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DOI: 10.1055/s-2007-970402
© Georg Thieme Verlag KG Stuttgart · New York
The Combination of Cultured Epidermal Autograft (CEA) and Split Thickness Skin Graft Technique (Meek) in Therapy for Severe Burns
Publication History
Publication Date:
10 April 2007 (online)
Abstract
In our treatment of severely burned patients cultured epidermal autografts (CEA) are indicated when the burned surface is more than 65% TBSA (total burn surface area). Therefore laboratory cultured sheets of keratinocytes are used. Since the cultured skin is extremely sensitive to pressure and friction, the available autologous skin is transplanted on the bearing surfaces of the patient. Due to the limited amount of available autologous skin a high expansion ratio is necessary. This can be reached with the help of the Meek technique. Therefore the early wound closure of the severely burned patient is favoured by a combination of CEA transplantation and Meek autografting.
Key words
Burns - cultured epidermal autografts - Meek technique - autologous skin
References
- 1 Alexander JW, Macmillan BJ, Law E. et al . Treatment of severe burns with widely meshed skin autograft and meshed skin albgraft overlay. J Trauma. 1981; 21 433-438
- 2 Cuono C, Langdon R, Birchall N. et al . Composite autologous allogenic skin replacement after burn injury. Plast Reconstr Surg. 1987; 80 626-635
- 3 Deitch EA. A policy of early excision and grafting in elderly burn patients shortens the hospital stay and improves survival. Burns. 1985; 12 109-114
- 4 Herndon DH, Barrow RE, Rutan RL. et al . A comparison of conservative versus early excision: therapies in severely burned patients. Ann Surg. 1989; 209 547-553
- 5 Hickerson WL, Compton C, Fletchall S. et al . Cultured epidermal autografts and allodermis combination for permanent burn wound coverage. Burns. 1994; 20 (Suppl 1) 52-55
- 6 Janzekovic Z. A new concept in the early excision and immediate grafting of burns. J Trauma. 1970; 10 1103-1108
- 7 Kreis RW, Mackle DP, Voemans AWFP, Hermans RP, Hoekstra MJ. Widely expanded postage stamp skin graft using a modified Meek technique in combination with an allograft overlay. Burns. 1993; 19 142-145
- 8 Muller M, Herndon DN. The challenge of burns. Lancet. 1994; 343 216-220
- 9 Munster AM, Meek M, Sharkey P. The effect of cardiosurgical intervention on mortality and cost-effectiveness in burns. Burns. 1994; 20 61-64
- 10 Munster AM, Weiner SH, Spence RJ. Cultured epidermis for the coverage of massive burn wounds: a single centre experience. Ann Surg. 1990; 211 676-680
- 11 Pletch JB, Nether DT, Nagaraj HS, Groff D. Early excision of major burns in children: effect on morbidity and mortality. J Pediatr Burn. 1985; 20 254-257
- 12 Raff T, Hartmann B, Wagner H, German G. Experience with the modified Meek technique. Acta Chirurgiae Plasticae. 1996; 38 142-146
- 13 Rheinwald JG, Green H. Serial cultivation of strains of human epidermal keratinocytes: the formation of keratinizing colonies from single cells. Cell. 1975; 6 331-344
- 14 Sheridan RL, Tompkins RG. Cultured autologous epithelium in patients with burns of ninety percent or more of the body surface. J Trauma. 1995; 38 48-50
- 15 Thompson B, Herndon DN, Abston S, Rutan T. Effect of early excision on patients with major thermal injury. J Trauma. 1987; 27 205-207
- 16 Tompkins RG, Burke JF, Schoenfeld DA. Prompt eschar excision: a treatment system contributing to reduced burn mortality. Ann Burn. 1986; 204 272-281
- 17 Tompkins RG, Remensyder JP, Burke JF. et al . Significant reduction in mortality for children with burn injuries through the use of prompt eschar excision. Ann Surg. 1988; 23 577-585
Correspondence
Dr. med. Christian Ottomann
Zentrum für Schwerbrandverletzte mit Plastischer Chirurgie
Unfallkrankenhaus Berlin
Warener Straße 7
12683 Berlin
Germany
Phone: +49/30/56 81 35 28
Fax: +49/30/56 81 35 03
Email: christian.ottomann@ukb.de