STSG

  • 文章类型: Journal Article
    白癜风的手术治疗保留用于稳定的顽固性白癜风斑块。厚皮移植(STSG)是白癜风手术治疗的重要既定方式,而自体,非培养,非胰蛋白酶化表皮细胞移植,也被称为焦特布尔技术(JT),是一种非常规的创新手术方式,用于治疗稳定型白癜风。
    要比较这两种技术,JT和STSG,关于重新着色的程度和模式,再着色区域的颜色匹配,患者满意度(皮肤病生活质量指数[DLQI]问卷和患者全球评估),稳定型白癜风患者的不良事件(如果有)。
    这是一项随机比较研究。我们将32例180例稳定型白癜风病变患者随机分为两组。第1组患者接受JT治疗,和第2组的STSG。手术后20周主观评估色素沉着的程度,颜色匹配,DLQI分数的变化,患者满意度。分类数据以数字(百分比)表示,并使用卡方检验在组间进行比较。计算人口统计数据的平均值和标准偏差,并使用学生t检验进行比较。概率P值<0.001被认为具有统计学意义。
    在JT组中72.5%的病变和在STSG组中40%的病变中,色素再沉着的程度优异(90%-100%色素再沉着)(P<0.001)。在JT组的95%的病变和STSG组的83.75%的病变中观察到75%的色素沉着(良好的色素沉着)(P=0.040)。DLQI评分有非常显著的下降。JT组术后DLQI(0.79±1.13)和术前DLQI(15.39±4.76)与STSG组术后DLQI(3.85±2.89)和术前DLQI(16.19±4.56)比较。各组间平均下降差异显著(P<0.001)。STSG组的不良事件在受体部位显著较高。
    发现JT在再色素沉着程度方面明显优于STSG。
    UNASSIGNED: Surgical treatment of vitiligo is reserved for stable recalcitrant vitiligo patches. Split-thickness skin grafting (STSG) is an important established modality for the surgical treatment of vitiligo, whereas autologous, non-cultured, non-trypsinized epidermal cell transplant, also known as Jodhpur technique (JT), is an unconventional innovative surgical modality for the treatment of stable vitiligo.
    UNASSIGNED: To compare the two techniques, JT and STSG, with regards to the extent and pattern of repigmentation achieved, color matching of the repigmented area, patient satisfaction (Dermatology Life Quality Index [DLQI] questionnaire and patient global assessment), and adverse events (if any) in patients with stable vitiligo.
    UNASSIGNED: It was a randomized comparative study. We randomized 32 patients with 180 stable vitiligo lesions into two groups. Patients in group 1 were treated with JT, and those in group 2 with STSG. They were subjectively evaluated 20 weeks post-surgery for the extent of repigmentation, color match, change in DLQI score, and patient satisfaction. The categorical data were presented as number (percent) and were compared among groups using Chi-square test. Mean and standard deviation were calculated for demographic data, and they were also compared by using student t-test. Probability P value < 0.001 was considered statistically significant.
    UNASSIGNED: The extent of repigmentation was excellent (90%-100% repigmentation) in 72.5% of lesions in the JT group and in 40% of lesions in the STSG group (P < 0.001). Seventy-five percent repigmentation (good repigmentation) was observed in 95% of lesions in the JT group and in 83.75% of lesions in the STSG group (P = 0.040). There was a highly significant decline in DLQI score. Post-procedure DLQI (0.79 ± 1.13) and pre-procedure DLQI (15.39 ± 4.76) in the JT group were compared with post-procedure DLQI (3.85 ± 2.89) and pre-procedure DLQI (16.19 ± 4.56) in the STSG group. The mean decline among groups differed significantly (P < 0.001). Adverse events were significantly higher in the STSG group at the recipient site.
    UNASSIGNED: JT is found to be significantly better than STSG with regard to the degree of repigmentation.
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  • 文章类型: Journal Article
    To identify the most appropriate, most suitable and most efficient dressing for split-thickness skin graft (STSG) donor sites. Comparing the wound healing rate, pain severity and duration, as well as the dressing change frequency in four randomised patient groups.
    A single-centre non-blinded randomised controlled trial was carried out during 2010-2014. All patients treated for skin defects/lesions (due to burns, trauma or ulcers) using STSG were included in the study. All patients were randomly allocated in four different donor site treatment groups; polyurethane (PU group, Mepilex); polyurethane with silicone membrane (PUSM group; Mepilex border,); transparent, breathable film (TBF group; Mepitel film) and cotton gauze dressings (CG group) using Excel 2007. We evaluated: wound healing time, pain severity and duration, the frequency of dressing change, donor site re-epithelialisation, donor site complications (signs of inflammation or infection). Patients were assessed on postoperative days: 1, 3, 6, 9, 12, 15, 18 and 21.
    After random allocation of study participants the number of patients in each group were: PU group n=25; PUSM group n=24; TBF group n=24; CG group n=25. The groups were homogenous according to gender, age, main pathology, donor site area and wound size. The STSG donor site healing time varied from 9 to 21 days. The mean healing time in the CG group was 14.76 days, whereas in the PU, PUSM, and TBF group it was significantly shorter; 12.25 days, 11.63 days and 10 days, respectively. Patients in the TBF group demonstrated the most rapid healing time with 66.7% of STSG donor sites healed by postoperative day 9. The pain duration interval in modern dressing groups (PU, PUSM and TBF groups) was 0-9 days, whereas it was 6-18 day in the CS group. Pain intensity mean on postoperative day 1 was 2.21 in the PU group; 1.67 in the PUSM group; 1.46 in the TBF group and 3.04 in the CG group. The average pain duration in Group PU, PUSM, and TBF was 4.08 days; 2.5 days; 2.29 days, respectively. The average number of times each dressing was changed in each group was, 2.83 times in the PU group and PUSM group and 1.46 times in the TBF group. The CG dressing group were changed once when the donor site wound re-epithelialised. There was one patient in the PU group who experienced signs of infection, was treated accordingly and excluded from the study.
    The fastest healing time was demonstrated by patients in the TBF group. The pain was not as severe and for a shorter period of time in modern dressing study groups. However, the pain was lightest and felt shortest in TBF dressing group. The modern dressings PU and PUSM had to be changed more frequently than TBF.
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