混合移植治疗大面积Ⅲ度烧伤的发展要素  

The Technical Developments and Important Factors of Intermingled Skin Transplantation in Treatment of Extensive Third Degree Burn.

作　　者：刘耀亮[1] 牛轶雯[1] 廖镇江[1] 徐惠贞[1] 朱德安 史济湘 

机构地区：[1]上海第二医科大学附属瑞金医院烧伤科,200025 [2]上海市烧伤研究所,200025

出　　处：《外科理论与实践》1999年第3期173-175,共3页Journal of Surgery Concepts & Practice

摘　　要：探讨混合移植治疗大面积Ⅲ度烧伤技术的发展要素。方法:1966年1995年底收住并经混合移植治疗的大面积Ⅲ度烧伤(Ⅲ度50％～99％,下称ETDB)184例,以1977年底前后分界分为两组。两组的烧伤面积(TBSA)、Ⅲ度、年龄的均值都具有可比性,比较两组的治愈率、首切痂日期、首切痂面积、总切痂面积、切痂次数、自体供皮总面积、头皮重复供皮次数、大张皮种类及创面闭合的伤后天数。结果:稳定渡过休克期后的早期切痂、扩大首切痂面积、扩大总切痂面积、多途径的扩大自体供皮总面积、灵活应用大张异体皮或异种猪皮覆盖切痂创面、缩短创面闭合天数等是该技术的发展要素,并与提高生存率有关。结论:坚持实施和发展混合移植在救治ETDB中仍具重要意义。结合应用异体(种)皮开孔嵌皮法及微粒植皮法等混合植皮封闭切痂创面,发挥各种方法的优势有望继续提高治愈率。The clinical study was designed to find technical developments and important factors in treatment of extensive third degree burn(Ⅲ degree burn 50-99% as next named ETDB) with the method of IST(staged escharectomy and intermingled skin transplantation). Methods: There were total 184 ETDB cases admitted and treated by IST during 1966 to 1995. These total 184 ETDB cases were divided into group A and group B by end of 1977. The 3 indices of mean TBSA, meanⅢ degree burn, mean age in two groups were all comparable. Then, the surviving rate, the postburn days for first escharectomy, the first escharectomy excised area(% BSA), times of repeated donated scalp skin, kinds of large sheet skin used after excharectomies, burn wound permanent covered postburn days were all investigated and compared. Results: The technical developments and important factors of IST should be as folio-wings: selected primary escharectomy early after shock stage, enlarged first escharetomy excised area, enlarged total escharectomies excised area, enlarged total autoskin donated area from multiple places, large sheets of alloskin and pigskin actively used to cover the exchar excised area, shortening the burn wound permanent covered postburn days. Conclusions: The developed technique of IST is still im-portant in treatment of ETDB. The correct performing IST is meaningfully related to increase the sur-viving rate of ETDB. If combining IST with microskin grafting technique after staged escharectomy, it will be hopeful to give full play of all their advantages and to progressively increase their surviving rate.

关 键 词：烧伤 Ⅲ度 混合移植 

分 类 号：R644.05[医药卫生—外科学] R622[医药卫生—临床医学]