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Die Hautzüchtung bei der Behandlung Schwerstverbrannter

Keratinocyte Cultivation in the TReatment of Severe Burns

  • Conference paper
Wahrung des Bestandes, Wandel und Fortschritt der Chirurgie

Part of the book series: Langenbecks Archiv für Chirurgie ((KONGRESSBAND,volume 1996))

Summary

In severe burns a total body surface area (TBSA) of more than 60% restricts possible donor areas for autologous STS coverage. Additional wound surfaces may further harm the patient. From a skin biopsy of 5 cm2 the total body surface can be covered using keratinocyte cultures to multiply cells by 1000 up to 10000. The cultured kerati-nocytes may be used as “sheets” (CEA) or suspended in fibrin glue (KFGS), which must be covered with meshed allogenic STS graft. Long culture times from 14 (KFGS) up to 28 days (CEA), infection of the culture and the woundbed, mechanical instability in the first period after grafting, restoring the dermal equivalent in full thickness burns and high costs are the problems of this new means of burn wound covering. Technical details of cultivation and coverage procedures using CEA and KFGS are discussed.

Zusammenfassung

Bei der Behandlung Schwerstverbrannter mit mehr als 60% betroffener Körperoberfläche begrenzen mangelnde Spenderareale die Deckungsmöglichkeiten mit autologem Epithel. Die Entnahme von Spalthauttransplantaten bedeutet zudem eine Vergrößerung der Wundfläche. Die Züchtung autologer Keratinozyten als „sheets“(CEA) bietet die Möglichkeit, die gesamte Körperoberfläche mit körpereigenem Epithel aus der Kultur von einer Biopsie von 5 cm2 zu decken. Alternativ steht das Verfahren der Deckung mit autologen Keratinozyten in Fibrinklebersuspension (KFGS), welche mit Fremdhaut übertransplantiert wird, zur Verfügung. Probleme bereiten die mit 14 (KFGS)-30 (CEA) Tagen relativ langen Kulturzeichen, Infektionen des Wundbettes oder der Kulturen, die mechanische Instabilität der Sheets nach der Transplantation, die hohen Kosten des Verfahrens und das fehlende dermale Äquivalent bei tiefgradigen Verbrennungen.

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Author information

Authors and Affiliations

  1. Klinik für Plastische, Hand- und Wiederherstellungschirurgie, Schwerstverbranntenzentrum Köln-Merheim, Ostmerheimerstraße 200, D-51109, Köln, Deutschland

    G. Spilker & M. W. Reifenrath

  2. Universitätshautklinik Bonn, Deutschland

    H. W. Kaiser

Authors
  1. G. Spilker
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  2. M. W. Reifenrath
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  3. H. W. Kaiser
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Editor information

Editors and Affiliations

  1. Deutschen Gesellschaft für Chirurgie, Steinhölzle 16, D-89197, Westerstetten-Vorderdenkental, Deutschland

    W. Hartel (Generalsekretär) (Generalsekretär)

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© 1996 Springer-Verlag Berlin Heidelberg

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Spilker, G., Reifenrath, M.W., Kaiser, H.W. (1996). Die Hautzüchtung bei der Behandlung Schwerstverbrannter. In: Hartel, W. (eds) Wahrung des Bestandes, Wandel und Fortschritt der Chirurgie. Langenbecks Archiv für Chirurgie, vol 1996. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80295-9_303

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  • DOI: https://doi.org/10.1007/978-3-642-80295-9_303

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-61617-7

  • Online ISBN: 978-3-642-80295-9

  • eBook Packages: Springer Book Archive

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