Van Kerckhoven Liza, Den Hondt Margot, Van Brussel Michel, Vranckx Jan
Department of Plastic, Aesthetic and Reconstructive Surgery, University Hospitals of Leuven Herestraat 49, 3000 Leuven, Belgium.
Int J Burns Trauma. 2020 Apr 15;10(2):21-27. eCollection 2020.
Tangential excision and autologous skin graft coverage is a foundational principle in burn surgery. Fibrin sealant (Artiss®) was developed recently as alternative to staples for graft fixation. The aim of this study was to assess whether graft-fixation with Artiss shows profit in terms of postoperative pain management compared to graft fixation with staples.
A retrospective single-center, single-surgeon frequency-matched cohort study was completed on 83 patients with thermal injury burns covering 1%-25% of total body surface area, requiring early excision and immediate coverage with split-thickness skin grafts. Grafts were fixated with Artiss only or staples only. Primary outcome parameters include complication rates (graft loss, need for regrafting and wound contamination), the requirement of pain medication for postoperative pain and the need for narcosis for postoperative procedures.
Graft-fixation with Artiss resulted in a decrease in administration of analgesics () and anesthetics () postoperatively. No statistically significant difference was found in complication rates () between both groups.
Fibrin sealant proved to be a safe and effective alternative to staples for graft fixation. It showed profit in short-term burn outcomes, reducing the need for analgesics and anesthetics postoperatively.
切线切除并自体皮肤移植覆盖是烧伤外科的一项基本原则。纤维蛋白密封剂（Artiss®）是最近开发的一种替代订书钉用于移植固定的产品。本研究的目的是评估与使用订书钉进行移植固定相比，使用Artiss进行移植固定在术后疼痛管理方面是否具有优势。
对83例热损伤烧伤患者进行了一项回顾性单中心、单术者频率匹配队列研究，这些患者的烧伤面积占体表面积的1%-25%，需要早期切除并立即用中厚皮片覆盖。移植仅用Artiss或仅用订书钉固定。主要结局参数包括并发症发生率（移植失败、再次移植需求和伤口污染）、术后疼痛所需的止痛药以及术后操作所需的麻醉。
使用Artiss进行移植固定导致术后镇痛药（）和麻醉药（）的使用减少。两组之间的并发症发生率（）没有统计学上的显著差异。
纤维蛋白密封剂被证明是一种安全有效的替代订书钉用于移植固定的产品。它在短期烧伤结局方面显示出优势，减少了术后对镇痛药和麻醉药的需求。
