Hautklinik, Klinikum Darmstadt GmbH Heidelberger Landstra.e 379 D-64297 Darmstadt.
Klinik und Poliklinik für Hautkrankheiten Universitätsmedizin Greifswald Ferdinand Sauerbruchstraße D-17475 Greifswald.
J Dtsch Dermatol Ges. 2017 Oct;15(10):990-997. doi: 10.1111/ddg.13337. Epub 2017 Sep 14.
Split-thickness skin grafts are commonly used in dermatosurgery. For occipital donor sites, retrospective studies have shown good results with respect to graft take and healing rates. Nevertheless, the majority of grafts in dermatosurgery are harvested from the thigh. To date, there has been no prospective randomized controlled study comparing occipital versus femoral donor sites.
Following micrographically controlled R0 tumor resection, 108 patients were randomized prior to undergoing split-thickness skin grafting (donor site: occiput vs. thigh). Follow-up examinations were carried out on day 3, 5, 7, and 14, as well as one month and three months after surgery. Documented data included graft take rates, re-epithelialization rates at the donor site, pain, cosmetic outcome, Vancouver Scar Scale (VSS), and complications.
Occipital donor sites showed significantly faster reepithelization, less pain, fewer complications, a better cosmetic outcome, and better results on the VSS. With regard to graft take rates, grafts harvested from the occiput were significantly superior on days 3 and 5.
This is the first randomized controlled trial showing a significant superiority of occipital compared to femoral donor sites regarding re-epithelialization, pain, cosmetic outcome and the Vancouver Scar Scale.
薄断层皮片移植在皮肤外科中被广泛应用。对于枕部供皮区，回顾性研究显示其在皮片成活率和愈合率方面具有良好的效果。然而，在皮肤外科中，大多数皮片是从大腿上获取的。迄今为止，还没有前瞻性随机对照研究比较枕部和股部供皮区。
在显微镜下进行 R0 肿瘤切除后，108 例患者在进行薄断层皮片移植（供皮区：枕部与大腿）前进行随机分组。在术后第 3、5、7 和 14 天，以及术后一个月和三个月进行随访检查。记录的数据包括皮片成活率、供皮区上皮化率、疼痛、美容效果、温哥华瘢痕量表（VSS）和并发症。
枕部供皮区的上皮化速度明显更快，疼痛较轻，并发症较少，美容效果较好，VSS 评分也更好。在皮片成活率方面，枕部取皮的皮片在第 3 天和第 5 天的优势明显。
这是首个随机对照试验，显示枕部供皮区在上皮化、疼痛、美容效果和温哥华瘢痕量表方面明显优于股部供皮区。
