Mundinger Gerhard S, Stalder Mark W, Lee James, Patterson Charles W, Sharma Silpa, Womac Daniel J, Sopko Nikolai A, Swanson Edward W
Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Children's Hospital of New Orleans, New Orleans, LA, USA.
Int J Low Extrem Wounds. 2023 Mar;22(1):103-112. doi: 10.1177/1534734621992284. Epub 2021 Mar 9.
Lower extremity traumatic wounds pose unique challenges in pediatric patients, including vessel caliber, compliance with postoperative instructions, parental concerns about multiple operations, and long-term function. An autologous heterogeneous skin construct (AHSC) has demonstrated the ability to cover avascular structures and regenerate full-thickness functional skin. The objective of this study is to report our experience using AHSC in a cohort of pediatric trauma patients. This study is a noncontrolled, retrospective cohort analysis of all pediatric patients (<19 years of age) treated with AHSC for lower extremity traumatic wounds with at least one exposed deep structure (tendon, bone, and/or joint) at a single institution between May 1, 2018, and April 1, 2019. Seven patients with 10 traumatic wounds met inclusion criteria. The median follow-up time was 11.8 months. Five patients were male (71%); the median age was 7 years (range = 2-15 years). Average wound size was 105 cm. All wounds achieved coverage of exposed structures and epithelial closure in a median of 13 and 69 days, respectively. There were no donor site complications and no reoperations required. All patients returned to normal activity, ambulate without limp, can wear shoes normally, and have normal tendon gliding. AHSC covered exposed structures and achieved closure within a single application in complex traumatic lower extremity wounds in a pediatric cohort.
下肢创伤性伤口给儿科患者带来了独特的挑战，包括血管管径、对术后医嘱的依从性、家长对多次手术的担忧以及长期功能。一种自体异种皮肤构建物（AHSC）已证明有能力覆盖无血管结构并再生全层功能性皮肤。本研究的目的是报告我们在一组儿科创伤患者中使用AHSC的经验。本研究是一项对2018年5月1日至2019年4月1日期间在单一机构接受AHSC治疗下肢创伤性伤口且至少有一个深部结构（肌腱、骨骼和/或关节）外露的所有儿科患者（<19岁）进行的非对照回顾性队列分析。7例患者的10处创伤性伤口符合纳入标准。中位随访时间为11.8个月。5例患者为男性（71%）；中位年龄为7岁（范围 = 2 - 15岁）。平均伤口大小为105平方厘米。所有伤口分别在中位时间13天和69天实现了外露结构的覆盖和上皮闭合。没有供区并发症，也无需再次手术。所有患者恢复了正常活动，行走无跛行，能正常穿鞋，肌腱滑动正常。在一个儿科队列中，AHSC在单次应用中覆盖了复杂创伤性下肢伤口的外露结构并实现了闭合。
