人工真皮联合瘢痕断层皮片修复治疗在烧伤后四肢大关节部位瘢痕增生挛缩畸形患者中的应用  

Application of artificial dermis combined with scar split thickness skin graft repair in the treatment of patients with scar hyperplasia and contracture deformity of extremities major joints after burns

作　　者：靳雪义 张宏 张岿 JIN Xue-yi;ZHANG Hong;ZHANG Kui(Department of Burns and Plastic Surgery,Zhoukou Burn Hospital,Zhoukou Port Hospital,Henan Province,466000,China)

机构地区：[1]周口港区医院周口烧伤医院烧伤整形科,河南周口466000

出　　处：《中国医疗美容》2020年第12期49-53,共5页China Medical Cosmetology

摘　　要：目的探讨人工真皮联合瘢痕断层皮片修复治疗在烧伤后四肢大关节部位瘢痕增生挛缩畸形患者中应用的临床效果。方法回顾性分析2018.01-2019.01期间我院收治的83例烧伤后四肢大关节部位瘢痕增生挛缩畸形患者临床资料,按照治疗方式不同将其分为治疗组(n=42,采用人工真皮联合瘢痕断层皮片修复治疗)和对照组(n=41,采用单纯应用瘢痕断层皮片移植修复治疗)。对比评估2组患者创面愈合时间、创面血运恢复时间及Ⅰ级创面愈合率。比较手术前及手术后6个月时2组瘢痕修复情况[温哥华瘢痕量表(VSS)]、肢体运动功能情况[运动功能评定量表(Fugl-Meyer,FMA)]、生活活动能力[日常生活活动能力量表(ADL)]变化。结果治疗组创面愈合时间、创面血运恢复时间均明显短于对照组(P均<0.05);手术后6个月时治疗组Ⅰ级创面愈合率明显高于对照组(P<0.05);2组VSS评分均较术前下降(P<0.05),且治疗组VSS评分明显低于同期对照组(P<0.05);2组FMA评分、ADL评分均较术前升高(P<0.05),且治疗组FMA评分、ADL评分明显高于同期对照组(P<0.05)。结论人工真皮联合瘢痕断层皮片修复治疗烧伤后四肢大关节部位瘢痕增生挛缩畸形效果良好,可促进创面愈合及血运恢复,改善患者四肢运动功能,值得临床推广。Objective To investigate the clinical effects of artificial dermis combined with scar split thickness skin graft repair in the treatment of patients with scar hyperplasia and contracture deformity of extremities major joints after burns.Methods The clinical data of patients with scar hyperplasia and contracture deformity of extremities major joints after burns who were treated in our hospital from January 2018 to January 2019 were retrospectively analyzed,and the patients were divided into treatment group(n=42,artificial dermis combined with scar split thickness skin graft repair)and control group(n=41,only scar split thickness skin graft repair)according to different treatment methods.The wound healing time,wound blood supply recovery time and grade I wound healing rate were compared and evaluated in the two groups.The scar repair status[Vancouver Scar Scale(VSS)],limb motor function[Fugl-Meyer Motor Function Assessment(FMA)],life activity ability[Activity of Daily Living(ADL)]were compared between the two groups before surgery and at 6 months after surgery.Results The wound healing time and wound blood supply recovery time in treatment group were significantly shorter than those in control group(P<0.05).At 6 months after surgery,the grade I wound healing rate in treatment group was significantly higher than that in control group(P<0.05).The VSS scores in the two groups were decreased compared with that before surgery(P<0.05),and the VSS score in treatment group was significantly lower than that in control group during the same period(P<0.05).The scores of FMA and ADL in the two groups were increased compared with those before surgery(P<0.05),and the FMA score and ADL score in treatment group were significantly higher than those in control group during the same period(P<0.05).Conclusion Artificial dermis combined with scar split thickness skin graft repair has a good effect in the treatment of scar hyperplasia and contracture deformity of extremities major joints after burns,and it can promote wound healing and

关 键 词：人工真皮 瘢痕断层皮片修复 烧伤 瘢痕增生挛缩畸形 

分 类 号：R644[医药卫生—外科学]