自体头皮移植修复瘢痕皮肤中厚供皮区创面的效果观察  

Clinical study of repairing donor site of thickness from cicatricial skin with auto-scalp grafting

作　　者：申传安[1] 柴家科[1] 张琳[1] 李东杰[1] 庹晓晔[1] 蔡建华[1] 王淑君[1] 朱华[1] 蔡金东[1] 

机构地区：[1]解放军总医院第一附属医院烧伤整形科,北京100048

出　　处：《中华医学杂志》2013年第12期921-923,共3页National Medical Journal of China

基　　金：全军“十二五”医学科研项目（CWS11J097）;首都临床特色应用研究（Z12110700102092）

摘　　要：目的观察自体头皮移植修复瘢痕皮肤中厚供皮区创面的临床效果。方法对2011年1至12月解放军总医院第一附属医院烧伤整形科收治的13例以瘢痕皮肤为中厚供皮区的大面积烧伤后整形患者（植皮组）的临床资料进行回顾性分析，瘢痕供皮区创面均采用自体中厚头皮皮片移植，并使用负压治疗技术固定皮片，手术后第7天拆除敷料，观察植皮组皮片成活率；术后12个月随访时应用温哥华瘢痕量表评分、瘙痒评分和瘢痕增生率（凸起瘢痕面积／瘢痕供皮区面积×100％）评价瘢痕供皮区瘢痕增生情况。并与2010年1至12月采用油纱覆盖瘢痕皮肤为中厚瘢痕供皮区的13例大面积烧伤后整形患者（对照组）的临床资料进行对比分析。结果两组患者性别和年龄的差异无统计学意义，具有可比性（P〉0．05）。植皮组术后第7天移植头皮全部成活，瘢痕供皮区创面愈合时间（7d）显著少于对照组（平均20d）（P〈0．01）。术后12个月，植皮组瘢痕供皮区瘢痕量表评分、瘙痒评分和瘢痕增生率分别为（1．5±0．5）、（1．24-0．4）分和14．6％±7．6％，均显著低于对照组的（6．7±1．1）、（2．0±0．7）分和55．8％±12．2％（均P〈0．01）。结论头皮移植修复瘢痕皮肤中厚供皮区创面具有较好的临床效果。Objective To study the effects of using auto-scalp for repairing donor site of thickness from cicatricial skin with auto-scalp grafting. Methods A total of 13 cases with donor site of thickness from cicatricial skin from January 2011 to December 2011 were analyzed. Wounds of donor site from cicatricial skin were grafted with auto-scalp and scalp were fixation was applied with negative pressure. The survival rate of auto-scalp graft was observed at Day 7 post-operation. At Month 12, hyperplastic scars at these donor sites of cicatricial skin were assessed through Vancouver Scar Assessment Table, scar itch assessment and scar proliferation rate. Wounds in the other thirteen cases with donor site of thickness from cicatricial skin from January 2010 to December 2010 were covered with vaseline gauze as control. Results No significant difference existed in the gender and age of the two groups patients （ P 〉 0. 05 ）. The auto-scalp graft all survived. And the average healing time of donor-site wound in cicatricial skin in grafting group （7 days） was significantly decreased than that of control group （ a mean of 20 days） （ P 〈 0. 01 ）. After followed up for twelve months, the scar formation assessment value （ 1.5 ± 0. 5 ）, scar itch assessment （ 1.2 ± 0. 4 ） and scar proliferation rate （ 14. 6% ± 7. 6% ） in grafting group were significantly less than those of control group （6.7±1.1, 2.0 ±0.7, 55.8% ±12.2%, all P〈0.01）. Conclusion Auto-scalp grafting may greatly shorten the healing procedure and ameliorate the quality of donor-site of thickness from cicatricial skin.

关 键 词：皮肤移植 瘢痕 烧伤 外科 整形 

分 类 号：R644[医药卫生—外科学]