• 【颊粘膜收获后使用异胚层闭合口腔内缺损的初步报告。】 复制标题 收藏 收藏
    DOI:10.1016/j.urology.2006.12.008 复制DOI
    作者列表:Kellner DS,Fracchia JA,Voigt E,Armenakas NA
    BACKGROUND & AIMS: :The ideal method for managing the intraoral defect after harvesting buccal mucosa for urethral reconstruction has not been clearly established. We describe a novel technique using AlloDerm to cover the harvest site, providing a simple means for a potentially less painful tension-free closure.
    背景与目标: : 尚未明确建立用于获取颊粘膜进行尿道重建后处理口腔内缺损的理想方法。我们描述了一种使用AlloDerm覆盖收获部位的新技术,为可能不那么痛苦的无张力闭合提供了一种简单的方法。
  • 【PET/CT模拟子宫癌肉瘤复发的同种异体移植物。】 复制标题 收藏 收藏
    DOI:10.3109/01443615.2013.841131 复制DOI
    作者列表:Adams BN,Musa FB,Taylor J,Holcomb K
    BACKGROUND & AIMS: -2
    背景与目标: -2
  • 【部分异体悬吊: 降低与乳房重建相关的同种异体移植成本。】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2012.02.016 复制DOI
    作者列表:Chepla KJ,Dagget JR,Soltanian HT
    BACKGROUND & AIMS: BACKGROUND:Many surgeons now incorporate Acellular Dermal Matrix (ADM) into expander-based breast reconstruction. ADM is safe, provides full expander coverage, eliminates the need for additional muscular dissection and has improved aesthetic outcomes. However, its use increases surgical costs. Whether this cost is offset by decreased operative times or a reduced number of revision procedures is unknown. METHODS:We have developed a new technique that minimises the amount of ADM required in many patients. The 'partial sling' approach has been used for 145 consecutive patients (197 breasts) by a single surgeon from 2007 to 2010. After mastectomy, any portion of the pectoralis major insertion at, or <1 cm from, the planned inframmary fold is left intact and becomes the inferior margin of the expander pocket. The minimal size of ADM required is then determined by measuring from the pectoralis to the lateral breast margin. In this study, we exclusively used AlloDerm. Preoperative breast measurements, intra-operative fill volume, time to exchange procedure, number of expansion procedures and complications were recorded for all patients. RESULTS:Patients were grouped according to the surface area (cm(2)) of ADM required. Good aesthetic outcomes were obtained in all groups. Two groups had a significant difference in intra-operative fill volumes but this did not correlate to an increase in the number of expansion procedures required. Of 197 reconstructed breasts less than 64 cm(2) of ADM was used for 40 breasts (20%). CONCLUSIONS:The partial AlloDerm sling can minimise the costs associated with ADM use in breast reconstruction for many patients without increasing complications or altering aesthetic outcomes.
    背景与目标:
  • 【异胚层对人新血管的起始和生长的影响。】 复制标题 收藏 收藏
    DOI:10.1002/lary.20679 复制DOI
    作者列表:Weiss SR,Tenney JM,Thomson JL,Anthony CT,Chiu ES,Friedlander PL,Woltering EA
    BACKGROUND & AIMS: OBJECTIVES/HYPOTHESIS:AlloDerm (LifeCell Corp., Branchburg, NJ) is commonly employed for reconstruction of ablative soft tissue and mucosal defects following surgical resections. Although devoid of growth factors, AlloDerm may serve as an adhesive matrix for binding of growth factors, increasing local angiogenesis, and wound healing. We hypothesized that AlloDerm would enhance angiogenesis and might be altered with autologous blood products to enhance initiation of the angiogenic response. METHODS:We used a human placental vein in a fibrin-thrombin clot-based angiogenesis model. Four groups, human placental vein (HPVM), HPVM with AlloDerm, HPVM with AlloDerm plus platelet-poor plasma, and HPVM with AlloDerm plus platelet-rich plasma were evaluated. Endothelial cell growth was evaluated visually (40x). Hematoxylin and eosin staining and immunofluorescent staining for growth within the AlloDerm matrix were also performed. To assess human umbilical vein endothelial cell (HUVEC) sites of attachment to AlloDerm, we incubated HUVEC cells with AlloDerm for a period of 2 weeks and evaluated attachment with anti-factor VIII immunofluorescence. RESULTS:Angiogenic initiation decreased in the combined placental vein with AlloDerm group (P < .0001 at day 7, 14, 21). Additionally, initiation in the AlloDerm plus platelet-poor plasma group was significantly better than the AlloDerm alone group when placentas 2 and 3 were compared (P < .0001). On hematoxylin and eosin staining and immunofluorescent factor VIII staining, no endothelial growth into the AlloDerm was noted in the samples analyzed. CONCLUSIONS:AlloDerm may be enriched with platelet-poor plasma to stimulate greater initiation and wound healing; however, AlloDerm inhibits angiogenic initiation in this model.
