Cram A E, Domayer M A
J Trauma. 1983 Oct;23(10):872-3. doi: 10.1097/00005373-198310000-00004.
Short-term storage of a patient's harvested skin is clinically desirable for numerous reasons. Previous experience in our center using a skin storage solution of saline with a high concentration of antibiotics resulted in poor graft viability and an unsatisfactory clinical outcome. This report defines an improved method of storage which allows longer storage time, yielding viable skin and results in subsequent graft acceptance on the patient. Split-thickness autografts from patients were stored in: 1) saline + 10(4) units/ml penicillin and 0.005 gm/ml streptomycin, or 2) RPMI-1640 + 25 units/ml penicillin and 25 mcg/ml streptomycin, at 4 degrees C. The pH range of the saline solution was 5.90-6.20, compared to 7.20-7.32 for the RPMI-1640 solution. The medium was changed every 3 to 4 days during the storage period. Before graft reapplication the autografts were rinsed with sterile saline. Previous clinical results using the saline-antibiotic storage solution resulted in poor graft viability and no graft survival was noted on patients after 5 days of skin storage. In contrast 11/16 autografts which had been stored in the RPMI-1640 solution for 5 to 22 days (median, 11 days) were successful takes when regrafted to patients. Graft loss was observed in five cases due to the following reasons: inability to immobilize graft (one); poor vascular bed (two); and bacterial infections (two). These data are in agreement with results reported in a separate paper, demonstrating the effectiveness of RPMI-1640 as a storage medium for maintaining viable human skin grafts which were subsequently transplanted to athymic nude mice.(ABSTRACT TRUNCATED AT 250 WORDS)
由于多种原因,临床上希望对患者采集的皮肤进行短期保存。我们中心之前使用高浓度抗生素生理盐水皮肤保存溶液的经验导致移植物活力不佳,临床结果不理想。本报告定义了一种改进的保存方法,该方法可延长保存时间,产生有活力的皮肤,并使随后的移植物被患者接受。患者的中厚自体皮片储存在:1)生理盐水 + 10⁴单位/毫升青霉素和0.005克/毫升链霉素中,或2)RPMI - 1640 + 25单位/毫升青霉素和25微克/毫升链霉素中,于4℃保存。生理盐水溶液的pH范围为5.90 - 6.20,而RPMI - 1640溶液的pH范围为7.20 - 7.32。在保存期间,每3至4天更换一次培养基。在重新移植自体皮片之前,先用无菌生理盐水冲洗。之前使用生理盐水 - 抗生素保存溶液的临床结果导致移植物活力不佳,皮肤保存5天后,患者身上未观察到移植物存活。相比之下,16块自体皮片中的11块在RPMI - 1640溶液中保存5至22天(中位数为11天)后,重新移植到患者身上时成功存活。由于以下原因,在5例中观察到移植物丢失:无法固定移植物(1例);血管床不佳(2例);以及细菌感染(2例)。这些数据与另一篇论文报道的结果一致,证明了RPMI - 1640作为一种保存培养基,对于维持随后移植到无胸腺裸鼠身上的有活力的人类皮肤移植物的有效性。(摘要截短于250字)