Nuñez-Gutiérrez H, Castro-Muñozledo F, Kuri-Harcuch W
Plastic and Reconstructive Surgery and Burn Unit, Hospital Azcapotzalco Norte, Mexico City, Mexico.
Plast Reconstr Surg. 1996 Nov;98(6):929-39; discussion 940-1. doi: 10.1097/00006534-199611000-00001.
Cultivation of human epidermal keratinocytes made possible the use of cultured autografts as part of the therapy of extensively burned patients. On the basis of our early results using banked cultured allografts and autografts, we developed an integral and combined burn therapy comprising banked cultured allografts for rapid healing of skin donor sites and deep partial-thickness burns, conventional split-thickness skin autografting, and when needed, cultured autografts for full-thickness burns. We compared hospital stay in 32 burn patients treated with the combined therapy and in 39 who were not treated with cultured epidermis. Three groups of patients were defined: 15 to 29 percent (n = 12), 30 to 49 percent (n = 10), and more than 49 percent (n = 10) burned body surface area. We found a 20 to 29 percent decrease in hospital stay in patients with up to 49 percent burned body surface area and a 46 percent reduction in patients suffering more extensive burns. Survival rate of extensively burned patients also was increased. We took advantage of the availability of banked cultured allografts for ambulatory treatment, without hospitalization, of pediatric patients with 5 to 20 percent burned body surface area. We show for the first time the use and benefits of this combined therapy.
人表皮角质形成细胞的培养使得使用培养的自体移植物成为大面积烧伤患者治疗的一部分。基于我们早期使用储存的培养异体移植物和自体移植物的结果，我们开发了一种综合的联合烧伤治疗方法，包括使用储存的培养异体移植物促进皮肤供区和深Ⅱ度烧伤的快速愈合、传统的中厚皮片自体移植，以及在需要时使用培养的自体移植物治疗全层烧伤。我们比较了32例接受联合治疗的烧伤患者和39例未接受培养表皮治疗的患者的住院时间。将患者分为三组：烧伤体表面积为15%至29%（n = 12）、30%至49%（n = 10）和超过49%（n = 10）。我们发现，烧伤体表面积达49%的患者住院时间减少了20%至29%，烧伤面积更大的患者住院时间减少了46%。大面积烧伤患者的生存率也有所提高。我们利用储存的培养异体移植物对烧伤体表面积为5%至20%的儿科患者进行门诊治疗，无需住院。我们首次展示了这种联合治疗方法的应用及其益处。