    背景与目标:
  • 【脱细胞真皮移植 (AlloDerm) 用于癌症去除后上眼睑的重建。】 复制标题 收藏 收藏
    DOI:10.1097/IOP.0b013e3181b78989 复制DOI
    作者列表:Hayek B,Hatef E,Nguyen M,Ho V,Hsu A,Esmaeli B
    BACKGROUND & AIMS: PURPOSE:To report the use of AlloDerm for reconstruction of large upper eyelid defects in cancer patients. METHODS:The clinical records of all patients who had AlloDerm as part of their upper eyelid reconstruction between July 2005 and July 2006 at a single institution were reviewed. Functional and cosmetic outcomes and postoperative complications were assessed. RESULTS:Two patients had recurrent sebaceous gland carcinoma, 2 had melanoma, and 1 had squamous cell carcinoma. The upper eyelid defect involved the full thickness and entire width of the upper eyelid in 4 patients and full thickness and two thirds of the upper eye eyelid in 1 patient. The reconstructive procedure included a modified Cutler-Beard procedure using AlloDerm as the posterior lamellar sandwich graft in all 5 patients. One patient had early postoperative adjuvant radiation therapy to the upper eyelid. Three patients had excellent functional and cosmetic outcome; 2 patients had satisfactory outcomes. Two patients had residual exposure keratopathy. Allergic reaction to AlloDerm, infectious transmission, and immunologic rejection were not encountered at the time of this report (mean follow-up time = 13 months). CONCLUSIONS:AlloDerm can be used as an alternative sandwich graft material to replace the tarsus for reconstruction of large upper eyelid defects using a modified Cutler-Beard procedure.
    背景与目标:
  • 【AlloDerm和Strattice在乳房再造中的应用: 优化结果的比较和技术。】 复制标题 收藏 收藏
    DOI:10.1097/PRS.0b013e31824ec429 复制DOI
    作者列表:Glasberg SB,Light D
    BACKGROUND & AIMS: BACKGROUND:Acellular dermal matrices are increasingly used to reinforce the lower pole of the breast during tissue expander/implant breast reconstruction. Although a low complication rate and good aesthetic outcome have been reported, meticulous technique is important for success. This retrospective study compared the clinical course and postoperative outcome of women who underwent breast reconstruction using AlloDerm or Strattice in the authors' practice and highlights key technical considerations that are important for optimizing outcomes. METHODS:Patient records were reviewed for demographic data, operative parameters (length and volume of drainage), and type and frequency of postoperative complications, which were compared between the AlloDerm and Strattice groups. Biopsy specimens of acellular dermal matrices were taken for histologic analyses. RESULTS:Ninety-six patients (126 reconstructions) received AlloDerm, and 90 (144 reconstructions) received Strattice. Total complications were significantly higher with AlloDerm (21.4 percent versus 6.3 percent; p = 0.0003) and were driven by a significantly higher seroma rate (12.7 percent versus 1.4 percent; p = 0.0003). All other complications were similar between the groups. The capsular contracture rate (grade 1 or 2) was 2.4 percent with AlloDerm and 2.8 percent with Strattice, indicating that both may play a role in capsule formation. This was supported by histologic analyses indicating an absence of synovia-like metaplasia at the acellular dermal matrix/tissue expander interface. CONCLUSIONS:: Complications in this series were of low severity, which, together with consistent clinical outcomes seen in the authors' practice, justifies the cost associated with the use of acellular dermal matrices in breast reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic: III.
