Lin T W
Burn Center and Surgical Department, Medical College of National Taiwan University, Taipei.
Burns. 1994 Aug;20(4):347-50. doi: 10.1016/0305-4179(94)90065-5.
Microskin grafting has proved to be an effective treatment for major burns when the area of available donor skin is inadequate. In fact, microskin grafting can be comparable to the patch graft of Gabarro. Further mincing procedures cut the skin patches into smaller pieces around 1 mm2. The healing process is completed by the epithelial migration between the micropatches. The possibly longest interpatch distance is related to the expansion ratio and the size of the microskin patch. From the equation L = x.(1.4 square root of Y-1.2) it is clear that the interpatch distance L is directly related to the patch side-length x. This means that when the patch side-length is doubled then the interpatch distance will be doubled. However the expansion ratio Y is related to its square root, so that the influence of the expansion ratio Y is much less important. For improving the healing process, the interpatch distance is better kept within 5 mm. With this understanding, we can calculate the required donor skin surface area for a given wound area according to the different side-length of micropatch, and also the possible maximum patch size for a given wound area for different available donor skin areas. As the area of available skin may be very limited, the maximum patch size may be smaller than the usual size (around 1 mm). Then we have to elongate the interpatch distance, though it would delay the healing. This is a purely theoretical reference. In normal clinical practice, the discussed conditions should be considered.
当可用供皮区面积不足时，微型皮片移植已被证明是治疗大面积烧伤的有效方法。事实上，微型皮片移植可与加巴罗的贴片移植相媲美。进一步的切碎程序将皮肤贴片切成约1平方毫米的更小碎片。愈合过程通过微贴片之间的上皮迁移完成。可能的最长贴片间距与扩展率和微型皮片的大小有关。从公式L = x·(1.4√Y - 1.2)可以看出，贴片间距L与贴片边长x直接相关。这意味着当贴片边长加倍时，贴片间距也将加倍。然而，扩展率Y与其平方根有关，因此扩展率Y的影响要小得多。为了改善愈合过程，贴片间距最好保持在5毫米以内。基于这种理解，我们可以根据微型贴片的不同边长计算给定伤口面积所需的供皮表面积，以及对于不同可用供皮面积的给定伤口面积可能的最大贴片尺寸。由于可用皮肤面积可能非常有限，最大贴片尺寸可能小于通常尺寸（约1毫米）。然后我们必须延长贴片间距，尽管这会延迟愈合。这只是一个纯粹的理论参考。在正常临床实践中，应考虑所讨论的情况。
