自体水疱皮移植治疗深度烧伤后瘢痕性色素脱失

Curative effect of autologous blister skin grafting on cicatricial depigmentation caused by deep burn

目的探讨自体水疱皮移植和Re Cell自体色素细胞移植治疗深度烧伤后瘢痕性色素脱失的临床治疗效果。方法选取2012年5月至2015年2月34例烧伤后瘢痕性色素脱失患者,手术观察色素脱失区共61处。将患者随机分为自体水疱皮组和ReC ell自体色素细胞组;自体水疱皮组(18例)32处,用BY-ⅡAM型表皮移植白癜风治疗仪磨削去除瘢痕性色素脱失区表皮,使用负压发疱分离器取自体水疱皮,将其移植覆盖在色素脱失区创面上;ReC ell自体色素细胞组(16例)29处,用电动取皮刀取刃厚皮片,应用ReC ell试剂盒将供体皮片制成活色素细胞悬液,将其均匀移植喷洒在剥脱表皮的色素脱失区。观察创面术后愈合时间和术后3个月色素脱失区色素恢复情况。结果自体水疱皮组的创面术后愈合时间明显短于ReC ell自体色素细胞组,自体水疱皮组术后3个月色素恢复的有效率明显高于ReC ell自体色素细胞组,差异均有统计学意义(P<0.05)。结论用磨削法和发疱分离自体表皮治疗深度烧伤后瘢痕性色素脱失简便易行,疗效确切,无缝合瘢痕和手术风险。

Objective To compare the treatment effect of autologous blister skin grafting with ReC ell autologous chromocyte grafting on cicatricial depigmentation caused by deep burn. Methods Thirty-four patients with cicatricial depigmentation caused by deep burn who were admitted into hospital from May 2012 to February 2015 were included in this study. The total 61 depigmentation areas were randomly divided into two groups;32 areas from 18 patients were treated with autologous blister skin grafting,and the other 29 areas from 16 patients were treated with ReC ell autologous chromocyte grafting. In the autologous blister skin grafting treated group,epidermis from the depigmentation area was removed by grinding with a BY-II AM type epidermal graft vitiligo treatment equipment. Then the autologous blister skin was harvested with the suction blistering method and grafted onto the wound of depigmentation area. In the ReC ell autologous chromocyte grafting treated group,split-thickness skin flap was harvested by electric dermatome. Then the donor skin was processed into chromocyte suspension with the ReC ell assay kit and evenly sprayed onto the depigmentation areas. The wound healing time and the pigment recovery 3 months after surgery were observed. Results The wound healing time of autologous blister skin grafting treated group was significantly shorter than that of Re Cell autologous chromocyte grafting treated group（ P 0. 05）. The effective rate of pigment recovery 3 months after surgery in autologous blister skin grafting treated group was markedly higher than that of Re Cell autologous chromocyte grafting treated group（ P 0. 05）.Conclusion The autologous epidermal grafting treatment using grinding and suction blistering method is simple and easy to perform,markedly effective,with no suture scar and low surgical risk,thus serving as a promising and ideal therapeutic method for burn scar depigmentation.