Autologous suction blister grafting for chronic leg ulcers

Costanzo, U; Streit, Markus; Braathen, L.R.

doi:10.1111/j.1468-3083.2007.02148.x

Cited by 23 publications

(27 citation statements)

References 21 publications

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“…The use of epidermal grafts or blister grafts for the treatment of vitiligo and chronic wounds has already been widely reported, but its use is limited because of the lack of reproducible and efficient harvesting techniques further limiting its potential to be used in the outpatient setting . This study demonstrates the feasibility of using a novel epidermal‐harvesting device to achieve definitive wound coverage in the outpatient setting.…”

Section: Discussionmentioning

confidence: 99%

A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management

Hachach‐Haram

Bystrzonowski

Kanapathy

et al. 2016

International Wound Journal

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Current wound management through the use of a split-thickness skin graft often requires hospital admission, a period of immobility, attentive donor site wound care and pain management. This study evaluates the feasibility of using a novel epidermal graft-harvesting device (CelluTome) that allows pain-free epidermal skin grafting in the outpatient clinic setting. A prospective series of 35 patients was performed in 2 centres, involving 10 acute and 25 chronic wounds. All patients were subjected to epidermal grafting in the outpatient specialist clinic, without the use of anaesthesia, and allowed to return home after the procedure. Completely healed wounds were noted in 22 patients (62·9%). The overall mean time for 50% and 100% reduction in wound size was 3·31 ± 2·33 and 5·91 ± 3·48 weeks, respectively. There was no significant difference in healing times between the acute and chronic wounds (50% reduction in wound size; acute 2·20 ± 0·91 weeks versus chronic 3·73 ± 2·63 weeks, P = 0·171. Hundred percent reduction in wound size; acute 4·80 ± 1·61 weeks versus chronic 6·83 ± 4·47 weeks, P = 0·183). The mean time for donor site healing was 5·49 ± 1·48 days. The mean pain score during graft harvest was 1·42 ± 0·95, and the donor site Vancouver Scar Scale was 0 for all cases at 6 weeks. This automated device offers autologous skin harvesting in the outpatient setting with minimal or no pain and a scar free donor site, equally benefiting both the acute and chronic wounds. It has the potential to save NHS resources by eliminating the need for theatre space and a hospital bed while at the same time benefiting patient care.

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Section: Discussionmentioning

confidence: 99%

A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management

Hachach‐Haram

Bystrzonowski

Kanapathy

et al. 2016

International Wound Journal

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“…Epidermal graft harvesting has previously been shown to be effective in the management of lower limb wounds . Recent case series have also shown that the CelluTome epidermal graft‐harvesting device is effective in managing a variety of acute and chronic wounds in a wide range of patients, offering a viable alternative to SSG .…”

Section: Discussionmentioning

confidence: 99%

The CelluTome epidermal graft‐harvesting system: a patient‐reported outcome measure and cost evaluation study

Smith

Edmondson

Bystrzonowski

et al. 2016

International Wound Journal

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Conventional split skin grafts (SSG) require anaesthesia, specialist equipment and can have high donor site (DS) morbidity. The CelluTome epidermal graft-harvesting device is a novel alternative, providing pain-free epidermal skin grafts (ESG) in the outpatient setting, with projected minimal DS trauma and improved patient satisfaction. This study aimed to compare ESG with SSG by evaluating patient-related outcome measures (PROMs) and the cost implications of both. Twenty patients answered a graft satisfaction questionnaire that evaluated: donor/graft site noticeability, aesthetic concerns, adverse problems and patient satisfaction. Cost/patient was calculated based on total operative expenses and five clinic follow-ups. In 100% of the ESG cases, there were no DS noticeability or adverse problems compared to 25% in the SSG group. Complete satisfaction with DS appearance was observed in 100% of the ESG cases (50% SSG). Noticeability, adverse problems and overall satisfaction were significantly better in ESG cases (P < 0.05). Graft site parameters were comparable with similar healing outcomes. The cost per patient for ESG was £431 and £1489 for SSG, with an annual saving of £126 960 based on 10 grafts/month. For the right patient, CelluTome provides comparable wound healing, with reduced DS morbidity and higher patient satisfaction.

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“…In a case series of five patients treated with epidermal micrografts, it was noticed that the micrografts did not appear to “take” but instead stimulated healing from the wound edges [14]. Also, in a study by Costanzo et al of 29 chronic, non-healing ulcers on the lower extremities treated with autologous epidermal grafting, they observed an increase in re-epithelialization from the wound edge, and ultimately, at 12 weeks, 89% of ulcers were healed [6]. …”

Section: Discussionmentioning

confidence: 99%

“…This technique results in cleavage through the lamina lucida as it is the weakest part of the skin and subject to cleavage with suction. This preserves the ultrastructure of the epidermis with only patchy hemidesmosome disruption [6]. Traditionally, it has been used in dermatology for treatment of leukoderma [7] but has been shown to be effective in the management of acute surgical wounds and chronic ulcers [8].…”

Section: Introductionmentioning

confidence: 99%

Clinical and Economic Benefits of Autologous Epidermal Grafting

Kirsner¹

2016

Cureus

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Chronic wounds are an increasingly prevalent disease with a significant healthcare burden. These wounds often do not respond to standard of care therapy alone, requiring the use of adjuvant therapies. Epidermal grafting, previously utilized primarily for correction of leukoderma, is increasingly being recognized as a beneficial therapy for wounds, both acute and chronic. Epidermal grafting has been shown to be effective in the management of chronic wounds, with successful healing in refractory patients. It has not only been shown to be effective, but it is also associated with lower cost and morbidity than traditional skin grafting techniques as well as improved donor site healing. Through the use of a novel epidermal harvesting system, the CelluTome™ Epidermal Harvesting System (KCI, an Acelity company, San Antonio, TX), this treatment modality has become more standardized, reproducible, and easy to use as well as less time consuming, making its use in the clinical setting more convenient and beneficial. Epidermal grafting, therefore, represents a promising, efficacious, and cost-effective option for treatment of refractory non-healing wounds.

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Autologous suction blister grafting for chronic leg ulcers

Abstract: Grafting of autologous suction blister roofs is an effective treatment option for non-healing leg ulcers. The advantages of the method are its lack of pain, low costs and immediate availability.

Cited by 23 publications

References 21 publications

A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management

A prospective, multicentre study on the use of epidermal grafts to optimise outpatient wound management

The CelluTome epidermal graft‐harvesting system: a patient‐reported outcome measure and cost evaluation study

Clinical and Economic Benefits of Autologous Epidermal Grafting

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