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題 名 | Scrotal Skin as Donor for Skin Grafting in a Deep Extensive Burn Patient--Harvest Technique and Articles Review=利用陰囊皮膚做大面積燒燙傷病人傷口皮膚移植病例報告--手術技巧及文獻回顧 |
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作 者 | 蔡可威; 林煌基; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 28:3 2019.09[民108.09] |
頁 次 | 頁211-217 |
分類號 | 416.412 |
關鍵詞 | 陰囊皮膚; 燒燙傷; 皮膚移植; Scrotal skin; Extensive burn; Autologous skin grafting; |
語 文 | 英文(English) |
中文摘要 | 背景:人工皮膚在近年有許多進展,但至今仍無法完全取代自體皮膚移植於燒燙傷病人作為最終永久性的傷口覆蓋。由於自體皮膚移植實用性與成本效益高,相對於人工皮膚,依然是此類傷口重建的首選。但許多大面積燒燙傷之病患,能做為自體皮膚移植之取皮區面積稀少,常不足以覆蓋燒燙傷之傷口。目的及目標:我們分享一例大面積燒燙傷病患使用陰囊皮膚做為自體皮膚移植的經驗、手術技巧與文獻回顧。材料及方法:一名二十二歲男大學生為新北市八仙樂園塵爆之受害者,有吸入性灼傷合併大面積燒燙傷位於臉部、頸部、軀幹、背部、四肢共10%深二度與80%三度燒燙傷。在治療與清創後,利用病患殘存可取用皮膚,包涵部份背部與陰囊皮膚,做為自體皮膚移植之供皮區來重建傷口。陰囊取皮的方式為以注射空針從陰囊之中縫(median raphe),將1000毫升之食鹽水注入肉膜層(Dartos fascia),使陰囊澎脤如一顆水球後再以電動取皮刀取皮。結果:陰囊皮膚共取皮兩次,以一個月為區間,每次取皮後供皮區於兩週內傷口癒合。植皮處亦癒合良好而病患在住院104天後出院。病患在門診追蹤,術後三年追蹤發現陰囊取皮處有色素減退但無增生疤痕。結論:於男性大面積燒燙傷之病患而缺乏植皮供皮時,以陰囊皮膚做為自體皮膚移植之取皮區是一個可行之手術方式。 |
英文摘要 | Background: Despite improvements in the development of skin substitutes, no single product stands out as the 'gold standard' to replace autologous skin grafts for definite and permanent wound closure in burn patients. The use of autologous skin grafts is still the main choice for skin grafting due to its practicality and cost-effectiveness when compared to bioengineered artificial skin. In patients with extensive burns, suitable donor sites for autologous skin grafting are often limited and insufficient to cover the burned areas. Aim and Objectives: We present a case of an extensive burn patient and describe the scrotal skin harvest technique, clinical application, and a review of the literature. Materials and Methods: A 22 year-old male college student who was injured during the dust explosion at the Formosa Fun Coast Water Park arrived at our plastic surgery department with inhalation injury and extensive deep burn injuries to his face, neck, torso, back, and four limbs with a sum of 10% deep second degree burns and 80% third degree burns. After initial resuscitation and management, autologous split-thickness skin grafts, harvested from the back and scrotum of the patient, were used to cover the recipient sites. Results: The scrotal donor site of the skin graft was harvested two times and healed within 10-14 days after harvest. The recipient sites also healed well and the patient was discharged 104 days after admission. The patient attends regular follow-up visits at our outpatient department and, to date, there are no complaints related to the scrotal donor site. Hypopigmentation without hypertrophic scar formation of the donor site was observed after 3 years of follow-up. Conclusion: In male patients with an extensive burn area, autologous skin grafting with the scrotum as an alternative donor site is a feasible technique. |
本系統中英文摘要資訊取自各篇刊載內容。