复合皮移植术在大面积烧伤瘢痕整形中的应用

Application of composite skin grafts on patients with scar after severe burns

目的观察复合皮移植术在大面积烧伤瘢痕整形中的临床应用效果。方法 2010年3月至2013年3月,应用复合皮移植术治疗8例大面积烧伤后瘢痕患者,均为男性,年龄23~47岁,共13个手术部位,其中腘窝部5例,膝部3例,小腿部2例,肘关节2例,大腿部1例。切除瘢痕组织后创面为4.0cm×7.0cm^15.0cm×18.0cm,采用一步法将异体脱细胞真皮基质与大张自体刃厚皮片复合移植修复创面。结果 8例患者随访3~22个月,复合皮成活率92%,愈合后外观平整,无排斥反应,关节功能良好。结论复合皮是修复大面积烧伤后瘢痕的理想材料。

Objective To investigate the effect of composite skin grafts on scar plastic operation of severe bums patients. Methods From May 2010 to May 2013, composite skin grafts were used in 8 cases （13 wounds） with scar after severe bums. There were all males, aged 23-47 years. Of them, 8 patients had 13 wounds. The wound locations were poples （5 wounds）, laps （3 wounds）, legs （2 wounds）, elbows （2 wounds）, thighs （1 wound）. After scar excision, the area of wounds ranged from 4.0cm×7.0cm to 15.0cm×18.0cm. ADM and autologous split-thickness skin graft were used to repair the wounds by one-step method. Results 8 patients were followed within 3-22 months. The survival rate of composite skin was 92%, the surface was smooth with slight wound contraction, no obvious immuno reaction and rejection was seen, the function of various joints were good. Conclusion Composite skin was an ideal material which could repair the sear of severe burns patients.