自体头皮移植修复中厚皮片供皮区的效果观察  

Clinical study on effect of auto-scalp grafting on repairing donor site of intermediate split thickness skin

作　　者：王常印[1] 崔正军[1] 杨高远 杨荣强[1] 郭鹏飞[1] 高娅[1] 孟庆楠[1] 邹仕波[1] 

机构地区：[1]郑州大学第一附属医院烧伤与修复重建外科,河南郑州450052

出　　处：《兰州大学学报（医学版）》2016年第4期14-18,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：河南省科技厅重大攻关项目(122101310200)

摘　　要：目的探讨自体头皮移植修复烧伤患者中厚皮片供皮区的临床效果。方法选择2009年5月—2014年5月收治的烧伤患者60例,按随机机械抽样法分为对照组、头皮组,每组各30例。两组患者烧伤创面经清创后,自大腿前外侧以电动取皮机切取厚0.3 mm中厚皮片修复烧伤创面。对照组供皮区创面应用单层凡士林油纱贴敷并适度加压包扎;头皮组用电动取皮机自头皮切取厚0.12~0.15 mm、大小10 cm×5 cm^20 cm×5 cm条状刃厚皮片,移植于中厚皮片供皮区。观察两组患者供皮区愈合时间,并应用温哥华瘢痕量表评分、瘙痒评分和瘢痕增生率评价瘢痕供皮区瘢痕增生情况。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)。头皮组术后第7天移植头皮全部成活,中厚皮片供皮区愈合时间(7 d)显著短于对照组(平均21 d)(P<0.01)。术后1年随访,头皮组供皮区瘢痕量表评分、瘙痒评分和瘢痕增生率分别为1.4±0.6分、1.3±0.3分和15.6%±7.1%,显著低于对照组的6.4±1.2分、2.1±0.6分和54.8%±13.2%(均P<0.01)。结论采用自体头皮移植修复烧伤患者中厚皮片供皮区可明显缩短创面愈合时间,且可减轻瘢痕增生程度。Objective To study the clinical effet of auto-scalp skin graft on treating donor site of intermediate split thickness skin graft in burnt patients. Methods 60 burned patients treated from May 2009 to May 2014 were divided into control group and scalp group according to random mechanical sampling method, 30 each group. After debriding the surface of the burned wound site in both groups, 0.3 mm intermediate split thickness skin graft was cut from the anterolateral thigh by using electrical dermatome to cover the wound. The donor site of intermediate split thickness skin graft in the control group was directly applied single-layer vaseline oil gauze and simply bandaged with compression dressings. Scalp skin graft in the scalp group is cut into strips（size 10 cm×5 cm^20 cm×5 cm, thickness 0.12~0.15 mm） with electrical dermatome to be grafted onto the donor site of intermediate split thickness skin. Compared the healing time of patients’ donor site in two groups and evaluated scar hyperplasia of donor site with the application of Vancouver scar rating scale,pruritus score and scar proliferation rate. Results No significant difference was found in the gender and ageobetween the two groups（P 〉 0.05）. All scalp skin graft survived 7 days after surgery, and healing time（7 d）of donor site of intermediate split thickness skin graft is notably shorter than that（average 21 d） in control group（P 〈 0.01）. In the 1 year follow-up, scar rating scale, pruritus score and scar proliferation rate in scalp group are 1.4±0.6, 1.3±0.3 and 15.6%±7.1% respectively, which are significantly lower than those in control group 6.4±1.2, 2.1±0.6 and 54.8 %±13.2 %（all P 〈 0.01）. Conclusion Auto-scalp grafting in repair of donor site of intermediate split thickness skin may greatly shorten the healing timeand ameliorate the scar hypertrophy.

关 键 词：自体头皮 回植 中厚皮片 供皮区 瘢痕 

分 类 号：R644[医药卫生—外科学]