烧伤创面愈合的理论探索与临床实践  

Basic and clinical research in the field of burn wound healing

作　　者：陆树良[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院烧伤科,200025

出　　处：《中华烧伤杂志》2008年第5期359-361,共3页Chinese Journal of Burns

基　　金：国家重点基础研究发展规划（G199905420、2005CB22603）;国家自然科学基金（30471784、30570705、30600645、30700871）

摘　　要：促进烧伤创面愈合是烧伤治疗的基本任务，而建立正确的创面治疗方法则依赖于对创面愈合机制的深入了解。50年来，我国烧伤医务工作者在创面愈合的临床实践和理论探索上作出了积极努力。The basic and clinical research in wound healing have made great progress in China in the past 50 years. The method of ＂ intermingle skin transplantation＂ which was first advocated by surgeons of Ruijin Hospital in 1966 greatly reduced the amount of autologous donor skin, thus making the coverage of an extensive burn wound possible. This method is also known as ＂ Chinese therapy＂. In 1986, doctors of Jishuitan Hospital reported successful coverage of an extensive burn wound with microautografts and allogeneic skin. The basic research of wound healing has been carried out since 1992, a series of studies showed the characteristics of biological behaviours of ceils in concern, extracellular matrix and growth factor, the mechanism underlying progressive injury in deep second burn wound, the effect of ＂ skin island＂ and the local immune tolerance induced by it （which are the key factors of intermingle transplantation）. The induction of local immune tolerance has now become the research hot subject of skin transplantation immunology. Stem cell research in the field of wound healing has been extensively carried out. The theory of ＂ dermal template defection＂ has been proposed as one of the mechanisms of scar formation. On the other hand, great progress has been achieved in the treatment of burns on the basis of clinical researches. Doctors of PLA 304 hospital found that excision of eschar on patients with extensive deep burn injury at early shock stage greatly decreased the occurrence of complications and mortality. Doctors of Ruijin Hospital reported that healing of deep second burn wound could be improved by tangential excision of burn eschar within 24 hours after burn injury. Doctors of Xiangya Hospital reported patients suffering from deep burns of the hands got satisfied functional restoration when treated with tangential excision of eschar while degraded dermal tissue could be retained with transplantation of autoskin grafts.

关 键 词：烧伤 伤口愈合 皮肤移植 

分 类 号：R644[医药卫生—外科学] R4[医药卫生—临床医学]