Indikation und klinische Ergebnisse der Hautpfropfung zur Behandlung problematischer Wunden

 

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Zusammenfassung

1920 stellte Braun erstmals eine neue Hauttransplantationstechnik zur Behandlung von Wunden vor, in denen konventionelle Hauttransplantationen aufgrund von Scherkräften, hohem Druck und exzessiver Wundsekretion nur selten erfolgreich durchgeführt werden können. Wir präsentieren klinische Anwendungsbeispiele und Ergebnisse aus den vergangenen 10 Jahren, in denen wir diese Technik bei Wundheilungsstörungen unterschiedlichster Genese eingesetzt haben. In Kombination mit der modernen Vakuumtherapie kann die Bildung eines Granulationsgewebes beschleunigt und die Transplantation auch erfolgreich an therapierefraktären Problemwunden durchgeführt werden.

Abstract

In 1920 Braun described a technique of skin grafting particularly designed for areas where shearing forces, high pressure and extensive secretion cause repetitive loss of conventionally transplanted skin. During the last 10 years we successfully used this technique when impaired wound healing was encountered due to various reasons. Clinical examples of application and results are presented. By combining this technique with vacuum therapy, formation of granulation tissue can be accelerated, thereby resulting in successful transplantation of problematic and therapy resistant wounds.

Literatur

• 1 Reverdin J L. Greffe epidermique.  Bulletin de la Societe Imperiale de Chirurgie de Paris. 1870;  Deuxième serie 10 511-519
  PubMedGoogle Scholar
• 2 Braun W. Zur Technik der Hautpfropfung.  Zentralb Chir. 1920;  47 1355-1361
  PubMedGoogle Scholar
• 3 Rumalla V K, Borah G L. Cytokines, growth factors, and plastic surgery.  Plast Reconstr Surg. 2001;  108 719-733
  PubMedGoogle Scholar
• 4 Pierce G F, Vande Berg J, Rudolph R, Tarpley J, Mustoe T A. Platelet-derived growth factor-BB and transforming growth factor beta 1 selectively modulate glycosaminoglycans, collagen, and myofibroblasts in excisional wounds.  Am J Pathol. 1991;  138 629-646
  PubMedGoogle Scholar
• 5 Laiho M, Keski-Oja J. Transforming growth factors-beta as regulators of cellular growth and phenotype.  Crit Rev Oncog. 1992;  3 1-26
  PubMedGoogle Scholar
• 6 Goldberg J A, Adkins P, Tsai T M. Microvascular reconstruction of the foot: weight-bearing patterns, gait analysis, and long-term follow-up.  Plast Reconstr Surg. 1993;  92 904-911
  CrossrefPubMedGoogle Scholar
• 7 Goldberg J A, Alpert B S, Lineaweaver W C, Buncke H J. Microvascular reconstruction of the lower extremity in the elderly.  Clin Plast Surg. 1991;  18 459-465
  PubMedGoogle Scholar
• 8 Braun W. Über Hautpfropfungen.  Medizinische Klinik. 1921;  14 398-401
  PubMedGoogle Scholar
• 9 Marcks K M. The use of implantation grafts in the healing of infected ulcers.  Am J Surg. 1941;  51 354
  CrossrefPubMedGoogle Scholar
• 10 Wangesteen O H. The implantation method of skin grafting.  Surg Gynecol Obstet. 1930;  50 634
  PubMedGoogle Scholar
• 11 Horton W S. Implant skin graftings. A case report.  Am J Surg. 1942;  55 597
  CrossrefPubMedGoogle Scholar
• 12 Bors E, Comarr A E. The buried epidermal grafts.  Surg Gynecol Obstet. 1948;  87 68
  PubMedGoogle Scholar
• 13 Zhang M L, Wang C Y, Chang Z D, Cao D X, Han X. Microskin grafting. II. Clinical report.  Burns Incl Therm Inj. 1986;  12 544-548
  PubMedGoogle Scholar
• 14 Tanner J C, Vandeput J J, Olley J F. The mesh skin graft.  Plast Reconstr Surg. 1964;  34 287-292
  PubMedGoogle Scholar
• 15 Alexander J W, MacMillan B G, Law E, Kittur D S. Treatment of severe burns with widely meshed skin autograft and meshed skin allograft overlay.  J Trauma. 1981;  21 433-438
  PubMedGoogle Scholar
• 16 Sawada Y. Buried chip skin grafting for treatment of perianal burns.  Burns Incl Therm Inj. 1989;  15 36-38
  PubMedGoogle Scholar
• 17 Horch R E, Stark G B, Spilker G. Treatment of perianal burns with submerged skin particles.  Zentralbl Chir. 1994;  119 722-725
  PubMedGoogle Scholar
• 18 Sawada Y, Nihei Y. A further application of buried chip skin grafting.  Acta Chir Plast. 1998;  40 68-72
  PubMedGoogle Scholar
• 19 Morykwas M J, Argenta L C. Nonsurgical modalities to enhance healing and care of soft tissue wounds.  J South Orthop Assoc. 1997;  6 279-288
  PubMedGoogle Scholar
• 20 Horch R E, Bach A D, Loos B, Kopp J. Sicherheitsaspekte und Indikationen der V.A.C. Therapie in der Plastischen Chirurgie.  European Surgery. 2003;  35 5-7
  CrossrefPubMedGoogle Scholar
• 21 Morykwas M J, Argenta L C, Shelton-Brown E I, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation.  Ann Plast Surg. 1997;  38 553-562
  CrossrefPubMedGoogle Scholar
• 22 DeFranzo A J, Marks M W, Argenta L C, Genecov D G. Vacuum-assisted closure for the treatment of degloving injuries.  Plast Reconstr Surg. 1999;  104 2145-2148
  CrossrefPubMedGoogle Scholar
• 23 Horch R E, Bach A D, Loos B, Schipper J, Kopp J. Prefabrication of threedimensional newly generated compound flaps in Plastic Surgery with the use of V.A.C.  European Surgery - Acta Chir Aust. 2003;  35 18-20
  PubMedGoogle Scholar
• 24 Obdeijn M C, de Lange M Y, Lichtendahl D H, de Boer W J. Vacuum-assisted closure in the treatment of poststernotomy mediastinitis.  Ann Thorac Surg. 1999;  68 2358-2360
  CrossrefPubMedGoogle Scholar
• 25 Vacuum-assisted closure for chronic wound healing. Tecnologica MAP Suppl 2000; 19-20
  Google Scholar
• 26 Yuan-Innes M J, Temple C L, Lacey M S. Vacuum-assisted wound closure: a new approach to spinal wounds with exposed hardware.  Spine. 2001;  26 E 30-E 33
  PubMedGoogle Scholar

Dr. med. Jürgen Kopp

Abteilung Plastische und Handchirurgie · Universitätsklinikum Erlangen

Krankenhausstraße 12

91054 Erlangen

Phone: +49 91 31/8 53 32 77

Fax: +49 91 31/8 53 93 27

Email: juergen.kopp@chir.imed.uni-erlangen.de