Hermans Michel He, Pittinger Tim, Bailey Kevin, Powell Heather M
President, Hermans Consulting LLC.
Professor of Surgery, NEOMED, Department of Surgery & Regional Burn Center, Children's Hospital Medical Center of Akron, Akron, OH.
Wounds. 2019 Jun;31(6):137-144. Epub 2019 Mar 29.
A new pneumatic dermatome with a circular excision blade was designed to improve a number of disadvantages of regular dermatomes.
This study analyzes the safety and efficacy of a new dermatome (test device) for the tangential excision of necrosis and harvesting of split-thickness skin grafts (STSGs).
Three porcine proof-of-concept studies were conducted to compare the test dermatome with conventional dermatomes (control devices) for both excision of necrosis (one study) and the harvesting of a STSG (2 studies). For the harvesting studies, donor sites and grafts were analyzed for viability, healing rate, and scar outcomes. Biomechanical tests also were performed on the donor sites. For the necrotectomy study, healing of the excised area and thickness of the excised tissues were studied.
The test device was similar to the control devices in viability of collected tissues, speed of healing, and donor site biomechanics. In 1 graft harvesting study, as well as in the excision study, uniformity of the thickness of the harvested tissues was better for the test device than for the control devices. The test device performed better than the controls on maneuverability, control of the consistency of the relationship between depth setting and actual graft thickness, device assembly, overall ease of use, depth of the debridement as intended, consistency of the debridement thickness, device accuracy, and size.
The studies showed the test device, when compared with the control devices, was equal on safety. On efficacy, consistency of the excised tissues was superior for the test device, which may result in better grafts and outcomes. Several aspects related to the ease of use, particularly maneuverability, were superior as well.
设计了一种带有圆形切除刀片的新型气动取皮刀,以改善常规取皮刀的一些缺点。
本研究分析一种新型取皮刀(测试装置)用于坏死组织切向切除和中厚皮片(STSG)获取的安全性和有效性。
进行了三项猪的概念验证研究,将测试取皮刀与传统取皮刀(对照装置)用于坏死组织切除(一项研究)和STSG获取(两项研究)进行比较。对于获取研究,分析供皮区和移植皮片的活力、愈合率和瘢痕结果。还对供皮区进行了生物力学测试。对于坏死组织切除术研究,研究切除区域的愈合情况和切除组织的厚度。
测试装置在收集组织的活力、愈合速度和供皮区生物力学方面与对照装置相似。在一项移植皮片获取研究以及切除研究中,测试装置获取组织的厚度均匀性优于对照装置。测试装置在可操作性、深度设置与实际移植皮片厚度之间关系的一致性控制、装置组装、总体易用性、预期清创深度、清创厚度的一致性、装置准确性和尺寸方面比对照装置表现更好。
研究表明,与对照装置相比,测试装置在安全性方面相当。在有效性方面,测试装置切除组织的一致性更优,这可能导致更好的移植皮片和结果。与易用性相关的几个方面,特别是可操作性,也更优。