Co-transplantation of acellular allogeneic dermis and autologous split-thickness skin for burn repair at functional parts / 中国组织工程研究

ABSTRACT

BACKGROUND:Autologous split-thickness skin grafting is the main therapy for burn repair at functional sites, which has achieved certain effects, but there are stil some deficiencies, such as poor texture, stiffness and poor toughness, as wel as severer hyperplasia that is easy to result in contracture deformity and poor functional recovery. OBJECTIVE: To analyze the clinical efficacy of skin co-transplantation on burn repair at functional sites. METHODS:Sixty patients with burns at functional sites (n=84) were randomized into two groups co-transplantation of acelular dermis and autologous split-thickness skin in experimental group and autologous split-thickness skin graft in control group. Survival rate of skin flap and rate of secondary operation were compared between two groups. At 1 month after transplantation, Vancouver Scar Scale was used to assess skin color, thickness, blood vessel distribution and flexibility, and meanwhile, the severity of scar was determined. RESULTS AND CONCLUSION:The survival rate of skin flap was significantly higher in the experimental group than the control group (93%vs. 70%,P < 0.05), and the rate of secondary operation was significantly lower in the experimental group compared with the control group (0vs. 13%,P < 0.05). At 1 month after transplantation, scores on the skin color, thickness, blood vessel distribution and flexibility were al lower in the experimental group than the control group (P < 0.05), but the incidence of mild hyperplasia in the experimental group was significantly higher than that in the control group (52% vs. 29%,P < 0.05). These findings indicate that co-transplantation of acelular alogeneic dermis and autologous split-thickness skin for burn repair at functional sites can effectively enhance the survival rate of skin flap, reduce the rate of secondary operation, contribute to wound healing and reduce the severity of hyperplasia.