保留脂肪组织削痂治疗Ⅲ度烧伤的临床探讨  

Treatment of tangential excision for third-degree burns with adipose tissue reserved

作　　者：蔡玉娥[1] 

机构地区：[1]商丘市第一人民医院烧伤整形科,476005

出　　处：《中华损伤与修复杂志（电子版）》2010年第4期33-35,共3页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的观察四肢Ⅲ度烧伤创面削痂保留健康脂肪组织植皮的临床疗效。方法 2000年1月至2008年1月商丘市第一人民医院收治四肢Ⅲ度烧伤患者162例,将其分成两组:A组削痂植皮92例;B组切痂植皮70例。观察两组创面愈合后外观(粗细与美观)及患者功能活动时的感觉,以及植皮成活率和创面愈合时间上的差异。结果 A组创面修复后与其对称的正常肢体比较,触之柔软,丰满有弹性,周径比较缩小3.8%,差异无统计学意义(P>0.05),功能活动时肢体充血时间短,麻木感轻。B组外观变化明显,周径比较缩小20.5%,差异具有统计学意义(P<0.05),功能活动时肢体充血时间长,麻肿感明显。两组植皮成活率和创面修复时间的比较差异无统计学意义(P>0.05)。结论四肢Ⅲ度烧伤创面削痂保留健康脂肪组织植皮能更好地维护肢体的外观,有助于功能活动的康复。Objective To observe the clinical effect of tangential excision and skin grafting for third-degree burns with adipose tissue reserved. Methods There were 162 cases of third-degree burn on extremities admitted in the hospital from January 2000 to January 2008, which were divided into two groups. Group A was 92 cases of tangential excision and skin grafting, and group B was 70 cases of skin grafting. Two groups were compared the appearance after wound healing （ e. g. thickness and goodliness）, the feeling of functional movement of patients＇ joints, the survival rate of grafted skin, and the time of wound healing. Results Group A ： compared to normal extremities of another side, healed wounds were soft, fleshy and e- lastic. The perimeter of extremity reduced by 3.8% which was not significantly different from normal side （P 〉 0.05 ）. Functional activities, congestive short limbs, and numb feeling reduced. Group B ： the appearance changed distinctly. The perimeter of extremity reduced by 20.5% which was significantly different from normal side （ P 〈 0.05 ）. The hyperaemia time was longer which was significantly different from normal side, and the numb and tumid feeling was intense. However, there were no significant differences between two groups about the survival rate of grafted skin and the time of wound healing （ P 〉 0.05 ）. Conclusion It can maintain the appearance of limb better and facilitate the rehabilitation of functional movements of joints to reserve the healthy adipose tissues before skin grafting in escharectomy on extremities for third-degree bums.

关 键 词：烧伤 皮肤移植 脂肪组织 创面修复 

分 类 号：R644[医药卫生—外科学]