对腹股沟区全厚皮片修复儿童皮肤缺损的疗效观察  

Efficacy of full-thickness inguinal skin graft to repair skin defects in children

作　　者：麻艺群 刘巍敏 张梦思[1] 朱辉[1] 范鑫 付晋凤[1] Ma Yiqun;Liu Weunin;Zhang Mengsi;Zhu Hui;Fan Xin;Fu Jinfeng(Department of Burns and Plastic Surgery,Yunnan Children's Medical Center,Children's Hospital Affiliated to Kunming Medical University,Kunming 650031,China;Department of Dermatological,Affiliated Hospital of Yunnan University,the Second People's Hospital of Yunnan Province,Kunming 650021,China)

机构地区：[1]昆明医科大学附属儿童医院,云南省儿童医学中心烧伤整形外科,昆明650031 [2]云南大学附属医院,云南省第二人民医院皮肤科,昆明650021

出　　处：《中华损伤与修复杂志（电子版）》2023年第3期235-240,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的比较腹股沟区全厚皮片、大腿中厚皮片修复儿童皮肤缺损的术后效果,探讨儿童皮肤缺损修复的更优化供区选择。方法选择2019年8月至2021年1月昆明医科大学附属儿童医院收治的皮肤缺损需行游离皮片植皮术患儿50例作为研究对象,其中腹股沟区全厚皮片供皮(腹股沟组)26例,大腿中厚皮片供皮(对照组)24例。观察对比两组供区愈合时间、疼痛、瘙痒及瘢痕情况,受区皮片色素沉着、柔软度、挛缩度、皮片边缘瘢痕情况。数据比较采用独立样本t检验、χ^(2)检验、秩和检验。结果两组患者性别、年龄、致伤原因、植皮面积差异无统计学意义,具有可比性(P>0.05)。腹股沟区全厚皮片及大腿中厚皮片术后均存活良好,成活率差异无统计学意义(84.0%±6.9%vs 88.0%±7.7%,P>0.05);腹股沟组供区愈合时间[(7.80±1.67)d]明显短于对照组[(11.67±1.95)d],差异有统计学意义(P<0.001);腹股沟组供区术后疼痛、瘙痒评分[(0.73±0.53)、(0.62±0.57)分]明显低于对照组[(1.42±0.65)、(1.78±0.46)分],差异有统计学意义(P<0.001);术后6个月随访,腹股沟组供区瘢痕评分[(0.57±0.58)分]明显低于对照组[(1.58±0.50)分],差异有统计学意义(P<0.001)。腹股沟组受区色素沉着、皮片柔软度、挛缩度[(1.04±0.54)、(0.39±0.50)、(0.36±0.49)分]优于对照组[(1.48±0.66)、(0.70±0.56)、(0.71±0.55)分],差异有统计学意义(P<0.05);腹股沟组受区皮片边缘瘢痕与对照组比较差异无统计学意义[(1.04±0.72)分vs(1.00±0.60)分,P>0.05]。结论对于儿童皮肤缺损修复,腹股沟区全厚皮片能有效缩短供区术后愈合时间,减少术后不良反应,供区及受区均有较好的美观效果,安全有效。Objective To compare the postoperative effects of full-thickness inguinal skin graft and medium-thickness thigh skin graft in children,and to explore more optimal donor site selection for repairing skin defects in children.Methods From August 2019 to January 2021,50 children with skin defects who needed free skin grafting were selected as the research objects.Among them,26 cases received inguinal skin donors(inguinal group)and 24 cases received thigh medium thickness skin donors(control group).The healing time,pain,itching and scar of the donor area,pigmentation,softness,contracture and marginal scar of the recipient area were observed and compared between the two groups.Data were compared by t-test,chi-square test and rank sum test.Results There were no significant differences in gender,age,cause of injury and skin graft area between the two groups(P>0.05).The survival rate of full-thickness inguinal skin grafts and medium-thickness thigh skin grafts had no significant differences(84.0%±6.9%vs 88.0%±7.7%,P>0.05).The healing time of donor site[(7.80±1.67)d]in inguinal group was significantly shorter than that of the control group[(11.67±1.95)d],and the difference was statistically significant(P<0.001).The pain and pruritus score of the donor site in inguinal group after operation(0.73±0.53,0.62±0.57)were significantly lower than those of the control group(1.42±0.65,1.78±0.46),and the difference was statistically significant(P<0.001).The scar score of donor site(0.57±0.58)in inguinal group was significantly lower than that of the control group(1.58±0.50),and the difference was statistically significant(P<0.001).The pigmentation,skin softness and contracture of the recipient area(1.04±0.54,0.39±0.50,0.36±0.49)in inguinal group were better than those of the control group(1.48±0.66,0.70±0.56,0.71±0.55),and the differences were statistically significant(P<0.05).There was no significant difference in marginal scar between the two groups(1.04±0.72 vs 1.00±0.60,P>0.05).Conclusion For the repair of skin

关 键 词：腹股沟 全厚皮片 中厚皮片 皮肤移植 儿童 

分 类 号：R622[医药卫生—整形外科]