A Study of Split Thickness Skin Graft Technique in Stable Acral Vitiligo

K, Sankara Rao; D, Subba Rao; Ramachandra, B; Srinivasulu, G; Lakshmi, N B

doi:10.14260/jemds/2016/372

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…We analyzed a total of 117 unique studies with 8776 unique patients (eTable 1 in the Supplement), including 19 studies with 1631 patients in the punch grafting group, 10 studies with 718 patients in the thin skin grafting group, 29 studies with 2652 patients in the suction blister grafting group, 45 studies with 2209 patients in the noncultured epidermal cell suspension (NCES) group, 9 studies with 185 patients in the noncultured follicular cell suspension (NCFS) group, and 17 studies with 1381 patients in the cultured epidermal cell suspension (CES) group; 11 studies included more than 1 procedure type. The median follow-up duration was 7 (range, 2-108) months.…”

Section: Resultsmentioning

confidence: 99%

“…In suction blister grafting, perigraft halo, variegated appearance, and color mismatch were frequently reported . Thin skin grafting was associated with graft contracture, overhanging margin, wrinkles over the graft surface, and perigraft halo . In cellular grafting techniques, pain, discomfort, and burning sensation were more commonly reported when compared with tissue grafting, which was likely owing to multiple injections of local anesthetic performed over a large area in the former.…”

Section: Resultsmentioning

confidence: 99%

“…10,24,[36][37][38]40,43,45,46,[48][49][50]54,55,57,60 Thin skin grafting was associated with graft contracture, over hanging margin, wrinkles over the graft surface, and perigraft halo. 15,20,[28][29][30][31][33][34][35] In cellular grafting techniques, pain, discomfort, and burning sensation were more commonly reported when compared with tissue grafting, 84,104 which was likely owing to multiple injections of local anesthetic performed over a large area in the former. Mottled pigmentation, marginal halo, and scarring were also reported in all the evaluated surgical interventions.…”

Section: Safety Of Each Surgical Interventionmentioning

confidence: 99%

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Surgical Interventions for Patients With Vitiligo

Bae

Lee

et al. 2021

JAMA Dermatol

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IMPORTANCE Surgical interventions are a key part of the therapeutic arsenal, especially in refractory and stable vitiligo. Comparison of treatment outcomes between the different surgical procedures and their respective adverse effects has not been adequately studied.OBJECTIVE To investigate the reported treatment response following different surgical modalities in patients with vitiligo.DATA SOURCES A comprehensive search of the MEDLINE, Embase, Web of Science, and Cochrane Library databases from the date of database inception to April 18, 2020, was conducted. The key search terms used were vitiligo, surgery, autologous, transplantation, punch, suction blister, and graft.STUDY SELECTION Of 1365 studies initially identified, the full texts of 358 articles were assessed for eligibility. A total of 117 studies were identified in which punch grafting (n = 19), thin skin grafting (n = 10), suction blister grafting (n = 29), noncultured epidermal cell suspension (n = 45), follicular cell suspension (n = 9), and cultured epidermal cell suspension (n = 17) were used.DATA EXTRACTION AND SYNTHESIS Three reviewers independently extracted data on study design, patients, intervention characteristics, and outcomes. Random effects meta-analyses using generic inverse-variance weighting were performed. MAIN OUTCOMES AND MEASURESThe primary outcomes were the rates of greater than 90%, 75%, and 50% repigmentation response. These rates were calculated by dividing the number of participants in an individual study who showed the corresponding repigmentation by the total number of participants who completed the study. The secondary outcomes were the factors associated with treatment response to the surgical intervention. RESULTS Among the 117 unique studies and 8776 unique patients included in the analysis, rate of repigmentation of greater than 90% for surgical interventions was 52.69% (95% CI, 46.87%-58.50%) and 45.76% (95% CI, 30.67%-60.85%) for punch grafting, 72.08% (95% CI, 54.26%-89.89%) for thin skin grafting, 61.68% (95% CI, 47.44%-75.92%) for suction blister grafting, 47.51% (95% CI, 37.00%-58.03%) for noncultured epidermal cell suspension, 36.24% (95% CI, 18.92%-53.57%) for noncultured follicular cell suspension, and 56.82% (95% CI, 48.93%-64.71%) for cultured epidermal cell suspension. The rate of repigmentation of greater than 50% after any surgical intervention was 81.01% (95% CI, 78.18%-83.84%). In meta-regression analyses, the treatment response was associated with patient age (estimated slope, −1.1418), subtype of vitiligo (estimated slope, 0.3047), and anatomical sites (estimated slope, −0.4050). CONCLUSIONS AND RELEVANCEThe findings of this systematic review and meta-analysis suggest that surgical intervention can be an effective option for refractory stable vitiligo. An appropriate procedure should be recommended based on patient age, site and size of the lesion, and costs.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Safety Of Each Surgical Interventionmentioning

confidence: 99%

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Surgical Interventions for Patients With Vitiligo

Bae

Lee

et al. 2021

JAMA Dermatol

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“…Some prominent advantages of this synthesis are the green process, shorter time of reaction, high yields, easy product isolation, and environmentfriendly catalyst, which is reusable without a considerable loss of activity. 31 Zirconium pyrophosphate nanoparticles are neutral, mild, and environmentally benign catalysts, and their remarkable performance in terms of the selectivity, reactivity, and high temperature stability have encouraged scientists to explore them for the synthesis of 1,4-dihydropyridines. 32,33 A three-component mixture of ethyl acetoacetate, aldehyde, NH 4 OAc, and ZrP 2 O 7 nanoparticles was reuxed in EtOH to afford 1,4dihydropyridines (Table 1; entry 8).…”

Section: Non-magnetic Metal Oxide/mixedmetal Oxide Nanoparticles Catamentioning

confidence: 99%