柱状微粒皮移植联合异种脱细胞真皮基质在小面积Ⅲ度烧伤创面修复中的应用  

Application of columnar micro-skin transplantation combined with xenogeneic acellular dermal matrix dressing in the repair ofⅢ°burn granulation wounds

作　　者：王国栋[1] 慕生枝[1] 韩锋 范荣辉[1] 郭亚东[1] 李建武 郑博文 孙要文[1] WANG Guo-dong;MU Sheng-zhi;HAN Feng;FAN Rong-hui;GUYa-dong;LI Jian-wu;ZHENG Bo-wen;SUN Yao-wen(Department of Burn and Plastic Surgery,Shanxi Prorincial People's Hiospital,Xi'an 710061,China)

机构地区：[1]陕西省人民医院烧伤整形医学美容外科,陕西西安710061

出　　处：《中国美容整形外科杂志》2020年第12期731-734,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的观察柱状微粒皮移植联合异种脱细胞真皮基质敷料在小面积Ⅲ度烧伤肉芽创面修复中的治疗效果。方法选择2018年4月至2020年4月住院治疗的小面积Ⅲ度烧伤肉芽创面患者16例,创面面积2.3 cm×2.4 cm^5.2 cm×15.5 cm。每例患者创面按1∶1分为甲、乙两个治疗区,甲区采用单纯中厚皮移植,乙区给予柱状微粒皮移植联合真皮基质敷料覆盖,获得两组配对样本:A组(16例甲区治疗组)和B组(16例乙区治疗组)。术后给予打包包扎或适度加压包扎。观察两组创面愈合时间、上皮化情况、愈合后瘢痕增生情况及瘙痒程度。对数据进行配对t检验。结果两组创面愈合时间比较,其差异具有统计学意义;两组创面愈合早期均未见明显水疱甚至破溃糜烂等情况,但A组供皮区愈合后早期6例出现水疱,2例出现破溃糜烂,B组供皮区未出现上述情况;A组及B组创面愈合后3~6个月瘢痕增生不明显,轻度瘙痒,两组愈合创面温哥华瘢痕评定量表评分比较,其差异无统计学意义(P>0.05),但是A组供皮区愈合后瘢痕增生明显,中度瘙痒;B组供皮区创面愈合后瘢痕增生不明显,无瘙痒,温哥华瘢痕评定量表评分两组比较,其差异具有统计学意义(P<0.05)。结论柱状微粒皮移植联合脱细胞真皮基质敷料治疗小面积Ⅲ度烧伤创面方法安全有效,创面愈合质量高,供皮区瘢痕增生不明显,该方法值得推广。Objective To observe the therapeutic effect of columnar micro-skin transplantation combined with xenogeneic acellular dermal matrix dressing in the repair ofⅢ°burn granulation wounds.Methods From April 2018 to April 2020,16 patients withⅢ°burn granulation wounds were selected.The area of wounds ranged from 2.3 cm×2.4 cm to 5.2 cm×15.5 cm.Each patient’s wound surface was divided into two treatment areas according to the ratio of 1∶1.Areaαwas treated by simple medium thick skin transplantation,and areaβwas covered by columnar micro-skin transplantation combined with dermal matrix dressing.Two groups of matched samples were obtained:group A(16 cases of areaα)and group B(16 cases of areaβ).The packing and bandaging or moderate pressure bandaging were given after operation.The healing time,epithelization,scar hyperplasia and pruritus of both groups were observed.The data was analyzed by paired t-test.Results There was statistical difference in wound healing time between group A and B.No obvious blister,ulceration and erosion occurred in the early stage of wound healing in both groups.In group A,there were 6 cases of blister in the early stage of donor skin healing and 2 cases of ulceration and erosion.In group B,no above situations occurred in the donor skin.There were no obvious scar hyperplasia at 3 to 6 months after wound healing in both groups,and the pruritus was mild.There was no significant difference in Vancouver Scar Scale scores between two groups.There was significant scar hyperplasia after donor site healing and moderate pruritus in group A.There was no significant scar hyperplasia and pruritus after donor site healing in group B.The difference of Vancouver Scar Scale scores between two groups was statistically significant.Conclusion The columnar micro-skin transplantation combined with acellular dermal matrix dressing is simple and effective in the treatment ofⅢ°burn granulation wounds.The quality of wound healing is high and the scar hyperplasia in the donor area is not obvious.

关 键 词：Ⅲ度烧伤创面 柱状微粒皮 异种脱细胞真皮基质敷料 

分 类 号：R644[医药卫生—外科学]