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Die Hautzüchtung bei der Behandlung Schwerstverbrannter

  • G. Spilker
  • M. W. Reifenrath
  • H. W. Kaiser
Conference paper
Part of the Langenbecks Archiv für Chirurgie book series (DTGESCHIR, volume 1996)

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.

Schlüsselwörter

Keratinozyten-Kultur-2b-3. gradige Verbrennung CEA Fibrinklebersuspension 

Keratinocyte Cultivation in the TReatment of Severe Burns

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.

Key words

Keratinocyte cultivation full thickness burns Cultured epidermal autograft keratinocyte fibrin glue suspension 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • G. Spilker
    • 1
  • M. W. Reifenrath
    • 1
  • H. W. Kaiser
    • 2
  1. 1.Klinik für Plastische, Hand- und WiederherstellungschirurgieSchwerstverbranntenzentrum Köln-MerheimKölnDeutschland
  2. 2.Universitätshautklinik BonnDeutschland

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