中厚皮供区创面愈合临床研究  

Clinical study on wound healing on split-thickness skin graft donor sites

作　　者：孙超锋[1] 李跃军[1] 李望舟[1] 吕晓星[1] 蒋立[1] 李靖[1] 冯剑[1] 陈绍宗[1] 李学拥[1] 

机构地区：[1]第四军医大学唐都医院整形烧伤科,陕西西安710038

出　　处：《兰州大学学报（医学版）》2016年第4期8-13,共6页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的观察中厚皮供区应用刃厚皮回植促进创面愈合减少瘢痕的作用。方法对2002—2010年收治的192例患者行背部或大腿外侧取中厚皮,将供皮区创面分为3组,治疗组（A组）即大张及邮票刃厚皮回植覆盖,对照组功能性敷料覆盖（B组）和凡士林纱布覆盖（C组）,刃厚皮供区又分为头部、大腿和后背3个部位。分别观察治疗组和对照组供皮区创面的愈合时间、局部疼痛、瘢痕生长情况。结果创面愈合的平均时间,A组为6.2±1.1 d,B组为11.1±2.1 d,C组为13.5±2.5 d;术后第2天和第5天疼痛评分,A组平均疼痛评分为2.3±0.86和1.9±0.8,B组为2.5±1.1和3.9±1.3,C组为3.8±1.4和5.9±2.1;术后6~12个月瘢痕评分,A组评分为2.8±1.5,B组为6.6±2.1,C组为8.2±3.6,3组比较差异有统计学意义（P〈0.01）。刃厚皮供区头部愈合时间、疼痛评分和瘢痕生长优于后背和大腿（P〈0.01）。结论刃厚皮回植能显著缩短中厚皮供区创面愈合时间,减轻患者治疗期间中厚皮供区疼痛,预防中厚皮供区瘢痕增生。Objective To observe the effect of ultra thin thickness skin regraft onto split-thickness skin graft（STSG） donor sites in healing wound and reducing scar formation. Methods 192 cases of patients who were harvested the STSG from the back or fermoribusinternus in our department from 2002 to 2010 were divided into 3 Groups, the treatment Group（Group A） were regrafted with the ultra thin thickness skin, the control Group（Group B） were covered with the occlusive hydrocellular dressing（ALLEVYN adhensive, Smith ＆Nephew） and（Group C） were covered with vaseline gauze. The skin donor site included the head, thigh and back. The wound healing time, local pain and the scar formation were observed respectively. Results The average wound healing time was 6.2 ± 1.1 days for Group A, 11.1 ± 2.1 days for Group B and 13.5 ± 2.5 days for Group C. The pain scores on day 2 and day 5 post operation assessed by the standard Baker Faceis were 2.3±0.86 and 1.9±0.8 for Group A, 2.5±1.1 and 3.9±1.3 for Group B and 3.8±1.4 and 5.9±2.1 for Group C. The scar scores assessed by Vancouver Scar Scale Assessment for the donor site following up 6~12 months post surgery were 2.8±1.5 for Group A, 6.6±2.1 for Group B and 8.2±3.6 for Group C. There were significant differences among these three Groups（P 〈 0.01）. The differences were found between donor site form head, thighand back（P 〈 0.01）. Conclusion Using thin thickness skin regraft onto STSG donor sites can significantly shorten the healing time of the STSG donor site, reduce the pain and prevent hyperplastic scar.

关 键 词：中厚皮供区 回植 创面愈合 

分 类 号：R622.1[医药卫生—整形外科]