Tomás-Velázquez Alejandra, Antoñanzas Javier, Salido-Vallejo Rafael, Redondo Pedro
Department of Dermatology, University Clinic of Navarra, 31008 Pamplona, Spain.
School of Medicine, University of Navarra, 31008 Pamplona, Spain.
J Clin Med. 2023 Sep 22;12(19):6109. doi: 10.3390/jcm12196109.
Repairing lower extremity defects presents challenges due to the scarcity of available local tissue. Skin grafting is a widely employed technique for addressing non-healing ulcers, improving the quality of life of patients and minimizing discomfort. However, using traditional donor sites, such as the thigh, can hinder mobility and result in noticeable scarring and pigmentation changes.
This study aims to assess the effectiveness of a novel approach utilizing autologous ultra-thin split-thickness skin grafts (STSGs) harvested from the scalp using a disposable, commercially available razor blade named DermaBlade.
Fifteen patients (median age: 72 years, eight males and seven females) with diverse lower limb lesions, including carcinomas and ulcers of varying etiologies, were prospectively enrolled. Donor sites included the sideburn extending to the hairy temporal skin (nine cases) and hairy occipital skin (six cases). Ultra-thin skin strips (<0.2 mm thick) were obtained from the scalp through the use of the disposable flexible blade DermaBlade. The strips were positioned over the receptor area with no sutures in most cases and secured using dressings. A substantial majority of patients (90%) achieved successful graft take with no complications. Swift re-epithelialization occurred within a median of 12 days for the donor site and 24 days for the receptor site. No hair transfer or alopecic scars were noted.
In contrast to traditional grafting methods, DermaBlade-assisted scalp grafting yields highly viable STSGs that adhere to wound beds without the need for sutures. Notable advantages of this technique encompass rapid wound healing, minimal complications, and superior cosmetic outcomes. Furthermore, it avoids scarring and alopecia, making it a promising approach for addressing lower extremity defects.
由于可用的局部组织稀缺，修复下肢缺损面临挑战。皮肤移植是一种广泛应用的技术，用于治疗不愈合溃疡、改善患者生活质量并减少不适。然而，使用传统的供皮区，如大腿，会妨碍活动，并导致明显的瘢痕形成和色素沉着变化。
本研究旨在评估一种新方法的有效性，该方法利用一种名为DermaBlade的一次性商用剃须刀片从头皮获取自体超薄断层皮片（STSGs）。
前瞻性纳入15例（中位年龄：72岁，8例男性和7例女性）患有各种下肢病变的患者，包括不同病因的癌和溃疡。供皮区包括延伸至颞部多毛皮肤的鬓角（9例）和枕部多毛皮肤（6例）。通过使用一次性柔性刀片DermaBlade从头皮获取超薄皮条（厚度<0.2mm）。在大多数情况下，皮条放置在受区上，无需缝合，使用敷料固定。绝大多数患者（90%）移植成功，无并发症。供皮区中位12天、受区中位24天迅速实现重新上皮化。未观察到毛发转移或秃发性瘢痕。
与传统移植方法相比，DermaBlade辅助的头皮移植产生高度存活的STSGs，无需缝合即可附着于创面床。该技术的显著优点包括伤口愈合快、并发症少和美容效果好。此外，它避免了瘢痕形成和脱发，使其成为治疗下肢缺损的一种有前景的方法。