    背景与目标:
  • 【无细胞尸体真皮 (AlloDerm): 腹部疝修补术的新选择。】 复制标题 收藏 收藏
    DOI:10.1097/01.sap.0000100895.41198.27 复制DOI
    作者列表:Buinewicz B,Rosen B
    BACKGROUND & AIMS: :AlloDerm is an intact human tissue matrix with the critical biochemical and structural components of the dermal extracellular scaffold that enable it to recellularize and revascularize. Its biologic nature provides AlloDerm with an improved capacity to reintegrate with surrounding tissues and less inclination toward infection, erosion, extrusion, and rejection compared with synthetic tissue replacement materials. This retrospective review describes the experience with AlloDerm for incisional hernia and transverse rectus abdominis musculocutaneous flap reconstructions at a plastic surgery practice that handles complex, nonprimary repairs. AlloDerm was observed to provide exceptional safety and tolerability, and to become reintegrated and vascularized with surrounding tissue for tolerable and persistent tissue replacement.
    背景与目标: : AlloDerm是一种完整的人体组织基质,具有真皮细胞外支架的关键生化和结构成分,使其能够再细胞化和再血管化。与合成组织替代材料相比,其生物学特性为同种异体提供了改善的与周围组织重新整合的能力,并且对感染,侵蚀,挤压和排斥的倾向较小。这项回顾性研究描述了在整形外科实践中进行切口疝和腹直肌横肌肌皮瓣重建术的经验,该手术可处理复杂的非原发性修复。观察到AlloDerm可提供出色的安全性和耐受性,并与周围组织重新整合并血管化,以进行耐受性和持续性的组织置换。
  • 8 The utility of Alloderm in hand resurfacing. 复制标题 收藏 收藏

    【Alloderm在手重铺中的效用。】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2009.05.027 复制DOI
    作者列表:Eo S,Cho S,Shin H,Kim JY
    BACKGROUND & AIMS: :Alloderm as a biomechanical scaffold in situations such as skin grafting has been previously demonstrated. In this paper we describe its utility in a broad range of post-traumatic and congenital hand defects. During the recent three years, 11 patients (7 male, 4 female) ranging in age from 8 to 84 years underwent hand resurfacing using acellular dermis graft. There were 10 traumatic and 1 congenital hand deformities (constriction ring syndrome). The acellular dermis was used as both a dermal filler and as a spacer construct. There was no obvious loss of the acellular dermis or infection. Stable resurfacing was achieved in all patients with reasonable functional and cosmetic outcomes.
    背景与目标: : 在植皮等情况下,同种异体作为生物力学支架已被证明。在本文中,我们描述了它在创伤后和先天性手部缺陷中的用途。在最近的三年中,使用脱细胞真皮移植物进行了11例年龄在8至84岁之间的患者 (7例男性,4例女性) 的手表面置换。有10例外伤性和1例先天性手畸形 (缩环综合征)。脱细胞真皮既用作真皮填充剂,又用作间隔物。无明显脱细胞真皮或感染。所有具有合理功能和美容效果的患者均获得了稳定的表面置换。
  • 【瘢痕疙瘩治疗: 无细胞人类真皮 (Alloderm) 有作用吗?】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2009.07.032 复制DOI
    作者列表:Patel NP,Lawrence Cervino A
    BACKGROUND & AIMS: BACKGROUND:Keloid management is faced with high recurrence rates. Keloid fibroblasts lack the normal negative feedback mechanism resulting in an exuberant scar formation. Alloderm doesn't undergo the same proliferative process as keloidal scar dermis. OBJECTIVE:To evaluate Alloderm as a treatment modality for keloids METHODS:A retrospective chart review of six patients with a total of eight large recurrent keloids was performed. Patients were treated with excision of the keloid followed by placement of Alloderm. Each patient was evaluated for recurrence and complications. RESULTS:During follow-up ranging from 1 month to 4(1/2) years there were 0% recurrences. Two out of 8 (25%) had residual induration. one of the two patients with residual induration, required an intralesional injection of kenalog at 6 months post-op. CONCLUSION:Our results from this small study show that with the use of Alloderm after keloid excision, recurrence is low. Further study is warranted.
