scholarly journals Surgical interventions for vitiligo

2020 ◽  
Vol 63 (12) ◽  
pp. 748-755
Author(s):  
Jung Min Bae ◽  
Hyun Jeong Ju
Keyword(s):  
Cell Suspension ◽  
Epidermal Cell ◽  
Normal Skin ◽  
Critical Factor ◽  
Skin Grafting ◽  
Surgical Interventions ◽  
Suction Blister ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Surgical Modality

Since nonsurgical treatment of vitiligo is not always successful, surgical interventions are viable options for patients with refractory vitiligo. Surgical treatment is a method in which melanocytes of normal skin are transplanted into vitiligo lesions and provided as a repigmentation source. Such treatments are primarily divided into tissue grafting and cellular grafting, depending on the nature of the graft. Tissue grafting includes split-thickness skin grafting, suction blister grafting, punch grafting, hair follicle transplantation, and smashed-skin grafting. Cellular grafting includes non-cultured epidermal cell suspension transplantation, non-cultured follicular cell suspension transplantation, and cultured epidermal cell suspension transplantation. Among these, suction blister grafting and micro-punch grafting have been widely performed for localized refractory vitiligo, and non-cultured epidermal cell suspension transplantation is adopted as the standard treatment for extensive vitiligo. Research on cultured cellular grafting to treat larger vitiligo areas is also ongoing. Selecting patients with stable vitiligo that has not spread for over 12 months is the most critical factor in the surgical outcome. It is also important to choose an appropriate surgical modality for each patient, and a combination of various procedures often improves the overall outcome. In conclusion, surgical intervention can be an effective and safe option for patients with vitiligo refractory to conventional treatments. Non-cultured epidermal cell suspension transplantation, which was denied by New Health Technology Assessment in Korea, should be approved to benefit patients with refractory vitiligo.

Outcomes of Split Thickness Skin Grafting on Lower Extremity Wounds in Diabetics

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 111-OR
Author(s):  
ELLIOT WALTERS ◽  
GREG STIMAC ◽  
NEHA RAJPAL ◽  
IRAM NAZ ◽  
TAMMER ELMARSAFI ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

668 Fixation of Split-Thickness Skin Grafts with Liquid Adhesive and Fibrin Glue in Place of Staples

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S190-S191
Author(s):  
Joshua Frost ◽  
Nathan Hallier ◽  
Tanir Moreno ◽  
Jared Covell ◽  
Ryan Keck ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Skin Grafting ◽  
Skin Grafts ◽  
Inclusion Criteria ◽  
Intact Skin ◽  
Body Area ◽  
Wound Site ◽  
Graft Take ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Introduction A critical component of split-thickness skin grafting is the fixation of the skin graft to the wound site. Graft displacement can result in graft failure, especially during the initial 48–72 hours following application. The most common method of securing grafts is with the use of staples, sometimes with the addition of fibrin glue in order to aid both graft adhesion and homeostasis. The use of staples, however, is associated with significant levels of patient discomfort, especially during staple removal. A possible alternative to staples is the use of liquid adhesives, in combination with steri-strips, to anchor the edges of skin grafts to intact skin. Certain liquid adhesives, such as gum-based resins, are cheaper to use than staples and offer the potential to secure small split-thickness skin grafts without the associated pain of staples. In this pilot study, we examined the effectiveness of using a combination of gum-based resin (Gum Mastic-Storax-Msal-Alcohol), fibrin glue, and steri-strips to secure partial-thickness grafts in 8 patients without the use of staples or sutures. Methods Patients were included in the study who required split-thickness skin grafts to treat wounds involving less than or equal to 15% total surface body area and whose wounds were not located in areas prone to graft displacement, such as the axilla and groin. For each patient, skin grafts were secured using fibrin glue (sprayed over the entire wound), and a combination of liquid adhesive and steri-strips applied around the wound perimeter. The success of each graft was determined by the percentage of graft take. Results From January 1st, 2020 to April 30th, 2020, 8 patients were identified who fit the inclusion criteria. Five of the patients received grafts to their lower extremities, two patients received grafts to their upper extremities, and one of the patients received a graft to the torso. The average wound site that was grafted was 116.7 cm2. Average graft take among the 8 patients was 96.9%, with a range of 90%-100%. No complications at the graft site were noted, such as hematomas or any other event that resulted in graft displacement or failure. Conclusions The results of the study demonstrate that a combination of liquid adhesive, fibrin glue, and steri-strips, can be used as an effective alternative to staples in small split-thickness skin grafts. The use of liquid adhesive in place of staples was advantageous because it eliminated to need for staple removal, which resulted in less discomfort for the patient and less work for the nursing staff.

