手背深Ⅱ度烧伤削痂后延期植皮术的疗效观察

Delayed dermatoplasty after eschar shaving in Treatment of deep partial thickness burns on the Dorsum Manus

目的:评价削痂后延期植皮术治疗手背深Ⅱ度烧伤后溶痂或合并感染创面的疗效。方法:61例患者,随机分组为试验组29例,对照组32例。试验组入院后即行手背削痂术,术后24～48h内行中厚皮移植术;对照组入院后保守治疗,待创面新鲜肉芽组织形成,行中厚皮移植术。结果:试验组及对照组治疗后,植皮术后20d植皮成活率达优者分别为69.0%和34.4%,术后1年掌指关节功能恢复达优者分别为72.4%和40.6%,术后2年手背皮肤质地恢复程度达优者分别为86.2%和31.2%。两组比较差异均有显著性(P<0.05)。结论:运用削痂后延期植皮术治疗手背深Ⅱ度烧伤后溶痂或合并感染创面疗效显著,明显优于肉芽创面形成后行中厚皮移植术。

Objective ：To assess the clinical efficacy of Delayed dermatoplasty after eschar shaving in the treatment of the shedding off of eschar or wounds combined with infection after deep partial thickness burns on the Dorsum Manus. Methods：61 patients with severe RA were enrolled. 29 pations （experimental groups） were performed with eschareetomy sooner afer hospitalization. 24-48 hours after escharectomy, tegenous splitthickness skin graft was performed . Other patients （reference groups） were treated with the conservative treatment after hospitalization, tegenous split-thickness skin graft was performed while fresh granulation tissue formation. Results：The superior rate of experimental groups and reference groups in the survival mate of dermatoplasty twenty days after surgery,the functional recovery rate of the metacarpophalangeal Joint one year after surgery,the recovery rate of the skin texture two years after surgery were 69.0% and 34.4% ;72.4% and 40. 6% ;86. 2% and 31. 2%, respectively. Conclusion： The treatment of Delayed dermatoplasty after eschar shaving is more effective than dermatoplasty while fresh granulation tissue formation in the patients of the shedding off of eschar or wounds combined with infection after deep partial thickness burns on the Dorsum Manus.