异体真皮替代材料联合自体刃厚皮移植在烧伤瘢痕整复中的应用效果  

Application Effect of Allogeneic Dermal Substitute Material Combined with Autologous Thick-thickness Skin Graft in Burn Scar Rehabilitation

作　　者：陈凯[1] 许喜生[1] 王永飞[1] 张玉玲[1] CHEN Kai;XU Xi-sheng;WANG Yong-fei;ZHANG Yu-ling(Department of Burn Plastic,Chenzhou First People's Hospital,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院烧伤整形科,湖南郴州423000

出　　处：《中国美容医学》2020年第9期77-80,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究异体真皮替代材料联合自体刃厚皮移植在烧伤瘢痕修复中的疗效,以及术后并发症和恢复效果。方法:选取笔者医院2011年1月-2018年1月入院的80例大面积深度烧伤后瘢痕整形患者,按照入院顺序分为观察组和对照组。观察组40例,采用异体真皮替代材料联合自体刃厚皮移植;对照组40例,采用后躯干浅表性瘢痕中厚皮移植。比较两组术后的创面愈合率及创面周围炎症反应积分、皮肤创面愈合时间及血运恢复时间、瘢痕情况以及术后不良反应情况。结果:治疗后,观察组皮肤创面愈合时间及血运恢复时间均明显少于对照组,差异有统计学意义(P<0.05)。观察组创面愈合率及创面周围炎症反应积分明显大于对照组,差异有统计学意义(P<0.05)。两组患者治疗后3个月,瘢痕柔软度、血管、色素、高度评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组患者术后不良反应总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:异体真皮替代材料联合自体刃厚皮移植相对于后躯干瘢痕皮移植术而言,恢复时间更短,修复效果更好且术后不良反应更少。Objective To explore the effect of allogeneic dermal substitute material combined with autologous thick-thickness skin graft on scar repair of burn patients,as well as postoperative complications and recovery effects.Methods 80 scar repair of burn patients admitted to our hospital between January 2011 and January 2018 were selected and divided into observation group and control group according to admission order.40 cases in the observation group were treated with allogeneic dermal substitute material combined with autologous thick-thickness skin graft,while 40 cases in the control group were treated with thick skin graft removed from superficial scar on trunk surface.The wound healing rate,the score of inflammation response around the wound,treatment cost,skin wound healing time,blood supply recovery time and postoperative adverse reactions were compared between the two groups.Results After treatment,the skin wound healing time and blood circulation recovery time in the observation group were significantly less than those in the control group,the differences were statistically significant(P<0.05).The wound healing rate and the scores of inflammatory reaction around the wound in the observation group were significantly higher than those in the control group(P<0.05).After 3 months of treatment,the scar softness,blood vessel,pigment and height score of the two groups were all decreased,and the observation group was lower than the control group(P<0.05).The total incidence of postoperative adverse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Compared with the split-thickness skin graft with superficial scar removed from trunk surface,the allogeneic dermal substitute material combined with autologous thick-thickness skin graft has shorter recovery time,better repair effect and fewer postoperative adverse reactions.

关 键 词：复合皮移植术 异体真皮替代材料 烧伤 瘢痕修复 血运恢复时间 炎症反应积分 

分 类 号：R644[医药卫生—外科学]