J-1型异种脱细胞真皮和自体薄皮片复合移植在深度烧伤创面中的临床应用

The clinical application of J-1 type acellular dermis and antilogous transplantation in composite thin slices of deep burn wounds

目的：探讨J-1型异种脱细胞真皮和自体薄皮片复合移植在深度烧伤创面中的临床应用效果。方法选取2010年1月～2014年1月本院收治的应用J-1型异种脱细胞真皮和自体薄皮片复合移植修复深度烧伤创面的30例患者为观察组,另选择应用自体断层皮片修复深度创面的20例患者为对照组,观察比较两组的创面植皮存活率、术后6个月植皮皮肤色泽、皮肤厚度、血管分布情况、柔软度、瘢痕生长情况、功能部位活动情况,并用温哥华瘢痕评分量表（VSS）进行评分。数据采用SPSS 14.0统计学软件进行分析。结果观察组创面植皮存活率为（95±5）%,术后6个月植皮皮肤色泽评分为（1.64±0.38）分、厚度为（2.13±0.44）分、血管分布为（1.75±0.46）分、柔软度为（2.78±0.53）分,瘢痕增生不明显,功能部位活动正常。对照组创面植皮存活率为（74±7）%,术后6个月植皮皮肤色泽评分为（2.57±0.35）分、厚度为（2.92±0.48）分、血管分布为（2.69±0.56）分、柔软度为（4.36±0.68）分,瘢痕增生明显,3例患者功能部位活动受限。两组患者皮片存活率、VSS评分（色泽、厚度、血管分布、柔软度）差异有统计学意义（P＆lt;0.01）。结论异种脱细胞真皮和自体薄皮片复合移植既可解决患者自体皮源不足的问题,促进创面愈合,最大限度恢复患者皮肤的外观及功能,又能解决中厚皮或全厚皮供区遗留瘢痕的问题,值得进一步临床推广。

Objective To investigate the clinical application effect of J-1 type acellular dermis and antilogous trans-plantation in composite thin slices of deep burn wounds. Methods 30 cases of patients with depth burn wound （had no bone exposed） using J-1 type acellular dermis and antilogous thin piece composite graft repair treated in our hospital from January 2010 to January 2014 were selected as observation group,20 cases of deep burn wounds using antilogous skin grafts to repair the fault treated in our hospital at the same time were selected as control group.Graft survival rate, graft skin color,thickness,vascular distribution,softness,scar growth,functional parts of the activity after 6 months treat-ment were observed and compared between the two groups,and Vancouver scar scale （VSS） was used to assess the in-dexes.SPSS 14.0 statistical software was used for analysis. Results In observation group,the wound graft survival rate was （95±5）%,after 6 months treatment,the grafting skin color score was 1.64±0.38,thickness score was 2.13±0.44,vascu-lar distribution score was 1.75±0.46,softness score was 2.78±0.53,scar was not obvious,functional parts activity were normal.In control group,the wound graft survival rate was （74±7）%,after 6 months treatment,the grafting skin color score was 2.57±0.35,thickness score was 2.92±0.48,vascular distribution score was 2.69±0.56,softness score was 4.36±0.68, scar was obvious,3 cases of patients with functional parts activity limited.There were significant differences about wound graft survival rate and VSS scores （grafting skin color,thickness,vascular distribution and softness） between the two groups （P〈0.01）. Conclusion Acellular dermis and antilogous thin piece composite graft repair not only can solve inadequate source of antilogous skin problems,promote the wound healing,maximize restore the appearance and function of the patient’s skin,but also can solve thick or full-thickness skin donor site scar problems,is worthy of further clinical promotion.