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中的应用

Application of Allogenic Acellular Dermal Matrix and Split-thickness Autologous Skin Composite Transplantation in Treatment of Deep Burn Wounds in Functional Locations

目的：探讨脱细胞异体真皮（ acelluar allogenic dermal matrix, ADM）和自体刃厚皮复合移植在机体重要功能部位深度烧伤创面早期治疗中的临床效果。方法解放军白求恩国际和平医院烧伤科2008年1月-2011年12月对37例53处关节功能部位深Ⅱ~Ⅲ度烧伤创面及时进行早期切削痂扩创,用ADM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。随访（12.15±1.35）个月,供皮区无明显瘢痕,关节功能恢复接近正常水平。结论 ADM和自体刃厚皮复合皮应用于重要功能部位深度烧伤创面早期治疗效果满意。

Objective To evaluate the clinical effect of allogenic acellular dermal matrix （ ADM ） and split-thickness autologous skin composite transplantation in early stage of treatment of deep burn wounds in important functional locations of body. Methods A total of 53 joint functional locations ofⅡ°-Ⅲ° deep burn wounds in 37 patients during January 2008 and December 2011 underwent ADM and split-thickness autologous composite transplantation after early scabs excision and wounds expansion in time, and survival rate of composite skingrafting pieces, recovery of joint func-tions and posterior cicatrization were also observed. Results Three parts of composite skin graft edges in 2 patients had scattered point-like necrosis and delayed healing, and other 35 patients underwent successful operation, and all the 50 composite flaps in important functional locations survived. There were no obvious scar and recovery of joint function in composite flaps with follow-up for 6-18 months were close to normal. Conclusion The effect of ADM and split-thick-ness autologous composite transplantation in early stage of treatment of deep burn wounds in important functional locations is satisfactory.