Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts.
Signature Dermatology and Aesthetics CarrolltonTexas.
Dermatol Surg. 2022 Oct 1;48(10):1083-1088. doi: 10.1097/DSS.0000000000003552. Epub 2022 Aug 23.
Autologous fractional full-thickness skin grafting is a method of harvesting full-thickness skin with reduced donor site morbidity compared with conventional skin grafting.
To demonstrate that full-thickness skin microbiopsies can be harvested with minimal scarring or complications.
In a nonrandomized, self-controlled, pilot trial, subjects ( n = 8) underwent tissue harvesting of full-thickness skin columns of 200, 400, 500, 600, 800 μm, 1, and 2 mm diameters. The extent of scarring was measured by using the Patient and Observer Scar Assessment Scale and blinded evaluation of photographs at 6 weeks postprocedure. Pain visual analog scale (VAS) and side effects were recorded.
When present, scars were first observed after 2 to 4 weeks, much more often for wounds >400 μm ( p < .001). Blinded dermatologists increasingly identified clinical scarring on photographs with larger harvested microcolumn diameters ( p < .001). Median VAS pain score was 0 (range 0-4). All subjects rated the procedure safe and tolerable.
Harvesting full-thickness skin microcolumns is well-tolerated over a wide range of column diameters. At diameters of less than 500 μm, side effects including scarring are minimal.
与传统植皮术相比，自体全层小皮片移植是一种采集全层皮肤的方法，可降低供区发病率。
证明可以微创方式获取全层皮肤活检，且不会产生严重瘢痕或并发症。
在一项非随机、自身对照、初步试验中，受试者（n=8）接受了 200、400、500、600、800μm、1mm 和 2mm 直径的全层皮肤柱组织采集。术后 6 周，采用患者和观察者瘢痕评估量表和照片盲法评估来测量瘢痕程度。记录疼痛视觉模拟评分（VAS）和不良反应。
当存在瘢痕时，在 2 至 4 周后首次观察到，直径>400μm 的伤口瘢痕发生率更高（p<0.001）。随着采集微柱直径的增大，盲法评估的皮肤科医生越来越多地在照片中识别出临床瘢痕（p<0.001）。VAS 疼痛评分中位数为 0（范围 0-4）。所有受试者均认为该操作安全且可耐受。
在广泛的微柱直径范围内采集全层皮肤微柱是可耐受的。在直径小于 500μm 时，包括瘢痕在内的不良反应极小。
