Epidermal Grafting Using a Novel Suction Blister–Harvesting System for the Treatment of Pyoderma Gangrenosum

Richmond, Nicholas A.; Lamel, Sonia A.; Braun, Liza R.; Vivas, Alejandra C.; Serena, Thomas E; Kirsner, Robert S.

doi:10.1001/jamadermatol.2014.1431

Cited by 37 publications

(47 citation statements)

References 8 publications

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“…Similarly, automated SBEG also proved useful when split-thickness skin graft (STSG) was contraindicated out of concern for poor wound healing at the donor site, such as the case in pyoderma gangrenosum [11]. The likely explanation is that the minimally invasive depth of SBEG, specifically cleavage of the lamina lucida with preserved epidermal ultrastructure, induces little inflammatory response, which results in expedited healing [16].…”

Section: Discussionmentioning

confidence: 99%

“…Harvesting the epidermis is relatively painless and can be performed without anesthesia. Additionally, the minimally invasive depth of epidermal grafting is believed to cause only a minor inflammatory response and the donor site is expected to heal in three to four days [11-12]. In contrast, alternative methods of skin grafting are likely to incur operating room expenses, require general anesthesia, and may result in donor site morbidity, which all serve to limit its use in patients who are poor surgical candidates.…”

Section: Introductionmentioning

confidence: 99%

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A Case Series of Complex Recalcitrant Wounds Treated with Epidermal Grafts Harvested from an Automated Device

Cai

Gowda

Chopra

et al. 2016

Cureus

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Introduction: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique. The authors present a case series of multimorbid patients who were poor surgical candidates and were treated with this technique.Methods: A retrospective review of all patients treated with CelluTome™ Epidermal Harvesting System (KCI, an Acelity company, San Antonio, TX) prior to May 2016 at our institution was conducted.Results: A total of 12 patients underwent 14 epidermal grafting procedures. Multiple comorbidities were identified, including smoking (33%), immunosuppression by immunotherapy or steroids (25%), chronic venous insufficiency (25%), diabetes mellitus (25%), malignancy (25%), polysubstance abuse (17%), HIV/AIDS (17%), and peripheral artery disease (8%). Among the two acute wounds (≤ 3 months) and 10 chronic wounds, the average wound size was 49.1 cm2 (± 77.6 cm2) and the median wound duration was 5.7 months (interquartile range: 4.1 - 15.8 months) before SBEG was attempted. These complex wounds had failed prior therapies, such as local wound care (100%), incision and drainage (58%), vacuum-assisted closure (33%), split-thickness skin graft (16%), and hyperbaric oxygen (8%). Following the procedure, all donor sites healed within one week. Three patients were lost to follow-up. Of the remaining nine patients, four patients had complete resolution of their wounds at a median follow-up of 13.1 weeks (interquartile range: 6.8-17.3 weeks). Among those with partial resolutions, the average wound size was 4.2 cm2 (± 2.1 cm2) with an average wound reduction of 79% (± 23%). No donor or recipient site complications were observed.Conclusions: The automated SBEG harvesting device is an effective and safe option for treating complex non-healing wounds in multimorbid patients who may be poor surgical candidates. This procedure demonstrates minimal contraindications to its use and donor or recipient site complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case Series of Complex Recalcitrant Wounds Treated with Epidermal Grafts Harvested from an Automated Device

Cai

Gowda

Chopra

et al. 2016

Cureus

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“…[5][6][7] In patient's with pyoderma gangrenosum, skin substitutes are good viable option for wound coverage compared to split thickness skin graft as patient's with pyoderma gangrenosum has pathergy. 4 …”

Section: Question 3 Answer (F)mentioning

confidence: 99%

Ace Your Certification: Skin Substitutes

Shah

2013

Journal of the American College of Clinical Wound Specialists

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“…Although several case series have previously reported good clinical outcome with EG, 3–5,7 the healing rate in comparison to conservative wound management is not known. In this report, we observe the weekly wound healing rate of EG compared with conservative treatment in 2 separate wounds in the same patient.…”

mentioning

confidence: 99%

“…3–5 EG involves harvesting the epidermis by applying continuous negative pressure on the donor site to raise blisters (Fig. 1).…”

mentioning

confidence: 99%

Epidermal Graft Accelerates the Healing of Acute Wound: A Self-controlled Case Report

Bystrzonowski

Hachach‐Haram

Kanapathy

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Epidermal Grafting Using a Novel Suction Blister–Harvesting System for the Treatment of Pyoderma Gangrenosum

Cited by 37 publications

References 8 publications

A Case Series of Complex Recalcitrant Wounds Treated with Epidermal Grafts Harvested from an Automated Device

A Case Series of Complex Recalcitrant Wounds Treated with Epidermal Grafts Harvested from an Automated Device

Ace Your Certification: Skin Substitutes

Epidermal Graft Accelerates the Healing of Acute Wound: A Self-controlled Case Report

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