Analyzing the Correlation of Five Indications to The Regenerative Effectiveness of Expanded Skin
Shuang-Bai Zhou, M.D., Ph.D., Si-Zheng Zhou, M.D., Cheng-An Chiang, M.D., Ph.D., Ji-Han Guo, M.D., Yun Xie, M.D., Kai Liu, M.D., Ph.D., Qing-Feng Li, M.D., Ph.D..
Shanghai Jiao Tong University, Shanghai, China.
PURPOSE: Skin expansion is a commonly used method for harvesting extra skin tissue for reconstruction. However, the outcome of skin expansion can be unpredictable. Therefore, our goal is to develop a scoring system that can predict the regenerative capacity of expanded skin.
METHODS: One hundred fifty-eight patients with 277 expanded skin cases during 2010 to 2014 were reviewed and photograph-evaluated for the expanded skin texture and regenerative condition. Overall texture of the expanded skin flaps (Good, Fair, Poor) were evaluated and documented by senior attending surgeons. The occurrence of five indications of skin regeneration limitation, including skin thickness, skin color, stretch mark, vessel varicose and skin lesion, during skin expansion were recorded. The correlation of indications to overall skin regeneration condition was statistically analyzed.
RESULTS: Among the 277 retrospective reviewed expansion cases, the ratio of skin deterioration showed significant differences between expansion sites (p<0.01). The scalp and forehead expanded skin had best skin condition. Skin deterioration cases was most commonly seen in neck and back expansion cases. The occurrence of each indication was different in different locations. The odds ratio (OR) of skin color, stretch marks, varicose vessels, skin thinning and skin lesion between Good and Poor was 44.97, 5.09, 22.26, 89.79, 4.61 respectively (all p<0.001).
CONCLUSION: The results from this retrospective study showed that skin color, stretch marks, varicose vessels, thickness and skin lesion were tightly related to the skin regeneration capacity. Integrated evaluating could help predict the regeneration capacity of expanded skin.
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