BACKGROUND: In our preliminary experiments we found that composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts applied to the excised burn wound in one stage led to better results in terms of viscoelastic properties than autologous split-thickness skin grafts. PATIENTS AND METHODS: In ten burn patients we applied composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts and followed the quality of the reconstructed skin cover with a special device, Cutometer MPA 580, over a period of four years. RESULTS: The cutometric curves demonstrated better viscoelastic properties in composite skin grafts than in conventional split-thickness skin grafts after four years. We found Cutometer MPA 580 to be an advantageous device for the objectification of improved quality of reconstructed skin cover. DISCUSSION: Among the various methods the cutometer showed the advantage of being a non-invasive, precise, and objective method of measuring skin's viscoelastic properties. The Vancouver Scar Score is a subjective evaluation of skin viscoelasticity. CONCLUSION: Our prospective clinical study clearly demonstrated that cutometric measurement produced objective results in contrast to clinical evaluation, the Vancouver Scar Score, and other non-quantitative methods. Our hypothesis that composite skin grafts consisting of allogeneic acellular dermis and thin epidermal autologous grafts applied onto the excised burn wound in one stage led to better results in terms of viscoelastic properties than autologous split-thickness skin grafts was fully confirmed.

• Publikační typ
• časopisecké články MeSH

Measurement of viscoelasticity of the skin using the device called cutometer seems to be a very precise and promising diagnostic method in different skin pathologies. However, only a very limited number of reports dealing with the use of cutometer in burns is available. The composite skin grafting using an allogeneic acellular dermis covered with a thin epidermal autologous graft is supposed to improve viscoelastic properties of grafted skin in full-thickness burns. Cutometer MPA 580® has been used for examination of healthy skin, healed and maturated autologous split-thickness skin grafts, and in two patiens 6 years after composite skin grafting using the allogeneic acellular dermis + thin autologous epidermal graft in one stage. Typical curves defined by values of R0–R9 parameters are presented. These data document significantly better viscoelastic properties of composite skin grafts than those of conventional split-thickness skin grafts after 6 years. Measurements of viscoelasticity of the skin, using a cutometer, will probably bring useful and precise data for evaluation of the reconstructed skin in burns. Significantly better properties of the composite skin graft were assessed clinically and measured by Cutometer MPA 580® 6 years after surgery.

• MeSH
• finanční podpora výzkumu jako téma MeSH
• homologní transplantace metody   statistika a číselné údaje   trendy   MeSH
• lidé MeSH
• popálení klasifikace   terapie   MeSH
• pružnost MeSH
• transplantace kůže metody   MeSH
• transplantáty klasifikace   statistika a číselné údaje   využití   MeSH
• zdravotnické prostředky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• kazuistiky MeSH
• klinické zkoušky MeSH

INTRODUCTION: The healing of grafted areas after surgical treatment of deep burns frequently generates mutilating scars, and rises the risk of subsequent scar hypertrophy. Scar assessment based on clinical evaluation is inherently subjective, which stimulates search for objective means of evaluation. OBJECTIVE: The aim of this study was to objectively evaluate the effect of using autologous platelet concentrate (APC) in combination with split thickness skin grafting (STSG) on scarring processes following surgery of deep burns as compared with application of STSG alone. METHOD: Selected viscoelastic properties of 38 scars on 23 patients in total were examined using the Cutometer MPA 580 under controlled conditions for long-term outcomes 1, 3, 6 and 12 months after surgery following deep burns. RESULTS: The findings of this study suggest that the STSG+APC combination reduces the time of scar viscoelastic properties recovery as compared with application of STSG alone. This was statistically significant for viscoelastic parameters R2 and Q1. CONCLUSION: APC has been advocated to enhance scarring after surgery of deep dermal and full thickness burns. We objectively demonstrated that the viscoelastic properties of scars treated with STSG+APC combination return more rapidly to the plateau state than areas treated with STSG only.

• MeSH
• analýza rozptylu MeSH
• autologní transplantace MeSH
• dospělí MeSH
• fyziologie kůže MeSH
• jizva hypertrofická etiologie   prevence a kontrola   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• plazma bohatá na destičky * MeSH
• pooperační komplikace MeSH
• popálení komplikace   chirurgie   MeSH
• pružnost MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace kůže metody   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH