Phillips G S A, Nizamoglu M, Wakure A, Barnes D, El-Muttardi N, Dziewulski P
St. Andrews Centre for Plastic Surgery and Burns, Chelmsford, United Kingdom.
Ann Burns Fire Disasters. 2020 Sep 30;33(3):245-252.
The gold standard of treatment for major burns is early burn excision and autografting. In major burns this is complicated by a lack of donor site availability. Another challenge after burn injury is achieving optimal cosmetic and functional outcomes. Dermal regeneration templates (DRT) are biomatrices that help to address these problems. Within our centre the most commonly used are two-stage Integra® and single-stage Matriderm®. We review the use and outcomes of DRT in primary burns reconstruction within our regional burns centre. All patients undergoing primary burn reconstruction using Integra® (n=59) or Matriderm® (n=35) over a 13-year period were included. Integra® was used in patients with significantly larger burns (20.4% TBSA vs 1.7% TBSA). Comparable levels of graft take were seen in both groups. Major infections were significantly higher in the Integra® group (11/35 compared to 3/59). There was no significant difference in haematoma development, hypertrophic scarring or the need for secondary reconstructive surgery. Burn contractures developed in 15 patients treated with Matriderm® and 21 with Integra®. DRT have been used safely and effectively and have played an increasingly important role in our service over the last 13 years. Integra® is used primarily in large burns with limited donor sites and Matriderm® in smaller burns in cosmetically sensitive areas.
大面积烧伤治疗的金标准是早期烧伤切除和自体植皮。在大面积烧伤中,这因供皮区不足而变得复杂。烧伤损伤后的另一个挑战是实现最佳的美容和功能效果。真皮再生模板(DRT)是有助于解决这些问题的生物基质。在我们中心,最常用的是两阶段的Integra®和单阶段的Matriderm®。我们回顾了DRT在我们地区烧伤中心原发性烧伤重建中的使用情况和结果。纳入了在13年期间所有使用Integra®(n = 59)或Matriderm®(n = 35)进行原发性烧伤重建的患者。Integra®用于烧伤面积明显更大的患者(20.4% 体表面积 vs 1.7% 体表面积)。两组的移植成活率相当。Integra®组的严重感染明显更高(11/35 对比 3/59)。血肿形成、增生性瘢痕或二次重建手术需求方面无显著差异。使用Matriderm®治疗的15例患者和使用Integra®治疗的21例患者出现了烧伤挛缩。在过去13年中,DRT已被安全有效地使用,并在我们的服务中发挥了越来越重要的作用。Integra®主要用于供皮区有限的大面积烧伤,而Matriderm®用于美容敏感区域的较小面积烧伤。