covering material as a means of reducing time to healing and level of patient's discomfort.
在进行中厚皮片移植（STSG）后，尽量缩短供皮区的愈合时间至关重要。研究表明，碎皮移植可改善STSG供皮区的外观。本研究的目的是调查在碎皮移植（MG）过程中，将剩余的采集皮肤切碎并回植到供皮区是否能缩短供皮区的愈合时间。STSG后供皮区的正常愈合时间为10 - 20天；因此，愈合时间超过一个月是不正常的。在最初入选本研究的96例患者（MG组：对照组 = 48 : 48）中，7例伤口愈合异常（愈合时间>1个月）的患者（MG组1例，对照组6例）被排除，因为他们的愈合时间过长（1.5至6个月）。所有供皮区均位于大腿外侧。将一部分皮肤切碎并均匀铺展在供皮区的整个表面。应用藻酸钙敷料，并覆盖保护性纱布敷料。对照组患者接受相同的治疗，只是未进行MG操作。STSG供皮区的MG使平均愈合时间缩短了约4天（9.1天对13.2天）。这种效果与供皮区大小和MG/STSG质量比无关。这种利用皮肤移植后剩余皮肤的方法，应在应用伤口覆盖材料之前进行，以缩短愈合时间并减轻患者的不适程度。
