大张表皮片覆盖预防断层皮片供区瘢痕

Preventing scarring in split-thickness skin donor sites with epidermal grafting

目的介绍一种用自体大张表皮片即时覆盖断层皮片供区以预防其瘢痕生长的方法。方法用鼓式或电动取皮机切取断层皮片,厚度在0.3~0.5mm之间,用电动取皮机切取大张表皮片,厚度0.07~0.12mm(0.0028in^0.0048in),供皮区一般首选在背部、腰部、臀部或头皮,其次是胸腹和四肢;将表皮片覆盖在断层皮片供区,边缘用纳米银纱布条压紧,外加缝合或钉皮钉固定。表皮片供区和移植区内层均用油纱布,外层纳米银纱布覆盖,以缝线包压法包扎。结果从1999年11月至2003年11月共用于118例的133个整形部位。断层皮片供区移植表皮片后,无瘢痕生长,平坦,光滑,外观接近正常皮肤,但无毛囊和汗腺。表皮片供区短时间内潮红,无瘢痕增生,3个月以后逐渐接近正常皮肤。结论大张表皮片移植覆盖断层皮片供区是一种预防断层皮片供区瘢痕生长的好方法,值得推广和应用。

Objective Introducing a new technique for preventing the scar growthing in split thickness skin donor sites using the great sheets of epidermis covering. Methods The donor sites of split thickness skin were grafting with the great sheets of the epidermis, of the thickness about 0.07 - 0.12 mm, harvested by electrical power dermatome and fixed the edges of the epidermal sheet with the verges of donor wound together using the nanopartieles-Ag-gauze stripes adding the sutures or skin stapler, dressing the wounds with the nanopartieles-Ag-gauze using the tie-over technique, left the dressing entire for a 5-day period. Results This method were used in a total of 209 donor sites of both the split-thickness skin and epidermis for 133 reconstructed sites of 118 cases from November 1999 to November 2003, and the smooth , near normal skin appearnee without scarring were obtained in the split thickness skin donor sites, and the epidermal donor sites healed good enough 5 days after surgery, and skin appearnee is near normal in 3 months later. Conclusions Covering the donor sites of split thickness skin with the large sheets of epidermis is an effective and useful method for preventing the scaring in the split thickness skin donor sites.