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Comparison of minipunch grafting versus split-skin grafting in chronic stable vitiligo.

机译:慢性稳定型白癜风的微型穿孔嫁接与劈开皮嫁接的比较。

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BACKGROUND: Minipunch grafting (MPG) and split-skin grafting (SSG) are common outpatient procedures for the surgical treatment of chronic stable vitiligo. However, there is a paucity of literature comparing the two procedures by the same group of investigators. OBJECTIVE: To compare the two techniques in patients with chronic stable localized vitiligo. METHODS: Sixty-four patients with stable vitiligo of 6 months duration were randomized into two groups to be taken up for MPG or SSG in a representative patch followed by PUVAsol therapy for 3 months. They were evaluated 3 months postoperatively for the degree of repigmentation and side effects. RESULTS: In the MPG group, 644 grafts, 2.5 mm in size, were placed on a total vitiliginous area of 521.25 cm2, whereas in the SSG group, 153 grafts covered a 1,489 cm2 recipient area. Three months postoperatively, in the first group, 15 cases (44.1%) showed very good to excellent (> 75%) repigmentation compared with 25 cases (83.3%) in group 2. Following MPG, 81 grafts (12.57%) were rejected. Cobblestoning was the main side effect, occurring in 13 cases (38.23%), and a variegated appearance was observed in 7 (20.58%) patients. The complications noted after SSG were achromic fissuring in four (13.3%) cases, graft contracture in four grafts (2.61%) in three patients, and rejection of seven grafts (4.57%) in one case; tire-pattern appearance in two patients (6.6%); milia formation in four (13.3%) patients; and depigmentation of the grafts in two (6.6%) cases. In both groups, superficial scarring was noted at the donor site in all cases, whereas hypertrophic scarring occurred in 3 (10%) patients after SSG. CONCLUSION: SSG carries a distinct advantage over MPG in producing excellent cosmetic matching over larger areas using fewer grafts, especially over the face and extremities.
机译:背景:微型穿孔移植(MPG)和劈开皮肤移植(SSG)是外科手术治疗慢性稳定白癜风的常见门诊程序。但是,很少有文献比较同一组研究人员的两种方法。目的:比较慢性稳定局限性白癜风患者的两种技术。方法:将64名病程稳定6个月的白癜风患者随机分为两组,以代表性贴剂接受MPG或SSG治疗,然后进行PUVAsol治疗3个月。术后3个月对他们的色素沉着程度和副作用进行了评估。结果:在MPG组中,将644个2.5毫米大小的移植物放置在521.25 cm2的玻璃体上,而在SSG组中,有153个移植物覆盖了1,489 cm2的受者区域。术后三个月,在第一组中,有15例(44.1%)表现出良好至极好(> 75%)的色素沉着,而在第2组中则为25例(83.3%)。MPG后,有81例移植物(12.57%)被拒绝。鹅卵石化是主要的副作用,发生在13例(38.23%)中,在7例(20.58%)患者中观察到杂色的外观。 SSG后发现的并发症为四例(13.3%)无色裂,三例四例(2.61%)的挛缩和一例七例(4.57%)的排斥。两名患者的轮胎花纹外观(6.6%);四名(13.3%)患者的形成; 2例(6.6%)发生了色素沉着和脱色。在两组中,在所有情况下均在供体部位发现浅表瘢痕形成,而SSG后3例(10%)患者发生肥厚性瘢痕形成。结论:SSG与MPG相比具有明显的优势,它可以使用较少的移植物,特别是在面部和四肢,在较大的区域产生出色的化妆品匹配。

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