生物敷料Ⅱ型作为肉芽创面小皮片移植后覆盖物的临床效果观察  

Clinical effect of Bio-dressing Type as covering material after graft of granulation wound

作　　者：赵刚宏 李勇 张莉[2] 刘继松 卓丹 余勇 章祥洲 Zhao Ganghong;Li Yong;Zhang Li;Liu Jisong;Zhuo Dan;Yu Yong;Zhang Xiangzhou(Department of Burn and Plastic Surgery,Affiliated Bengbu Third People’s Hospital,Bongbu,Anhui 233000,China;Plastic Surgery,First Affiliated Hospital,Bengbu Medical College,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院附属蚌埠市第三人民医院烧伤整形科,安徽蚌埠233000 [2]蚌埠医学院第一附属医院整形外科,安徽蚌埠233000

出　　处：《感染．炎症．修复》2018年第2期103-106,129,共5页Infection Inflammation Repair

基　　金：安徽省蚌埠市科技创新指导类项目(20170326)

摘　　要：目的:探讨生物敷料Ⅱ型(脱细胞猪皮)作为肉芽创面小皮片移植后覆盖物的临床效果。方法:22例肉芽创面植皮患者,肉芽创面总面积为5%～8%TBSA,随机分为观察组和对照组。肉芽创面在小皮片移植后应用生物敷料Ⅱ型覆盖为观察组,以凡士林纱布覆盖为对照组,两组各11例。以视觉模拟评分(VAS评分)作为疼痛评分,比较两组术后第5天换药前和换药后30 min疼痛评分、平均换药次数、平均愈合时间;两组创面愈后予以相同的瘢痕康复治疗及功能锻炼,创面愈合后3个月采用温哥华瘢痕评分量表(VSS)评价瘢痕增生情况。结果:术后第5天首次换药,换药前30 min VAS评分:观察组(2.63±0.67)分,对照组(3.54±1.21)分;换药后30 min VAS评分:观察组(3.09±1.13)分,对照组(7.63±0.92)分;观察组换药前、后VAS评分均明显低于对照组(P<0.05);观察组换药次数(5.27±1.19)次,对照组为(10.27±2.79)次,观察组换药次数明显少于对照组(P<0.05);观察组愈合时间为(13.09±3.20)d,对照组为(19.27±2.32)d,观察组创面愈合时间明显缩短(P<0.05);创面愈合后3个月瘢痕VSS评分,观察组:色泽(1.90±0.70)分,血管分布(1.63±0.67)分,厚度(2.36±0.80)分,柔软度(2.72±0.78)分,对照组分别为(3.18±0.87)、(2.36±0.67)、(3.27±0.64)、(4.00±0.89)分,观察组明显优于对照组(P<0.05)。结论:与传统的凡士林纱布相比,生物敷料Ⅱ型作为肉芽创面小皮片移植后覆盖物可以减轻患者植皮术后的换药疼痛、减少换药次数、加快创面的愈合、减轻瘢痕增生,效果良好。To explore the clinical effect of Bio-dressing TypeⅡ(acellular pig skin)as a covering for granulation wound skin graft.Methods:Twenty-two patients with 5%to 8%of total granulation area were involved in the study.They all received granulation wound skin grafting and were randomly and equally divided into two groups.In 11 patients of observation group,their granulation wounds were covered by Bio-dressing TypeⅡafter small skin grafting,but in 11 of the control group,vaseline gauze was used instead of Bio-dressing TypeⅡ.Visual analogue scale(VAS score)was used to assess the pain.The VAS score 30 minutes before and after dressing on the fifth day after operation,average dressing-change time,average healing days were compared.Patients in the two groups received the same scar rehabilitation and functional exercise after recovery.Scar hyperplasia was assessed by Vancouver scar scale(VSS)score,and VSS score was compared between the two groups 3 months after wound healing.Results:The first dressing change was performed on the fifth day after operation,and the VAS scores 30 minutes before dressing change was 2.63±0.67 in the observation group but 3.54±1.21 in the control group;the VAS scores 30 minutes after dressing change was 3.09±1.13 in the observation group but 7.63±0.92 in the control group,with a statistically significant difference between the two groups(both P<0.05).The times of dressing change were(5.27±1.19)times in the observation group and(10.27±2.79)times in the control group,the difference was statistically significant(P<0.05).The healing time was(13.09±3.20)days in the observation group and(19.27±2.32)days in the control group,there was statistically significant difference between the two groups(P<0.05).The VSS score in the observation group 3 months after wound healing was significantly higher than that in the control group(P<0.05).In the observation group,the color score was 1.90±0.70,blood vessel distribution 1.63±0.67,the thickness 2.36±0.80,and the softness was 2.72±0.78,while they wer

关 键 词：脱细胞猪皮 肉芽创面 疼痛 瘢痕增生 

分 类 号：R622[医药卫生—整形外科]