Department of Plastic Surgery, Wound Repair and Regeneration, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.
Department of Plastic and Reconstructive Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan.
Int J Mol Sci. 2017 Dec 25;19(1):57. doi: 10.3390/ijms19010057.
Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales ( < 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis.
采用高度扩张的网状皮片移植的培养上皮自体移植物（CEA），用于治疗超过 30%的体表面积的大面积成人烧伤。对 8 例患者进行的前瞻性研究，在 12 个月的随访中评估了主观和客观发现。通过广义估计方程（GEE）或广义线性混合模型（GLMM），比较了超过 1:6 网片加 CEA、1:6 网片加 CEA 间隙和 1:3 网片在 3、6 和 12 个月时的愈合情况，包括伸展性、粘弹性、颜色和经表皮水分流失。在任何时间点，配对治疗之间均未观察到显著差异。在 6 个月和 12 个月时，超过 1:6 网片加 CEA 在温哥华和曼彻斯特瘢痕量表上的专家评估得分显著更高（<0.01）。扩展皮肤移植加 CEA 最大限度地减少了供体资源，并且瘢痕的质量与传统的低扩展网片薄皮片移植（如 1:3 网片）相当或相似。对瘢痕进行纵向分析可能进一步阐明瘢痕形成和发病机制的分子变化。
