符合功能与美学要求的皮肤移植术修复中小面积深度烧/创伤创面的应用

Application of skin transplantation with functional and aesthetic requirements for the repair of deep burn wounds in small and medium size

目的探究符合功能与美学要求的皮肤移植术修复中小面积深度烧/创伤创面的应用。方法回顾性分析我院收治的中小面积深度烧/创伤患者47例。深度烧伤创面应用削痂法、浅切痂法对受皮区创面坏死组织削/切除,创伤创面将坏死组织清创至正常组织。两者均尽最大限度将创面正常皮下组织保留,做好止血处理。对于供皮区,皮下注射低浓度肾上腺素0.9%氯化钠溶液使其肿胀。应用鼓式取皮机、滚轴取皮刀切/削取大张中厚断层皮,约为0.3-0.6mm;使受区纵轴与游离皮片长轴相互垂直移植,皮片尽量实施不开洞。皮片与皮片、创缘与皮片选用3-0丝线进行缝合,实施包扎、制动。结果 47例深度烧/创伤创面患者均实施改进皮肤移植术,移植皮片成活率超过96%,皮片移植100%成活者所占比例为92.39%。结论做好创面处理工作,对取皮技术进行改进,合理选择供区,应用大张薄中厚与中厚断层皮对中、小面积深度烧伤及创伤创面实施尽量不开洞移植,可使修复部位与供皮区符合功能与美学要求。

Objective To explore the application of skin transplantation with functional and aesthetic requirements for the re- pair of deep burn wounds in small and medium size, Methods Retrospective analysis of 47 cases of small and medium deep burn patients admitted to our hospital. Deep burn wounds were treated with tangential excision and superficial excision, and the necrotic tissue was excised and excised. Both of them were as far as possible to keep the normal subcutaneous tissue of the wound surface, and do a good job of hemostasis. For the donor skin, subcutaneous injection of low concentration of adrenaline 0.9% Sodium Chlo- ride Solution to make its application of swelling, drum dermatome, Humby knife cut leather/fault cut from large thick, about 0.3-0. 6mm ;the zone axis and the free skin flap transplantation long axis perpendicular to each other, try not to implement the opening. The skin and the skin,the wound margin and the skin piece uses the 3-0 silk thread to carry on the suture,carries on the dress- ing,the brake. Results 47 patients with deep burn wound were treated with improved skin grafting,the survival rate of skin graft was more than 96%, and the proportion of skin graft survival rate of the patients was 92.39%. Conclusion Do the work of skin wound treatment, technical improvement, reasonable selection of full thickness skin donor area, and application of large thick thin and small area deep burn wounds and try not to open the implementation of the transplantation, and the donor site can ensure the repair area conforms to the functional and aesthetic requirements.