人工真皮与自体皮复合移植联合物理抗菌敷料治疗深度烧伤创面的临床研究  

Clinical Study of Composite Transplantation of Artificial Dermis and Autologous Skin Combined with Physical Antibacterial Dressing in the Treatment of Deep Burn Wounds

作　　者：李永超 袁志明 刘婷 齐丹 LI Yongchao;YUAN Zhiming;LIU Ting;QI Dan(Department of General Surgery 3,Hengshui People's Hospital,Hengshui 053000,Hebei,China;Sterilization and Supply Room,Hengshui People's Hospital,Hengshui 053000,Hebei,China)

机构地区：[1]衡水市人民医院普外三科,河北衡水053000 [2]衡水市人民医院消毒供应室,河北衡水053000

出　　处：《中国美容医学》2025年第2期44-48,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究人工真皮与自体皮复合移植联合物理抗菌敷料治疗深度烧伤创面对患处瘢痕状态、感染率及肢体功能的影响。方法:选取2019年10月-2021年10月笔者医院收治的200例Ⅲ、Ⅳ度烧伤创面患者,按随机数字表法分为对照组和实验组,各100例。两组均行人工真皮+自体刃厚皮片移植治疗,对照组围术期创面给予常规消毒换药治疗,实验组在对照组基础上给予物理抗菌敷料喷涂治疗。比较两组患者术后恢复情况(创面愈合率、人工真皮成活率、细菌清除率、创面愈合时间)、术前及术后7 d时疼痛程度[视觉模拟量表(VAS)评分法]、术后1个月及3个月时瘢痕状态[温哥华瘢痕量表(Vancouver scar scale,VSS)]、术后3个月及6个月时肢体功能(Fugl-Meyer功能量表)。结果:治疗后,实验组创面愈合率、人工真皮成活率及细菌清除率高于对照组,创面愈合时间短于对照组(P<0.05);术后3、7 d,实验组疼痛评分低于对照组(P<0.05);术后3个月,实验组VSS评分低于对照组(P<0.05);术后6个月,实验组患肢功能优于对照组(P<0.05)。结论:人工真皮与自体皮复合移植联合物理抗菌敷料治疗深度烧伤创面,能有效改善瘢痕状态,降低感染率,并促进患者肢体功能恢复。Objective To explore the effect of composite transplantation of artificial dermis and autologous skin combined with physical antibacterial dressing on scar status of affected site,infection rate and limb function in the treatment of deep burn wounds.Methods 200 patients with deep burn wounds admitted to the author's hospital from October 2019 to October 2021 were selected and divided into control group and experimental group according to randomized control method,with 100 cases in each group.Both groups were treated with artificial dermis and autologous split-thickness skin grafting.The control group was treated with routine disinfection and dressing change during perioperative period,and the experimental group was treated with physical antibacterial dressing spraying on the basis of the control group.Postoperative recovery status(wound healing rate,artificial dermal survival rate,bacterial clearance rate,wound healing time),pain degree[visual analogue scale(VAS)]before surgery and at 7 days after surgery,scar status[Vancouver scar scale(VSS)]at 1 month and 3 months after surgery,limb function(Fugl-Meyer function scale)at 3 months and 6 months after surgery were compared between the two groups of patients.Results After treatment,the wound healing rate,survival rate of artificial dermis and bacterial clearance rate in experimental group were higher than those in control group,and the wound healing time was shorter than that in control group(P<0.05).The pain scores of the experimental group were lower than those of the control group at 3 and 7 days after operation(P<0.05).At 3 months after operation,the VSS score of the experimental group was lower than that of the control group(P<0.05).At 6 months after operation,the limb function of the experimental group was better than that of the control group(P<0.05).Conclusion Composite transplantation of artificial dermis and autologous skin combined with physical antibacterial dressing in the treatment of deep burn wounds can effectively improve scar status,reduce infectio

关 键 词：人工真皮 物理抗菌敷料 深度烧伤 创面 瘢痕 感染率 肢体功能 

分 类 号：R641[医药卫生—外科学]