复合皮片移植治疗烧伤后功能部位瘢痕20例  

Compound flap transplantation in the treatment of 20 patients with scar of functional position after burns

作　　者：杨建德[1] 韦元强[1] 莫海龙[1] 罗三彤[1] 

机构地区：[1]柳州医学高等专科学校第一附属医院,广西壮族自治区柳州市545002

出　　处：《中国组织工程研究与临床康复》2007年第8期1544-1545,共2页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的：观察复合皮片移植对烧伤后功能部位瘢痕的修复效果。方法：选择2002-05/2005-12在柳州医学高等专科学校第一附属医院烧伤整形科住院的复合皮片移植治疗烧伤功能部位瘢痕患者20例,患者均知情同意。所有病例均在全麻下行功能部位瘢痕切除,将脱细胞异体真皮（广西北生药业北京桀亚莱福生物技术有限公司生产,物理性能柔软、有弹性、弯曲不易断裂、乳白色、呈网状、分光洁面与粗糙面）移植于创面上,异体真皮粗糙面紧贴创面,光洁面朝上,缝合创周。取自体薄皮片（取自头皮、躯干或四肢）移植于异体真皮上,皮片间隙尽量小,以减少异体真皮外露。术后2周换药,术后定时随访。观察术后2周-1年复合皮的移植成活率、挛缩率、平整光滑度、皮肤弹性、关节部位功能恢复情况及供皮区愈合情况。结果：20例患者复合皮移植后随访时间1个月-1年,1-3个月4例,4-6个月3例,7个月-1年13例。31个部位复合皮移植一期成活30个部位,另1个部位创面因自体皮片间隙过大异体真皮外露影响皮片成活,植皮成活率达93.00%。植皮区外观平整,较光滑,弹性尚可,挛缩轻,关节功能活动良好。供皮区愈合良好。结论：复合皮片移植成活率高,能明显改善烧伤功能部位瘢痕所致功能障碍及外观畸形。AIM： To observe the restorative effect of compound flap transplantation on the scar of functional position after bums. METHODS： Twenty inpatients with scar of functional position after bums treated by compound flap transplantation were selected from the Department of Bums and Plastic Surgery, First Hospital Affiliated to Liuzhou Medical College between May 2002 and December 2005, and all patients knew and agreed with the items. All patients were removed of the scar of, functional position under to transplant the acellular allogenic dermis （it was manufactured by Beijing Dieyalaifu Biotechnological Co., Ltd of Guangxi Beisheng Pharmaceutical Group, and it was characteristics of soft, flexible with better tenacity. Besides, it was milk white in net with two kinds of surfaces： smooth surfaces and rough surfaces）. Acallular allogenic dermis of rough surface closely adhered to the wound with smooth surface up toward, and the wound was sutured. Autologous skin grafts （obtained from scalp, trunk or extremities） were transplanted into acallular allogenic dermis, and the flap gaps shall be kept as small as possible, so as to reduce the exposure of acallular allogenic dermis. Wounds were dressed at 2 weeks postoperation, and the follow-up was conducted regularly. The survival rate, contraction rate, the smooth and glossy degree, skin elasticity, joint function, and healing of donors were observed from 2 weeks to one year after the surgery. RESULTS： Twenty patients were followed after compound flap transplantation with the time ranged from one month to one year, including 4 patients within 1-3 months, 3 patients within 3-6 months, and 13 patients within 6 months to one year. Thirty functional positions out of 31 healed in the first period. While the flap in another position was influenced by exposed acallular allogenic dermis due to over large gaps among autoallergic flaps. The survival rate of transplanted flap was 93.00%, and the flaps transplanted were smooth in appearance with proper elasticity and l

关 键 词：皮肤移植 真皮/移植 瘢痕/治疗 

分 类 号：R622.1[医药卫生—整形外科]