皮肤软组织扩张器联合重组人表皮生长因子在面颈部瘢痕中应用

Application of skin soft tissue expander combined with recombinant human epidermal growth factor in facial and neck scars

目的研究皮肤软组织扩张器联合重组人表皮生长因子(rhEGF)在面颈部瘢痕中应用效果。方法选取我院面颈部瘢痕患者60例(2017年9月~2018年10月),简单随机法分为联合组(n=30)与扩张组(n=30)。扩张组仅单纯应用皮肤软组织扩张器治疗,联合组应用皮肤软组织扩张器+rhEGF治疗。观察对比2组创面愈合时间、创面愈合率、皮肤扩张情况、Ⅰ/Ⅲ型胶原比值、羟脯氨酸(OHP)含量及并发症发生率。结果联合组创面愈合时间短于扩张组,术后1周、2周创面愈合率高于扩张组(P <0.05);干预后,联合组扩张用时较扩张组短,即时回缩率较扩张组低,皮肤扩张率较扩张组高(P <0.05);干预后,联合组Ⅰ/Ⅲ型胶原比值较扩张组低,OHP含量较扩张组高(P <0.05);2组并发症发生率对比无显著差异(P>0.05)。结论面颈部瘢痕患者应用皮肤软组织扩张器与rhEGF联合治疗,可显著加快创面愈合时间与组织修复速度,提高皮瓣移植成功率及创面愈合率,改善修复质量,且并发症少,安全性较高。

Objective To study the effect of skin soft tissue expander combined with recombinant human epidermal growth factor(rhEGF) in facial and neck scars. Methods 60 patients with cervical scars in our hospital(September 2017 to October 2018) were randomly divided into a combination group(n=30) and an expansion group(n=30). The expansion group was treated only with a skin soft tissue expander, and the combined group was treated with a skin soft tissue expander + rhEGF. The healing time, wound healing rate, skin expansion,Ⅰ/Ⅲ collagen ratio, hydroxyproline(OHP) content and complication rate of the two groups were observed and compared. Results The wound healing time of the combined group was shorter than that of the dilated group. The wound healing rate was higher than that of the dilatation group at 1 week and 2 weeks after operation(P < 0.05). After the intervention, the expansion time of the combined group was shorter than that of the expansion group, and the immediate retraction rate was lower than that of the expansion group. The rate of skin expansion was higher than that of the dilated group(P < 0.05).. After intervention, the ratio of type Ⅰ/Ⅲ collagen in the combined group was lower than that in the dilated group, and the OHP content was higher than that in the dilated group(P < 0.05).. Significant difference(P > 0.05). Conclusion Patients with facial and neck scars combined with skin soft tissue expander and rhEGF can significantly accelerate wound healing time and tissue repair speed, improve flap success rate and wound healing rate, improve repair quality, and have fewer complications and higher safety.