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官方杂志> 大面积烧伤的治疗——皮肤组织工程与其他创面处理技术的结合与临床应用
大面积烧伤的治疗——皮肤组织工程与其他创面处理技术的结合与临床应用
      来源:Burns & Trauma

Skin tissue engineering advances in severe burns: review and therapeutic applications

Alvin Wen Choong Chua, YikCheong Khoo, Bien Keem Tan, Kok Chai Tan, Chee Liam Foo and Si Jack Chong.


How to cite this article: Chua AWC, Khoo YC, Tan BK,Tan KC, Foo CL, Chong SJ. Skin tissue engineering advances in severe burns: review and therapeutic applications. Burns & Trauma 2016 4:3.


干细胞和组织工程基础研究所取得的成就促进了人工皮肤替代物的研发和应用,为这类产品开创了广阔前景。目前的技术可利用少量皮肤组织,在体外培养出复层上皮组织用于烧伤患者,虽可部分缓解大面积烧伤患者自体供区皮源不足,但不能从根本上解决严重烧伤患者治疗中同种异体皮源紧张的问题。商业化生产的多种真皮替代物不失为一种有效应用手段,但该类产品非常昂贵,缺乏正常皮肤微结构且不连续。目前组织工程皮肤替代物在临床上主要作为植皮的辅助手段促进创面覆盖,加速创面愈合和上皮化,预防和减少瘢痕形成。


皮肤组织工程技术和产品在烧伤创面处理中扮演越来越重要的角色,但对于大面积特别是深度烧伤的创面处理,当前的技术手段还有很大局限性。Burns & Trauma 最新刊出“Skin tissue engineering advances in severe burns: review and therapeutic applications”一文,详细介绍了各种代表性皮肤组织工程产品的特点和最新进展,并系统综述了皮肤组织工程与其他创面覆盖技术的结合在大面积烧伤治疗方面的应用以及待解决的问题。欢迎访问期刊网站www.burnstrauma.com阅读全文。


Abstract

Current advances in basic stem cell research and tissue engineering augur well for the development of improved cultured skin tissue substitutes: a class of products that is still fraught with limitations for clinical use. Although the ability to grow autologous keratinocytes in-vitro from a small skin biopsy into sheets of stratified epithelium (within 3 to 4 weeks) helped alleviate the problem of insufficient donor site for extensive burn, many burn units still have to grapple with insufficient skin allografts which are used as intermediate wound coverage after burn excision. Alternatives offered by tissue-engineered skin dermal replacements to meet emergency demand have been used fairly successfully. Despite the availability of these commercial products, they all suffer from the same problems of extremely high cost, sub-normal skin microstructure and inconsistent engraftment, especially in full thickness burns. Clinical practice for severe burn treatment has since evolved to incorporate these tissue-engineered skin substitutes, usually as an adjunct to speed up epithelization for wound closure and/or to improve quality of life by improving the functional and cosmetic results long-term. This review seeks to bring the reader through the beginnings of skin tissue engineering, the utilization of some of the key products developed for the treatment of severe burns and the hope of harnessing stem cells to improve on current practice.


Keywords


Burns, Skin tissue engineering, Stem cells, Cultured epithelial autografts, Dermal substitutes, Microskin grafting