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Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns
BACKGROUND: Staged excision and grafting with viable cryopreserved alloskin or fresh pigskin at an early stage is a main strategy for wound management in massive burns. Alloskin is the gold standard of a biological temporary skin substitute, and the main drawback to its wider use is the limited numb...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964051/ https://www.ncbi.nlm.nih.gov/pubmed/27574692 http://dx.doi.org/10.1186/s41038-016-0045-9 |
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author | Zuo, Haibin Song, Guodong Shi, Wen Jia, Jun Zhang, Yonghu |
author_facet | Zuo, Haibin Song, Guodong Shi, Wen Jia, Jun Zhang, Yonghu |
author_sort | Zuo, Haibin |
collection | PubMed |
description | BACKGROUND: Staged excision and grafting with viable cryopreserved alloskin or fresh pigskin at an early stage is a main strategy for wound management in massive burns. Alloskin is the gold standard of a biological temporary skin substitute, and the main drawback to its wider use is the limited number of donors. In this paper, we compare the use of fresh pigskins to cryopreserved alloskins as temporary skin substitutes on subcutaneous tissue wounds after tangential excision by observing the clinical performances of these grafts in cases of a massive burn. METHODS: We selected six adult massive burn patients undergoing tangential excision and skin grafting on subcutaneous tissue wounds (TESGSTW) at our burn center from January 1, 2003 to December 31, 2013. The general clinical data and survival percentage of skins at postoperative weeks (POWs) 1, 2, and 3 were analyzed. In our clinical practice, we also observed the phenomenon that several viable cryopreserved alloskin or fresh pigskin grafts used as temporary coverage on subcutaneous tissue wounds had long-term survival after repeated desquamation. The macroscopic and histological results of one typical case were also analyzed. RESULTS: In this study, the first three TESGSTW operations were performed at 2–3, 5–8, and 11–16 days post-injury. The operation areas were 30.3 ± 7.9 % total body surface area (TBSA), 19.0 ± 6.0 % TBSA, and 12.0 ± 1.7 % TBSA, respectively. The survival percentage of the cryopreserved alloskins or fresh pigskins at POWs 1, 2, and 3 were 80.0 ± 10.0 % vs 75.7 ± 5.3 % (t = 1.01, P = 0.16), 71.2 ± 10.6 % vs 66.4 ± 6.2 % (t = 1.09, P = 0.30), and 48.7 ± 2.5 % vs 35.0 ± 7.0 % (t = 3.83, P = 0.03), respectively. The microscopic observation of the survival of alloskins or pigskins in one typical case showed rete ridges and a basilar membrane at the joint of the epidermis and dermis at an early stage; these structures disappeared with extended time post-operation. CONCLUSIONS: From the clinical observations, fresh pigskin and cryopreserved alloskins could be used with equal effectiveness at an early stage (within 2 weeks post-operation) as temporary coverage on massive burns after TESGSTW. After engraftment, several cryopreserved alloskins or fresh pigskins could co-survive in a massive burn patient for an extended amount of time. The co-survival of alloskin and pigskin will provide clues for further research into skin transplantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s41038-016-0045-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4964051 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-49640512016-08-29 Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns Zuo, Haibin Song, Guodong Shi, Wen Jia, Jun Zhang, Yonghu Burns Trauma Research Article BACKGROUND: Staged excision and grafting with viable cryopreserved alloskin or fresh pigskin at an early stage is a main strategy for wound management in massive burns. Alloskin is the gold standard of a biological temporary skin substitute, and the main drawback to its wider use is the limited number of donors. In this paper, we compare the use of fresh pigskins to cryopreserved alloskins as temporary skin substitutes on subcutaneous tissue wounds after tangential excision by observing the clinical performances of these grafts in cases of a massive burn. METHODS: We selected six adult massive burn patients undergoing tangential excision and skin grafting on subcutaneous tissue wounds (TESGSTW) at our burn center from January 1, 2003 to December 31, 2013. The general clinical data and survival percentage of skins at postoperative weeks (POWs) 1, 2, and 3 were analyzed. In our clinical practice, we also observed the phenomenon that several viable cryopreserved alloskin or fresh pigskin grafts used as temporary coverage on subcutaneous tissue wounds had long-term survival after repeated desquamation. The macroscopic and histological results of one typical case were also analyzed. RESULTS: In this study, the first three TESGSTW operations were performed at 2–3, 5–8, and 11–16 days post-injury. The operation areas were 30.3 ± 7.9 % total body surface area (TBSA), 19.0 ± 6.0 % TBSA, and 12.0 ± 1.7 % TBSA, respectively. The survival percentage of the cryopreserved alloskins or fresh pigskins at POWs 1, 2, and 3 were 80.0 ± 10.0 % vs 75.7 ± 5.3 % (t = 1.01, P = 0.16), 71.2 ± 10.6 % vs 66.4 ± 6.2 % (t = 1.09, P = 0.30), and 48.7 ± 2.5 % vs 35.0 ± 7.0 % (t = 3.83, P = 0.03), respectively. The microscopic observation of the survival of alloskins or pigskins in one typical case showed rete ridges and a basilar membrane at the joint of the epidermis and dermis at an early stage; these structures disappeared with extended time post-operation. CONCLUSIONS: From the clinical observations, fresh pigskin and cryopreserved alloskins could be used with equal effectiveness at an early stage (within 2 weeks post-operation) as temporary coverage on massive burns after TESGSTW. After engraftment, several cryopreserved alloskins or fresh pigskins could co-survive in a massive burn patient for an extended amount of time. The co-survival of alloskin and pigskin will provide clues for further research into skin transplantation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s41038-016-0045-9) contains supplementary material, which is available to authorized users. BioMed Central 2016-05-27 /pmc/articles/PMC4964051/ /pubmed/27574692 http://dx.doi.org/10.1186/s41038-016-0045-9 Text en © Zuo et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zuo, Haibin Song, Guodong Shi, Wen Jia, Jun Zhang, Yonghu Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title | Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title_full | Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title_fullStr | Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title_full_unstemmed | Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title_short | Observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
title_sort | observation of viable alloskin vs xenoskin grafted onto subcutaneous tissue wounds after tangential excision in massive burns |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964051/ https://www.ncbi.nlm.nih.gov/pubmed/27574692 http://dx.doi.org/10.1186/s41038-016-0045-9 |
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