脱细胞异体真皮联合自体刃厚皮移植在早期烧伤患者后期瘢痕修复中的应用

Application of acellular allogeneic dermis combined with autologous blade thick skin graft in the repair of scar in patients with early burn

目的探究脱细胞异体真皮(ADM)联合自体刃厚皮移植在早期烧伤患者后期瘢痕修复中的应用。方法选取2017年1月～2018年1月我院早期烧伤患者120例,根据治疗方案分组,各60例。对照组施行自体刃厚皮移植,试验组施行ADM+自体刃厚皮移植。观察两组皮片成活率、术后第7 d创面愈合率、创面愈合时间,对比术前、术后3 d血清表皮生长因子(EGF)、转化生长因子β(TGF-β)水平,并于术后6个月随访两组瘢痕增生程度。结果试验组术后第7 d创面愈合率、皮片成活率较对照组高,创面愈合时间较对照组短(P <0.05);与对照组比较,术后3 d试验组血清EGF、TGF-β较高(P<0.05);术后6个月后,试验组瘢痕增生程度轻于对照组((P <0.05)。结论 ADM联合自体刃厚皮移植用于早期烧伤患者,在提高皮片成活率及创面愈合率、缩短创面愈合时间、减轻瘢痕增生程度方面具有重要作用。

Objective To investigate the application of acellular allogeneic dermis(ADM)combined with autologous blade thick skin grafting in the repair of scar in patients with early burns.Methods A total of 120 patients with early burns in our hospital from January 2017 to January 2018 were enrolled.According to the treatment plan,60 patients were included.The control group underwent autologous blade thick skin grafting,and the experimental group performed ADM+autologous blade thick skin graft.The survival rate of the two groups of skin grafts,the wound healing rate at the 7th day after operation,and the healing time of the wounds were observed.The levels of serum epidermal growth factor(EGF)and transforming growth factor beta(TGF-β)were compared before and 3 days after operation.The degree of scar hyperplasia was followed up at 6 months after surgery.Results On the 7th day after operation,the wound healing rate and skin survival rate of the experimental group were higher than those of the control group,and the wound healing time was shorter than that of the control group(P<0.05).Compared with the control group,the serum EGF and TGF-of the experimental group were 3 days after operation.βwas higher(P<0.05);after 6 months,the degree of scar hyperplasia in the experimental group was lighter than that in the control group(P<0.05)Conclusion ADM combined with autologous blade thickness skin grafting for early burn patients plays an important role in improving skin survival rate and wound healing rate,shortening wound healing time and reducing scar hyperplasia.