异种（猪）脱细胞真皮基质在瘢痕整形中的应用  

Clinical application of xenogenic（porcine） acelluar dermal atrix（ADM） in scar treatment

作　　者：冯祥生[1] 陈晓东[1] 谭家驹[1] 潘银根[2] 吴秋合[3] 阮树斌[1] 沈锐[1] 张凤刚[1] 林泽鹏[1] 王晓萍[1] 曾映红[1] 林颜[1] 

机构地区：[1]广东省佛山市第一人民医院烧伤整形科,528000 [2]江苏省启东市人民医院烧伤科 [3]济南市中心医院烧伤科

出　　处：《中华整形外科杂志》2007年第5期391-393,共3页Chinese Journal of Plastic Surgery

基　　金：国家重点基础研究发展规划项目（G1999054205.2-17）;佛山市重点科技攻关项目（0308022）

摘　　要：目的 探讨异种（猪）脱细胞真皮基质在切除瘢痕后做为真皮替代物的临床作用。方法 采用DR脱细胞猪皮和大张自体刃厚皮复合移植（一步法和二步法）覆盖切除瘢痕后的创面。结果 对47例瘢痕患者中的22例进行异种（猪）脱细胞真皮基质移植7d左右，再植大张自体刃厚皮的二步法复合移植，其中在脂肪层上复合移植成活率（88．3±3．7）％，在深筋膜层上复合移植成活率为（89．7±3．4）％。25例采用异种（猪）脱细胞真皮基质＋自体刃厚皮同时复合移植的一步法，在脂肪层上复合移植成活率（92．5±4．1）％，在深筋膜层上复合移植成活率为（93．2±5．2）％。复合移植成活后，创面颜色淡红，表面平坦光滑，柔韧性好。最长随访时间90d，复合区皮肤近似正常，皮肤结实、光滑、平整，可捏起，仅见移植边缘有少许轻微瘢痕增生，功能好。结论 一步法复合移植比二步法成活率高，且脂肪层上的复合移植皮比深筋膜上的复合移植皮肤弹性较好，也更柔软、丰满，两者在功能上则无区别。异种（猪）脱细胞真皮基质是覆盖瘢痕切除后创面的较理想的真皮替代物。Objective To investigate the role of xenogenic （porcine） ADM as dermal substitute in scar treatment. Methods After scar excision, the wounds were covered with composite grafts of DR procine ADM and autologous thin split-thickness grafts in one stage or in two stages. Results 22 out of 47 cases were treated in two-staged procedure. After the ADMs were applied to the wound, the autologous thin split-thickness grafts were implanted 7 days later. 25 cases were treated in one-staged procedure. The survival rates of composite grafts were （88.3 ± 3.7） % for subcutaneous recipient bed and （89.7 ± 3.4） % for deep fascia recipient bed in group with two-staged procedure, compared with （92.5± 4.1 ） % and （93.2 ± 5.2） %, respectively, in group with one-staged procedure. Early ,after grafts taken, the grafts had a pink colour and smooth surface. The patients were followed up for 90 days at most. The survived composite grafts were durable, elastic, smooth and soft with good function and appearance like normal skin. They could even be pinched up. The scar along the edge of the grafts was slightly hypertrophic. Conclusions The survival rate of composite graft is higher in patients with one- staged procedure. The elasticity and textural of the taken grafts are better on subcutaneous recipient bed than on deep fascia recipient bed, though the function has no difference. Xenogenic（porcine） ADM can be an optimal dermal substitute for wound coverage after scar excision.

关 键 词：瘢痕 复合移植 异种(猪)脱细胞真皮基质 

分 类 号：R686[医药卫生—骨科学]