人工真皮在重度烧伤患者关节瘢痕挛缩松解术后创面修复中的应用效果分析  

Application of Artificial Dermis in Repairing Wounds after Joint Scar Contracture Excision in Severely Burned Patients

作　　者：桑晨 王栋[1] 丁金艳 李小龙[1] 王政刚 毛宇峰 SANG Chen;WANG Dong;DING Jinyan;LI Xiaolong;WANG Zhenggang;MAO Yufeng(Department of Burns and Plastic Surgery,Zhucheng People’s Hospital Affiliated with Weifang Medical University,Weifang,Shandong 262200,China)

机构地区：[1]潍坊医学院附属诸城市人民医院烧伤整形科,山东潍坊262200

出　　处：《中国烧伤创疡杂志》2022年第6期430-433,440,共5页The Chinese Journal of Burns Wounds & Surface Ulcers

基　　金：潍坊市卫生健康委员会科研项目(WFWSJK-2020-057)。

摘　　要：目的分析探讨人工真皮在重度烧伤患者关节瘢痕挛缩松解术后创面修复中的应用效果。方法选取2018年3月至2020年9月潍坊医学院附属诸城市人民医院收治的34例重度烧伤创面愈后关节瘢痕挛缩患者作为研究对象,根据不同治疗方法将其分为研究组(16例)和对照组(18例),研究组患者于瘢痕松解术后采用人工真皮、负压封闭引流、湿润烧伤膏及自体刃厚皮片移植治疗,对照组患者于瘢痕松解术后采用中厚皮片移植、负压封闭引流及湿润烧伤膏治疗,对比观察两组患者瘢痕松解术后创面愈合时间以及瘢痕评分变化情况。结果研究组患者瘢痕松解术后创面愈合时间为(15.06±1.84)d,明显短于对照组患者的瘢痕松解术后创面愈合时间(20.61±5.05)d(t=4.152,P<0.001);瘢痕松解术后3、6、12个月,研究组患者温哥华瘢痕量表(VSS)评分均明显低于对照组(t=3.136、2.258、2.389,P=0.004、0.031、0.023)。结论人工真皮可有效促进重度烧伤患者关节瘢痕挛缩松解术后创面愈合,缩短创面愈合时间,改善瘢痕增生情况,值得临床推广应用。Objective To analyze the effect of applying artificial dermis in repairing the wounds after joint scar contracture excision in severely burned patients.Methods 34 patients with joint scar contracture following the healing of severe burns,admitted into Zhucheng People’s Hospital Affiliated with Weifang Medical University between March 2018 and September 2020,were enrolled and then divided into study group(n=16)and control group(n=18)based on different treatments they received.Patients in study group were treated with artificial dermis,vacuum sealing drainage,Moist Exposed Burn Ointment(MEBO)and autologous split-thickness skin grafting after scar contracture excision,while patients in control group,after scar contracture excision,were treated with medium-thickness skin grafting,vacuum sealing drainage and MEBO.The wound healing time after scar contracture excision and changes of scar scores were compared between the two groups.Results The wound healing time after the scar excision was(15.06±1.84)d in study group,being obviously shorter than(20.61±5.05)d in control group(t=4.152,P<0.001).On month 3,6 and 12 after the excision,the Vancouver scar scale(VSS)scores were all significantly lower in study group compared with control group(t=3.136,2.258 and 2.389,P=0.004,0.031 and 0.023).Conclusion Artificial dermis can effectively promote the wound healing of joint scar contracture excision in severely burned patients,shorten the wound healing time,and ameliorate the scar hyperplasia condition,deserving to be promoted in clinical practice.

关 键 词：烧伤 瘢痕挛缩 关节挛缩 人工真皮 移植 创面修复 

分 类 号：R644[医药卫生—外科学]