Wood F, Liddiard K, Skinner A, Ballentyne J
Royal Perth and Princess Margaret Hospital, Burn Unit, University of Western Australia, Australia.
Burns. 1996 Sep;22(6):451-4. doi: 10.1016/0305-4179(95)00177-8.
Since the introduction of cultured epithelial autograft (CEA) for the treatment of burns wounds, the resulting scar has caused a great deal of concern. When CEA is applied to a deep wound the resulting scar is subject to breakdown with minimal trauma. It takes a considerable period of time, in some instances years, before the dermal-epidermal junction matures and the skin is able to endure the wear and tear of normal existence. Therefore it is understandable that the introduction of pressure garments for treating into these scars has been somewhat delayed. However, we believe that early aggressive pressure therapy is the treatment of choice in those cases where there is a strong chance of the scar becoming hypertrophic. This paper presents an approach to the problems of scar management with CEA, not only for the case of a major full-thickness burn, but also for a lesser burn injury. The concept of a hydrophobic fabric as a lining garment is introduced. The garment design has been changed, to pay particular attention to reduction of shearing forces and dissipation of pressure. The development of our hydrophobic pressure garment is beneficial as it both reduces surface maceration and shearing injury. Since it protects the fragile CEA, formal pressure management can be instituted early in the treatment programme.
自从采用培养的上皮自体移植（CEA）治疗烧伤创面以来，所形成的瘢痕引起了广泛关注。当将CEA应用于深度创面时，所形成的瘢痕在受到最小程度的创伤时就会破裂。在真皮 - 表皮连接成熟且皮肤能够承受正常生活的磨损之前，需要相当长的一段时间，在某些情况下甚至是数年。因此，用于治疗这些瘢痕的压力衣的引入有所延迟是可以理解的。然而，我们认为，在瘢痕有很大可能发展为增生性瘢痕的情况下，早期积极的压力治疗是首选的治疗方法。本文提出了一种处理CEA所致瘢痕问题的方法，不仅适用于大面积全层烧伤的情况，也适用于较轻的烧伤损伤。文中介绍了一种将疏水织物用作内衬衣物的概念。服装设计已有所改变，特别注重减少剪切力和压力的分散。我们开发的疏水压力衣很有益处，因为它既能减少表面浸渍又能减少剪切损伤。由于它能保护脆弱的CEA，所以可以在治疗方案的早期就开始进行正规的压力管理。
