Cultured epithelial autografts in extensive burn coverage of severely traumatized patients: a five year single-center experience with 30 patients
Cultured epithelial autografts in extensive burn coverage of severely traumatized patients: a five year single-center experience with 30 patients
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DOI：
10.1016/s0305-4179(99)00143-6
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发表时间：
2000-06-01
期刊：
影响因子：
2.7
通讯作者：
Perrot, J
中科院分区：
文献类型：
--
作者：
Carsin, H;Ainaud, P;Perrot, J
目的：我们报告了最近5年在单个商业实验室对严重烧伤和其他创伤患者进行自体培养上皮移植（CEA）的大型单中心系列研究的经验。摘要背景数据：最初对CEA应用的乐观态度已经被随后的报告所缓和，这些报告断言这种模式是不可靠和昂贵的。关于其临床作用的讨论仍在继续。方法：1991 ~ 1996年30例患者，CEA平均应用于37±17%的体表面积（TBSA）。这些患者的平均烧伤面积为78 +/- 10%，平均三度烧伤面积为65 +/- 16%，内窥镜确认吸入性损伤发生率为90%，其他严重情况发生率为37%。结果：CEA实现了平均26 +/- 15% TBSA的永久覆盖，比传统自体移植物（平均25 +/- 10% TBSA）的覆盖面积大。这些严重烧伤和其他创伤患者的存活率为90%。最终CEA平均为69±23%。在子集分析中，只有较年轻的年龄与较好的CEA成绩显著相关（单因素分析p = 0.0001，多因素分析p < 0.04，学生t检验）。结论：Epicel CEA成功地为严重创伤患者提供了广泛、永久的烧伤覆盖，证明了在预后较差的患者群体中实现高生存率的重要辅助手段。根据我们的经验，CEA在治疗烧伤bbb （60% TBSA）中具有非常高的有益价值。在研究的一些病例中，CEA很可能是一种挽救生命的治疗方法。(C) 2000 Elsevier Science Ltd and ISBI。版权所有。
Objective: We report recent five-year experience in a large, single center series of severely burned and otherwise traumatized patients given cultured epithelial autografts (CEA) from a single commercial laboratory.Summary background data: Initial optimism over CEA application has been tempered by subsequent reports asserting that this modality is unreliable and expensive. Discussion continues over its clinical role.Methods: From 1991 to 1996, CEA were applied to a mean 37 +/- 17% of total body surface area (TBSA) of 30 patients. These patients had 78 +/- 10% average burn size, 65 +/- 16% average third-degree burn size, 90% prevalence of endoscopically confirmed inhalation injury and 37% prevalence of other serious conditions.Results: CEA achieved permanent coverage of a mean 26 +/- 15% of TBSA, an area greater than that covered by conventional autografts (a mean 25 +/- 10% of TBSA). Survival was 90% in these severely burned and otherwise traumatized patients. Final CEA take was a mean 69 +/- 23%. In subset analyses, only younger age was significantly associated with better CEA take (p = 0.0001 in univariate analysis, p < 0.04 in multivariate analysis, Student's t-test).Conclusions: Epicel CEA successfully provided extensive, permanent burn coverage in severely traumatized patients, proving an important adjunct to achievement of a high survival rate in a patient population whose prognosis previously had been poor. In our experience CEA appear to have a very high beneficial value in the management of burns > 60% TBSA. In some cases studied it is very likely that CEA was a life-saving treatment. (C) 2000 Elsevier Science Ltd and ISBI. All rights reserved.