脱细胞异体真皮与自体微粒皮复合移植治疗深度烧伤愈合后皮肤质量观察

The observation of the quality after the wound healing of composite transplantion of accellular allo-dermismatrix with auto-microskin on deep burn wound

目的:为大面积深度烧伤创面修复选择良好的覆盖材料,以解决自体中厚皮源不足的难题;提高创面愈合质量。方法:对16例大面积烧伤患者切削痂后分二组植皮,实验组:采用脱细胞异体真皮基质和自体微粒皮复合移植(简称复合皮移植),对照组:单纯用微粒皮移植,并用温哥华瘢痕评量表定期随访观察创面近、远期效果。结果:术后1个月,实验组与对照组创面愈合的外观、质地、耐磨性、关节的功能及温哥华评分无明显差异。术后6个月,12个月,实验组创面愈合后的外观、质地、耐磨性、关节功能及温哥华瘢痕评分明显优于对照组。结论:对大面积深度烧伤患者行复合皮移植,可减轻瘢痕增生,改善创面外观及关节功能,可达到中厚皮移植的效果。

Objective this paper is to select opportune coverage materials for the restoration of Large area and deep burn wound to improve the wound healing effects and to address the source of autologous Medium Ternstroemia problem of insufficient. Methods 16 cases of large area and deep burn wound were divided into two groups to graft skin after eschar excision： the experimental group ： the clinical observation of composite transplantation of acellular dermal matrix with autologous split-thickness skin （composite transplantation for short） the control group： transplantation with split-thickness skin simply, and then the long-term effects of the wound and donor site were evaluated with Vancouver scar scale. Results one months after the surgery,there was no marked difference in the the appearance, texture, abrasion resistance, function of joint and Vancouver score of the experimental group and the control group . Six and tweleve months after the surgery, the appearance, texture, abrasion resistance, function of joint, patients＇ satisfaction and Vancouver score of the experimental group obviously excelled the control one. Conclusions The composite transplantation for a patient of large area deep burn wound is opportunely operated, relieving scar hyperplasia, improving the wound appearance and the function of joint, achieving the effect of the middle thickness skin transplantation.