小柱皮散布式种植治疗肉芽创面临床观察  

Clinical observation on tiny skin adipose tissue columns in treating granulation wound

作　　者：彭敏 常东方[1] 姚智华 孔超 李朝芬 唐治琴 唐津渝 PENG Min;CHANG Dongfang;YAO Zhihua;KONG Chao;LI Chaofen;TANG Zhiqin;TANG Jinyu(Department of Burns and Plastic Surgery,Affiliated Yongchuan Hospital of Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院烧伤整形外科,402160

出　　处：《重庆医学》2022年第22期3840-3846,共7页Chongqing medicine

基　　金：重庆市2021年科卫联合医学科研项目(2021MSXM270)。

摘　　要：目的观察小柱皮以等距散布方式种植修复肉芽创面的临床效果。方法110例肉芽创面患者分为2组,各55例。观察组采用小柱皮散布式种植术,小柱皮为直径2 mm高3 mm的柱形皮肤皮下脂肪组织,间距5 mm种植在同直径柱形坑内;对照组采用邮票皮移植术,皮片大小5 mm×5 mm,间距5 mm平铺移植。比较分析2组术后供皮区疼痛程度、植皮成活率、皮下积血积液率、移植物不全成活率、创面愈合时间,术后1年供皮区、植皮区瘢痕评分。结果观察组供皮创面术后疼痛评分低于对照组(P=0.004);观察组植皮成活率高于对照组(P=0.005);观察组移植物不全成活率低于对照组(P<0.001);观察组术后皮下积血积液率低于对照组(P<0.001);观察组创面平均愈合时间短于对照组(P<0.001);术后1年观察组植皮区、供皮区瘢痕评分低于对照组(P<0.001)。结论小柱皮散布式种植术修复肉芽创面具有极高的移植成活率和稳定的愈合质量,供皮区损伤小,利用率高,易操作,易推广。Objective To observe the clinical effect of granulation wound repair by tiny skin adipose tissue columns with equidistant scattering manner.Methods A total of 110 cases of granulation wounds were randomly divided into 2 groups(55 cases in each group).The observation group adopted the tiny skin adipose tissue columns scattering grafting method.tiny skin adipose tissue columns were column-shaped cutaneous and subcutaneous adipose tissue,2 mm in diameter and 3 mm in length,and which were implanted into the same diameter column-shaped hole in granulation wounds with spacing of 5 mm.Whereas the control group adopted the stamp-shaped skin grafting method,and the graft size was 5 mm×5 mm and transplanting with spncing of 5 mm.The pain level in postoperative donor site,survival rates of the grafts,subcutaneous blood and effusion survival rate of tiny skin adipose tissue columns grafts accumulation rate,wound healing time,scar score of donor site and skin graft site 1 year after operation were analyzed and compared between two groups.Results The postoperative pain scores of donor sites in the observation group were lower than that in the control group(P=0.004);the survival rate of tiny skin adipose tissue columns grafts in the observation group was higher than that in the control group(P=0.005);the non-survival rate of each graft in the observation group was lower than that in the control group(P<0.001);the postoperative subcutaneous blood and effusion accumulation rate in the observation group was lower than that in the control group(P<0.001);the average wound healing time in the observation group was shorter than that in the control group(P<0.001);the scar score of the grafting sites and the donor sites 1 year after operation in the observation group were lower than that in the control group(P<0.001).Conclusion The tiny skin adipose tissue columns scattering grafting method in repairing granulation wounds has the extremely high transplant survival rate and stable healing quality,with less donor sites injuries,and highe

关 键 词：肉芽创面 小柱皮 皮下脂肪 等距 柱形坑 种植 

分 类 号：R644[医药卫生—外科学]