自体皮片移植结合异体真皮在烧伤致功能部位瘢痕挛缩畸形中的应用  

Application of autologous skin graft combined with allogeneic dermis in scar contracture deformity at functional site caused by burn

作　　者：黄晓栋[1] 陈晓武[1] 万里[1] 黄静[1] HUANG Xiao-dong;CHEN Xiao-wu;WAN Li;HUANG Jing(Department of Burn Plastic Surgery,Dongguan People's Hospital,Dong-guan 523059,China)

机构地区：[1]东莞市人民医院烧伤整形外科,广东东莞523059

出　　处：《中国美容整形外科杂志》2020年第11期650-652,697,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 观察自体皮片移植结合异体真皮在功能部位烧伤后瘢痕挛缩畸形修复中的应用效果。方法 选择2018年1—9月收治的69例功能部位烧伤瘢痕挛缩畸形患者,其中对36例行瘢痕切除松解后薄中厚皮移植术(对照组);对33例行自体刃厚皮片移植结合异体真皮移植术(观察组);采用温哥华瘢痕量表(vancouver scar scale,VSS)评价术后3、6、10个月的临床效果,并记录供皮区创面和植皮区创面的愈合时间。结果 观察组术后3、6、10个月VSS评分分别为(3.90±0.49)分、(4.86±0.74)分、(5.27±0.83)分,低于术前的(13.96±2.39)分,且低于对照组的(5.27±0.72)分、(7.72±0.93)分、(8.85±1.19)分,其差异有统计学意义(P<0.05)。观察组和对照组优良率分别为54.55%(18/33)和30.56%(11/36),其差异有统计学意义(P<0.05)。观察组供皮区愈合时间短于对照组,供皮区VSS评分低于对照组,其差异有统计学意义(P<0.05)。两组植皮区愈合时间、感染率比较,其差异无统计学意义(P>0.05)。结论 自体皮片移植结合异体真皮修复功能部位烧伤后瘢痕挛缩畸形可显著改善局部功能,缩短供皮区愈合时间,减少供皮区瘢痕形成。Objective To observe the efficacy of autologous skin graft combined with allogeneic dermis in the repair of scar contracture deformity at functional site caused by burn. Methods Sixty-nine patients with scar contracture deformity at functional site caused by burn from January to September 2018 were selected. Thirty-six patients underwent autologous thin, medium-thickness and thick skin grafts transplantation after scars resection and release(control group);33 patients underwent autologous split-thickness skin grafts transplantation combined with allogeneic dermal transplantation(observation group). The clinical efficacy of 3, 6 and 10 months after operation was evaluated by Vancouver Scar Scale(VSS), the wounds of donor sites of skin grafts and the wound healing time of skin grafting area were recorded. Results The VSS scores of observation group at 3, 6 and 10 months after operation were(3.90±0.49),(4.86±0.74) and(5.27±0.83), which were lower than those before the operation of(13.96±2.39) and the control group of(5.27±0.72),(7.72±0.93) and(8.85±1.19).The difference was statistically significant(P<0.05). The excellent and good rate of the observation group was 54.55% and the control group was 30.56%, the difference was statistically significant(P<0.05). The healing time of donor sites of skin grafts of the observation group was shorter than that of the control group, the VSS scores were lower than those of the control group. The difference was statistically significant(P<0.05). There was no significant difference in healing time of skin grafting area and infection rate between the two groups(P>0.05).Conclusion Autologous skin graft combined with allogeneic dermis can significantly improve local function of scar contracture deformity at functional site after burn, shorten the healing time and reduce the formation of scar in donor sites of skin grafts.

关 键 词：自体皮片 异体真皮 烧伤 瘢痕挛缩畸形 

分 类 号：R644[医药卫生—外科学]