Markel Justin E, Franke Jacob D, Woodberry Kerri M, Fahrenkopf Matthew P
From the Department of Internal Medicine, Cedars-Sinai Medical Center, West Hollywood, Calif.
Department of Plastic and Reconstructive Surgery, Corewell Health-Michigan State University College of Human Medicine, Grand Rapids, Mich.
Plast Reconstr Surg Glob Open. 2024 Sep 18;12(9):e6174. doi: 10.1097/GOX.0000000000006174. eCollection 2024 Sep.
This article is a narrative review of split-thickness skin graft donor site (STSG-DS) management since the international guidelines were created in 2018. Although many new interventions have been developed, there is a lack of quality, multicentered clinical trials to produce updated evidence-based recommendations.
Electronic databases, including Google Scholar, Web of Science, Medline, and PubMed, were searched by two independent researchers for literature regarding STSG-DS management published from 2018 through 2022, using specific terms in the text, title, and abstract. The primary endpoint assessed was STSG-DS healing, as measured by wound epithelialization.
Thirty-one articles were selected, including three systemic review/meta-analyses, five case series, 14 randomized controlled clinical trials, six observational studies, and three nonrandomized trials. Novel interventions for STSG-DS management included in this article describe applications of human amniotic membranes, acellular dermal matrices, cell suspensions and growth factors, biomaterials, electromagnetic radiation, and natural products.
Various interventions have shown promise for STSG-DS management since the creation of the 2018 international guidelines; however, studies with more standardized protocols and endpoints are needed to produce up-to-date, evidence-based recommendations and improve outcomes for patients undergoing split-thickness skin grafting.
本文是一篇叙述性综述,回顾了自2018年制定国际指南以来的中厚皮片供区(STSG-DS)管理情况。尽管已经开发了许多新的干预措施,但缺乏高质量的多中心临床试验来提供最新的循证建议。
两名独立研究人员通过电子数据库,包括谷歌学术、科学网、医学索引和PubMed,使用文本、标题和摘要中的特定术语,搜索2018年至2022年发表的关于STSG-DS管理的文献。评估的主要终点是STSG-DS愈合情况,通过伤口上皮化来衡量。
共筛选出31篇文章,包括3篇系统评价/荟萃分析、5篇病例系列、14项随机对照临床试验、6项观察性研究和3项非随机试验。本文中包含的STSG-DS管理新干预措施描述了人羊膜、脱细胞真皮基质、细胞悬液和生长因子、生物材料、电磁辐射和天然产物的应用。
自2018年国际指南制定以来,各种干预措施在STSG-DS管理方面显示出前景;然而,需要更多具有标准化方案和终点的研究来提供最新的循证建议,并改善接受中厚皮片移植患者的预后。