The Use of Skin Regeneration Technique in the Treatment of Full-Thickness Skin Defects

摘要

A total of 434 patients have been treated with cultured epithelium transplantation between March 1985 and April 2003, 285 patients by autografting and 149 patients by allografting. Nevertheless, this approach of cultured epithelium is confined only to the epidermis and not the dermis. This results in poor "graft take" and failure of skin regeneration even by autografting in full-thickness skin defects. Regeneration of the dermis is essential for improving the "take" rate of cultured epithelia. Currently, transplantation of cultured autologous epithelium over a previously transplanted dermal allograft is an effective method of treatment for full-thickness skin defects such as third-degree burns and giant nevus resection wounds. However, there are problems with this technique, such as rejection of allograft skin and a short supply of allograft skin. Attention has shifted to the use of cell-free dermis, the development of cultured dermis and cultured skin by tissue engineering techniques. This article describes the present status of skin regeneration techniques for the treatment of full-thickness skin defect via cultured autologous epithelium transplantation and the experience of this department in the treatment of full-thickness skin defects.