自体刃厚皮片移植结合异体真皮移植术治疗功能部位烧伤瘢痕挛缩畸形的效果  

Effect of Autologous Blade Thickness Skin Graft Combined with Allogeneic Dermal Graft in the Treatment of Functional Site Burn Scar Contracture Deformity

作　　者：廖晓南 任书信 刘晨阳 LIAO Xiaonan;REN Shuxin;LIU Chenyang(Department of Plastic Surgery,Nanyang Second People’s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第二人民医院整形外科,河南南阳473000

出　　处：《河南医学研究》2021年第27期5101-5104,共4页Henan Medical Research

摘　　要：目的评估自体刃厚皮片移植结合异体真皮移植术治疗功能部位烧伤瘢痕挛缩畸形的效果。方法选取2019年1月至2020年6月南阳市第二人民医院收治的86例功能部位烧伤瘢痕挛缩畸形患者,按照随机数表法分成研究组与对照组,每组43例。对照组接受瘢痕切除松解后薄中厚皮移植术治疗,研究组接受自体刃厚皮片移植结合异体真皮移植术治疗。统计对比两组手术前后温哥华瘢痕量表(VSS)评分、弹性参数[无负压时皮肤回弹量(Ua)与有负压时最大拉伸量(Uf)之比(R2)、皮肤测试时第1次循环过程中皮肤恢复时弹性部分(Ur)与负压时弹性部分(Ue)之比(R5)]、血清转化生长因子-β(TGF-β)、表皮生长因子(EGF)水平。结果两组时间、组间、交互作用下VSS评分对比,差异有统计学意义,且术后3、6个月研究组VSS评分低于对照组(P<0.05)。两组时间、组间、交互作用下R2、R5对比,差异有统计学意义,且术后3、6个月研究组R2、R5高于对照组(P<0.05)。术后1个月,研究组血清EGF、TGF-β水平高于对照组(P<0.05)。结论自体刃厚皮片移植结合异体真皮移植术治疗功能部位烧伤瘢痕挛缩畸形,可改善瘢痕,优化皮肤弹性,提高血清TGF-β、EGF水平。Objective To evaluate the effect of autologous blade thickness skin graft combined with allogeneic dermal graft in the treatment of functional site burn scar contracture deformity.Methods A total of 86 patients with functional site burn scar contracture deformity admitted to Nanyang Second People’s Hospital from January 2019 to June 2020 were selected and divided into study group and control group according to the random number table method,with 43 cases in each group.Control group received thin-medium-thickness skin graft after scar excision and loosening,and study group received autologous blade thickness skin graft combined with allogeneic dermal graft.The Vancouver scar scale(VSS)scores,elastic parameters[the ratio of the skin rebound(Ua)without negative pressure to the maximum stretch(Uf)with negative pressure(R2),the ratio of the first measurement of the elastic part(Ur)during skin recovery to the elastic part(Ue)with negative pressure(R5)],serum transforming growth factor-β(TGF-β),epidermal growth factor(EGF)levels before and after surgery were calculated and compared.Results There were statistical differences in the VSS scores under time,between groups and interactions between the two groups,and the VSS scores of study group were lower than those of control group at 3 and 6 months after surgery(P<0.05).There were differences in the R2 and R5 under time,between groups and interactions between the two groups,and the R2 and R5 of study group were higher than those of control group at 3 and 6 months after surgery(P<0.05).The serum EGF and TGF-βlevels of study group were higher than those of control group at 1 month after surgery(P<0.05).Conclusion Autologous blade thickness skin graft combined with allogeneic dermal graft can improve scars,optimize skin elasticity and increase the serum TGF-βand EGF levels.

关 键 词：功能部位 烧伤瘢痕挛缩畸形 自体刃厚皮片移植 异体真皮移植 

分 类 号：R622.1[医药卫生—整形外科]