gms | German Medical Science

32. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2014)

15.01. - 18.01.2014, Arosa, Schweiz

Combined Split-thickness skin (STSG) and cultured epithelial (CEA) autografts for coverage of massive burn injuries

Meeting Abstract

  • D.L. Hoppe - Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls Universität Tübingen
  • T. Manoli - Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls Universität Tübingen
  • A. Wenger - Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls Universität Tübingen
  • O. Lotter - Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls Universität Tübingen
  • H.-E. Schaller - Klinik für Hand-, Plastische, Rekonstruktive und Verbrennungschirurgie, Berufsgenossenschaftliche Unfallklinik, Eberhard-Karls Universität Tübingen

Deutschsprachige Arbeitsgemeinschaft für Verbrennungsbehandlung. 32. Jahrestagung der Deutschsprachigen Arbeitsgemeinschaft für Verbrennungsbehandlung (DAV 2014). Arosa, Schweiz, 15.-18.01.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dav32

doi: 10.3205/14dav32, urn:nbn:de:0183-14dav326

Published: June 18, 2014

© 2014 Hoppe et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Background: Up to date the real usefulness of cultured keratinocytes in extended full-thickness burn wounds is been controversially discussed. Due to the limited availability of donor sites, they might broaden conservative surgical strategies and provide a life-saving temporary closure. Nevertheless important limitations like the time consuming culturing (2-3 weeks), high sensitivity to infection, variable take rates, high costs,the lack of a dermal layer (fibrocytes) or a long-term fragility hindered their frequent clinical implementation. Wide meshing (1:6 or 1:9) provokes secondary healing of the interstices and often results in delays, scar hypertrophy or contracture.

Methods: In this case report the "take" of combined STSG (expansion rate 1:6) with sheet or suspension CEA on a predefined area (each 120cm2) of a >80% TBSA adult survivor is presented. In this case report the "take" of combined STSG (expansion rate 1:6) with sheet or suspension CEA on a predefined area (each 120cm2) of a >80% TBSA adult survivor is presented. The engraftments were analyzed and edited with digital photo software in order to estimate the total epidermal coverage on day 3, 5, 7,10 and 14. Complications like partial and total graft loss, spontaneous blistering and infection were also determined a 4 months follow-up.

Results: Supplemented CEA sheets supported the mesh graft's adherence and led to a faster defect repair. Although filling the interstices, CEA suspension had no additional effect on the mesh graft compared to the control area (STSG alone).

Conclusion: CEA sheets can be considered as a useful complement in traditional wide expanded STSG for a speedier and permanent healing in massive burn wounds.