Kim Youn Hwan, Hwang Kyu Tae, Kim Ki Ho, Sung Il Hoon, Kim Sang Wha
Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Korea.
J Wound Care. 2019 Apr 1;28(Sup4):S12-S17. doi: 10.12968/jowc.2019.28.Sup4.S12.
To use both acellular human dermis and skin grafting simultaneously for improved skin grafting without contracture. The study also aims to address the lack of research on the application of an acellular human dermis in diverse clinical cases.
The study examined patients who had received acellular human dermis (CGDerm, CGBio, Seoul, Korea) and split-thickness skin grafting (STSG) simultaneously for lower limb, full-thickness skin defects between September 2012 and June 2014. The researchers performed chart reviews retrospectively and examined the patients based on the following factors: gender, age, injury mechanism, size, exposed structure, pre-coverage dressing method, coverage method, post-operational engraftment and total healing period, contracture development, elasticity, and infection development.
A sample of 27 patients with a total of 30 wounds took part in the study. Of these wounds, 29 showed successful engraftment without infection or contracture. In one case, continued seroma was observed and, following new coverage of both the acellular human dermis and STSG, engraftment was successful.
Human dermis can play an important role in securing the availability of surrounding tissue and in contracture prevention, both of which are key to lower limb reconstruction. Of the types available, acellular human dermis showed lower infection rates than other human dermis types, and its engraftment rate was higher than in STSG-only cases. These findings suggest that acellular human dermis use in STSG is effective and safe in lower limb reconstruction.
同时使用脱细胞人真皮和皮肤移植术以改善皮肤移植效果且无挛缩形成。该研究还旨在解决脱细胞人真皮在多种临床病例应用方面缺乏研究的问题。
该研究对2012年9月至2014年6月期间因下肢全层皮肤缺损同时接受脱细胞人真皮（CGDerm，CGBio，韩国首尔）和中厚皮片移植（STSG）的患者进行了检查。研究人员进行了回顾性病历审查，并基于以下因素对患者进行检查：性别、年龄、损伤机制、面积、暴露结构、术前覆盖敷料方法、覆盖方法、术后移植情况和总愈合期、挛缩发展情况、弹性及感染发生情况。
共有27例患者的30处伤口参与了该研究。在这些伤口中，29处移植成功，无感染或挛缩形成。在1例病例中，观察到持续存在血清肿，在再次用脱细胞人真皮和STSG覆盖后，移植成功。
人真皮在确保周围组织可用性和预防挛缩方面可发挥重要作用，而这两者对于下肢重建均至关重要。在可用的真皮类型中，脱细胞人真皮的感染率低于其他类型的人真皮，其移植率高于仅行STSG的病例。这些研究结果表明，在下肢重建中，脱细胞人真皮用于STSG是有效且安全的。
