Horch R, Stark G B, Kopp J, Spilker G
Department of Plastic and Reconstructive Surgery, Cologne Medical Centre Merheim, Germany.
Burns. 1994;20 Suppl 1:S23-6. doi: 10.1016/0305-4179(94)90084-1.
In an effort to improve the take of finely meshed autografts a modification of the sandwich technique, as first published by Alexander et al. (1981), was developed. In contrast to the techniques described by other authors, the wound bed is sealed with fibrin glue spray after excision of the burns. Widely meshed autografts are then covered with non-meshed (only scarcely sliced) glycerolized allograft sheets, being fixed with staples. Patients are placed on fluidized beds and are exposed without dressings from the fifth day onwards. Histologically and clinically, it can be assumed that part of the glycerolized allodermis is incorporated. During the weeks after transplantation, a creeping substitution of the allodermis by autologous tissue takes place. This would suggest a co-existence between glycerol-preserved hypo-allergenic allografts and auto-epidermis. Research on the definitive fate of allodermis in cases of sandwich grafting is continuing.
为了提高细网眼自体皮片的成活率,对亚历山大等人(1981年)首次发表的三明治技术进行了改良。与其他作者描述的技术不同,烧伤切除后用纤维蛋白胶喷雾封闭创面床。然后用非网眼状(仅轻微切片)甘油化同种异体皮片覆盖宽网眼自体皮片,并用吻合钉固定。患者置于流化床,从第五天起不包扎暴露。从组织学和临床角度来看,可以推测部分甘油化异体真皮被整合。在移植后的几周内,自体组织对异体真皮进行逐步替代。这表明甘油保存的低致敏性异体皮与自体表皮共存。关于三明治移植中异体真皮最终命运的研究仍在继续。