학술논문
Novel Application of Cultured Epithelial Autografts (CEA) with Expanded Mesh Skin Grafting Over an Artificial Dermis or Dermal Wound Bed Preparationv.
Document Type
Article
Author
Akita, Sadanori; Hayashida, Kenji; Yoshimoto, Hiroshi; Fujioka, Masaki; Senju, Chikako; Morooka, Shin; Nishimura, Gozo; Mukae, Nobuhiko; Kobayashi, Kazuo; Anraku, Kuniaki; Murakami, Ryuichi; Hirano, Akiyoshi; Oishi, Masao; Ikenoya, Shintaro; Amano, Nobuyuki; Nakagawa, Hiroshi; Nagasaki University plastic surgeons group
Source
Subject
*AUTOGRAFTS
*TRANSPLANTATION of organs, tissues, etc.
*SKIN grafting
*VISCOELASTICITY
*SCARS
*WOUNDS & injuries
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Language
ISSN
1661-6596
Abstract
Cultured epithelial autografts (CEA) with highly expanded mesh skin grafts were used for extensive adult burns covering more than 30% of the total body surface area. A prospective study on eight patients assessed subjective and objective findings up to a 12-month follow-up. The results of wound healing for over 1:6 mesh plus CEA, gap 1:6 mesh plus CEA, and 1:3 mesh were compared at 3, 6, and 12 months using extensibility, viscoelasticity, color, and transepidermal water loss by a generalized estimating equation (GEE) or generalized linear mixed model (GLMM). No significant differences were observed among the paired treatments at any time point. At 6 and 12 months, over 1:6 mesh plus CEA achieved significantly better expert evaluation scores by the Vancouver and Manchester Scar Scales (p < 0.01). Extended skin grafting plus CEA minimizes donor resources and the quality of scars is equal or similar to that with conventional low extended mesh slit-thickness skin grafting such as 1:3 mesh. A longitudinal analysis of scars may further clarify the molecular changes of scar formation and pathogenesis. [ABSTRACT FROM AUTHOR]