密集式缝合固定法应用于颌颈部植皮术临床效果观察  

Clinical effect of the concentrated suture fixation method on skin transplantation in the jaw and neck region

作　　者：张庆富[1] 周慧敏[1] 王车江[1] 冯建科[1] 邵洪波[1] 白永强[1] 许顺江[1] 崔冬生[1] 闫宝勇[1] 李增宁[1] 

机构地区：[1]河北医科大学第一医院烧伤整形外科,石家庄050031

出　　处：《中华烧伤杂志》2012年第4期244-247,共4页Chinese Journal of Burns

基　　金：河北省自然科学基金（302551）

摘　　要：目的观察密集式缝合固定法在颌颈部深度烧伤创面或烧伤后瘢痕畸形创面皮肤移植修复术中的临床应用效果。方法2002年4月-2011年12月，将笔者单位收治的114例颌颈部深度烧伤及烧伤后壤痕畸肜患者按照随机数字表法分为打包组和密集缝合组，每组57例（48例烧伤患荷、9例壤痕畸形患着）．均移植自体中厚断层皮片修复创面。打包组患荇按照打包法固定皮片，密集缝合组忠暂按密集式缝合固定法固定皮片。术后14d，观察移植皮片的微循环灌流地及皮下血肿、术区感染、皮肤坏死情况；术后6个月，观察创缘瘢痕增生、移植皮肤弹性及挛缩情况。对计量资料行“检验．计数资料行Fisher确切概率法检验或x!检验。结果（1）术后14d，密集缝合组、打包组皮片的做循环灌流艟分别为（2．86±0．18）、（2．33±0．15）V，组间比较差异有统计学意义（u=17．776，P〈0．05）（2）术后14t1，打包组4例、密集缝合组3例患者出现皮下血肿，组间比较差异无统计学意义（X2=0．152，P〉0．05）。（3）术后14d．打包组l例患者发生术区感染，密集缝合组无一例患行发生术区感染，组问比较差异无统计学意义（P〉0．05）。（4）术后14d，打包组6例患者移植皮肤出现片状坏死，密集缝合组无一例患者移植皮肤出现片状坏死，组间比较差异有统计学意义（P〈0．05）．（5）术后6个月，打包组21例、密集缝合组6例患者创缘呈现“蜈蚣腿”样瘢痕增生，组间比较差蚌有统计学意义（X2=10．920，P〈0．05）、（6）术后6个月，打包组17例、密集缝合组4例患者移植皮肤弹性惹．组闸比较差异有统计’学意义（X2=9．865，P〈0．05）。（7）术后6个月，扪’包纽15例、密集缝合组4例患者移植皮肤明硅挛缩，组间比较差异有统计学意义（X2=11．684，P〈0．05）、结论密集式缝合同定法适�Objective To obserw~ the clinical effect of＂ the concentrated suture fixation method on skin lransp]anlalion on deep burn wound or wound of eieatricial deformily after burn in the jaw and neck re- gime. Methods One hundred and fourleen patients, hospitalized from April 2002 to Deeember 2011, with deep burn or cieatrieiaI deformity after burn in lhe jaw and neck region, were divided into packaging group and coneenh＇ated suture group according to the random number table. Eaeh group had 57 patients ineluding 48 eases with deep burn and 9 eases with eieatricial deformity. Traditional suture-package fixation method and e.coentrated suture fixation method were respectively used in packaging group and concentrated suture group to fix lhe autologous medium split-thickness skin in transplantation on wounds or scars. On post operation day （POD） 14, the skin mierocireulatorv perfusion flow of skin graft was measured, and the nccurrence of ecchymoma, infectinn, and necrosis of skin in operative region were observed. The elasticity and contracture of grafted skin and sear hyperplasia on wound edge were observed 6 months after operation. Measure- ment data were processed with u test, while enumeration data with Fisher＇s exact test or Chi-square test. Results （ 1 ） On POD 14, ｜he skin microcir（＇ulatory perfusion flow in concentrated suture group [ （2.86 ±0.18） V] was significantly higher than that in packaging group [ （2.33 ±0. 15） V, u = 17. 776, P 〈 0. 05 ]. （2） Ecchymoma occurred in 4 patients of packaging group and 3 patients of concentrated suture group, but the difference between two groups was not statistically significant （X2 = 0. 152, P 〉 0.05）. （3） Infection in operative region was observed in 1 patient of packaging group, while no patient in concentrated suture group showed this symptom. The difference between two groups was not statistically significant （ P 〉 0.05）. （4） Grafted skin in 6 patients of packaging group showed foliated necrosis, which was not observ

关 键 词：烧伤 颌 颈 瘢痕 皮肤移植 固定法 

分 类 号：R644[医药卫生—外科学]