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尸体皮片移植在创面处理中的多功能性。

Versatility in the use of cadaveric skin grafts for wound management.

机构信息

German Hospital, Buenos Aires, Argentina.

出版信息

Wounds. 2024 Sep;36(9):303-311. doi: 10.25270/wnds/24004.

Abstract

BACKGROUND

Cadaveric skin grafts were initially used for the management of acute burn wounds. The biological coverage of the wound improves the quality of the wound bed, which prepares it to receive an autologous skin graft. The benefits of cadaveric skin graft in burn wounds have led to its use in the management of acute and chronic wounds of diverse etiologies.

OBJECTIVE

To evaluate the use of cadaveric skin graft and subsequent autologous split-thickness skin graft (STSG) in the management of wounds of diverse etiologies at a single institution.

MATERIALS AND METHODS

A retrospective analysis was performed of patients with wounds of different etiologies managed with cadaveric skin grafts followed by a second procedure in which autologous STSG was performed from May 2017 through May 2022 in the Plastic and Reconstructive Surgery Department of German Hospital, Buenos Aires, Argentina.

RESULTS

A total of 25 patients with wounds of different etiologies were included. The mean affected body surface area (BSA) was 1.87%. The mean engraftment percentage of the cadaveric skin graft was 96.6%. The mean engraftment percentage of the STSG was 90.6%. All patients demonstrated improvement in local edema and inflammation, reduced secretions, and reduced pain after treatment. Two patients (8%) had complications, with 1 case of delayed healing of the donor site and 1 case of hypertrophic scarring.

CONCLUSIONS

Cadaveric skin graft with subsequent STSG is a simple, safe, and effective alternative for the management of complex wounds of diverse etiologies. This technique is particularly useful in patients with multiple comorbidities who are at risk of recurrence and of developing multiple wounds during their lifetime.

摘要

背景

尸体皮片最初用于急性烧伤创面的处理。创面的生物覆盖可以改善创面床的质量,使其为接受自体皮片移植做好准备。尸体皮片在烧伤创面中的应用优势使其也被用于多种病因的急性和慢性创面的处理。

目的

评估在一家机构中使用尸体皮片移植联合后续自体刃厚皮片(STSG)移植处理多种病因创面的效果。

材料和方法

对 2017 年 5 月至 2022 年 5 月期间在阿根廷布宜诺斯艾利斯德国医院整形与重建外科接受尸体皮片移植联合后续自体 STSG 治疗的不同病因创面患者进行回顾性分析。

结果

共纳入 25 例不同病因创面患者,平均受累体表面积(BSA)为 1.87%。尸体皮片的平均移植成活率为 96.6%,自体 STSG 的平均移植成活率为 90.6%。所有患者在治疗后局部水肿和炎症均得到改善,分泌物减少,疼痛减轻。2 例(8%)患者出现并发症,1 例供区愈合延迟,1 例发生增生性瘢痕。

结论

尸体皮片联合自体 STSG 是处理多种病因复杂创面的一种简单、安全且有效的方法。对于那些存在复发风险和在其一生中易发生多处创面的合并多种疾病的患者,这种技术特别有用。

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