Kalamanova A, Anderson B H, Cust A R, Fulton I C
Equine Department, Ballarat Veterinary Practice Pty Ltd, Miners Rest, Victoria, 3352, Australia.
Aust Vet J. 2020 Oct;98(10):517-522. doi: 10.1111/avj.12998. Epub 2020 Aug 12.
There are several skin grafting methods described in the human and animal literature. Currently, there are five types of free grafts used in horses: pinch and punch grafts, split and full-thickness sheet or mesh grafts and tunnel grafts. Published methods of tunnel grafting describe the use of alligator forceps. The alligator forceps create a poor tunnel and are excessively traumatic to the granulation bed. This technique utilised a 13G Jamshidi needle that was placed across the granulation bed and created a uniform tunnel. The Jamshidi needle was atraumatic to the granulation bed increasing the opportunity for graft survival. A twin bladed scalpel allowed for the quick creation of uniform width grafts. Removal of the overlying tunnel 'roof' took place 5-14 days later to allow graft expansion. This case series included five horses with distal limb wounds and one with a wither injury. Four horses required general anaesthesia for graft placement and three required general anaesthesia for the removal of the tunnel roof. The acceptance of the grafts varied from 70% to 100%. Graft expansion to cover the granulation tissue took 2-5 months. This case series demonstrates that this technique of graft production and placement is an easy method for achieving successful skin grafting. Compared to other graft types, tunnel grafts are more readily accepted. Cosmetic and functional results achieved are better than those with pinch and punch grafts. Tunnel grafting does not require expensive equipment or advanced training, and in some cases can be performed under standing sedation.
人和动物文献中描述了几种皮肤移植方法。目前，马匹中使用的游离移植有五种类型：捏取和打孔移植、中厚和全厚皮片或网状移植以及隧道移植。已发表的隧道移植方法描述了使用鳄齿钳。鳄齿钳造成的隧道不佳，对肉芽床的创伤过大。本技术使用一根13G的詹氏针，将其穿过肉芽床并形成一个均匀的隧道。詹氏针对肉芽床无创伤，增加了移植存活的机会。一把双刃手术刀可快速制作宽度均匀的移植物。5 - 14天后去除覆盖的隧道“顶部”以利于移植物扩张。该病例系列包括5匹远端肢体受伤的马和1匹肩胛部受伤的马。4匹马在移植时需要全身麻醉，3匹马在去除隧道顶部时需要全身麻醉。移植物的成活率在70%至100%之间。移植物扩张以覆盖肉芽组织需要2至5个月。该病例系列表明，这种移植物制作和放置技术是一种实现成功皮肤移植的简便方法。与其他移植类型相比，隧道移植更容易被接受。获得的美容和功能效果优于捏取和打孔移植。隧道移植不需要昂贵的设备或高级培训，在某些情况下可以在站立镇静下进行。
