Buller Mitchell, Lee Thomas J, Davis Jared, Wilhelmi Bradon J
Division of Plastic and Reconstructive Surgery, University of Louisville, Louisville, Ky.
Eplasty. 2017 Jul 7;17:e21. eCollection 2017.
The objective of this article is to review the methods currently used for the bolstering of skin grafts and compare their advantages and disadvantages with those of the dry, sterile surgical scrub brush. We report a series of cases performed at a single institution and compare the cost-effectiveness, application, and limitations of this method with other options for skin graft bolstering. A PubMed search using the parameters "(bolster) AND skin graft" was conducted, yielding 85 results. A total of 40 publications met the criteria for our literature review. The costs of the foam bolsters utilized as stents for skin grafts were obtained from the Central Supply and Resource Division of the University of Louisville Hospital for a cost analysis. The cost per square centimeter of each bolster material was calculated. At $0.003/cm, the 3M Reston foam is the most inexpensive of the 3 bolster materials analyzed. The dry, sterile surgical scrub brush has a similar cost at $0.006/cm but carries the advantage of sterility. The material cost of negative pressure wound therapy is $0.47/cm, and the cost of the system as a whole makes it a much more expensive alternative. In 6 patients with defects of varying size and location, the scrub brush bolster showed a near 100% graft take and no complications. The dry, sterile surgical scrub brush presents a readily available and low-cost option for the stenting of small skin grafts and should be considered a viable method in the armamentarium of available skin graft bolsters.
本文的目的是回顾目前用于支撑皮肤移植的方法，并将其优缺点与干燥、无菌的手术擦洗刷的优缺点进行比较。我们报告了在单一机构进行的一系列病例，并将这种方法的成本效益、应用和局限性与其他皮肤移植支撑方法进行了比较。使用参数“(支撑物) AND 皮肤移植”在PubMed上进行搜索，得到85个结果。共有40篇出版物符合我们文献综述的标准。从路易斯维尔大学医院中央供应和资源部门获取了用作皮肤移植支架的泡沫支撑物的成本，以进行成本分析。计算了每种支撑材料每平方厘米的成本。3M Reston泡沫每平方厘米0.003美元，是所分析的3种支撑材料中最便宜的。干燥、无菌的手术擦洗刷每平方厘米成本类似，为0.006美元，但具有无菌的优势。负压伤口治疗的材料成本为每平方厘米0.47美元，整个系统的成本使其成为一种更为昂贵的选择。在6例大小和位置各异的缺损患者中，擦洗刷支撑物显示移植成活率接近100%，且无并发症。干燥、无菌的手术擦洗刷为小面积皮肤移植的支撑提供了一种现成且低成本的选择，应被视为现有皮肤移植支撑手段中的一种可行方法。
