脱细胞真皮联合自体刃厚皮移植治疗烧伤后瘢痕(附36例报告)  

Repair of postburn scar deformities by composite grafting of acellular dermal matrix with racor thin autoskin

作　　者：王静[1] 孙曙光[1] 王良喜[1] 吴静[1] 毛学飞[1] 

机构地区：[1]解放军第97医院,江苏徐州221004

出　　处：《山东医药》2006年第17期25-26,共2页Shandong Medical Journal

摘　　要：目的探讨脱细胞真皮联合自体刃厚皮移植治疗烧伤后瘢痕的可行性及效果。方法对36例烧伤后瘢痕患者在严格无菌条件操作下将瘢痕切除(保留深筋膜上2~3 mm脂肪组织)后,植入脱细胞真皮和自体刃厚皮,创面用成纤维细胞生长因子(EGF)和抗生素外敷加压包扎,制动肢体。结果修复面积为6 cm×8 cm^28cm×30 cm,脱细胞真皮与自体刃厚皮贴覆成活>98%;6例随访6个月~2 a,无排斥反应,皮肤弹性、外观良好,触之柔软,关节部位功能良好;多次供皮区无瘢痕,仅有轻度色素沉着。结论脱细胞真皮是一种修复瘢痕切除后创面的理想组织工程化材料,其与自体刃厚皮移植联合治疗烧伤后瘢痕增生近期效果良好,尤其对自体皮源有限者可起到自体全厚皮的作用。[Objective] To investigate the effect of composite grafting of allogeneic acellular dermal matrix （ADM） With razor thin autoskin in repair of postburn scar deformities. [Methods] Thirty-six patients with hypertrophic scar which affected the function or the appearance were enrolled. The scar was excised completely but the subcutaneous fatty tissue of two to three centimeters thick was reserved, and epidermal growth factor （EGF） was applied on the wound, followed by one-stage composite grafting of allogeneic ADM with razor thin autoskin. The maximal repair area was 28 cm × 30 cm, and the minimal repair area was 6 cm × 8 cm. [Results] The survival rate of the composite skin grafts was more than 98%. During the follow-up of six cases for six months to two years, all the composite skin grafts were soft and had good elasticity, and the functions and appearances were good. No rejection was found. The donor, Site provided razor graft repeatedly and healed with no scar formation. [Conclusions] The composite skin graft of allogeneic ADM with razor thin autoskin is an ideal material and can replace full thickness autoskin graft in repair of postburn scar deformities, which is more useful for the patients with limited donor site.

关 键 词：脱细胞真皮 自体刃厚皮 瘢痕 脂肪 

分 类 号：R622.1[医药卫生—整形外科]