Park Jae Yeon, Lee Tae Geun, Kim Ji Ye, Lee Myung Chul, Chung Yoon Kyu, Lee Won Jai
Department of Plastic and Reconstructive Surgery, Institute for Human Tissue Restoration, Yonsei University College of Medicine, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
Arch Craniofac Surg. 2014 Apr;15(1):14-21. doi: 10.7181/acfs.2014.15.1.14. Epub 2014 Apr 10.
There are several options for replacement of the dermal layer in full-thickness skin defects. In this study, we present the surgical outcomes of reconstruction using acellular dermal substitutes by means of objective and subjective scar assessment tools.
We retrospectively reviewed the medical records of 78 patients who had undergone autologous split-thickness skin graft with or without concomitant acellular dermal matrix (CGDerm or AlloDerm) graft. We examined graft survival rate and evaluated postoperative functional skin values. Individual comparisons were performed between the area of skin graft and the surrounding normal skin. Nine months after surgery, we compared the skin qualities of CGDerm graft group (n=25), AlloDerm graft group (n=8) with skin graft only group (n=23) each other using the objective and subjective measurements.
The average of graft survival rate was 93% for CGDerm group, 92% for AlloDerm group and 86% for skin graft only group. Comparing CGDerm grafted skin to the surrounding normal skin, mean elasticity, hydration, and skin barrier values were 87%, 86%, and 82%, respectively. AlloDerm grafted skin values were 84%, 85%, and 84%, respectively. There were no statistical differences between the CGDerm and AlloDerm groups with regard to graft survival rate and skin functional analysis values. However, both groups showed more improvement of skin quality than skin graft only group.
The new dermal substitute (CGDerm) demonstrated comparable results with regard to elasticity, humidification, and skin barrier effect when compared with conventional dermal substitute (AlloDerm).
对于全层皮肤缺损的真皮层替代有多种选择。在本研究中，我们通过客观和主观的瘢痕评估工具展示了使用脱细胞真皮替代物进行重建的手术效果。
我们回顾性分析了78例接受自体中厚皮片移植（伴或不伴脱细胞真皮基质（CGDerm或AlloDerm）移植）患者的病历。我们检查了移植皮片的存活率并评估了术后皮肤功能值。对移植皮片区域与周围正常皮肤进行个体比较。术后9个月，我们使用客观和主观测量方法相互比较了CGDerm移植组（n = 25）、AlloDerm移植组（n = 8）和单纯皮片移植组（n = 23）的皮肤质量。
CGDerm组的移植皮片平均存活率为93%，AlloDerm组为92%，单纯皮片移植组为86%。将CGDerm移植皮肤与周围正常皮肤比较，平均弹性、水合作用和皮肤屏障值分别为87%、86%和82%。AlloDerm移植皮肤的值分别为84%、85%和84%。CGDerm组和AlloDerm组在移植存活率和皮肤功能分析值方面无统计学差异。然而，两组的皮肤质量改善均优于单纯皮片移植组。
与传统真皮替代物（AlloDerm）相比，新型真皮替代物（CGDerm）在弹性、保湿和皮肤屏障作用方面显示出相当的效果。
