期刊
BURNS
卷 36, 期 1, 页码 114-120出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.burns.2009.02.023
关键词
Integra Artificial Skin (R); Skin substitute; Reconstructive surgery; Burn scar; Keloid; Adolescents; Children
Integra Artificial Skin (R), a biosynthetic dermal template, is well established in acute burn surgery. The aim of the study was to determine the role of Integra in the surgical treatment of postburn scars in a younger population. Between March 1998 and November 2004, 17 patients (n = 17; mean age = 13.15 years) underwent complete excision of hypertrophic scars or keloids (1-4% TBSA; extremities = 47%, head/neck = 35%, trunk = 18%) with subsequent implantation of Integra for defect closure. Split thickness skin grafting (STSG) of the Integra-derived neodermis was performed 3 weeks after the first operation. Scar excision and primary Integra implantation was successful in all but one patient (94%) who (6%) needed reimplantation once. Integra's mean take rate was 99.7% for all primarily successful patients. Complications occurred in three patients (18%), including minor problems without long-term consequences in 12% (seroma formation), and major problems in 6% (hematoma formation). Take rate of STSG ranged from 50% to 100% (mean 94%). Functional and cosmetic long-term outcome showed results scored excellent in 53%, good in 36%, and fair in 11%. Comparison of pre- and postoperative findings revealed a significant functional improvement in all and a considerable cosmetic improvement in all but two patients. These results suggest that Integra is a valid new treatment modality for extensive burn scar revision in younger patients. (C) 2009 Elsevier Ltd and ISBI. All rights reserved.
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