Cargando…
Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo
BACKGROUND: Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known a...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153318/ https://www.ncbi.nlm.nih.gov/pubmed/35655647 http://dx.doi.org/10.4103/JCAS.JCAS_205_20 |
_version_ | 1784717822781292544 |
---|---|
author | Verma, Manjulata Saini, Shivani Rao, Pankaj Chouhan, Chandraprakash Kachhawa, Dilip |
author_facet | Verma, Manjulata Saini, Shivani Rao, Pankaj Chouhan, Chandraprakash Kachhawa, Dilip |
author_sort | Verma, Manjulata |
collection | PubMed |
description | BACKGROUND: Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known as Jodhpur technique (JT), is an unconventional innovative surgical modality for the treatment of stable vitiligo. AIMS: To compare the two techniques, JT and STSG, with regards to the extent and pattern of repigmentation achieved, color matching of the repigmented area, patient satisfaction (Dermatology Life Quality Index [DLQI] questionnaire and patient global assessment), and adverse events (if any) in patients with stable vitiligo. MATERIALS AND METHODS: It was a randomized comparative study. We randomized 32 patients with 180 stable vitiligo lesions into two groups. Patients in group 1 were treated with JT, and those in group 2 with STSG. They were subjectively evaluated 20 weeks post-surgery for the extent of repigmentation, color match, change in DLQI score, and patient satisfaction. The categorical data were presented as number (percent) and were compared among groups using Chi-square test. Mean and standard deviation were calculated for demographic data, and they were also compared by using student t-test. Probability P value < 0.001 was considered statistically significant. RESULTS: The extent of repigmentation was excellent (90%–100% repigmentation) in 72.5% of lesions in the JT group and in 40% of lesions in the STSG group (P < 0.001). Seventy-five percent repigmentation (good repigmentation) was observed in 95% of lesions in the JT group and in 83.75% of lesions in the STSG group (P = 0.040). There was a highly significant decline in DLQI score. Post-procedure DLQI (0.79 ± 1.13) and pre-procedure DLQI (15.39 ± 4.76) in the JT group were compared with post-procedure DLQI (3.85 ± 2.89) and pre-procedure DLQI (16.19 ± 4.56) in the STSG group. The mean decline among groups differed significantly (P < 0.001). Adverse events were significantly higher in the STSG group at the recipient site. CONCLUSIONS: JT is found to be significantly better than STSG with regard to the degree of repigmentation. |
format | Online Article Text |
id | pubmed-9153318 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-91533182022-06-01 Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo Verma, Manjulata Saini, Shivani Rao, Pankaj Chouhan, Chandraprakash Kachhawa, Dilip J Cutan Aesthet Surg Original Article BACKGROUND: Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known as Jodhpur technique (JT), is an unconventional innovative surgical modality for the treatment of stable vitiligo. AIMS: To compare the two techniques, JT and STSG, with regards to the extent and pattern of repigmentation achieved, color matching of the repigmented area, patient satisfaction (Dermatology Life Quality Index [DLQI] questionnaire and patient global assessment), and adverse events (if any) in patients with stable vitiligo. MATERIALS AND METHODS: It was a randomized comparative study. We randomized 32 patients with 180 stable vitiligo lesions into two groups. Patients in group 1 were treated with JT, and those in group 2 with STSG. They were subjectively evaluated 20 weeks post-surgery for the extent of repigmentation, color match, change in DLQI score, and patient satisfaction. The categorical data were presented as number (percent) and were compared among groups using Chi-square test. Mean and standard deviation were calculated for demographic data, and they were also compared by using student t-test. Probability P value < 0.001 was considered statistically significant. RESULTS: The extent of repigmentation was excellent (90%–100% repigmentation) in 72.5% of lesions in the JT group and in 40% of lesions in the STSG group (P < 0.001). Seventy-five percent repigmentation (good repigmentation) was observed in 95% of lesions in the JT group and in 83.75% of lesions in the STSG group (P = 0.040). There was a highly significant decline in DLQI score. Post-procedure DLQI (0.79 ± 1.13) and pre-procedure DLQI (15.39 ± 4.76) in the JT group were compared with post-procedure DLQI (3.85 ± 2.89) and pre-procedure DLQI (16.19 ± 4.56) in the STSG group. The mean decline among groups differed significantly (P < 0.001). Adverse events were significantly higher in the STSG group at the recipient site. CONCLUSIONS: JT is found to be significantly better than STSG with regard to the degree of repigmentation. Wolters Kluwer - Medknow 2022 /pmc/articles/PMC9153318/ /pubmed/35655647 http://dx.doi.org/10.4103/JCAS.JCAS_205_20 Text en Copyright: © 2022 Journal of Cutaneous and Aesthetic Surgery https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Verma, Manjulata Saini, Shivani Rao, Pankaj Chouhan, Chandraprakash Kachhawa, Dilip Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title | Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title_full | Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title_fullStr | Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title_full_unstemmed | Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title_short | Tertiary Health Care-Based Randomized Controlled Study to Compare Autologous, Non-cultured, Non-trypsinized Epidermal Cell Transplant (Jodhpur Technique) with Split-Thickness Skin Grafting (STSG) in Stable Vitiligo |
title_sort | tertiary health care-based randomized controlled study to compare autologous, non-cultured, non-trypsinized epidermal cell transplant (jodhpur technique) with split-thickness skin grafting (stsg) in stable vitiligo |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9153318/ https://www.ncbi.nlm.nih.gov/pubmed/35655647 http://dx.doi.org/10.4103/JCAS.JCAS_205_20 |
work_keys_str_mv | AT vermamanjulata tertiaryhealthcarebasedrandomizedcontrolledstudytocompareautologousnonculturednontrypsinizedepidermalcelltransplantjodhpurtechniquewithsplitthicknessskingraftingstsginstablevitiligo AT sainishivani tertiaryhealthcarebasedrandomizedcontrolledstudytocompareautologousnonculturednontrypsinizedepidermalcelltransplantjodhpurtechniquewithsplitthicknessskingraftingstsginstablevitiligo AT raopankaj tertiaryhealthcarebasedrandomizedcontrolledstudytocompareautologousnonculturednontrypsinizedepidermalcelltransplantjodhpurtechniquewithsplitthicknessskingraftingstsginstablevitiligo AT chouhanchandraprakash tertiaryhealthcarebasedrandomizedcontrolledstudytocompareautologousnonculturednontrypsinizedepidermalcelltransplantjodhpurtechniquewithsplitthicknessskingraftingstsginstablevitiligo AT kachhawadilip tertiaryhealthcarebasedrandomizedcontrolledstudytocompareautologousnonculturednontrypsinizedepidermalcelltransplantjodhpurtechniquewithsplitthicknessskingraftingstsginstablevitiligo |