Sivyer Graham William
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
JPRAS Open. 2018 Feb 13;16:31-35. doi: 10.1016/j.jpra.2018.01.006. eCollection 2018 Jun.
Two cases are presented where large (25 mm and 45 mm diameter) skin cancers were emoved followed by the application of full thickness skin grafts over the defect where the margins of these defects had been de-epithelialized in order to enhance the take of the full thickness skin grafts. FTSGs have a greater risk of failure as compared to split skin grafts (SSG). This relates to the thickness of the graft (split vs full thickness) and the time to vascularization of the defect bed (48 hours). It is proposed that de-epithelialization of the wound (recipient) margin provides an immediate partial wound vascular bed, reducing the need for adequate vascularization of the recipient wound bed. These cases suggest that with marginal de-epithelialization of the recipient wound margin, survival of a large skin graft can be enhanced.
本文介绍了两例病例，其中切除了直径较大（分别为25毫米和45毫米）的皮肤癌，然后在缺损处应用全厚皮片，这些缺损的边缘已进行了去上皮处理，以提高全厚皮片的成活率。与断层皮片（SSG）相比，全厚皮片（FTSG）失败的风险更大。这与皮片的厚度（断层与全厚）以及缺损床血管化的时间（48小时）有关。有人提出，伤口（受区）边缘的去上皮处理可提供即时的部分伤口血管床，减少对受区伤口床充分血管化的需求。这些病例表明，通过对受区伤口边缘进行边缘去上皮处理，可以提高大面积皮肤移植的成活率。
