脱细胞异体真皮和自体刃厚皮复合移植在功能部位深度烧伤早期治疗中的临床应用

Evaluate the clinical effect of acelluar allogeneic dermal matrix with split thickness autologous skin composite transplantation on early treatment of important functional location of body

目的：探讨脱细胞异体真皮和自体刃厚皮复合移植在人体重要功能部位深度烧伤创面早期治疗中的临床效果。方法2008年1月-2011年12月对37例53处关键功能部位深 II 度～III 度烧伤创面于24～120 h 内局部进行早期切削痂扩创后，用脱细胞异体真皮和自体刃厚皮行复合移植，观察复合植皮的成活率、关节功能恢复及后期瘢痕形成等情况。结果除2例3个部位复合皮片边缘有散在点状坏死延迟愈合外，其余35例手术均成功，50处关键功能部位复合皮片均成活愈合好。复合皮片光滑柔软，弹性好，关节功能恢复好；随访6～18（12．2＆#177;1．4）个月，供皮区无明显瘢痕，色泽接近正常皮肤，植皮区无明显增生挛缩的瘢痕，关节功能恢复接近正常水平。结论脱细胞异体真皮和自体刃厚皮应用于人体重要功能部位深度烧伤创面早期治疗是比较理想的方法，愈后植皮区关节功能恢复好，柔软度及弹性好，无明显增生及挛缩瘢痕。

Objective To evaluate the clinical effect of acelluar allogeneic dermal matrix with split thickness autolo -gous skin composite transplantation on early treatment of deep burn wounds of important functional location of body .Methods From January 2008 to December 2011, 37 cases of 53 key functional parts of the deep II degree -III degree burn wound within 24 -120 h local crust early after debridement with removal the survival rate of the cells and autologous allogeneic der -mal thickness skin graft composite line , observe the composite skin graft, restore joint function and post-scar formation and so on.Results Except three sites in addition to two cases of composite skin graft edge with scattered punctate necrosis delayed healing, the remaining 35 cases were with successful surgery , 50 key functional parts of the composite skin grafts survived healing well.Composite skin smooth and soft pieces, good elasticity, good recovery of joint function; followed up for 6-18 （12.2 ＆#177;1.4） months, no significant donor site scar, close to the normal skin color, skin graft area without obvious prolifera -tion of scar contracture, joint function near normal levels .Conclusion Acelluar allogeneic dermal matrix with split thickness autologous composite skin graft is an ideal method in early treatment of deep burn wounds of key functional locations .The re-covery of joint function is good , flexibility and elasticity are good, there is no significant proliferation and scar contracture in translated spots after surgery.