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[Skin cultivation in treatment of severely burned patients]
G Spilker1, M W Reifenrath, H W Kaiser
1Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Schwerstverbranntenzentrum Köln-Merheim.
Abstract:
In severe burns a total body surface area (TBSA) of more than 60% restricts possible donor areas for autologous STS coverage. Additional wound surfaces may further harm the patient. From a skin biopsy of 5 cm2 the total body surface can be covered using keratinocyte cultures to multiply cells by 1000 up to 10,000. The cultured keratinocytes may be used as "sheets" (CEA) or suspended in fibrin glue (KFGS), which must be covered with meshed allogenic STS graft. Long culture times from 14 (KFGS) up to 28 days (CEA), infection of the culture and the woundbed, mechanical instability in the first period after grafting, restoring the dermal equivalent in full thickness burns and high costs are the problems of this new means of burn wound covering. Technical details of cultivation and coverage procedures using CEA and KFGS are discussed.