人工真皮修复儿童四肢烧伤后瘢痕挛缩的临床效果

Clinical effect of artificial dermis in the repair of scar contracture in children with limbs burn

目的:探讨人工真皮支架植入术联合自体刃厚皮移植术修复儿童四肢烧伤后瘢痕挛缩的疗效。方法:选择烧伤后瘢痕挛缩影响功能患儿28例,按照手术方法不同分为观察组和对照组,各14例。观察组瘢痕切除后行人工真皮联合自体刃厚皮移植术;对照组行瘢痕松解后中厚皮移植术。比较2组患儿术后供皮区愈合时间、植皮成活率、术后1周创面感染率及术后随访6个月取皮区、植皮区瘢痕增生情况。结果:观察组供皮区愈合时间明显短于对照组(P<0.01)。术后1周2组植皮区创面均无感染,所植皮片基本存活。术后随访6个月,2组供皮区温哥华瘢痕量表评分差异无统计学意义(P>0.05),而观察组植皮区温哥华瘢痕量表评分优于对照组(P<0.05)。结论:应用人工真皮支架联合自体刃厚皮修复儿童四肢烧伤后瘢痕挛缩效果较好,值得推广。

ObjectiveTo explore the clinical effects of artificial dermis stent implantation combined with autologous split-thicknessskin graft in repairing the scar contracture in children with limbs burn. Methods：Twenty-eight children with scar contracture after burnwere divided into the observation group and control group according to the treatment method（14 cases each group）. The observationgroup was treated with artificial dermis combined with autologous split-thickness skin graft after scar excision,and the control group weretreated with thickness skin graft after scar release. The healing time of donor skin area,survival rate of skin graft,wound infection rateafter 1 week of operation,and scar hyperplasia in donor skin area and skin graft area between two groups were compared. Results：Thehealing time of donor skin area in observation group was significantly shorter than that in control group（P 〈 0. 01）. No infection in twogroups was found after 1 week and 2 weeks of operation,and all skin grafts were survival. The difference of the VSS score between twogroups after 6 months of following up was not statistically significant（P 〉 0. 05）,and the score of skin graft area in observation groupwas better than that in control group（P 〈 0. 01）. Conclusions：The clinical effect of artificial dermis stent implantation combined withautologous split-thickness skin graft in repairing the scar contracture in children with limbs burn is good,which is worthy of promotion.