title: Use of a novel epidermal harvesting system in resource-poor countries.
abstract: The 2010 earthquake in Port-au-Prince, Haiti, highlighted the need for wound care in resource-poor countries. Subsequently, the University of Miami in Florida established one of the first interprofessional wound care centers located at Bernard Mevs Hospital in the central portion of Port-au-Prince, caring for patients with acute and chronic wounds. In 2012, the authors used a novel epidermal harvesting system (CelluTome Epidermal Harvesting System; Kinetic Concepts Inc, San Antonio, Texas) to harvest epithelium to be grafted on 7 patients at the Mevs Hospital with longstanding wounds. Epidermal microblisters were obtained from each patient's thigh using the CelluTome Epidermal Harvesting System. After 35 minutes, microblisters were raised using the device harvester, and an adhesive dressing was inserted into the harvester for transfer to the wound site. In patients with lower-extremity wounds, a 2-layer compression dressing was placed over epidermal grafts. Six of the 7 wounds improved or achieved complete closure in 4 weeks. One of the patients with a 2-year-old thigh wound failed to demonstrate improvement; this may have been secondary to an inability to adequately secure the graft. All donor sites healed without any visible scarring. The authors were able to conclude that epidermal grafting may represent a viable reconstructive option for patients in resource-poor countries.
authors: Thomas Serena, MD, is CEO of the Serena Group Inc in Cambridge, Massachusetts. Adler Francius, MD, is the In-Country Medical Director of the Wound Center at the Bernard Mevs Hospital in Port-au-Prince, Haiti. Cristin Taylor, PA-C, DPT, is a Physician Assistant at the Sinai Hospital of Baltimore in Maryland. John MacDonald, MD, is a member of the Department of Dermatology and Cutaneous Surgery at the Miller School of Medicine, University of Miami, Florida.
authors: Thomas
authors: T
authors: Serena
authors: Adler
authors: A
authors: Francius
authors: Cristin
authors: C
authors: Taylor
authors: John
authors: J
authors: MacDonald
mesh_terms: D000328:Adult; D000368:Aged; D003906:Developing Countries; D055866:Earthquakes; D004817:Epidermis / Q000637:transplantation; D005260:Female; D005431:Florida; D006205:Haiti; D006295:Health Resources / Q000191:economics*; D006801:Humans; D015601:Injury Severity Score; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000191:economics / Q000379:methods; D012189:Retrospective Studies; D012494:Sampling Studies; D016038:Skin Transplantation / Q000191:economics / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000191:economics* / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D055815:Young Adult