自身对照分析功能部位深度烧伤同种真皮复合刃厚皮移植疗效  

Self-Controlled Study on the Effect of Allogenic Derma Combined with Autologous Split-thick Skin Grafting on Deep Burn Wounds in Functional Sites

作　　者：黄涛 李先慧 张彦标 黄波 赵莉 Huang Tao;Li Xianhui;Zhang Yanbiao;Huang Bo(Department of Burn and Plastic,the General Hospital of Western Theater Command,Chengdu,Sichuan,610083,P.R.China)

机构地区：[1]西部战区总医院烧伤整形科,四川成都610083

出　　处：《西南军医》2019年第2期120-124,共5页Journal of Military Surgeon in Southwest China

摘　　要：目的探讨应用同种异体脱细胞真皮基质材料复合自体刃厚皮移植修复患者功能部位深度烧伤的效果。方法选取2014年6月至2017年12月西部战区总医院烧伤整形外科51例功能部位深度烧伤患者,共164个创面,全为深II度～III度烧伤创面。根据是否位于功能部位将其分为两组,实验组82个创面分别位于手背部、腕部、肘部、膝部及足踝部等功能部位,给予同种异体脱细胞真皮基质材料复合自体刃厚皮移植一期修复;对照组为同一患者功能部位附近大小近似的82个深度烧伤创面,给予同样厚度自体皮片移植修复。观察两组创面移植皮片的成活率及修复部位瘢痕增生情况。结果两组资料移植皮片存活率及二次手术率结果比较差异无显著性意义(P> 0.05)。实验组皮肤色泽、厚度、血管分布、柔软度各项评分(根据温哥华瘢痕评分量表)及瘢痕程度判定均显著低于对照组,有统计学意义(P<0.05)。结论功能部位深度烧伤创面,采用脱细胞同种异体真皮复合自体刃厚皮移植修复,能有效减轻功能部位瘢痕增生,有利于促进功能部位的功能恢复。Objective To investigate the effect of allogenic derma combined with autologous split-thick skin grafting on deep burn wounds in functional sites.Methods A total of 164 wounds in 54 cases with deep burns of grade Ⅱ to Ⅲ were selected and divided,based on the wound location(at the functional site or not),into 2 groups:experiment group and control group;the 82 wounds in experiment group were located in dorsal hand,wrist,elbow,knee,ankle and other functional areas and allogenic acellular dermal matrix(ADM)combined with autologous split-thick skin grafting was performed while 82 deep burn wounds of similar size near the functional site of the same cases were repaired by grafting autologous skin the same thickness;a comparative study between the 2 groups was made on the survival rate of skin flap and scar proliferation in the repaired areas.Results There existed no significant differences in survival rate of skin flap and the rate of second operation rate between the 2 groups(P >0.05);the scores of the items in Vancouver Scar Scale,including skin color,thickness and blood vessel distribution,in experiment group were all much lower than those in control group,the difference was of statistical significance(P <0.05).Conclusions ADM combined with autologous split-thick skin grafting for deep burn wounds in functional sites can effectively reduce the scar proliferation and promote the function recovery.

关 键 词：同种异体脱细胞真皮基质 自体刃厚皮 功能部位创面 深度烧伤 瘢痕 

分 类 号：R622.1[医药卫生—整形外科]