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碱性成纤维细胞生长因子浸渍胶原明胶海绵在2周内完成真皮样组织形成:一项前瞻性队列研究。

Basic fibroblast growth factor-impregnated collagen gelatin sponge completes formation of dermis-like tissue within 2 weeks: A prospective cohort study.

作者信息

Matsumine Hajime, Niimi Yosuke

机构信息

Department of Plastic and Reconstructive Surgery, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.

出版信息

Regen Ther. 2022 Aug 23;21:210-215. doi: 10.1016/j.reth.2022.07.007. eCollection 2022 Dec.

Abstract

INTRODUCTION

This study included patients who underwent full-thickness skin reconstruction using a two-stage procedure comprising basic fibroblast growth factor-impregnated collagen gelatin sponge (bFGF-CGS) implantation and autologous skin grafting, and the take rate of skin grafts was compared between groups of patients who underwent autologous skin grafting after a waiting period of <2 weeks or ≥2 weeks.

METHODS

An acute, full-thickness skin defect was treated with thorough debridement of contaminated/necrotic tissue, followed by washing with saline and hemostasis with electrocautery. Then, an FGF-CGS was fixed to the skin defect wound using non-absorbable sutures, and after confirming regeneration of sufficient dermis-like tissue, the second-stage autologous skin grafting was performed for wound closure. Patients were divided into two groups according to the waiting period before the second operation, namely, <2 weeks (early group) and ≥2 weeks (late group), and the take rate of skin grafts was compared.

RESULTS

We enrolled and treated 25 cases (18 men, 7 women; mean age: 49 [range 2-86] years). The mean take rate of skin grafts was 93% (range 80%-100%) in the early group and 92% (range 65%-100%) in the late group, with no significant difference between the two groups. There was a significant difference between the groups in mean time to complete healing: 25.2 ± 9.7 days in the early group vs 44.7 ± 27 days in the late group (p < 0.05).

CONCLUSION

Our data suggest that bFGF-CGF can form dermis-like granulation tissue with sufficient quality as a graft bed for skin transplantation within 2 weeks.

摘要

引言

本研究纳入了采用两阶段手术进行全层皮肤重建的患者,该手术包括植入碱性成纤维细胞生长因子浸渍胶原明胶海绵(bFGF - CGS)和自体皮肤移植,比较了在等待期<2周或≥2周后接受自体皮肤移植的患者组之间的皮肤移植成活率。

方法

对急性全层皮肤缺损进行彻底清创,清除污染/坏死组织,然后用生理盐水冲洗,电灼止血。接着,使用不可吸收缝线将FGF - CGS固定于皮肤缺损伤口,在确认有足够的真皮样组织再生后,进行二期自体皮肤移植以闭合伤口。根据第二次手术前的等待期将患者分为两组,即<2周(早期组)和≥2周(晚期组),比较两组的皮肤移植成活率。

结果

我们纳入并治疗了25例患者(18例男性,7例女性;平均年龄:49岁[范围2 - 86岁])。早期组皮肤移植的平均成活率为93%(范围80% - 100%),晚期组为92%(范围65% - 100%),两组之间无显著差异。两组在平均完全愈合时间上存在显著差异:早期组为25.2±9.7天,晚期组为44.7±27天(p<0.05)。

结论

我们的数据表明,bFGF - CGF可在2周内形成质量足够的真皮样肉芽组织作为皮肤移植的植床。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d34e/9420878/086af54207da/gr1.jpg

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