大张中厚头部皮片在儿童功能部位创面修复中的应用  

Application of large piece of mid -thick head skin for repair of wound in childrens′functional location

作　　者：刘军[1] 刘建云[1] 李亚文[1] 王辉[1] 

机构地区：[1]甘肃省人民医院烧伤科,甘肃省兰州730000

出　　处：《中国基层医药》2016年第18期2760-2763,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：甘肃省卫生行业科研计划项目（GSWSKY-2015-07）

摘　　要：目的：探讨应用大张中厚头部皮片在儿童功能部位创面修复中的临床效果。方法研究组选择功能部位烧伤及瘢痕挛缩患儿24例，应用电动取皮机切取大张中厚头皮（皮片厚度≥0．25 mm），将大张中厚头直接或打孔后移植于功能部位创面缝合包扎或打包固定，皮肤移植后1周进行抗瘢痕治疗及功能锻炼；对照组选择中厚皮，供皮部位位于大腿、背部，全厚皮位于腹部。两组于术后3个月根据温哥华瘢痕评分量表对术区瘢痕组织进行评估分析。结果研究组功能部位烧伤及瘢痕挛缩畸形创面一期修复，通过早期抗瘢痕治疗，功能与外形修复效果满意，随访期间发现修复部位仍有不同程度瘢痕增生，但功能活动未受到明显影响；头部供皮区无明显瘢痕增生，未发现秃发畸形。与对照组术后3个月比较：术区色泽（t ＝0.48，P ＞0．05）、术区血管分布（t ＝0．47，P ＞0．05）、瘢痕厚度（t ＝0．07，P ＞0．05）及柔软度（t ＝0．42，P ＞0.05）4个指标差异均无统计学意义。结论儿童大张中厚头皮移植适用于儿童功能部位及瘢痕挛缩畸形的修复治疗，结合早期抗瘢痕治疗和功能锻炼，功能与外形均可达到临床满意效果，而且可为后期进一步进行功能与外形的修复提供更多皮源及手术方式的选择。Objective To investigate the clinical effect of large piece of mid -thick head skin applicated in repairing of wound in childrens′functional location.Methods 24 children with functional parts burn and scar con-tracture were selected.Using electric machine,the large piece of mid -thick head skin（thickness ≥0.25mm）was taken,then transplanted it to functional location directly or punching,and dressed or suture package fixed it,1 week after the skin transplanting,anti -scarring therapy and functional exercise were carried out.Control group：selected the thighs,back,abdomen as donor sites;The scar of operation area of the two groups were evaluated and analyed after 3 months by the Vancouver Scar Scale Rating.Results In the study group,the functional parts burn and scar con-tracture deformity was primary wound repairing,by the early anti -scarring therapy,the function and appearance was satisfied with repairing,during follow -up,there were varying degrees of repair site scar,but functional activity was not significantly affected;There were no scar hyperplasia of the head blood supply area,no bald hair deformity,compared with the control group after 3 months：surgical color （t =0.48,P 〉0.05）,surgical vascular distribution （t =0.47, P 〉0.05）,scar thickness （t =0.07,P 〉0.05）and softness （t =0.42,P 〉0.05）,four indicators had no significant statistical difference.Conclusion The large piece of mid -thick head skin transplanting applied in children functional parts and scar contracture deformity restorative treatment,combined with early anti -scarring therapy and functional exercise,function and appearance can achieve satisfactory clinical results,but also for further post -repair function and appearance of the skin to provide more options source and surgical methods.

关 键 词：儿童 大张中厚头皮 功能部位 创面修复 

分 类 号：R726.5[医药卫生—儿科]