    背景与目标:
  • 【同种异体对即刻组织扩张器/植入物重建过程中扩张器动力学和并发症的影响: 一项配对队列研究。】 复制标题 收藏 收藏
    DOI:10.1097/SAP.0b013e31816f2836 复制DOI
    作者列表:Preminger BA,McCarthy CM,Hu QY,Mehrara BJ,Disa JJ
    BACKGROUND & AIMS: :AlloDerm (LifeCell, Branchburg, NJ) is gaining acceptance in tissue expander/implant (TE/I) breast reconstruction. Anecdotal evidence suggests its use limits postoperative musculoskeletal morbidity and allows injection of greater initial fill-volumes and rapid postoperative expansion. The objective of this study was to evaluate AlloDerm's impact on expansion rates in immediate TE/I reconstruction. A matched, retrospective cohort study was performed. Medical records of patients who underwent immediate TE/I reconstruction from 2004 to 2005 were reviewed. Two cohorts were identified: (1) underwent TE/I reconstruction with AlloDerm, and (2) underwent standard TE/I reconstruction. Individuals were matched 1:1 on the basis of: expander size (+/-100 mL), history of irradiation, and indication for mastectomy. Cohorts were compared for intraoperative volume injected (mL), rate of postoperative expansion (mL/ injection), number of expansions, and time to completion of expansion (days). Incidence of complications was evaluated. Pairwise comparisons were performed using the Wilcoxon sign rank test and McNemar test. Ninety immediate TE/I reconstructions were evaluated. Forty-five TE/I-AlloDerm reconstructions were matched to standard TE/I reconstructions. Intraoperatively, expanders in the AlloDerm and non-AlloDerm cohorts were filled to a mean volume of 223.8 and 201.1 mL (P = 0.180). Median number of expansions performed was 5 and 6 in the AlloDerm and non-AlloDerm cohorts (P = 0.117). There was no difference in the mean rate of postoperative tissue expansion (AlloDerm: 97 mL/injection versus non-AlloDerm: 95 mL/injection [P = 0.907]), nor in the incidence of complications (P = 0.289). Minor complications occurred in 13.1% of AlloDerm cases (cellulitis [n = 3], seroma [n = 3], hematoma [n = 1]. Although this study does not address AlloDerm's efficacy in decreasing morbidity or improving esthetic outcomes in TE/I reconstruction, it indicates that AlloDerm does not increase the rate of tissue expansion after immediate TE placement. It does not, however, appear to increase the risk of postoperative complications.
