Skin Transplantation

皮肤移植
  • 文章类型: English Abstract
    Second-degree burns are the most common type of burns in clinical practice and hard to manage. The treatment needs not only to consider the possible different effects of dressing change or surgical treatment itself, but also requires the evaluation of many factors such as burn site, ages of patients, and burn area. At present, there are no unified standards or specifications for the surgical procedures of wound treatment, as well as infection diagnosis and grading of second-degree burn wounds, which seriously affects the formulation of clinical treatment plans. The consensus writing group developed the Expert consensus on the treatment of second-degree burn wounds (2024 edition) Ⅱ: surgical treatment and infection prevention and treatment based on evidence-based medical evidence and combined with expert opinion. This expert consensus put forward 29 specific recommendations from two aspects: surgical treatment and infection prevention and treatment of second-degree burn wounds, aiming to form a standardized clinical treatment plan for second-degree burns.
    Ⅱ度烧伤是临床中最为常见但处理十分棘手的烧伤类型,其治疗不仅需要考虑换药或手术处置方式本身可能产生的不同影响,还需评估烧伤部位、患者年龄及烧伤面积等多方面的因素。目前对于Ⅱ度烧伤创面治疗的手术方式以及感染诊断、分级等尚未形成统一的标准和规范,严重影响临床治疗方案的制订。本共识编写组以循证医学证据为基础,结合专家意见,制订《Ⅱ度烧伤创面治疗专家共识(2024版)Ⅱ:手术治疗和感染防治》。本共识从Ⅱ度烧伤创面的手术治疗及感染防治2个方面提出29条具体推荐意见,旨在形成规范化的Ⅱ度烧伤临床治疗方案。.
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  • 文章类型: English Abstract
    The treatment of burn injury patients is a unique challenge for clinicians. The extent of thermal injuries ranges from very small burns to life-threatening burn injuries. Insufficient treatment can result in a substantial impairment in the quality of life. In order to avoid such sequelae a targeted treatment must be carried out. A precise diagnosis determines the necessary treatment. Superficial second-degree burns (2a) not involving the face, hand or joints with a total body surface area smaller than 10% can usually be treated with modern wound dressings in an outpatient setting. Deep second-degree burns (2b) are an indication for debridement. In addition to the classical surgical procedures with tangential excision, enzymatic debridement can also be employed. Similarly, indeterminate burns (2a/2b) are also considered to be an indication for enzymatic debridement. Third-degree burns are treated with early debridement and skin grafting. These patients can also benefit from special dermal replacement procedures for an improvement of the functional and esthetic results. Due to the long-term visible sequelae of burns, aftercare of these patients is indicated.
    UNASSIGNED: Die Behandlung brandverletzter Patienten stellt eine herausfordernde Tätigkeit dar. Das Ausmaß der thermischen Verletzung reicht von kleinsten Verbrennungen bis zu lebensbedrohlichen Brandverletzungen. Eine unzureichende Behandlung kann eine erhebliche Einschränkung der Lebensqualität nach sich ziehen. Zur Vermeidung solcher Folgen muss eine zielgerichtete Behandlung erfolgen. Die Diagnosestellung gibt die Behandlung vor. Oberflächlich zweitgradige Verbrennungen (2a) mit einer Fläche kleiner als 10 % Körperoberfläche (KOF), die weder Gesicht, Hände oder gelenkübergreifend sind, können in der Regel mit modernen Wundauflagen ambulant behandelt werden. Tief zweitgradige Wunden (2b) stellen eine Indikation zum Débridement dar. Neben dem klassischen chirurgischen Verfahren mit tangentialer Exzision, wird hierfür auch das enzymatische Débridement eingesetzt. Auch nicht klar zuzuordnende Wunden (2a/2b) stellen eine Indikation für das enzymatische Débridement dar. Die drittgradige Verbrennung bedarf nach dem zeitnahen Débridement einer Hautransplantation. Zudem können für diese Patienten spezielle Hautersatzverfahren zur Verbesserung des funktionellen und ästhetischen Ergebnisses zur Anwendung kommen. Aufgrund der langfristig sichtbaren Folgen einer Verbrennung ist eine Nachsorge dieses Patientengutes indiziert.
