一项前瞻性、多中心、新型同源皮肤结构在深度、部分厚度和全层烧伤中的试点试验。

Q3 Medicine Annals of burns and fire disasters Pub Date : 2020-09-30
M J Feldman, M M McLawhorn, J Han, A C Marcu, S E Burkey, T E Travis, L S Johnson
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引用次数: 0

摘要

裂厚皮肤移植是治疗深度烧伤的标准护理方法。他们经常收缩,有不可预测的美容效果,缺乏真皮附属物,并导致疼痛,明显的供体部位。自体同源皮肤结构(AHSC)已被证明可以产生全层皮肤结构。本研究考察了ahsc治疗烧伤创面的安全性、植入性和愈合质量。在获得IRB批准和知情同意后,需要移植的深度部分/全层烧伤患者接受AHSC和STSG并行治疗。2平方厘米的全层收获物在fda注册的工厂加工成AHSC,在48小时内返回,并与STSG一起应用于4平方厘米的区域。AHSC供体点主要关闭。用数码摄影和调查员评估90天的伤口愈合情况。记录所有不良事件(ae)。8例患者的烧伤创面TBSA平均值为13.3%[范围2-58%],其中白人5例,非洲裔3例,平均体重指数(BMI)为26.8。伤害主要是由于火焰烧伤,还有油脂、烫伤、接触、摩擦和闪光造成的伤害。从损伤到AHSC治疗的平均时间为11天[范围5-35天]。在研究结束时,所有患者都有足够的移植和完全的上皮化。患者需要一次应用AHSC,不需要在应用部位进行其他手术。stsg治疗的伤口最常见的ae包括增生性瘢痕和瘙痒。一个未感染的AHSC采收部位出现开裂。没有其他与AHSC治疗相关的不良反应。AHSC治疗在需要进一步研究的深度、部分和全层烧伤创面是可行的。
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A Prospective, Multicenter, Pilot Trial Of A Novel Homologous Skin Construct On Deep Partial-Thickness And Full-Thickness Burns.

Split-thickness skin grafting (STSG) is the standard of care for treating deep burns. They often contract, have unpredictable cosmetic outcomes, lack dermal appendages, and result in painful, conspicuous donor sites. An autologous homologous skin construct (AHSC) has been shown to produce full-thickness skin architecture. This study examined the safety profile, engraftment, and quality of healing of a pilot group of AHSC-treated burn wounds. Following IRB approval and informed consent, patients with deep-partial/full-thickness burns requiring grafting underwent side-by-side treatment with AHSC and STSG. A 2 cm2 fullthickness harvest was processed into AHSC at an FDA-registered facility, returned within 48 hours, and applied to a 4 cm2 area alongside a STSG. AHSC donor site was closed primarily. Wounds were evaluated for healing with digital photography and investigator assessments for 90 days. All adverse events (AEs) were recorded. Eight patients with average 13.3% TBSA [range 2-58%] burn wounds were treated: 5 Caucasian and 3 African American with an average body mass index (BMI) of 26.8. Injury was due to predominantly flame burn, with additional injury from grease, scald, contact, friction and flash. Mean time between injury and AHSC treatment was 11 days [range 5-35 days]. All patients had adequate engraftment and complete epithelialization by the end of the study. Patients required one application of AHSC and no other additional surgical procedures at the application sites. The most common AEs for STSG-treated wounds included hypertrophic scarring and pruritus. One non-infected AHSC harvest site experienced a dehiscence. There were no other AEs related to AHSC treatment. AHSC treatment is feasible in deep partial and fullthickness burn wounds warranting additional investigation.

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来源期刊
Annals of burns and fire disasters
Annals of burns and fire disasters Nursing-Emergency Nursing
CiteScore
1.20
自引率
0.00%
发文量
0
期刊介绍: "Annals of Burns and Fire Disasters" is the official publication of the Euro-Mediterranean Council for Burns and Fire Disasters (MBC) and the European Burns Association (EBA). It is a peer-reviewed journal directed to an audience of medical as well as paramedical personnel involved in the management of burn injuries. The journal publishes original articles in the form of clinical and basic research, scientific advances. It publishes also selected abstracts from international journals.
期刊最新文献
MBC Report. SFB. Investigation Of Common Burn Mechanisms, And Training And Safety Conditions In The Workplace. Brûlure Et Atteinte Oculaire: Incidence, Facteurs De Risque Et Pronostic. Brûlures Profondes Des Membres Inférieurs Chez Les Patients Diabétiques: À Propos De 30 Cas.
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