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Short‐term Preservation of Human Autografts

 

作者: ALERT CRAM,   MARILYN DOMAYER,  

 

期刊: The Journal of Trauma: Injury, Infection, and Critical Care  (OVID Available online 1983)
卷期: Volume 23, issue 10  

页码: 872-873

 

ISSN:0022-5282

 

年代: 1983

 

出版商: OVID

 

数据来源: OVID

 

摘要:

Short-term storage of a patient's harvested skin is clinically desirable for numerous reasons. Previous experience in our center using a skin storage solution of saline with a high concentration of antibiotics resulted in poor graft viability and an unsatisfactory clinical outcome. This report defines an improved method of storage which allows longer storage time, yielding viable skin and results in subsequent graft acceptance on the patient.Split-thickness autografts from patients were stored in: 1) saline + 104units/ml penicillin and 0.005 gm/ml streptomycin, or 2) RPMI-1640 + 25 units/ml penicillin and 25 mcg/ml streptomycin, at 4°C. The pH range of the saline solution was 5.90–6.20, compared to 7.20–7.32 for the RPMI-1640 solution. The medium was changed every 3 to 4 days during the storage period. Before graft reapplication the autografts were rinsed with sterile saline.Previous clinical results using the saline-antibiotic storage solution resulted in poor graft viability and no graft survival was noted on patients after 5 days of skin storage. In contrast 11/16 autografts which had been stored in the RPMI-1640 solution for 5 to 22 days (median, 11 days) were successful takes when regrafted to patients. Graft loss was observed in five cases due to the following reasons: inability to immobilize graft (one); poor vascular bed (two); and bacterial infections (two). These data are in agreement with results reported in a separate paper, demonstrating the effectiveness of RPMI-1640 as a storage medium for maintaining viable human skin grafts which were subsequently transplanted to athymic nude mice.Our results indicate that with proper storage techniques viable autografts can be maintained to 22 days without resorting to freezing. The RPMI-1640 solution was clearly superior to the saline solution with medium pH being an important factor in skin storage. Improvements in skin storage at this center have reduced the number of surgical procedures for many patients and have resulted in a shortened time of wound closure in these cases.

 

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