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  • DOI:
    文章类型: Systematic Review
    背景:自2017年以来,IFSG的临床使用在美国大幅增加,在欧洲和亚洲也有一些用途。然而,关于这种使用的共识数据很少。
    目的:作者试图为IFSG在急性和慢性LEW治疗中的临床应用提供共识建议。
    方法:美国的一个由8名临床专家组成的小组根据自己的临床实践和文献,使用2个周期的NFG程序来制定共识声明。在2021年10月的首次会议上,小组成员讨论了DFU的管理,VLU,非典型LEW,以及他们实践中的创伤性LEW。起草了共识声明,投票,并按相对重要性进行评级。在2022年10月的第二次会议上,小组讨论了初步调查结果;进行了第二次调查,小组成员修订了建议,并在最终报告中指出了每个建议的相对重要性。还对2016年1月至2022年11月发表的英语文章进行了系统的文献综述,使用搜索词:“鱼皮,\"\"鱼皮移植,“\”鱼组织,“\”完整的鱼皮移植,\"\"鳕鱼皮,“”Omega3脂肪酸接枝。\"
    结果:生成了43个陈述,并将其分为5个部分,包括对LEW的一般建议和针对DFU的建议,VLU,非典型LEW,和创伤性LEW。主要的一般建议是需要根据临床评估和审查相关测试结果来确定伤口病因。对于DFU和VLU,主要建议是坚持一线治疗(即,护理标准,遵循常规指南[多层压迫疗法],卸载,并评估伤口灌注),然后再引入IFSG。
    结论:在过去几年中,使用IFSGs的出版物和临床经验大幅增加。43项共识建议旨在指导医生在急性和慢性LEW的管理中最佳使用IFSG。
    Since 2017, the clinical use of IFSG has increased substantially in the United States, with some use in Europe and Asia as well. However, scant consensus data have been published on such use.
    The authors sought to develop consensus recommendations for the clinical use of IFSG in the management of acute and chronic LEWs.
    A panel of 8 expert clinicians in the United States used a 2-cycle NFG process to develop consensus statements based on their own clinical practice and the literature. At their initial meeting in October 2021, panel members discussed the management of DFUs, VLUs, atypical LEWs, and traumatic LEWs in their practices. Consensus statements were drafted, voted on, and rated by relative importance. At the second meeting in October 2022, the panel discussed the initial survey results; a second survey was conducted, and panel members revised the recommendations and indicated the relative importance of each in the final report. A systematic literature review of English-language articles published from January 2016 through November 2022 was conducted as well, using the search terms: \"fish skin,\" \"piscine graft,\" \"fish tissue,\" \"intact fish skin graft,\" \"Cod skin,\" \"Omega 3 fatty acid graft.\"
    Forty-three statements were generated and grouped into 5 sections comprising general recommendations for LEWs and recommendations specific to DFUs, VLUs, atypical LEWs, and traumatic LEWs. The primary general recommendation is the need to determine wound etiology based on clinical evaluation and reviewing related test results. For DFUs and VLUs, the main recommendations are to adhere to first-line therapy (ie, standard of care, follow conventional guidelines [multilayer compression therapy], offloading, and assessment of wound perfusion) before introducing IFSG.
    Publications on and clinical experience in the use of IFSGs have increased substantially in the past several years. The 43 consensus recommendations are meant to guide physicians in the optimal use of IFSG in the management of acute and chronic LEWs.
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  • 文章类型: Journal Article
    白癜风表现为皮肤上的色素斑和斑块,并且可以显着影响患者的生活质量。尽管有几种治疗方式,在个体和疾病亚型之间,色素沉着的发生率差异很大.对于药物治疗效果不佳的稳定型白癜风患者,黑素细胞-角质形成细胞移植程序(MKTP)是可行的选择。虽然这种自体非培养细胞移植程序的变化是由世界各地的皮肤科外科医生进行的,并显示出良好的耐受性和有效性,它在美国仍未得到充分利用。我们对MKTP进行了全面的概述,强调循证和实用技术,以提高患者的治疗效果。作为一种宝贵的资源,这项审查旨在支持寻求将MKTP纳入其实践并提高对其益处的认识的皮肤科外科医生,最终培养更全面的白癜风护理方法。
    Vitiligo manifests as depigmented macules and patches on the skin and can significantly impact a patient\'s quality of life. Despite the availability of several treatment modalities, rates of repigmentation can vary widely among individuals and disease subtypes. For patients with stable vitiligo who have not achieved satisfactory results with medical treatments, the melanocyte-keratinocyte transplantation procedure (MKTP) is a viable option. While variations of this autologous non-cultured cellular grafting procedure are performed by dermatologic surgeons worldwide and has shown good tolerability and effectiveness, it remains under utilized in the United States. We present a comprehensive overview of MKTP, highlighting evidence-based and practical techniques to enhance patient outcomes. By serving as a valuable resource, this review aims to support dermatologic surgeons seeking to incorporate MKTP into their practice and promote awareness regarding its benefits, ultimately fostering a more comprehensive approach to vitiligo care.
