Schiozer W A, Hartinger A, von Donnersmarck G H, Mühlbauer W
Department of Plastic, Reconstructive and Hand Surgery, Klinikum Bogenhausen, Munich, Germany.
Burns. 1994 Dec;20(6):503-7. doi: 10.1016/0305-4179(94)90006-x.
In patients with extensive deep burns and scarce donor sites autogenic cultured epithelial grafts (auto-CEG) have become a real alternative. In deep burns the 'take' rate of auto-CEG applied directly on subcutaneous fat, fascia or muscle is unreliable and frequently disappointing. The auto-CEG seems to need a dermal base. Improved results have been reported when auto-CEG were applied to the dermal base of a viable cryopreserved donor skin. We extended this principle by using the dermal layer of non-viable glycerol-preserved donor skin (GPDS). We report on two patients with deep burns of 55 and 80 per cent TBSA in whom we used the composite grafting of auto-CEG on non-viable allogeneic dermis from GPDS. The estimated 'take' rates were 70 and 77 per cent. The grafted areas remained stable for 4 and 8 months respectively. The two-layer skin substitute gave a permanent cover for full thickness burn wounds of higher quality and better 'take' rate than previous results, where the auto-CEG had been grafted directly onto the debrided wounds.
对于广泛深度烧伤且供皮区稀缺的患者，自体培养上皮移植片（auto-CEG）已成为一种切实可行的替代方法。在深度烧伤中，直接应用于皮下脂肪、筋膜或肌肉上的auto-CEG的“成活率”不可靠，且常常令人失望。auto-CEG似乎需要真皮基底。有报道称，将auto-CEG应用于存活的冷冻保存供皮的真皮基底时，效果有所改善。我们通过使用非存活的甘油保存供皮（GPDS）的真皮层扩展了这一原理。我们报告了两名分别为55%和80%体表面积深度烧伤的患者，在他们身上我们将auto-CEG复合移植到来自GPDS的非存活同种异体真皮上。估计的“成活率”分别为70%和77%。移植区域分别保持稳定4个月和8个月。与之前将auto-CEG直接移植到清创后的伤口相比，这种双层皮肤替代物为全层烧伤创面提供了质量更高、“成活率”更好的永久性覆盖。
