Division of Plastic and Maxillofacial Surgery, Bambino Gesu' Children's Hospital, Research Institute, Rome, Italy.
Landspitali University Hospital, Reykjavik, Iceland.
J Wound Care. 2022 Oct 2;31(10):824-831. doi: 10.12968/jowc.2022.31.10.824.
More specific strategies are needed to support children requiring skin grafting. Our goal was to identify procedures that reduce operating times, post-operative complications, pain and length of hospital stay. Patient safety, optimal wound bed support and quick micro-debridement with locoregional anaesthesia were prioritised. Ultimately, a novel acellular fish skin graft (FSG) derived from north Atlantic cod was selected for use.
We admitted consecutive paediatric patients with various lesions requiring skin grafting for definitive wound closure. All FSGs were applied and bolstered in the operating room following debridement.
In a cohort of 15 patients, the average age was 8 years and 9 months (4 years 1 month-13 years 5 months). Negative pressure wound therapy (NPWT) was given to 12 patients. Rapid wound healing was observed in all patients, with a wound area coverage of 100% and complete healing in 95% of wounds. Time until engraftment in patients receiving NPWT was reduced by about a half (to an average 12 days) from our standard experience of 21 days. Ten patients received locoregional anaesthesia and were discharged after day surgery. The operating time was <60 minutes, and no complications or allergic reactions were reported. Excellent pliability of the healed wound was achieved in all patients, without signs of itching and scratching in the postoperative period. This case series is the first and largest using FSG to treat paediatric patients with different wound aetiologies. We attribute the rapid transition to acute wound status and the good pliability of the new epidermal-dermal complex to the preserved molecular components of the FSG, including omega-3.
FSG represents an innovative and sustainable solution for paediatric wound care that results in shorter surgery time and reduced hospital stays, with accelerated wound healing times.
需要更具体的策略来支持需要植皮的儿童。我们的目标是确定可以减少手术时间、术后并发症、疼痛和住院时间的程序。优先考虑患者安全、最佳创面支持和局部麻醉下的快速微清创。最终，选择了一种新型的源自北大西洋鳕鱼的去细胞鱼皮移植物（FSG）用于治疗。
我们收治了连续的儿科患者，这些患者因各种病变需要植皮进行确定性伤口闭合。所有 FSG 均在清创后于手术室进行应用和固定。
在 15 名患者的队列中，平均年龄为 8 岁 9 个月（4 岁 1 个月至 13 岁 5 个月）。12 名患者接受了负压伤口治疗（NPWT）。所有患者均观察到快速愈合，创面面积覆盖率达到 100%，95%的伤口完全愈合。接受 NPWT 的患者的植皮时间缩短了近一半（从我们的标准经验 21 天缩短到平均 12 天）。10 名患者接受局部麻醉，并在日间手术后出院。手术时间<60 分钟，未报告任何并发症或过敏反应。所有患者的愈合伤口都具有极好的柔韧性，术后无瘙痒和搔抓迹象。本病例系列是第一个也是最大的使用 FSG 治疗不同病因儿童伤口的病例系列。我们将快速过渡到急性伤口状态和新的表皮-真皮复合物的良好柔韧性归因于 FSG 保留的分子成分，包括欧米伽 3。
FSG 为儿科伤口护理提供了一种创新和可持续的解决方案，可缩短手术时间和住院时间，并加速伤口愈合时间。
