健康脂肪层移植MEEK皮片修复Ⅲ度烧伤创面的临床疗效  

Clinical effect after healthy fat layer transplanted by MEEK free skin grafting in third degree of burn-surface

作　　者：孟进松 林国安 李文军 肖荣 尚新志 

机构地区：[1]解放军159医院烧伤中心,河南驻马店463000

出　　处：《实用医药杂志》2017年第7期600-602,共3页Practical Journal of Medicine & Pharmacy

基　　金：原济南军区后勤科研计划项目(CJN14L005)

摘　　要：目的观察烧伤创面健康脂肪层移植MEEK皮片后,皮片成活及成活后皮肤弹性情况。方法 2011年12月—2016年10月,治疗组和对照组52例MEEK皮片移植患者,其中,25例58处Ⅲ度烧伤创面浅筋膜层移植MEEK皮片患者为治疗组,手术时,用滚轴刀削痂至健康脂肪层;另外27例63处Ⅲ度创面健康深筋膜层移植MEEK皮片患者为对照组,手术时,用滚轴刀或外科刀削切至深筋膜浅层。治疗组和对照组在术区止血、冲洗、手术人员、取皮厚度、植皮包扎相同的条件下,治疗组在健康脂肪层移植MEEK皮片,对照组在健康深筋膜浅层移植MEEK皮片,比较两组植皮成活率和后期效果。结果治疗组58处创面,除2处创面积血、1处创面感染外,其他55处创面的皮片成活率均在90%以上;对照组63处创面,除3处创面积血、2处创面感染外,其他58处创面皮片成活率也在90%以上,但治疗组皮片成活后组织丰满度和弹性均优于对照组。结论通过两组121处创面移植MEEK皮片对比,皮片成活率无明显差异,说明健康脂肪层不影响MEEK皮片成活,并且治疗组能最大程度保留皮下脂肪,皮片成活后组织较丰满,弹性相对较好,这方面优于深筋膜层移植MEEK皮片。Objective To observe free skin survival and afterwards skin elasticity after healthy fat layer transplanted by MEEK free skin grafting in burn-surface. Methods From Dec. 2011 to Oct. 2016 the 52 patients to be subject to MEEK free skin grafting were divided into treatment group（n=25 cases） and control one （n=27 cases）;the former received MEEK free skin in II[ degree burn-surface superficial fascia layer（during operation,using a roller cutter cut the deep fascia to healthy fat layer,totaled 58 sites）;the latter,in III degree burn-surface healthy deep fascia layer received MEEK free skin grafting（during operation,during a rolled cutter or lancet cut to superficial layer of deep fascia,totalled 63 sites）;then under same relevant condition,free skin survival rate and longer-term outcome in both groups were compared. Results In former except for 2 sites wound-surface hemotocele,and I site being infected,rest 55 sites were upto 90% more than survival rate; meanwhile in the latter,respectively 3 sites and 2 sites rest 58 up to more thorn 90%;but free skin＇s elasticity and plump the former was superior to the latter. Conclusion Two group＇s survival rate has no statistical difference which show that healthy fat layer does not affect MEEK free skin survival,and the former is able to maintain the maximum amount of subcutaneous fat,its dermatome is more plump,with better elasticity.

关 键 词：Ⅲ度烧伤创面 健康脂肪 健康深筋膜 MEEK植皮 

分 类 号：R644[医药卫生—外科学]