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  • 文章类型: English Abstract
    Burns are the leading cause of accidental injuries among Chinese children. Due to the strong wound repair ability and the demand for growth and development in pediatric patients, there are many options for the treatment of deep partial-thickness burn wounds in pediatric patients, while many controversies about the strategies for treatment of this kind of wounds also exist. This article assembled the consensus reached by experts in burns and relevant fields in China and abroad on the management of thermal-induced deep partial-thickness burn wounds in pediatric patients aged 1-6 years, including definition and diagnosis, surgical treatment, non-surgical treatment, wound dressings, application of growth factors, treatment of infectious wounds, prevention and treatment of scar, to provide guiding recommendations for the diagnosis and treatment of deep partial-thickness burn wounds in pediatric patients in China.
    烧伤是我国儿童意外伤害的主要原因。因儿童创面修复能力强及生长发育的需求,儿童深Ⅱ度烧伤创面的治疗选择较多,有关该类创面治疗策略的争议也较多。该文集合了国内外烧伤及相关领域专家,针对热力学因素所致的1~6岁儿童深Ⅱ度烧伤创面的处理,在定义与诊断、手术治疗、非手术治疗、创面覆盖物、生长因子应用、感染性创面的治疗、瘢痕防治等方面形成共识,以期为我国儿童深Ⅱ度烧伤创面的诊疗提供指导性建议。.
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  • 文章类型: Journal Article
    为了达成国际专家共识,并就植发手术的最佳做法提出建议,专注于移植前和移植后的护理。
    采用改进的德尔菲法达成共识。一个国际科学委员会编制了一份81份问卷。由来自4大洲17个国家的38名头发移植专家组成的小组对问卷进行了评估。
    进行了两轮共识,81份声明中有59份(73%)达成共识。专家建议强调正确选择头发移植的候选人,以及患者在移植前需要接受适当的脱发治疗。在计划手术时,应评估和考虑合并症,移植前应制定个体化的围手术期护理计划。某些与出血风险增加相关的药物应在手术前退出。给出了移植后护理的具体建议。移植后,患者应逐渐恢复正常的护发方案。应在移植后的第一年进行密切随访。
    本研究就毛发移植的一般方面提出了许多基于共识的建议,包括候选人选择,移植前的药物治疗,麻醉,移植后恢复头发护理。
    UNASSIGNED: To achieve international expert consensus and give recommendations on best practices in hair transplantation surgery, focusing on pre- and post-transplantation care.
    UNASSIGNED: A modified Delphi method was used to reach consensus. An international scientific committee developed an 81-statement questionnaire. A panel of 38 experts in hair transplantation from 17 countries across 4 continents assessed the questionnaire.
    UNASSIGNED: Two consensus rounds were carried out, with 59 out of 81 statements (73%) reaching consensus. Expert recommendations emphasize the correct selection of candidates for hair transplantation and the need for patients to have received adequate medical treatment for alopecia before transplant. Comorbidities should be assessed and considered while planning surgery, and an individualized plan for perioperative care should be drawn up before transplant. Certain medications associated with increased risk of bleeding should be withdrawn before surgery. Specific recommendations for post-transplantation care are given. After transplantation, patients should gradually resume their normal haircare regimen. Close follow-up should be carried out during the first year after transplant.
    UNASSIGNED: This study presents numerous consensus-based recommendations on general aspects of hair transplantation, including candidate selection, medical therapy prior to transplantation, anesthesia, and resuming haircare after transplantation.
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  • DOI:
    文章类型: Journal Article
    根据他们自己的临床经验和对现有同行评审数据的审查,作者就使用SHSFM治疗开放性伤口达成共识.基质具有不同的孔径和纤维等特征(即,混合量表),适用于开放性伤口的治疗。本报告介绍了SHSFM的设计和实用性,其作用机制,以及应用的方法,以及临床结果。作者讨论了自己的经验和对已发表文献的回顾,然后描述他们的协议和使用SHSFM的理由。这些共识声明包括有关使用SHSFM的适当伤口的建议,与SHSFM一起使用其他伤口疗法,再应用率,制备方法,以及适当使用的额外讨论。这份报告不是文献综述,而是初步临床经验的陈述。共识声明表明,SHSFM可用于治疗多种伤口,并可用于通过皮肤移植或通过次要意图将伤口分期闭合。
    Based on their own clinical experience and review of the available peer-reviewed data, the authors developed a consensus opinion on the use of an SHSFM for open wounds. The matrix has features such as varying pore sizes and fibers (ie, hybrid-scale) and is indicated for the treatment of open wounds. This report describes the design and utility of the SHSFM, its mechanism of action, and the methods of application, as well as clinical outcomes. The authors discuss their own experience and review of the published literature, then describe their protocols and rationale for the use of the SHSFM. These consensus statements include recommendations regarding appropriate wounds for use of the SHSFM, use of other wound therapies in conjunction with the SHSFM, reapplication rates, preparation methods, and additional discussions of appropriate use. This report is not a literature review, but rather is a statement of preliminary clinical experience. The consensus statements indicate that the SHSFM may be used to treat a variety of wounds and can be used to stage wounds to closure via skin grafts or by secondary intention.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    Facial hair transplantation has become an increasingly popular modality to create a more masculine appearance for transmasculine patients.
