Spilker G, Reifenrath M W, Kaiser H W
Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Schwerstverbranntenzentrum Köln-Merheim.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:1149-55.
In severe burns a total body surface area (TBSA) of more than 60% restricts possible donor areas for autologous STS coverage. Additional wound surfaces may further harm the patient. From a skin biopsy of 5 cm2 the total body surface can be covered using keratinocyte cultures to multiply cells by 1000 up to 10,000. The cultured keratinocytes may be used as "sheets" (CEA) or suspended in fibrin glue (KFGS), which must be covered with meshed allogenic STS graft. Long culture times from 14 (KFGS) up to 28 days (CEA), infection of the culture and the woundbed, mechanical instability in the first period after grafting, restoring the dermal equivalent in full thickness burns and high costs are the problems of this new means of burn wound covering. Technical details of cultivation and coverage procedures using CEA and KFGS are discussed.
在严重烧伤中，超过60%的总体表面积（TBSA）会限制自体脱细胞真皮基质（STS）覆盖的可能供区。额外的创面可能会进一步伤害患者。从5平方厘米的皮肤活检样本中获取的细胞，通过角质形成细胞培养可使细胞数量增加1000至10000倍，从而覆盖全身表面积。培养的角质形成细胞可用作“薄片”（CEA）或悬浮于纤维蛋白胶中（KFGS），且必须覆盖网状异体脱细胞真皮基质移植物。培养时间长，从14天（KFGS）到28天（CEA）不等，培养物和创面床会发生感染，移植后初期存在机械稳定性问题，全层烧伤中真皮替代物的恢复以及成本高昂，这些都是这种新型烧伤创面覆盖方法存在的问题。文中讨论了使用CEA和KFGS的培养及覆盖程序的技术细节。
