异体脱细胞真皮基质与自体皮片复合移植的临床应用

Clinical applicationg of composite skin graft with allogeneic acellular dermal matrix and thin thickness skin

目的:探讨异体脱细胞真皮基质与自体皮片复合移植修复大面积深度烧伤及瘢痕切除后皮肤缺损创面及其愈合后皮肤的外形和功能。方法:应用异体脱细胞真皮基质与自体刃厚皮片组成复合皮移植,以自体刃厚皮片移植作为对照,采用一步移植法治疗切痂后大面积深度烧伤创面及瘢痕切除后皮肤缺损共56例患者60处创面,观察术后皮片的成活情况、外形及功能恢复情况并随访。结果:60处创面全部愈合,移植皮片生长良好,瘢痕增生不明显,未见明显挛缩,皮肤弹性较好。在6～12个月的观察期内,自体刃厚皮片与异体脱细胞真皮基质复合移植后,功能和形态优于单纯自体刃厚皮片移植;随访2年复合移植未发现明显的排异反应。结论:异体脱细胞真皮基质与自体皮片复合移植修复大面积深度烧伤及瘢痕切除后皮肤缺损创面愈合良好,无瘢痕增生,皮肤外观功能满意,无排异反应。

Objective Explore of the skin appearance and function of the composite skin grafts with allogeneic acellular dermal matrix and thin thickness skin to repair the skin defects of large area deep burn and scar resection.Methods Application of allogeneic acellular dermal matrix and autologous thin thickness skin composite of composite skin transplantation,with the transplantation of autogenous thin thickness skin was used as control,using the one-step transplantation to treatment 56 patients with 60 wounds of full-thickness skin defects of large area deep burn and scar resection,after operation we were observed and follow-up on skin grafts survival,appearance and functionrecovery.Results 60 wounds were all healing,the transplanted skin grafts growing well and has better elasticity scar formation and no obvious contracture.In the observation period of 6 to 12 months,the function and morphology of the composite skin grafts with allogeneic acellular dermal matrix and thin thickness skin were better than that of autologous thin thickness skin graft transplantation.Followed for 2 years composite graft did not find significant rejection.Conclusion The composite skin grafts with allogeneic acellular dermal matrix and thin thickness skin were using to repair the skin defects of large area deep burn and scar resection,the wound healing well,satisfied with the appearance of the skin function,no scar formation and rejection.