刃厚头皮皮片移植联合弹力套压迫治疗特重度烧伤患者手背部深度烧伤的临床观察  

Clinical Observation on the Treatment of the Deep Burn on the Back of the Hand of Patients with Extremely Severe Burn by Scalp Epidermal Skin Graft and Elastic Sleeve Compression

作　　者：袁家德[1] 姜杰 赵静[1] 边曦[1] 刘虎[1] 柯家祥[1] 朱志军[1] 李宁[1] YUAN Jiade;JIANG Jie;ZHAO Jing;BIAN Xi;LIU Hu;KE Jiaxiang;ZHU Zhijun;LI Ning(Department of Burn and Plastic Surgery,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China;Department of General Surgery,Jimo Second People's Hospital,Qingdao 266214,Shandong,China)

机构地区：[1]青岛市市立医院烧伤整形科,山东青岛266011 [2]青岛市即墨区第二人民医院普外科,山东青岛266214

出　　处：《中国美容医学》2023年第6期41-43,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨特重度烧伤患者在身体无法提供大片中厚皮片或全厚皮片时用刃厚头皮皮片移植联合弹力套压迫治疗手背部深度烧伤的疗效。方法:选择近8年笔者科室收治的6例特重度烧伤伴手背部深度烧伤的患者为研究对象,患者烧伤面积均大于80%,采用早期切削痂移植刃厚头皮并在植皮成活后尽早戴弹力套压迫术区或全手部,术后随访3~32个月,观察患者手部疗效。结果:6例患者中1例患者手部因削痂后基底血供较差导致植皮成活率较低,待创面肉芽组织生长再次植皮治疗后创面愈合,创面瘢痕增生较明显;其他5例患者手部均植皮成活良好,瘢痕增生不明显,远期随诊手功能无明显障碍。结论:对于身体无法提供大片中厚或全厚皮片的特重度烧伤患者,早期使用刃厚头皮皮片移植联合弹力套压迫治疗手背部深度烧伤,是简单有效的治疗方法,可以取得良好的远期效果。Objective To explore the efficacy of scalp epidermal skin graft combined with elastic sleeve compression in the treatment of deep burn on the back of hand in patients with extremely severe burn when the body cannot provide large medium or full thickness skin graft.Methods Six cases of extremely severe burns with deep burns on the back of the hands treated in the author's department in the past 8 years were selected as the study objects,and the burn area of the patients was more than 80%.Early scab cutting and thick scalp transplantation were adopted,and elastic sleeves were put on to compress the operative area or the whole hand as soon as possible after the skin graft was successful.The postoperative follow-up was 3-32 months to observe the curative efiect of the patients'hands.Results Among the 6 patients,1 patient had a low survival rate of skin grafting due to poor base blood supply after crusting.After the growth of wound granulation tissue and skin grafting,the wound healed and wound scar hyperplasia was obvious.The other 5 patients had good hand skin grafting survival,scar hyperplasia was not obvious,and there was no obvious dysfunction of hand function after long-term follow-up.Conclusion It is a simple and efiective method to treat the deep burn on the back of the hand with scalp epidermal skin graft combined with elastic sleeve compression in the early stage for the patients with extremely severe burns whose body cannot provide large or medium thickness skin graft.

关 键 词：刃厚头皮皮片 弹力套压迫 特重度烧伤 手背部深度烧伤 移植 

分 类 号：R622.1[医药卫生—整形外科]