早期磨痂后生物皮覆盖修复深Ⅱ度烧伤创面136例报告

Reparation of Wound by Biological Skin Substitute for Deep ⅡDegree Burns after Dermabrasion at An Early Stage:Report of 136 Cases

目的观察早期磨痂术后生物皮覆盖修复深Ⅱ度烧伤创面的效果。方法136例创面分别于伤后1～2d内,在全麻无菌技术下用消毒钢丝球或电动磨削机彻底磨去创面坏死痂皮组织,然后用生物皮覆盖,观察创面愈合时间及瘢痕增生情况。创面愈合后1～1.5年随访观察。结果130例创面Ⅰ期愈合,Ⅰ期愈合率96.0%,6例因生物皮出现部分液化感染,创面延期愈合。愈合时间为13～20d,平均(15±2)d。随访130例肤色基本正常,4例出现轻度瘢痕增生,2例出现花斑样色素沉着。结论早期磨痂能有效清除创面坏死组织,降低烧伤毒素的产生,全身炎症反应较轻;生物皮完全无菌,与创面粘附性不变,抗原性减小,可以有效保护创面,使创面愈合快,瘢痕增生少,是一种十分理想的创面覆盖物。

Objective To observe the effects of reparation of wound by biological skin substitute for deep Ⅱ degree burns after the Dermabrasion at an early stage. Methods Under total anesthesia and aseptic technique necrosis callus of 136 wounds were abraded by disinfection of the wire ball or electric grinding machine in the 1 -2 d after burn, and then used biological skin to cover. Result Following up the time of wound healing and scar formation from wound to 1 - 1.5 years after burn, We found that 130 eases are the primary healing, the rate of primary healing is 96.0 % , 6 cases delayed wound healing for the partial liquefied infection of biological skin. Healing time is 13 - 20 d, the average time is （ 15 ＋ 2） d. Skin color of 130 cases is normal. Four cases is a mild scar formation, and two cases appeared versicolor pigmentation. Conclusion the Dermabrasion at an early stage can effectively remove the necrotic tissue of wounds and reduce the production of burning toxins, the systemic inflammatory response is lighter; Biological skin is aseptic and wound adhesion is unchanged, furthermore reduce the antigencity, so it can effectively protect the wound, make the wound healing faster and reduce scar formation. It, therefore, is a very good wound cover.