    背景与目标: : AlloDerm (LifeCell,新泽西州布兰奇堡) 正在组织扩张器/植入物 (TE/I) 乳房重建中获得认可。轶事证据表明,其使用限制了术后肌肉骨骼的发病率,并允许注射更大的初始填充量和术后快速扩张。这项研究的目的是评估AlloDerm在即时TE/I重建中对膨胀率的影响。进行了一项匹配的回顾性队列研究。回顾了2004年2005年立即进行TE/I重建的患者的病历。确定了两个队列 :( 1) 用同种异体进行TE/I重建,(2) 进行标准TE/I重建。1:1根据以下因素对个体进行匹配: 扩张器大小 (/-100 mL),照射史和乳房切除术的适应症。比较队列的术中注射量 (mL),术后扩张率 (mL/注射),扩张次数和扩张完成时间 (天)。评估并发症的发生率。使用Wilcoxon符号秩检验和McNemar检验进行成对比较。对90例即时TE/I重建进行了评估。45种TE/I-同种异体重建与标准TE/I重建相匹配。术中,将同种异体和非同种异体队列中的扩张剂填充至平均体积为223.8和201.1 mL (P = 0.180)。在同种异体和非同种异体队列中进行的扩增的中位数为5和6 (P = 0.117)。术后组织扩张的平均速率 (同种异体: 97 mL/注射与非同种异体: 95 mL/注射 [P = 0.907]) 没有差异,并发症的发生率也没有差异 (P = 0.289)。13.1% 同种异体病例发生轻微并发症 (蜂窝织炎 [n = 3],血清肿 [n = 3],血肿 [n = 1]。尽管这项研究没有解决同种异体在TE/I重建中降低发病率或改善美学结果的功效,这表明AlloDerm不会增加立即放置TE后的组织扩张率。但是,它似乎不会增加术后并发症的风险。
  • 【在闭合巨大的脐膨出时使用异胚层。】 复制标题 收藏 收藏
    DOI:10.1016/j.jpedsurg.2005.12.067 复制DOI
    作者列表:Alaish SM,Strauch ED
    BACKGROUND & AIMS: :Giant omphaloceles are associated with a considerable loss of abdominal domain. Early primary repair of the fascia is either not possible or poorly tolerated by the infant. Current surgical options result in a ventral hernia requiring future surgery or involve the chronic use of prosthetic patches with or without tissue expanders. This case presentation describes an alternative surgical approach that results in early fascial closure using an interposition graft of Alloderm.
    背景与目标: : 巨大的omphaloceles与腹部结构域的大量损失有关。婴儿无法进行筋膜的早期初级修复或耐受不良。当前的手术选择导致腹疝需要将来进行手术,或者涉及长期使用带有或不带有组织扩张器的假体补片。本病例介绍介绍了一种替代的手术方法,该方法使用同种异体移植物可导致早期筋膜闭合。
  • 【使用异胚层进行鼓膜穿孔修复。】 复制标题 收藏 收藏
    DOI:10.1067/mhn.2000.105920 复制DOI
    作者列表:McFeely WJ Jr,Bojrab DI,Kartush JM
    BACKGROUND & AIMS: BACKGROUND:Some patients lack quality autologous tissue for tympanic membrane (TM) grafting. AlloDerm (LifeCell Corp, The Woodlands, TX) is a preserved allograft that has been effective in nonotologic applications. OBJECTIVE:The goal of this study was to investigate AlloDerm in the repair of chronic TM perforations. METHODS:Ten adult chinchillas underwent a controlled, 2-stage procedure for creation and repair of bilateral TM perforations. Myringoplasties were performed. The control side (left) was repaired with autologous fascia; AlloDerm was used in all right ears. Grafts were assessed at 3 to 8 weeks. RESULTS:Complete TM perforation closure was noted in 9 of 10 (90%) control ears and 8 of 10 (80%) AlloDerm-treated ears. Fascia and AlloDerm integrated consistently with host tissues. No variables demonstrated statistical significance. CONCLUSIONS:AlloDerm appeared to be an ideal substitute for grafting of the TM. It was equally effective as fascia. Clinical trials in human beings appear warranted. Potential health care savings are discussed.
