Sheridan R, Choucair R, Donelan M, Lydon M, Petras L, Tompkins R
Shriners Burns Hospital, Boston, MA 02114, USA.
J Burn Care Rehabil. 1998 Nov-Dec;19(6):528-30. doi: 10.1097/00004630-199811000-00012.
We grafted 10 sites on 6 children with limited (< 25%) areas of body surface available for donor harvest with an acellular allogenic dermis and a thin autograft. Matched control sites were grafted with autograft alone. Study site autografts (0.0074 +/- 0.0007 in, median 0.006 in, range 0.006 to 0.012 in) were thinner than control site autografts (0.0102 +/- 0.0008 in, median 0.012 in, range 0.006 to 0.013 in), with a P value of .015. Endopoints were initial engraftment (in percent) as judged by a blinded experienced observer and Vancouver scar scores. The 6 children (3 girls and 3 boys) had an average age of 5.2 +/- 0.9 years (range 2.8 to 10 years) and an average burn size of 68.7% +/- 6.7% total body surface area (range 47% to 85% total body surface area). The 10 study and control sites were treated with 10 separate procedures; 9 of the procedures were reconstructive and 1 was performed for the excision of an acute burn. Successful initial epithelialization was noted at 7 days postburn for 83% +/- 3.4% (range 60% to 95%) at the cryopreserved acellular human dermis sites and 83.3% +/- 4.3% (range 60% to 98%) at the control sites (not significant, P = .96). At a mean follow-up interval of 43.7 +/- 3.6 weeks (median 52, range 26 to 52 weeks), the differences between the study and control sites in the total mean (pigmentation, vascularity, pliability, and height) of the patients' Vancouver scar scores were not different.
我们用脱细胞异体真皮和薄自体皮片对6名儿童的10个部位进行了移植，这些儿童可供取皮的体表面积有限（<25%）。匹配的对照部位仅移植自体皮片。研究部位的自体皮片（0.0074±0.0007英寸，中位数0.006英寸，范围0.006至0.012英寸）比对照部位的自体皮片（0.0102±0.0008英寸，中位数0.012英寸，范围0.006至0.013英寸）更薄，P值为0.015。终点指标为盲法经验丰富的观察者判断的初始移植成功率（百分比）和温哥华瘢痕评分。这6名儿童（3名女孩和3名男孩）的平均年龄为5.2±0.9岁（范围2.8至10岁），平均烧伤面积为体表面积的68.7%±6.7%（范围47%至85%体表面积）。10个研究部位和对照部位采用10种不同的手术方法进行治疗；其中9例手术为重建手术，1例为急性烧伤切除手术。冷冻保存的脱细胞人真皮部位在烧伤后7天的初始上皮化成功率为83%±3.4%（范围60%至95%），对照部位为83.3%±4.3%（范围60%至98%）（无显著差异，P = 0.96）。在平均随访间隔43.7±3.6周（中位数52周，范围26至52周）时，患者温哥华瘢痕评分的总平均值（色素沉着、血管分布、柔韧性和高度）在研究部位和对照部位之间没有差异。