Uncommon Responses of Segmental Vitiligo to Melanocyte-Keratinocyte Transplantation Procedure

2015 ◽  
Vol 19 (2) ◽  
pp. 177-181 ◽  
Author(s):  
Prescilia Isedeh ◽  
Ahmed Al Issa ◽  
Henry W. Lim ◽  
Smita S. Mulekar ◽  
Sanjeev V. Mulekar
Keyword(s):  
Observational Study ◽  
Skin Grafting ◽  
Retrospective Observational Study ◽  
Recipient Site ◽  
Treated Area ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Background Patients with segmental vitiligo (SV), unlike those with nonsegmental vitiligo (NSV), have a more predictable course and are more responsive to surgery. Objective To report 10 patients with SV treated with the melanocyte-keratinocyte transplantation procedure (MKTP), who responded with unusual responses not previously reported in the literature. Methods This is a retrospective, observational study that reports 10 patients with SV who underwent the MKTP between May 2003 and May 2012. Results Two patients had successful repigmentation after split-thickness skin grafting after failure of the MKTP. Two patients developed a hypopigmented ring at a margin of the MKTP-treated area. One patient had complete repigmentation after a second MKTP. Two patients developed koebnerization of the recipient site. Three patients developed new vitiligo patches in previously unaffected areas after the MKTP. Conclusions Uncommon and even suboptimal responses can occur following the MKTP in SV patients. There is a need for studies to provide better understanding and outcomes for SV patients undergoing the MKTP.

EKSISI DAN MEGA PROSTHESIS PADA GIANT CELL TUMOR PROXIMAL TIBIA (LAPORAN KASUS)

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Mujaddid Idulhaq ◽  
Bayu Sakti Jiwandono ◽  
Ariya Maulana Nasution ◽  
Handry TH
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Limb Salvage ◽  
Proximal Tibia ◽  
Skin Grafting ◽  
Cell Tumor ◽  
Limb Salvage Surgery ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Muscular Flap

Giant cell tumor (GCT) merupakan tumor destruktif tulang yang muncul di antara dekade kedua dan keempat, lokasi predileksi umumnya pada epifisis tulang panjang. Pemilihan tatalaksana operasi sangat penting dan masih menjadi perdebatan. Sebagaimana masih beragamnya pilihan tindakan pembedahan. Klasifikasi Campanacci dapat digunakan sebagai acuan untuk panduan tatalaksana. Pada kasus ini kami melaporkan seorang wanita, usia 18 tahun dengan diagnosa giant cell tumor pada proximal tibia dextra dengan Campanacci grade III. Pasien telah menjalani operasi limb salvage tahap pertama berupa eksisi luas pada proximal tibia dextra dan knee arthrodesis. Setelah 4 bulan dilakukan operasi limb salvage tahap kedua yaitu knee arthroplasty dengan megaprosthesis. Untuk mencegah komplikasi implant expose, dilakukan muscular flap dan split thickness skin grafting (STSG). Setelah dilakukan evaluasi selama 4 bulan, klinis pasien baik, pasien dapat berjalan alat bantu dan tanpa nyeri, tidak ada komplikasi pada luka operasi dan fiksasi implan baik. Kesimpulan yang didapatkan bahwa limb salvage surgery pada giant cell tumor proximal tibia dapat dilakukan dengan tindakan rekonstruksi dua tahap. Teknik muscular flap dan split thickness skin grafting (STSG) dapat digunakan untuk mencegah terjadinya implant expose.

scholarly journals Minimally Invasive Technologies for Treatment of HTS and Keloids: Fractional Laser

2020 ◽  
pp. 279-285
Author(s):  
M. Tretti Clementoni ◽  
E. Azzopardi
Keyword(s):  
Minimally Invasive ◽  
Burn Injury ◽  
State Of The Art ◽  
Skin Grafting ◽  
Complex Problem ◽  
Fractional Laser ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Insight Into

AbstractThis chapter presents a state-of-the-art insight into the use of fractional laser for the management of this complex problem. In particular, we focus on the management of complex scars such as those occurring post-burn injury and split-thickness skin grafting.

Expansion potential of skin grafts with novel I-shaped auxetic incisions

2021 ◽  
Author(s):  
Vivek Gupta ◽  
Arnab Chanda
Keyword(s):  
Skin Grafting ◽  
Burn Injuries ◽  
Skin Grafts ◽  
Severe Burn ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Shape Pattern ◽  
Severe Burn Injuries ◽  
Poisson's Ratios ◽  
Poisson’S Ratios

Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.

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