Early application of examethasone improves the survival of autogenous island flap and prognosis of patients with burn scar after transplantation / 中国组织工程研究

ABSTRACT

BACKGROUND:Autologous island flap transplantation is the main therapy for burn scars. Floating and necrosis of transplanted flaps mainly impact the therapeutic effects. Dexamethasone has immunoregulatory function during trauma and stress process. OBJECTIVE:To investigate the effect of dexamethasone on immune balance of Th1/Th2 and prognosis in patients with burn scars undergoing autologous island flap transplantation. METHODS:Sixty-eight patients with burn scars undergoing transplantation of pedicled island flap were selected and randomly divided into control group and experimental group. Patients in the two groups were treated with negative pressure drainage under skin flap, infection prevention, improvement of microcirculation. After that, dexamethasone sodium phosphate (0.2 mg/kg) was immediately given in the experimental group, and the dose gradualy decreased after 3 days until drug withdrawal at 7 days. Levels of Th1, Th2, Th1/Th2 and interferon-γ, interleukin-4 were compared between the two groups before and 1 week after transplantation. In addition, incidence rates of skin flap necrosis, hemodynamic disorder, and effusion were compared between the two groups. RESULTS AND CONCLUSION:The levels of Th1, Th2, Th1/Th2, interferon-γ and interleukin-4 had no obvious differences between the two groups before flap transplantation. At 1 week after transplantation, the levels of Th1 and Th1/Th2 were higher, while the levels of Th2, interferon-γ and interleukin-4 were lower in the experimental group than the control group. Moreover, the incidence of complications was also lower in the experimental group than the control group. In conclude, dexamethasone can decrease the incidence of complications after island flap transplantation, which is maybe the result of adjusting immune balance of Th1/Th2.