硅胶膜防治烧伤瘢痕增生及挛缩

SILICONE GEL SHEET IN THE TREATMENT OF BURN SCARS WITH HYPERTROPHY AND CONTRACTURES

1986年1988年应用硅胶膜治疗各年龄、程度不等的烧伤增生及挛缩瘢痕40例显示早期应用疗效最佳。经两年随访,显效率70％(关节功能恢复正常、瘢痕平、软),有效率20％(关节功能和瘢痕外观明显改善),无效率10％(关节功能和瘢痕外观无改变)电镜发现:经治疗的瘢痕内有大量巨噬细胞,胞内有丰富的溶酶体释出溶酶体酶。本文对硅胶膜治疗作用机理,影响疗效的因素等作了讨论。

This study was made during the period of 1986～1988 to evaluate the effect of the silicone gel sheet on burn scars with hypertrophy and contrateures in 40 patients varying in age and severity. Results showed that the treated areas faded rapidly, and in one to two months relief of hypertrophy and contractures was noticeable. About two years, follow-up indicated that 70％ of the patients had significant improvement, the scars not interfering with functioning of the joints and appearing soft and flat; 20％ had improvement, with a recovery of function to a certain extent and an alleviation or hypertrophy of the sears; 10％ had no changes in colour, thickness or function. It was found under the electronic microscope that in most cases the treated areas abounded with macrophages, in which the lysosomes discharged lysokinase to hydrolyse chondrotin A sulfate and collagen, preventing hypertrophy and contractures, and thus keeping the scars from growing thicker. This mechanism has not been suggested before.