烧伤后瘢痕性色素脱失治疗31例

Treatment of dyspigmentation caused by burn scar

目的:用一种手术方法治疗烧伤后扁平状瘢痕性色素脱失的疗效并讨论其临床意义.方法:烧伤后皮肤色素脱失区无明显瘢痕增生患者31(男13,女18)例,年龄15～34岁.用磨削法或用电动取皮机去除瘢痕表皮,保留瘢痕基底,取0.1～0.2mm刃厚皮片游离移植.结果:治疗后,31例患者移植表皮全部成活,移植表皮与周围皮肤颜色配比良好,界限不明显.经3mo～1a随访,临床效果良好,无白斑复发.结论:用磨削法或用电动取皮机去除瘢痕表皮后刃厚皮片游离植皮较以往的全厚皮移植简便易行,无继发畸形,无缝合瘢痕,是一种治疗烧伤后扁平状瘢痕性色素脱失的理想方法.

AIM: To introduce a new surgical procedure in treating dyspigmentation caused by flat burn scar. METHODS: Thirty-one patients (13 males, 18 females) with dyspigmentation caused by flat burn scar were included in the study. After removing the cuticular layer of the scar by grinding or with a power-driven dermatome, the scar base was free grafted with razor-thin autograft. RESULTS: The operation was performed successfully in all cases. After 3 months to 1 year, the treated areas had satisfactory appearance and close color match. There was no secondary scar and no recrudescence of dyspigmentation. CONCLUSION: Free grafting with razor-thin autograft after removing cuticular layer of the scar by grinding or with a power-driven dermatome is an ideal method to treat dyspigmentation..