Abstract：
OBJECTIVE: Under optimal conditions, afferent and efferent human skin graft microcirculation can be restored 8-12 days postgrafting. Still, the evidence about the reperfusion dynamics beyond this period in a dermato-oncologic setting is scant. We aimed to characterise the reperfusion of human skin grafts over 4 weeks according to the necrosis extension (less than 20%, or 20%-50%) and anatomic location using laser speckle contrast imaging (LSCI).
METHODS: Over 16 months, all eligible adults undergoing skin grafts following skin cancer removal on the scalp, face and lower limb were enroled. Perfusion was assessed with LSCI on the wound margin (control skin) on day 0 and on the graft surface on days 7, 14, 21 and 28. Graft necrosis extension was determined on day 28.
RESULTS: Forty-seven grafts of 47 participants were analysed. Regardless of necrosis extension, graft perfusion equalled the control skin by day 7, surpassed it by day 21, and stabilised onwards. Grafts with less than 20% necrosis on the scalp and lower limb shared this reperfusion pattern and had a consistently better-perfused centre than the periphery for the first 21 days. On the face, the graft perfusion did not differ from the control skin from day 7 onwards, and there were no differences in reperfusion within the graft during the study.
CONCLUSIONS: Skin graft reperfusion is a protracted process that evolves differently in the graft centre and periphery, influenced by postoperative time and anatomic location. A better knowledge of this process can potentially enhance the development of strategies to induce vessel ingrowth into tissue-engineered skin substitutes.
METHODS: Over 16 months, all eligible adults undergoing skin grafts following skin cancer removal on the scalp, face and lower limb were enroled. Perfusion was assessed with LSCI on the wound margin (control skin) on day 0 and on the graft surface on days 7, 14, 21 and 28. Graft necrosis extension was determined on day 28.
RESULTS: Forty-seven grafts of 47 participants were analysed. Regardless of necrosis extension, graft perfusion equalled the control skin by day 7, surpassed it by day 21, and stabilised onwards. Grafts with less than 20% necrosis on the scalp and lower limb shared this reperfusion pattern and had a consistently better-perfused centre than the periphery for the first 21 days. On the face, the graft perfusion did not differ from the control skin from day 7 onwards, and there were no differences in reperfusion within the graft during the study.
CONCLUSIONS: Skin graft reperfusion is a protracted process that evolves differently in the graft centre and periphery, influenced by postoperative time and anatomic location. A better knowledge of this process can potentially enhance the development of strategies to induce vessel ingrowth into tissue-engineered skin substitutes.
摘要：
目标：在最佳条件下，移植后8-12天可以恢复人皮肤移植的传入和传出微循环。尽管如此，在皮肤肿瘤环境中，超过这段时间的再灌注动力学的证据很少。我们的目的是根据坏死范围（小于20％，或20％-50％）和使用激光散斑对比成像（LSCI）的解剖位置。
方法：超过16个月，所有符合条件的成年人在去除头皮上的皮肤癌后接受皮肤移植，面部和下肢被覆盖。在第0天用LSCI在伤口边缘(对照皮肤)上和在第7、14、21和28天在移植物表面上评估灌注。在第28天确定移植物坏死延伸。
结果：分析了47名参与者的47个移植物。不管坏死的扩展,移植物灌注在第7天等于对照皮肤，在第21天超过对照皮肤，并稳定。头皮和下肢坏死小于20％的移植物具有这种再灌注模式，并且在最初的21天中，其灌注中心始终比外周更好。在脸上，从第7天开始，移植物灌注与对照皮肤没有差异，并且在研究期间移植物内的再灌注没有差异。
结论：皮肤移植物再灌注是一个长期的过程，在移植物中心和周围有不同的演变，受术后时间和解剖位置的影响。对该过程的更好了解可以潜在地增强诱导血管向内生长到组织工程皮肤替代品中的策略的开发。
方法：超过16个月，所有符合条件的成年人在去除头皮上的皮肤癌后接受皮肤移植，面部和下肢被覆盖。在第0天用LSCI在伤口边缘(对照皮肤)上和在第7、14、21和28天在移植物表面上评估灌注。在第28天确定移植物坏死延伸。
结果：分析了47名参与者的47个移植物。不管坏死的扩展,移植物灌注在第7天等于对照皮肤，在第21天超过对照皮肤，并稳定。头皮和下肢坏死小于20％的移植物具有这种再灌注模式，并且在最初的21天中，其灌注中心始终比外周更好。在脸上，从第7天开始，移植物灌注与对照皮肤没有差异，并且在研究期间移植物内的再灌注没有差异。
结论：皮肤移植物再灌注是一个长期的过程，在移植物中心和周围有不同的演变，受术后时间和解剖位置的影响。对该过程的更好了解可以潜在地增强诱导血管向内生长到组织工程皮肤替代品中的策略的开发。
