Mecott-Rivera Gabriel Ángel, Aguilar-Baqueiro Jorge Alejandro, Bracho Stephano, Miranda-Maldonado Ivette, Franco-Márquez Rodolfo, Castro-Govea Yanko, Dorsey-Treviño Edgar Gerardo, García-Pérez Mauricio Manuel
Department of Plastic, Aesthetic, and Reconstructive Surgery, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, 64460, Monterrey, Mexico.
Department of Pathology, Faculty of Medicine, Universidad Autónoma de Nuevo León, 64460, Monterrey, Mexico.
Burns. 2018 Dec;44(8):2051-2058. doi: 10.1016/j.burns.2018.07.007. Epub 2018 Aug 14.
Improving epithelialization of donor sites of split-thickness skin grafts (STSG) is extremely important in burned patients. We aimed to assess the efficacy of pirfenidone, a drug with anti-inflammatory, antifibrotic, and antioxidant effects, to accelerate wound healing. We hypothesized that pirfenidone accelerates the epithelialization rates in donor sites.
We included 28 patients requiring STSGs with donor sites of at least 7.5×10cm. After harvesting, the donor sites were randomly treated with either non-adherent gauze or topical pirfenidone and covered with non-adherent gauze. To assess epithelialization, biopsies were taken at day 7 and 10 on the pirfenidone group, and at day 10 on the control group. Percentage of epithelialization was assessed on the same days through clinical photographs. The pathologists and the clinical observer were blinded to the group and timepoint of the samples.
24 patients were included in the study, with a median age of 21(5-73) for control group and 28(9-61) for pirfenidone. The thickness of epithelium was 75.10±60μm at day 10 for the control group; and 98.21±6μm at day 7, and 108±22μm at day 10 for the pirfenidone group (p=<0.05). Epithelization rate was 83.58±14.09% at day 10 for the control group; and 98.7±1.8% at day 7, and 99.5±1.6% at day 10 for the pirfenidone group.
Pirfenidone is efficient in reducing the healing times when applied in STSG donor sites, at both days 7 and 10.
提高烧伤患者中厚皮片（STSG）供皮区的上皮化程度极为重要。我们旨在评估具有抗炎、抗纤维化和抗氧化作用的药物吡非尼酮促进伤口愈合的疗效。我们假设吡非尼酮可加快供皮区的上皮化速度。
我们纳入了28例需要进行中厚皮片移植且供皮区面积至少为7.5×10cm的患者。取皮后，供皮区随机采用不粘连纱布或外用吡非尼酮处理，并用不粘连纱布覆盖。为评估上皮化情况，在吡非尼酮组第7天和第10天以及对照组第10天进行活检。通过临床照片在同一天评估上皮化百分比。病理学家和临床观察者对样本的分组和时间点不知情。
24例患者纳入研究，对照组中位年龄为21岁（5 - 73岁），吡非尼酮组为28岁（9 - 61岁）。对照组第10天上皮厚度为75.10±60μm；吡非尼酮组第7天为98.21±6μm，第10天为108±22μm（p<0.05）。对照组第10天上皮化率为83.58±14.09%；吡非尼酮组第7天为98.7±1.8%，第10天为99.5±1.6%。
在中厚皮片供皮区应用吡非尼酮，在第7天和第10天均可有效缩短愈合时间。