    背景与目标:
  • 【在下眼睑回缩手术中,使用同种异体和真皮脂肪移植物对下眼睑牵开器进行 “恩手套” 溶解。】 复制标题 收藏 收藏
    DOI:10.1097/IOP.0b013e3181c53d38 复制DOI
    作者列表:Chang HS,Lee D,Taban M,Douglas RS,Goldberg RA
    BACKGROUND & AIMS: PURPOSE:To describe a minimally invasive surgical technique using AlloDerm or dermis-fat grafts for lower eyelid retraction. METHODS:A retrospective review of all patients undergoing lower eyelid retraction surgery via a minimal invasive, "en-glove" technique from 2005 through 2009. Charts were reviewed for the type of graft (AlloDerm or dermis-fat) used, the etiology of lower eyelid retraction, and the follow-up time. Outcome measures included lower eyelid height (measured from the corneal light reflex to the lower eyelid margin, or MRD2), reduction of lagophthalmos, cosmetic appearance, complications, and need for further surgery. Presurgery and postreconstruction photographs were reviewed and graded for functional and cosmetic outcome. RESULTS:A total of 8 patients underwent successful lower eyelid retraction surgery using this minimally invasive technique. Etiologies included thyroid eye disease and cicatricial paralytic lower eyelid retraction. Mean improvement in MRD2 was 1.5 mm for the AlloDerm group (4 patients, 7 eyelids) and 1.0 mm for the dermis-fat group (4 patients, 4 eyelids) after a minimum of 3 months' follow-up. The cosmetic result was satisfactory in all cases. CONCLUSIONS:"En-glove" lower eyelid retraction surgical technique offers a minimally invasive approach for the release of the lower eyelid retractors and allows for volume augmentation using either AlloDerm or dermis-fat spacer graft.
    背景与目标:
  • 14 Dorsal Augmentation with AlloDerm. 复制标题 收藏 收藏

    【带异体的背侧增强。】 复制标题 收藏 收藏
    DOI:10.1055/s-2008-1063568 复制DOI
    作者列表:Gryskiewicz JM
    BACKGROUND & AIMS: :The augmentation-reduction principle is becoming pervasive in nasal surgery. Rhinoplasty surgeons have discovered that nasal skin does not consistently contract. Therefore, nasal augmentation is an increasingly accepted technique, and grafts are required. Autogenous cartilage is the grafting material of choice. There are drawbacks to autogenous material, especially in secondary rhinoplasty patients who are often graft-depleted. Cartilage grafts may cause unsightly irregularities over time. Therefore, an interest in alternative soft tissue substitutes has developed. AlloDerm is freeze-dried acellular cadaver dermis. AlloDerm acts as a filler to expand portions of the nasal skin envelope to balance the overresected nose and adhere to the augmentation-reduction principle. AlloDerm facilitates touch-ups, especially in the author's own personal patients. It is soft, thin, and pliable and can be placed under very thin skin. AlloDerm obviates the necessity for graft harvest. It is safe in that it can eliminate the risk of donor-site problems for dorsal onlays such as cranial bone or rib grafts. It is natural and acts as an excellent camouflage graft when used as padding over a cartilage graft. It is incorporated into the surrounding tissue and does not develop unsightly irregularities over time. Extrusion is rare. It does not shift over time. It is especially useful in donor-site-depleted patients. Overcorrection is absolutely necessary because a portion of the implanted AlloDerm is always absorbed. Resorption is most common over the bony dorsum with about 20 to 30% of the graft absorbing. Resorption is disappointing for the patient and frustrating for the surgeon. Absorption does not seem to relate to the number of layers used. No graft absorption has been noted after 1 year. Therefore, it is safe to assume that the patient has a stable result from the AlloDerm graft after 1 year, and no further change should be anticipated. It is easy to use. The advantages and caveats should be kept in mind when evaluating a patient for a dorsal graft.
