Abstract：
BACKGROUND: Traditional fixation of autografts in the treatment of burns involves the use of sutures and staples. A novel fibrin sealant, Artiss, has been introduced as an alternate method of fixation and has shown promising safety and efficacy results in the adult population. Our study assessed the effectiveness of fibrin sealant to secure autologous split thickness skin grafts (ASTSG) in the pediatric burn population.
METHODS: We performed a retrospective cohort study of pediatric patients under 18 years of age who received autografting for the treatment of burns at our institution between 2017 and 2023. We compared ASTSG secured with fibrin sealant to those managed traditionally with sutures or staples. Outcomes of interest include the need for return trips to the operating room (OR), time to wound healing, graft take, and total time in the operating room.
RESULTS: 83 patients underwent a total of 142 individual ASTSGs for management of unique body area injuries. 66.3 % were male, median age was 79 months, and scald was the most common mechanism of injury (41.0 %). Forty-five (39.5 %) traditionally affixed ASTSG required at least one return to the OR while only one (3.6 %) ASTSG secured with fibrin sealant required an additional return to the OR (p < 0.001). Graft take was similar in both groups (92.9 % for fibrin sealant vs. 93.9 % for traditional methods, p = 1). Time to wound healing was also similar: 16 vs. 15 days for fibrin glue and traditional methods, respectively (p = 0.23).
CONCLUSIONS: Outcomes from autograft fixation with fibrin sealant were comparable to those treated with traditional methods, with a reduction in the need for return trips to the operating room. These data suggest that fibrin sealant is a suitable alternative to traditional fixation methods in pediatric autografting.
METHODS: We performed a retrospective cohort study of pediatric patients under 18 years of age who received autografting for the treatment of burns at our institution between 2017 and 2023. We compared ASTSG secured with fibrin sealant to those managed traditionally with sutures or staples. Outcomes of interest include the need for return trips to the operating room (OR), time to wound healing, graft take, and total time in the operating room.
RESULTS: 83 patients underwent a total of 142 individual ASTSGs for management of unique body area injuries. 66.3 % were male, median age was 79 months, and scald was the most common mechanism of injury (41.0 %). Forty-five (39.5 %) traditionally affixed ASTSG required at least one return to the OR while only one (3.6 %) ASTSG secured with fibrin sealant required an additional return to the OR (p < 0.001). Graft take was similar in both groups (92.9 % for fibrin sealant vs. 93.9 % for traditional methods, p = 1). Time to wound healing was also similar: 16 vs. 15 days for fibrin glue and traditional methods, respectively (p = 0.23).
CONCLUSIONS: Outcomes from autograft fixation with fibrin sealant were comparable to those treated with traditional methods, with a reduction in the need for return trips to the operating room. These data suggest that fibrin sealant is a suitable alternative to traditional fixation methods in pediatric autografting.
摘要：
背景：传统的自体移植物固定治疗烧伤涉及使用缝线和钉。一种新型的纤维蛋白密封剂，艺术家,已被引入作为固定的替代方法，并在成年人群中显示出有希望的安全性和有效性结果。我们的研究评估了纤维蛋白密封剂在小儿烧伤人群中确保自体分层厚度皮肤移植物（ASTSG）的有效性。
方法：我们在2017年至2023年期间，对18岁以下接受自体移植治疗烧伤的儿科患者进行了一项回顾性队列研究。我们比较了用纤维蛋白密封剂固定的ASTSG与传统用缝合线或U形钉固定的ASTSG。感兴趣的结果包括需要返回手术室(OR)，伤口愈合的时间，移植，以及在手术室的总时间。
结果：83例患者接受了142例单独的ASTSGs治疗，以治疗独特的身体部位损伤。66.3%为男性，中位年龄为79个月，烫伤是最常见的损伤机制(41.0%)。传统上固定的45(39.5%)ASTSG需要至少一次返回OR,而用纤维蛋白密封剂固定的仅一个(3.6%)ASTSG需要额外返回OR(p<0.001)。两组的移植物摄取相似（纤维蛋白密封剂的92.9％与传统方法为93.9%，p=1)。伤口愈合的时间也相似：16vs.15天用于纤维蛋白胶和传统方法，分别(p=0.23)。
结论：用纤维蛋白密封剂自体移植固定的结果与用传统方法治疗的结果相当，减少了返回手术室的需要。这些数据表明，纤维蛋白密封剂是小儿自体移植中传统固定方法的合适替代方法。
方法：我们在2017年至2023年期间，对18岁以下接受自体移植治疗烧伤的儿科患者进行了一项回顾性队列研究。我们比较了用纤维蛋白密封剂固定的ASTSG与传统用缝合线或U形钉固定的ASTSG。感兴趣的结果包括需要返回手术室(OR)，伤口愈合的时间，移植，以及在手术室的总时间。
结果：83例患者接受了142例单独的ASTSGs治疗，以治疗独特的身体部位损伤。66.3%为男性，中位年龄为79个月，烫伤是最常见的损伤机制(41.0%)。传统上固定的45(39.5%)ASTSG需要至少一次返回OR,而用纤维蛋白密封剂固定的仅一个(3.6%)ASTSG需要额外返回OR(p<0.001)。两组的移植物摄取相似（纤维蛋白密封剂的92.9％与传统方法为93.9%，p=1)。伤口愈合的时间也相似：16vs.15天用于纤维蛋白胶和传统方法，分别(p=0.23)。
结论：用纤维蛋白密封剂自体移植固定的结果与用传统方法治疗的结果相当，减少了返回手术室的需要。这些数据表明，纤维蛋白密封剂是小儿自体移植中传统固定方法的合适替代方法。
