脱细胞真皮加自体刃厚皮移植用于特大面积烧伤后期瘢痕畸形整复15例临床观察  

The clinical observation of 15 cases of scar deformities in the later stage of burn was treated with the removal of epidermal dermis and autologous edge skin grafting

作　　者：朱正坤 周宪章 陈胜 张国栋 陈娟 ZHU Zheng-kun;ZHOU Xian-zhang;CHEN Sheng;ZHANG Guo-dong;CHEN Juan(Bone wound burn rehabilitation department, Guangdong work injury rehabilitation hospital,Guangdong Province, 510440, China)

机构地区：[1]广东省工伤康复医院骨创烧伤康复科,广东广州510440

出　　处：《中国医疗美容》2018年第2期32-35,共4页China Medical Cosmetology

基　　金：广东省工伤康复中心(医院)院内科研项目课题;项目编号:2015C008_B;广东省医学科学技术研究基金项目;项目编号:A2015259

摘　　要：目的探讨脱细胞真皮加自体刃厚皮移植应用于特大面积烧伤后期皮源奇缺,瘢痕增生挛缩畸形的治疗效果。方法选择2014年10月-2017年6月,由广东省工伤康复医院收治特大面积烧伤后期皮源奇缺伴瘢痕增生挛缩畸形病人共15例,其中男性12例,女性3例;年龄27~73岁,平均43.3岁。15例中,位于膝关节7例,位于肘关节8例,合并残余创面9例。入院后先行关节松动等康复治疗,达平台期后行瘢痕切除挛缩松解后,异体脱细胞真皮加自体刃厚皮移植修复创面。术后继续行关节松动等康复治疗,以达到最大的功能。结果 15例特大面积烧伤后期瘢痕挛缩畸形行异体脱细胞真皮加自体刃厚皮移植修复创面全部成活,创面皮片色泽良好,质地柔软,耐磨,无挛缩,功能障碍明显改善。供皮区愈合外观佳,可反复取皮,创面无复发。结论同种异体脱细胞真皮加自体刃厚皮移植用于特大面积烧伤后期瘢痕挛缩畸形的整复既可使植皮区皮片挛缩小,功能相对较好,又能修复创面,还能达到节约皮源,减少取皮区疤痕的目的。Objective To investigate the therapeutic effect of acellular dermis combined with autografted thick-skinned skin grafts in the treatment of severe skin scarring and hypertrophic scar contracture in large area burn patients.Methods Choose from October2014to June2017,15cases of hypertrophic scar contracture accompanied by hypertrophic scar contracture were treated in Guangdong Provincial Work Injury Rehabilitation Hospital,including12males and3females,aged27-73years old,An average of43.3years old.In15cases,7cases were located in the knee joint,8cases were located in the elbow joint,and9cases were associated with residual wounds.After admission,first joint rehabilitation and other rehabilitation,up to the platform after the scar contracture release,allogeneic acellular dermal plus autologous blade thick skin graft repair wound.After surgery to continue joint rehabilitation and other loose,in order to achieve the maximum function.Results Fifteen cases of hypertrophic scar contracture in the late stage of burn injury were treated with allogeneic acellular dermal and autograft.All the wounds were repaired.The wounds had good color,soft texture,abrasion resistance,no contracture and significant improvement of dysfunction.Good skin for the healing of the skin area can be repeated to take the skin,no recurrence of the wound.Conclusions Allogeneic acellular dermal plus autologous blade thick skin graft for hypertrophic scar burn contracture deformity can make the skin graft skin flap contracture is small,relatively good function,but also to repair the wound,but also to save the skin source,To reduce the purpose of taking the skin scars.

关 键 词：脱细胞真皮 刃厚皮 特大面积烧伤 瘢痕 移植 

分 类 号：R622[医药卫生—整形外科]