自体皮源奇缺条件下瘢痕挛缩畸形的晚期临床修复  

Repair of contracture deformities of the patients with extremely limited donor skin at late postburn stage

作　　者：陈璧[1] 贾赤宇[1] 徐明达[1] 朱雄翔[1] 王波涛[1] 姚庆君[1] 刘亚玲[1] 

机构地区：[1]第四军医大学西京医院烧伤科,西安710032

出　　处：《中华烧伤杂志》2003年第6期361-364,共4页Chinese Journal of Burns

摘　　要：目的　寻找对烧伤后畸形伴自体皮源奇缺患者进行晚期修复的新方法。　方法　 5例特重度、特大面积烧伤患者治愈后伴较严重畸形 ,且自体皮源奇缺。采用柔软成熟的瘢痕皮肤作为修复的皮源 ,用扩张器扩张瘢痕皮肤后 ,切取中厚瘢痕皮片进行修复 ;不宜行瘢痕皮肤扩张术时 ,切取刃厚瘢痕皮片与异体脱细胞真皮基质组成复合皮进行修复。观察两种方法的疗效。　结果　所移植的扩张瘢痕皮片和复合皮均成活 ,功能和外形恢复良好 ,远期疗效近似正常自体中厚皮移植。　结论　采用不同厚度的瘢痕皮片修复烧伤畸形是可行的 ,可扩大自体皮源。此法对于皮源奇缺的瘢痕患者尤其适用。Objective To explore new methods to repair postburn contracture deformities in patients with extremely limited donor skin. Methods Five severely burned patients with extremely limited donor skin but severe deformities were enrolled in the study. The mature and the pliable scarred skin was utilized as the donor site for reconstruction of the postburn deformities. Split-thickness scarred skin was harvested for repair of postburn deformities after the scarred skin was expanded by expander, while thin razor-thin scarred skin with allo-acellular dermal matrix(ADM) was employed for the repair of postburn deformities when skin expansion was infeasible. Results All the expanded scarred skin and composite skin grafts survived completely with good function and configuration. The long-term follow-up result was satisfactory, and the grafted skin was similar to that with split-thickness skin grafting. Conclusion It is feasible to employ various split-thickness scarred skin for the reconstruction of postburn deformities. This technique is a new effective procedure for the reconstruction of postburn deformities, especially for those with extreme scarcity of donor site. [

关 键 词：瘢痕挛缩畸形 皮肤移植 脱细胞真皮基质 皮肤扩张术 复合皮 烧伤 

分 类 号：R644[医药卫生—外科学]