CULTURED AUTOLOGOUS KERATINOCYTES IN FIBRIN GLUE SUSPENSION, EXCLUSIVELY AND COMBINED WITH STS-ALLOGRAFT (PRELIMINARY CLINICAL AND HISTOLOGICAL REPORT OF A NEW TECHNIQUE)

被引：92

作者：

KAISER, HW ^{[1
]}

STARK, GB ^{[1
]}

KOPP, J ^{[1
]}

BALCERKIEWICZ, A ^{[1
]}

SPILKER, G ^{[1
]}

KREYSEL, HW ^{[1
]}

机构：

[1] UNIV BONN,MED CTR,DEPT DERMATOL,BONN,GERMANY

来源：

BURNS | 1994年 / 20卷 / 01期

关键词：

D O I：

10.1016/0305-4179(94)90101-5

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The use of cultured epidermal cell sheets has become a recognized method for the coverage of extensive burns. The disadvantages are a long time-lag until the cells are available, the fragility and difficult handling of the grafts, and unpredictable 'take' and extremely high costs. In three patients with deep partial and full skin thickness burns we have applied cultured autologous keratinocytes suspended in fibrin glue. In two of these patients the keratinocyte culture in the fibrin matrix (KFGS) was overgrafted with allogeneic, glycerine-preserved split thickness cadaver skin. The area thus covered ranged from 3 to 15 per cent TBSA. Cultured grafts were available between 2.5 and 3 weeks. The non-confluent cells developed a continuous epithelial layer within the 4 days until the first dressing change. Histological examination showed a stratified neoepidermis. Clinically the new skin had satisfactory stability and mechanical quality. The epidermis of the allogeneic overgrafts desquamated within a few days without signs of inflammation, but there are indications that the STS-allograft dermis is at least partly integrated into the new skin and may serve as a scaffold for the grafted cell culture. The fibrin glue matrix seems to give sufficient adherence stability to keratinocytes that are grafted in an actively proliferating state. Further advantages are the easy repetition and application, as well as a reduction in operating time and costs in these severely injured patients.

引用

页码：23 / 29

页数：7

共 29 条

[11]

Cuono, Langdon, McGuire, Use of cultured epidermal autografts and dermal allografts as skin replacement after burn injury, Lancet, 1, (1986)

[12]

Cuono, Langdon, Birchall, Et al., Composite autologous-allogenic skin replacement: development and clinical application, Plast Reconstr Surg, 80, (1987)

[13]

Langdon, Cuono, Birchall, Reconstitution of structure and cell function in human skin grafts derived from cryopreserved allogenic dermis and autologous cultured keratinocytes, Journal of Investigative Dermatology, 91, (1988)

[14]

Alexander, McMillan, Law, Et al., Treatment of severe burns with widely meshed skin autograft and mesh skin overlay, J Trauma, 21, (1981)

[15]

Kreis, Vloemans, Hoekstra, Et al., The use of non-viable glycerol-preserved cadaver skin combined with widely expanded autografts in the treatment of extensive third degree burns, J Trauma, 29, (1989)

[16]

Horch, Stark, Spilker, Cologne burn center experience with glycerol-preserved allogenic skin: clinical experiences and histologic findings (overgraft and sandwich-technique), Burns, (1994)

[17]

Hunyadi, Farkas, Bertenyi, Et al., Keratinocyte grafting: a new means of transplantation for full-thickness wounds, J Dermatol Surg Oncol, 14, (1988)

[18]

Ronfard, Broly, Mitchel, Use of keratinocytes cultured on fibrin glue in the treatment of burn wounds, Burns, 17, (1991)

[19]

Gallico, O'Conner, Compton, Et al., Permanent coverage of large burn wounds with autologous cultured epithelium, New Engl J Med, 311, (1984)

[20]

Stark, Kaiser, Kopp, Et al., Kultivierte autologe Keratinozyten in einer Fibrin-Matrix zur Deckung von Brandwunden, 30th Annual Meeting of the German Society for Plastic and Reconstructive Surgery, (1992)

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