早期切痂微粒皮移植联合功能部位修复重建治疗大面积深度烧伤13例

Early Crust-excision and Micro-skin Grafting Combined with Reconstruction of Functional Location for Large Deep Burn in 13 Patients

目的探讨早期切痂微粒皮移植联合功能部位修复重建治疗大面积深度烧伤的效果。方法在止血带下进行手术切痂深度至深筋膜浅层,止血后,异体皮覆盖自体微粒皮移植。对腕、踝、肘、膝、手、足背等功能部位行自体中厚皮移植或异体真皮基质覆盖自体刃厚皮复合移植。结果13例17处移植大张自体中厚皮及复合皮全部成活,无明显瘢痕挛缩,功能恢复较好。结论早期切痂大张异体皮覆盖自体微粒皮移植修复创面同时进行保护肢体功能的大张自体皮移植术,一次修复深度烧伤创面,疗程短,功能好,费用低。

Objective To discuss the outcome of early crust-excision and micro-skin grafting combined with reconstruction of functional location for the treatment of large deep burn. Methods Operation performed under tourniquet, the crusts were ablated down to the superficial layer of deep fascia, and then autologous micro-skin grafting, combined with allogenous skin coverage, was conducted in 13 patients. The functional parts, such as wrist, ankle, elbow, knee, hand and foot dorsum, Were treated with autologous split-thickness skin grafting or complex skin grafting （ i. e. autologous split-thickness skin plus allogenous dermal matrix）. Results All the patients＇ 17 large autologous split-thickness skins and complex skins wereall survived without obvious scar contracture, and the functions of the above functional parts recovered well. Conclusion It is recommended that the deep burn wounds be repaired at a time with early ernst-excision and micro-skin grafting combined with allogenous skin coverage or large autologous Skin grafting for functional parts, because of short therapeutic duration, good functional recovery and low expense.