Clinical application and viability of cryopreserved cadaveric skin allografts in severe burn: A retrospective analysis

被引:49
作者
Cleland, Heather [1 ,2 ]
Wasiak, Jason [3 ,4 ]
Dobson, Hannah [5 ]
Paul, Michelle [5 ]
Pratt, George [5 ]
Paul, Eldho [4 ]
Herson, Marisa [6 ]
Akbarzadeh, Shiva [1 ,2 ]
机构
[1] Monash Univ, Alfred Hosp, Victorian Adult Burns Serv, Skin Culture Lab, Melbourne, Vic 3181, Australia
[2] Monash Univ, Alfred Hosp, Dept Surg, Melbourne, Vic 3181, Australia
[3] Monash Univ, Alfred Hosp, Victorian Adult Burns Serv, Melbourne, Vic 3181, Australia
[4] Monash Univ, Alfred Hosp, Sch Publ Hlth & Prevent Med, Melbourne, Vic 3181, Australia
[5] Alfred Hosp, Victorian Adult Burns Serv, Skin Culture Lab, Melbourne, Vic, Australia
[6] Donor Tissue Bank Victoria, Melbourne, Vic, Australia
关键词
Burns; Skin; Allograft; Cadaver; Viability; DONOR; PRESERVATION; BANK;
D O I
10.1016/j.burns.2013.05.006
中图分类号
R4 [临床医学];
学科分类号
100218 [急诊医学];
摘要
Introduction: Cadaveric cutaneous allografts are used in burns surgery both as a temporary bio-dressing and occasionally as definitive management of partial thickness burns. Nonetheless, limitations in the understanding of the biology of these grafts have meant that their role in burns surgery continues to be controversial. Methods: A review of all patients suffering 20% or greater total body surface area (TBSA) burns over an eight year period that received cadaveric allografts were identified. To investigate whether tissue viability plays a role in engraftment success, five samples of cryopreserved cadaveric cutaneous allograft processed at the Donor Tissue Bank of Victoria (DTBV) were submitted to our laboratory for viability analysis using two methods of Trypan Blue Exclusion and tetrazolium salt (MTT) assays. Results: During the study period, 36 patients received cadaveric allograft at our institution. The average total burn surface area (TBSA) for this group of patients was 40% and all patients received cadaveric skin as a temporizing measure prior to definitive grafting. Cadaveric allograft was used in complicated cases such as wound contamination, where synthetic dressings had failed. Viability tests showed fewer than 30% viability in processed allografts when compared to fresh skin following the thawing process. However, the skin structure in the frozen allografts was histologically well preserved. Conclusion: Cryopreserved cutaneous cadaveric allograft has a positive and definite role as an adjunct to conventional dressing and grafting where available, particularly in patients with large TBSA burns. The low viability of cryopreserved specimens processed at DTBV suggests that cell viability in cadaveric allograft may not be essential for its clinical function as a wound dressing or even as permanent dermal substitute. (C) 2013 Elsevier Ltd and ISBI. All rights reserved.
引用
收藏
页码:61 / 66
页数:6
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