Romero-Flores V, Salgado RM, Melchor JM, Krötzsch E

Language: Spanish
References: 18
Page: 59-66
PDF size: 399.80 Kb.

ABSTRACT

Split skin graft harvesting is a common practice in the treatment of burn patients; however, it takes 14 days to recover the epithelial layer. Nowadays, dressings help to minimize the recovery period and have better quality in the resulting epithelization. We present the results of a clinical comparative study carried out at the Tacubaya Pediatric Hospital, in Mexico City. The epithelialization effect in mid-thickness skin graft donor sites treated with homologous epidermal culture versus heterologous porcine small intestinal submucosa was clinically and histomorphologically analyzed. We assessed early changes in the presence of matured epithelia in 55% of the patients treated with the homologous epidermis versus 33.3% of those treated with the acellular matrix. An abundant inflammatory infiltrate was observed in 44.4% of the tissues treated with the epidermal culture versus 77.8% of those treated with small intestinal submucosa. Clinically, during the first months, the donor sites treated with the homologous epidermis presented less erythema in comparison with those treated with small intestinal submucosa, which had hematic traces and desquamation; however, we did not observe significant differences in the maturation of scars and clinical characteristics after six months of treatment.

REFERENCES

1. Voineskos SH, Ayeni OA, McKnight L et al. Systematic review of skin graft donor-site dressings. Plast Reconstr Surg 2009; 124 (1): 298-306.

2. Demirtas Y, Yagmur C, Soylemez F et al. Management of split-thickness skin graft donor site: a prospective clinical trial for comparison of five different dressing materials. Burns 2010; 36 (7): 999-1005.

3. Liu J, Li Y, Rong X et al. Application of crystalline cellulose membrane (Veloderm®) on split-thickness skin graft donor sites in burn or reconstructive plastic surgery patients. J Burn Care Res 2013; 34 (3): e176-e182.

4. Healy C, Greig AV, Murphy AD et al. Prospective randomized controlled trial: fibrin sealant reduces split skin graft donor-site pain. Plast Reconstr Surg 2013; 132 (1): 139e-146.

5. Klnç H, Sensöz Ö, Özdemir R et al. Which dressing for split-thickness skin graft donor sites? Ann Plast Surg 2001; 46 (4): 409-414.

6. Wang TH, Ma H, Yeh FL et al. The use of “composite dressing” for covering split-thickness skin graft donor sites. Burns 2010; 36 (2): 252-255.

7. Argirova M, Hadjiski O, Victorova A. Acticoat versus Allevyn as a split-thickness skin graft donor-site dressing: a prospective comparative study. Ann Plast Surg 2007; 59 (4): 415-422.

8. Disa JJ, Alizadeh K, Smith JW et al. Evaluation of a combined calcium sodium alginate and bio-occlusive membrane dressing in the management of split-thickness skin graft donor sites. Ann Plast Surg 2001; 46 (4): 405-408.

9. Brenner M, Hilliard C, Peel G. Management of pediatric skin-graft donor sites: a randomized controlled trial of three wound care products. J Burn Care Res 2015; 36 (1): 159-166.

10. Dornseifer U, Lonic D, Gerstung TI et al. The ideal split-thickness skin graft donor-site dressing: a clinical comparative trial of a modified polyurethane dressing and aquacel. Plast Reconstr Surg 2011; 128 (4): 918-924.

11. Dreifke MB, Jayasuriya AA, Jayasuriya AC. Current wound healing procedures and potential care. Mater Sci Eng C Mater Biol Appl 2015; 48: 651-662.

12. Shi L, Ronfard V. Biochemical and biomechanical characterization of porcine small intestinal submucosa (SIS): a mini review. Int J Burn Trauma 2013; 3 (4): 173-179.

13. Salgado RM, Bravo L, García M et al. Histomorphometric analysis of early epithelialization and dermal changes in mid–partial-thickness burn wounds in humans treated with porcine small intestinal submucosa and silver-containing hydrofiber. J Burn Care Res 2014; 35 (5): 330-337.

14. Arámbula H, Sierra-Martínez E, González-Aguirre NE et al. Frozen human epidermal allogenic cultures promote rapid healing of facial dermabrasion wounds. Dermatol Surg 1999; 25 (9): 708-712.

15. Tamariz-Domínguez E, Castro-Muńozledo F, Kuri-Harcuch W. Growth factors and extracellular matrix proteins during wound healing promoted with frozen cultured sheets of human epidermal keratinocytes. Cell Tissue Res 2002; 307 (1): 79-89.

16. Monroy RC, Martínez ES, Aguilar EJ et al. Aloinjertos de epidermis cultivada para áreas donadoras de piel y lesiones de espesor total en pacientes politraumatizados. An Med Asoc Hosp ABC 2003; 48 (2): 84-88.

17. Still J, Glat P, Silverstein P et al. The use of a collagen sponge/living cell composite material to treat donor sites in burn patients. Burns 2003; 29 (8): 837-841.

18. Rakel BA, Bermel MA, Abbott LI et al. Split-thickness skin graft donor site care: a quantitative synthesis of the research. Appl Nurs Res 1998; 11 (4): 174-182.