Transfer of free skin grafts with a preserved subcutaneous vascular network in African black patients
- VernacularTitle:带真皮下血管网游离植皮在非洲黑种人病例中的应用
- Author:
Hao WU
;
Sadao TSUKADA
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;11(4):778-779,封4
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Burns or traumatic scare can sometimes result in contractures especially when occurring in African blacks. The fat-free skin graft has been applied frequently to treat them and in some cases, it has failed to take.Preserved subcutaneous vascular network (PSVN) skin transplantation were successfully uses in Asian areas.OBJECTIVE: To analyze the feasibility and superiority of preserved subcutaneous vascular network (PSVN) skin transplantation in African black people.DESIGN: A prospective clinical study.SETTING: Maradi Province Hospital of Niger.PARTICIPANTS: From November 1998 to April 2001, 49 free skin grafts with PSVN in 24 patients aged from 9 months to 20 years were performed by a single surgeon (WH) as a member of a Chinese Medical Team in Maradi Province Hospital of Niger. The newly burnt patients and those with other traumatic skin defects were excluded. All the enrolled patients were informed with the intervention and agreed to be operated.METHODS: The current approach of preserved subcutaneous vascular network (PSVN) was based on the original technique described by Tsukada. Bloc excision including a relatively massive amount of fat tissue was performed from the contralateral inferior quadrant of the abdomen. The fat layer was carefully trimmed away with a pair of scissors, exposing the vascular network plane, which should be well protected from injury, leaving a slight layer of about 2 mm of attached fat. Once this was done, the graft was placed on the recipient sites. Four corner sutures were placed to hold the graft in the proper orientation, following by sutures placed around the periphery. Occasionally, central sutures might be indicated to ensure adherence of the graft over a concave portion of wound, but this need not be done routinely. A pressure dressing pack was then applied on the PSVN skin graft for about 7 to 10 days. Sutures were moved after about 10 to 14 days. Post-operative care was as usual. Fo,owing-up was performed ordinarily.MAIN OUTCOME MEASURES: Survival and functional recovery of the skin grafts postoperatively.RESULTS: All the 24 patients were included in this clinical study and analysis. The 49 free skin grafts with PSVN healed without difficulty or complication in 24 patients, with some cases of tiny, superficial blisters and spot necrosis, the surface area of the largest graft measured 15 cm×6 cm, 91.6 % of the grafts were successful. The resulting surface had good appearance texture without secondary contracture and satisfactory function when observed over an average follow-up of 6 months (3 to 18 months).CONCLUSION: The technique of preserved subcutaneous vascular network (PSVN) skin transplantation could be used with satisfactory results in African black people.
