Beretta Craft-Coffman , Bounthavy Homsombath , Caryn Cramer , Zaheed Hassan , Shawn Fagan , Kevin Lack , Joan Wilson
{"title":"结合改良 MEEK 手术后的 CEA 移植取材","authors":"Beretta Craft-Coffman , Bounthavy Homsombath , Caryn Cramer , Zaheed Hassan , Shawn Fagan , Kevin Lack , Joan Wilson","doi":"10.1016/j.burnso.2023.11.001","DOIUrl":null,"url":null,"abstract":"<div><p>Resourceful surgical planning for coverage of large burns has led to refinement of early innovative procedures including meshed split thickness skin grafts (STSG), MEEK procedure, and use of cultured epidermal autografts (CEAs). The use of STSG remains standard of care for burn wound coverage; however, manual expansion of STSG is limited due to shortcomings with expansion rates greater than 4:1. The MEEK micrografting method is a method of preparing skin grafts with a device instead of manually with an autograft mesher, allowing reliable expansion rates of autografts up to 9:1. Although the CEA indication for use includes both with and without STSG, use of meshed STSG placed under CEA has been reported to minimize shear forces and hasten graft take. The purpose of this study was to evaluate success of graft take in patients receiving MEEK and CEA for wound coverage in extensive burns at a single burn center experienced in the use of both MEEK and CEA. Data in 15 patients who received both MEEK and CEA for the treatment of large burns (mean total body surface area [TBSA] of 66%) demonstrated a high rate of successful engraftment (87%), and an overall 73% survival rate.</p></div>","PeriodicalId":72486,"journal":{"name":"Burns open : an international open access journal for burn injuries","volume":"8 1","pages":"Pages 23-28"},"PeriodicalIF":0.0000,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468912223000408/pdfft?md5=94a45072722a88dcc5dcabcc984049c5&pid=1-s2.0-S2468912223000408-main.pdf","citationCount":"0","resultStr":"{\"title\":\"CEA graft take after combining with a modified MEEK procedure\",\"authors\":\"Beretta Craft-Coffman , Bounthavy Homsombath , Caryn Cramer , Zaheed Hassan , Shawn Fagan , Kevin Lack , Joan Wilson\",\"doi\":\"10.1016/j.burnso.2023.11.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Resourceful surgical planning for coverage of large burns has led to refinement of early innovative procedures including meshed split thickness skin grafts (STSG), MEEK procedure, and use of cultured epidermal autografts (CEAs). The use of STSG remains standard of care for burn wound coverage; however, manual expansion of STSG is limited due to shortcomings with expansion rates greater than 4:1. The MEEK micrografting method is a method of preparing skin grafts with a device instead of manually with an autograft mesher, allowing reliable expansion rates of autografts up to 9:1. Although the CEA indication for use includes both with and without STSG, use of meshed STSG placed under CEA has been reported to minimize shear forces and hasten graft take. The purpose of this study was to evaluate success of graft take in patients receiving MEEK and CEA for wound coverage in extensive burns at a single burn center experienced in the use of both MEEK and CEA. Data in 15 patients who received both MEEK and CEA for the treatment of large burns (mean total body surface area [TBSA] of 66%) demonstrated a high rate of successful engraftment (87%), and an overall 73% survival rate.</p></div>\",\"PeriodicalId\":72486,\"journal\":{\"name\":\"Burns open : an international open access journal for burn injuries\",\"volume\":\"8 1\",\"pages\":\"Pages 23-28\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-12-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2468912223000408/pdfft?md5=94a45072722a88dcc5dcabcc984049c5&pid=1-s2.0-S2468912223000408-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Burns open : an international open access journal for burn injuries\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2468912223000408\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Burns open : an international open access journal for burn injuries","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2468912223000408","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
为覆盖大面积烧伤而制定的手术计划使早期的创新手术更加完善,包括网状分层皮肤移植(STSG)、MEEK 手术和使用培养表皮自体移植物(CEA)。STSG仍是烧伤创面覆盖的标准护理方法,但由于STSG人工扩张率大于4:1的缺陷,STSG的人工扩张受到限制。MEEK 微移植法是一种用设备而不是用自体移植物网格器手动准备皮肤移植物的方法,可使自体移植物的可靠扩张率达到 9:1。虽然 CEA 的适应症包括使用和不使用 STSG,但有报道称,在 CEA 下使用网状 STSG 可最大限度地减少剪切力并加快移植物的吸收。本研究的目的是评估在一家同时使用 MEEK 和 CEA 的烧伤中心接受 MEEK 和 CEA 覆盖大面积烧伤创面的患者的移植成功率。15 名同时接受 MEEK 和 CEA 治疗大面积烧伤(平均体表总面积 [TBSA] 为 66%)的患者的数据显示,移植成功率很高(87%),总体存活率为 73%。
CEA graft take after combining with a modified MEEK procedure
Resourceful surgical planning for coverage of large burns has led to refinement of early innovative procedures including meshed split thickness skin grafts (STSG), MEEK procedure, and use of cultured epidermal autografts (CEAs). The use of STSG remains standard of care for burn wound coverage; however, manual expansion of STSG is limited due to shortcomings with expansion rates greater than 4:1. The MEEK micrografting method is a method of preparing skin grafts with a device instead of manually with an autograft mesher, allowing reliable expansion rates of autografts up to 9:1. Although the CEA indication for use includes both with and without STSG, use of meshed STSG placed under CEA has been reported to minimize shear forces and hasten graft take. The purpose of this study was to evaluate success of graft take in patients receiving MEEK and CEA for wound coverage in extensive burns at a single burn center experienced in the use of both MEEK and CEA. Data in 15 patients who received both MEEK and CEA for the treatment of large burns (mean total body surface area [TBSA] of 66%) demonstrated a high rate of successful engraftment (87%), and an overall 73% survival rate.