Nuri Takashi, Ueda Koichi, Fujimori Yasushi
Department of Plastic and Reconstructive Surgery, Osaka Medical College, Osaka, Japan.
Department of Plastic and Reconstructive Surgery, Moriguchi Keijinkai Hospital, Osaka, Japan.
Plast Reconstr Surg Glob Open. 2018 Jun 19;6(6):e1782. doi: 10.1097/GOX.0000000000001782. eCollection 2018 Jun.
This is the first case report of long-term follow-up after applying the autologous cultured dermal substitute to establish the wound bed before split skin graft. The results suggest that application of autologous cultured cultured dermal substitute contributes to establish the high-quality wound bed for skin graft. Split-thickness skin grafts (STSGs) are the gold standard for the treatment of burn scar contracture. Young patients in particular may require additional skin grafts as they grow, and donor site for skin grafts may be limited. We applied autologous cultured dermal substitutes (CDSs) that are expected to establish a high-quality wound bed to allow thin STSGs. This is the first report of follow-up after application of autologous CDS combined with thin STSG. A male neonate suffered third-degree burns (20% of the total body surface area) on the back. After 2 years, scar contracture of the gluteal regions were released and autologous CDS were applied. Five days after the treatment, a super thin (4-6/1,000 per inch) skin grafting was performed. After 3 years, scar contracture of the back was released and autologous CDS was applied for 2 weeks. Then a split-thick graft was harvested from the same donor site. Ten years after the last operation, the width of the skin graft on his back has extended from 5-8 cm. The contour of the grafted skin is soft, smooth, and can be pinched. This long-term result shows the autologous CDS can be expected to establish the high-quality wound bed that allows thin STSG.
这是首例关于在进行分层皮片移植前应用自体培养真皮替代物建立创面床并进行长期随访的病例报告。结果表明,应用自体培养真皮替代物有助于为皮肤移植建立高质量的创面床。分层皮片移植(STSGs)是治疗烧伤瘢痕挛缩的金标准。尤其是年轻患者,随着生长可能需要额外的皮肤移植,而皮肤移植的供区可能有限。我们应用了有望建立高质量创面床以允许进行薄分层皮片移植的自体培养真皮替代物(CDSs)。这是首例关于应用自体CDS联合薄分层皮片移植后的随访报告。一名男性新生儿背部遭受三度烧伤(占全身表面积的20%)。2年后,松解臀部瘢痕挛缩并应用自体CDS。治疗5天后,进行了超薄(每英寸4 - 6/1000)皮肤移植。3年后,松解背部瘢痕挛缩并应用自体CDS 2周。然后从同一供区取分层皮片。最后一次手术后10年,其背部皮肤移植的宽度从5 - 8厘米扩展。移植皮肤的轮廓柔软、光滑且可捏起。这一长期结果表明,自体CDS有望建立允许进行薄分层皮片移植的高质量创面床。