    This aim of this study was to review the current literature regarding facial hair transplantation and provide recommendations and best practices for transgender patients.
    A comprehensive literature search of the PubMed, MEDLINE, and Embase databases was conducted for studies published through April 2020 for publications discussing facial hair transplant in transmasculine patients, in addition to the nontransgender population. Data extracted include patient demographics, techniques, outcomes, complications, and patient satisfaction.
    We identified 2 articles discussing facial hair transplantation in transmasculine patients. Due to the paucity of publications describing facial hair transplantation in transmasculine patients, data regarding facial hair transplant from the cisgender population were utilized to augment our review and recommendations.
    Facial hair transplant is a safe and effective means of promoting a masculine appearance for transgender patients. Nevertheless, facial hair transplantation should be deferred until at least 1 year after the initiation of testosterone therapy to allow surgeons to more accurately identify regions that would benefit the most from transplantation. Additionally, providers should engage patients in discussions about any plans to undergo facial masculinization surgery because this can alter the position of transplanted hairs. Currently, follicular unit extraction from the occipital scalp is the preferred technique, with use of the temporal scalp if additional grafts are needed. Patients should be advised that a secondary grafting procedure may be needed a year after initial transplant to achieve desired density.
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  • 文章类型: Journal Article
    目前,在亚太地区,没有统一的指导方针来管理皮肤银行。因此,皮肤银行要么不受监管,要么依靠国家的立法或国际认证来维护其质量标准。通过全面检讨及整理亚太烧伤协会(APBA)成员的最佳国际惯例,制订了一套新的皮肤银行指引,从捐赠者的筛选和测试中,皮肤恢复,processing,储存和分配,和质量保证。审查的国家监管要求包括欧洲指令,澳大利亚的治疗用品管理局和新加坡的组织银行标准。进一步的技术和质量管理建议来自美国组织银行协会(AATB),美国食品和药物管理局的标准和指导文件,各种相关的欧洲指南,日本组织移植协会指南和亚太外科组织银行协会。主要根据AATB标准改编,新的亚太烧伤协会治疗应用皮肤银行指南提供了一个全面的手册,解决:治理和合同;员工职责;质量管理;设施,设备和用品管理;捐赠者的同意和测试;以及与皮肤恢复有关的良好做法的建议,processing,储存和分配。除了补充现行的通用法规外,它们提供了大多数立法中未解决的主要方面的技术规范。这套新的区域皮肤银行准则将成为APBA区域成员采用的开始,并有望最终制定一套标准,从长远来看,来自该地区的同种异体皮肤可以具有相似的质量,这可以简化进口过程,方便成员之间的同种异体移植交换。
    Currently, there are no harmonized guidelines which govern skin banking in the Asia Pacific region. Therefore, skin banks are either unregulated or rely on their nation\'s legislation or international accreditation to uphold their quality standards. A new set of skin banking guidelines was developed through a comprehensive review and collation of best international practices for the Asia Pacific Burn Association (APBA) members, from donor screening and testing, to skin recovery, processing, storage and distribution, and quality assurance. National regulatory requirements reviewed include the European directives, Australia\'s Therapeutic Goods Administration and Singapore\'s tissue banking standards. Further technical and quality management recommendations are referenced from the American Association of Tissue Banks (AATB), the United States Food and Drug Administration standards and guidance documents, various relevant European guides, Japanese Society of Tissue Transplantation guidelines and the Asia Pacific Association of Surgical Tissue Banking. Adapted mainly from the AATB standards, the new Asia Pacific Burn Association Guidelines for Skin Banking in Therapeutic Applications offer a comprehensive manual, addressing: governance and contracts; staff responsibilities; quality management; facilities, equipment and supplies management; donor consent and testing; and recommendations of good practices pertaining to skin recovery, processing, storage and distribution. Besides complementing current generic regulations, they provide technical specifications of major aspects unaddressed in most legislations. This inaugural set of new regional skin banking guidelines would be a start for regional members of the APBA to adopt, and will hopefully culminate in a set of standards so that, in the long run, skin allografts from this region can be of similar quality, which can simplify import process and facilitate the exchange of allografts between members.
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