Clinical application of microskin grafting to repair granulation or decrustation wounds.
ABSTRACT One hundred seven granulating or decrustation wounds in 58 patients were grafted with microskin grafts of different sizes. The modified procedure has been used successfully for different wound sites, such as limb, chest, abdomen, and the back, with satisfactory results. Signs of epithelialization were shown within 5 to 22 days in 40 patients. The wound healing rate was 94.4%, including 71.9% total healing rate and 22.4% improved healing rate. We think that this method could be applied to either granulation or decrustation wounds in addition to excision wounds.
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ABSTRACT: The standard of care for wound coverage is to use an autologous skin graft. However, large or chronic wounds become an exceptionally challenging problem especially when donor sites are limited. It is important that the clinician be aware of various treatment modalities for wound care and incorporate those methods appropriately in the proper clinical context. This report reviews an alternative to traditional meshed skin grafting for wound coverage: micrografting. The physiological concept of micrografting, along with historical context, and the evolution of the technique are discussed, as well as studies needed for micrograft characterization and future applications of the technique.Journal of diabetes science and technology 07/2010; 4(4):808-19. DOI:10.1177/193229681000400407
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ABSTRACT: Selectively decellularized split-thickness porcine skin (SDSTPS) may be an optimal alternative for allograft. This study was designed to explore the efficacy of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds and to resolve the problem of the shortage and risk of cadaver skin allografts. Full-thickness xenogenic skin was harvested from a healthy ternary pig, and SDSTPS was produced by the glutaraldehyde-trypsin-detergent method. Split-thickness autograft skin was harvested from patients and minced into microskin autografts. The microskin autografts with overlaid SDSTPS were applied to 31 patients with deep burn wounds, 4 to 6 days after injury, and comparisons with cadaver skin allograft were carried out on both sides of the torso and limbs. The cases were followed up for 18 months. The following parameters were investigated: time of rejection and exfoliation, percentage of epithelialized wound area, number of cases with wound ulcer, hypertrophic scars, pain and itching, apparent deformity, and functional impairment. The rejection and exfoliation time of the skin xenograft was 17 ± 3 days and that of the skin allograft was 14 ± 2 days (P < .05), whereas the epithelialized wound area 3 weeks postoperatively for the skin xenograft and allograft was 87 ± 21% and 83 ± 41% (P > .05), respectively. There was no significant difference in skin morphology between the two groups. The satisfactory function was observed in the follow-up visit for 18 months postoperatively. The authors' results indicate that the clinical effect of microskin autografts overlaid with SDSTPS in the repair of deep burn wounds is similar to that of microskin autograft overlaid with frozen cadaver skin, and SDSTPS could be an optimal alternative for allograft.Journal of burn care & research: official publication of the American Burn Association 03/2011; 32(3):e67-73. DOI:10.1097/BCR.0b013e318217f8e2 · 1.43 Impact Factor
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ABSTRACT: This article demonstrates how a feminist political ecology (FPE) framework can be utilized to expand scholarly conceptualizations of water inequality in Delhi, India. I argue that FPE is well positioned to complement and deepen urban political ecology work through attending to everyday practices and micropolitics within communities. Specifically, I examine the embodied consequences of sanitation and ‘water compensation’ practices and how patterns of criminality are tied to the experience of water inequality. An FPE framework helps illuminate water inequalities forged on the body and within particular urban spaces, such as households, communities, streets, open spaces and places of work. Applying FPE approaches to the study of urban water is particularly useful in analyzing inequalities associated with processes of social differentiation and their consequences for everyday life and rights in the city. An examination of the ways in which water practices are productive of particular urban subjectivities and spaces complicates approaches that find differences in distribution and access to be the primary lens for viewing how water is tied to power and inequality.Geoforum 03/2011; 42(2):143-152. DOI:10.1016/j.geoforum.2011.01.004 · 1.93 Impact Factor