Freund Gerrit, Schäfer Benedikt, Beier Justus P, Boos Anja M
Department of Plastic Surgery, Hand Surgery-Burn Center, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
JPRAS Open. 2024 Oct 18;43:79-91. doi: 10.1016/j.jpra.2024.07.013. eCollection 2025 Mar.
Over the past few years, treatment of burn injuries has evolved beyond primary surgical therapy with the development of enzymatic debridement and new types of skin replacement materials by providing complex personalized therapy concepts aimed at preserving and replacing the dermal layer of the skin. The aim of our study was to develop an individualized treatment algorithm for mixed depth burn wound and evaluate the outcomes of individualized combined treatment of mixed depth burn wounds with enzymatic debridement and decellularized fish skin. A total of 18 patients with a mean age of 34.8 years and mean follow-up of 447.6 days were included. The mean total burn surface area was 12.3%. All patients received enzymatic debridement and an average area of 247.2 cm of decellularized fish skin. Days until complete epithelization were 49.4 ± 25.79 days. No patient developed scar contracture or keloid. The Patient and Observer Scar Assessment Scale (POSAS) observer scale showed an overall impression average of 2.2 ± 0.83. The POSAS patient scale showed an overall impression average 2 ± 0.7. The Vancouver Scar Scale showed an average score of 1.89 ± 1.45. In conclusion, combined treatment using enzymatic debridement and decellularized fish skin, polylactide membrane, or split skin grafts allows for a more individualized therapy for mixed depth burn wounds. Fish skin was found to provide a satisfying result in terms of the overall outcome of the developed scar tissue and could lead to a reduction in the area that requires autologous transplantation.
在过去几年中，烧伤治疗已超越了单纯的外科手术治疗，随着酶促清创术的发展以及新型皮肤替代材料的出现，通过提供旨在保留和替代皮肤真皮层的复杂个性化治疗方案得以实现。我们研究的目的是制定一种针对混合深度烧伤创面的个体化治疗算法，并评估酶促清创术和脱细胞鱼皮联合治疗混合深度烧伤创面的个体化治疗效果。共纳入18例患者，平均年龄34.8岁，平均随访447.6天。平均烧伤总面积为12.3%。所有患者均接受了酶促清创术，并平均使用了247.2平方厘米的脱细胞鱼皮。完全上皮化所需天数为49.4±25.79天。没有患者出现瘢痕挛缩或瘢痕疙瘩。患者和观察者瘢痕评估量表（POSAS）观察者量表的总体印象平均分为2.2±0.83。POSAS患者量表的总体印象平均分为2±0.7。温哥华瘢痕量表的平均评分为1.89±1.45。总之，使用酶促清创术和脱细胞鱼皮、聚乳酸膜或分层皮片进行联合治疗，可为混合深度烧伤创面提供更个体化的治疗。就所形成瘢痕组织的总体结果而言，发现鱼皮能提供令人满意的效果，并可减少需要自体移植的面积。
