Department of Plastic and Reconstructive Surgery, Medical School of Jeonbuk National University.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
J Craniofac Surg. 2022;33(1):303-306. doi: 10.1097/SCS.0000000000007684.
The authors compared facial scars after split-thickness skin grafts (STSGs) performed with a dermal substitute or after full-thickness skin grafts (FTSGs) in facial defect.
The medical records of patients who had undergone FTSG or STSG with dermal substitute after skin cancer surgery between March 2016 and December 2018 were retrospectively reviewed. The scars resulting from skin grafts were assessed using the patient and observer scar assessment scales (PSAS and OSAS) in our clinic after a minimum of 6 months postoperatively.
Of the 50 study subjects, 35 patients (FTSG group) received FTSG only and 15 patients (STSG group) received STSG with the dermal substitute. The total scores of PSAS and OSAS were significantly lower in the FTSG group and it is suggested that both patients and observers thought that better scar outcomes were achieved when FTSGs were used. However, for defects smaller than 1.8 cm2 and defects located in the periorbital area, there was no statistically significant difference in the scores of PSAS and OSAS in the 2 groups. Interestingly, for defects located in the periorbital area, although there was no significant difference, PSAS and OSAS scores were lower in the STSG group than in the FTSG group. In other word, scar outcomes in the STSG group were better.
Although there was no significant difference, unlike what we usually know, our result shows that STSG with dermal substitute tended to produce comparable or rather better results than FTSG under some conditions.
作者比较了在面部缺损中使用真皮替代物进行的断层皮片移植(STSG)和全厚皮片移植(FTSG)后的面部瘢痕。
回顾性分析了 2016 年 3 月至 2018 年 12 月间因皮肤癌手术后行 FTSG 或 STSG 联合真皮替代物治疗的患者的病历。术后至少 6 个月,在我院使用患者和观察者瘢痕评估量表(PSAS 和 OSAS)对皮片移植后的瘢痕进行评估。
在 50 例研究对象中,35 例患者(FTSG 组)仅接受 FTSG,15 例患者(STSG 组)接受 STSG 联合真皮替代物。FTSG 组 PSAS 和 OSAS 的总分明显较低,表明患者和观察者均认为 FTSG 可获得更好的瘢痕效果。然而,对于小于 1.8cm²的缺损和眶周区域的缺损,两组 PSAS 和 OSAS 的评分无统计学差异。有趣的是,对于眶周区域的缺损,虽然无统计学差异,但 PSAS 和 OSAS 评分在 STSG 组低于 FTSG 组。换句话说,STSGS 组的瘢痕效果更好。
尽管无统计学差异,但与我们通常的认知不同,我们的结果表明,在某些情况下,使用真皮替代物的 STSG 倾向于产生与 FTSG 可比或更好的结果。