    背景与目标: : 鼻外科手术中增减原则越来越普遍。隆鼻外科医生发现鼻皮肤不会持续收缩。因此,鼻增强是一种越来越被接受的技术,并且需要移植。自体软骨是首选的移植材料。自体材料有缺点,尤其是在经常移植物枯竭的二次鼻整形术患者中。随着时间的推移,软骨移植物可能会导致难看的不规则。因此,人们对替代软组织替代品产生了兴趣。AlloDerm是冷冻干燥的无细胞尸体真皮。AlloDerm充当填充物,以扩大鼻腔皮肤包膜的一部分,以平衡过度切除的鼻子并坚持增强减少原则。AlloDerm促进了修饰,尤其是在作者自己的个人患者中。它柔软,薄,柔韧,可以放在非常薄的皮肤下。异种动物消除了嫁接收获的必要性。它是安全的,因为它可以消除诸如颅骨或肋骨移植物等背侧的供体部位问题的风险。它是自然的,当用作软骨移植物的衬垫时,它是一种出色的伪装移植物。它被整合到周围的组织中,并且不会随着时间的推移而发展出难看的不规则性。挤压很少见。它不会随着时间的推移而变化。它在供体部位耗尽的患者中特别有用。过度校正是绝对必要的,因为植入的同种异体的一部分总是被吸收的。在骨背上最常见的是吸收约20至30% 的移植物。吸收对患者来说是令人失望的,对外科医生来说是令人沮丧的。吸收似乎与所使用的层数无关。1年后未发现移植物吸收。因此,可以安全地假设患者在1年后从同种异体移植物获得稳定的结果,并且不应预期进一步的变化。它很容易使用。在评估患者的背侧移植物时,应牢记其优点和注意事项。
  • 【联合同种异体®和薄皮片移植治疗烧伤后上肢疼痛性瘢痕挛缩。】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2010.04.017 复制DOI
    作者列表:Oh SJ,Kim Y
    BACKGROUND & AIMS: :Postburn dyspigmented scar contractures of the upper extremity often require aesthetic improvement. The ideal reconstruction of this deformity remains a challenge because the various available skin grafts and flaps result in skin colour mismatches, prominent marginal scars and donor morbidity. Postburn scar contractures and dyspigmented areas of the upper extremity can be improved by a combination of dermabrasion and Alloderm(®) graft over scar-releasing defect. Their raw surfaces are subsequently re-surfaced with thin split-thickness skin graft (0.005-0007 inches thick). Twenty-seven patients with wide dyspigmented scar contractures of the upper extremity underwent the combined techniques described by us. The median patient age at burn incidents was 3 years and at operation was 24 years. Median thin skin graft area was 180cm(2), and the median AlloDerm(®) graft area was 40cm(2). Thin skin and AlloDerm(®) grafts took root completely in all patients without re-grafting. Follow-up periods ranged from 30 to 67 months (average 47.6 months). Re-pigmentation was achieved in all cases and all scar contractures were adequately released and treated with an AlloDerm(®) graft. Paired differences between preoperative and postoperative parameters as determined by the Vancouver Scar Scale (VSS) were significant. Focal hypertrophic scar and reddish-coloured graft sites gradually improved over 3-4 years postoperatively. Graft margin and donor scars were inconspicuous. Our described combined technique was found to treat these deformities effectively. We suggest that the use of Alloderm(®) and thin skin grafting be considered in patients concerned about this type of cosmetic disfigurement.
    背景与目标: : 烧伤后上肢的疤痕挛缩通常需要改善美学。这种畸形的理想重建仍然是一个挑战,因为各种可用的皮肤移植物和皮瓣会导致皮肤颜色不匹配,明显的边缘疤痕和供体发病率。烧伤后的疤痕挛缩和上肢的呼吸困难区域可以通过磨皮和异种动物的组合来改善 (®) 移植超过瘢痕释放缺损。它们的原始表面随后用薄的裂厚皮肤移植物 (0.005-0007英寸厚) 重新表面。27例上肢广泛的疤痕挛缩患者接受了我们描述的联合技术。烧伤事件的中位患者年龄为3岁,手术年龄为24岁。中位值为180厘米 (2),中位值为同种异体 (®) 移植面积为40厘米 (2。皮肤薄、皮肤薄 (®) 移植物在所有患者中完全生根,无需重新移植。随访期为30至67个月 (平均47.6个月)。在所有情况下均实现了色素沉着,并且所有疤痕挛缩均得到充分释放并用异种动物治疗 (®) 嫁接。由温哥华疤痕量表 (VSS) 确定的术前和术后参数之间的配对差异显着。术后3-4年,局灶性肥厚性瘢痕和红色移植物部位逐渐改善。移植物边缘和供体疤痕不明显。我们所描述的组合技术被发现可以有效地治疗这些畸形。我们建议使用Alloderm (®),对于这种类型的化妆品毁容的患者,应考虑进行薄皮肤移植。

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