异种脱细胞真皮与自体薄皮片联合移植临床研究

The clinical study on complex graft of heterogeneous de - cell dermis with self - thin skin

目的 探讨异种（猪）脱细胞真皮与自体薄皮片复合移植修复深度烧伤创面和瘢痕切除创面的可行性，为烧伤治疗寻找新的填充物与覆盖材料。方法 用胰酶消化法脱除断层猪的上皮细胞，制成细网状无细胞真皮支架，再与自体薄皮片联合移植修复各类创面。结果 用于切痴创面移植１８例，成活率７８％；用于瘢痕切除创面移植１１例，成活率９１％；用于肉芽创面移植４例，成活率 １００％。愈后创面外观平整，柔软有弹性，关节部位功能恢复良好，与单纯使用薄皮片移植的创面比较有明显区别。结论 异种（猪）脱细胞真皮能长期存活在人体中，具有组织填充、抑制瘢痕增生的作用，与自体薄皮复合移植是治疗大面积深度烧伤创面和瘢痕切除创面较理想方法。

Objective To discuss the feasibility of compound skin in consisted of heterogeneous (pig) corium without cell and autogenous thin skin repairing surface of deep burning and wound scar removed and to provide a new filling and covering material for treating burning wound. Methods Epithelia of pigskin were taken off by digeston with pancreatic enzyme to create corium frame net without cell. The surfaces of wounds were repaired by grafting the curium and autogenous thin skin together. Results Wounds with scar removed were grafted in 18 patients with a survival rate of 78% ; wounds with scar removed were grafted in 11 patients with a survival rate of 91% granulation wounds were grafted in 4 cases with a survival rate of 100% . The surface of wound was plat, soft and elastic and the articular functions were good after healing. There was significant difference between this method and grafting method only with thin skin. Conclusion The heterogeneous (pig) corium can live in human body, for fill wounds and restrict scar growth. Surfaces of great deep burning wounds and scar removed can be successfully repaired with heterogeneous (pig) curium and autogenous thin skin.