Lando双层人工真皮修复材料与自体皮片联合修复深度电烧伤的效果研究  

Clinical effects of Lando? double-layer artificial dermis repair material combined with autologous skin patch in repairing deep electric burn

作　　者：苑莎莎 范炜[1] 焦建强[1] 梁清国 李烨[1] 王香坤 YUAN Shasha;FAN Wei;JIAO Jianqiang(Department of Burns,The Fifth Hospital of Baoding City,Hebei,Baoding 071030,China)

机构地区：[1]河北省保定市第五医院烧伤科,071030

出　　处：《河北医药》2022年第23期3578-3581,共4页Hebei Medical Journal

摘　　要：目的 探讨Lando双层人工真皮修复材料与自体皮片联合修复深度电烧伤的效果。方法 以2016年6月至2019年3月保定市第五医院烧伤整形科收治的24例深度电烧伤患者为研究对象,创面深度深Ⅱ度~Ⅲ度,创面面积0.5%~4.5%。患者随机分为联合修复组和对照组,对照组患者实施传统皮片移植治疗。联合修复组患者实施Lando~?双层人工真皮材料修复,约2周后再次实施自体刃厚皮片修复,同时给予八珍汤加黄芪治疗。常规换药、抗感染治疗,观察皮片成活情况,随访2年,观察瘢痕及关节功能情况,检测2组术后创面生长细胞因子。结果 2组皮片存活良好,均未出现感染。关节处活动度较好。供皮区伤口均愈合良好,无瘢痕。对照组供皮区域出现4处较明显瘢痕。2组皮片坏死面积、皮片边缘糜烂、结痂的发生率、植皮后创面愈合时间等差异均无统计学意义(P>0.05),瘢痕评分差异有统计学意义(P<0.05)。2组术后创面中生长细胞因子血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)逐渐升高,术后第3天、7天组间差异均无统计学意义(P>0.05);术后14 d联合组VEGF、TGF-β1升高均较自体组明显,差异均有统计学意义(P<0.05)。患者治疗后各炎性因子指标均逐渐降低,分别对组间第3天、第7天、第14天IFN-γ、TNF-α、IL-1、IL-12指标进行比较,差异均无统计学意义(P>0.05)。结论 Lando~?双层人工真皮修复材料与自体刃厚皮片联合用于修复深度电烧伤的治疗效果好,值得临床推广。Objective To investigate the clinical effects of Lando double-layer artificial dermis repair material combined with autologous skin patch in repairing deep electric burn.Methods A total of 24 patients with deep electric burn who were treated in our hospital from June 2016 to March 2019 were enrolled in the study, whose wound depth was Ⅱ~Ⅲ degree and the wound area was 0.5%~4.5%. These patients were randomly divided into combined repair group and control group. The patients in control group received traditional skin graft treatment, however, those in combined repair group were treated by Lando double-layer artificial dermal material repair, after 2-week treatment, who were repaired with an autogenous blade thick skin patch, moreover, who were treated by Bazhen decoction combined with Astragalus, with routine dressing change and anti-infective treatment.The patients in both groups were followed up for two years.The scar status and joint function, and the levels of postoperative wound growth cytokines were observed and compared between the two groups.Results The skins in both groups survived well, and no infection occurred, and the joints had better mobility. The wounds in the donor area healed well without scars. There were 4 obvious scars in the skin donor area in control group. There were no significant differences in the area of skin necrosis, the incidence of skin edge erosion, scab, and wound healing time after skin grafting between the two groups(P>0.05),but, there were significant differences in the scar scores between the two groups(P<0.05). The levels of growth cytokines VEGF and TGF-β1 in both groups were increased gradually, but, there were no significant differences in the levels on the 3rd and 7th day after surgery between the two groups(P>0.05).However the levels of VEGF and TGF-β1 at 14d after surgery in combined group increased were significantly higher than those in control group(P<0.05).Conclusion The combination of Lando double-layer artificial dermis repair material combined with autologou

关 键 词：电烧伤 外科皮瓣 移植 Lando双层人工真皮 深度烧伤 

分 类 号：R644[医药卫生—外科学]