自体头皮移植修复儿童重度瘢痕创面的效果观察

Observation on the Effect of Autogenous Scalp Transplantation to Repair Severally Scar Wound in Children

目的:探讨自体头皮移植在儿童重度瘢痕创面中的应用效果。方法:选择2018年2月-2020年1月儿童重度瘢痕创面患者48例为对象,随机数字表法分为三组,比较负压氧冲洗治疗联合自体头皮移植组(观察组)、人工真皮复合自体头皮移植组(对照1组)、中厚皮移植组(对照2组)对儿童重度瘢痕创面修复的影响。比较三组植皮成活率、供皮区创面愈合时间、温哥华瘢痕评分量;根据病案首页提取数据,计算患儿住院时间及总费用。结果:观察组和对照1组植皮成活率高于对照2组(P<0.05);对照2组供皮区愈合时间、住院时间均长于观察组和对照1组(P<0.05)。根据病案首页提取数据分析,观察组与对照2组住院总费用均低于对照1组(P<0.05);三组修复前与修复后12个月,瘢痕色泽、血管分布、厚度及柔软度VSS评分比较,差异均有统计学意义(P<0.01);修复后12个月VSS评分三组间比较,差异无统计学意义(P>0.05)。结论:自体头皮移植修复用于儿童瘢痕创面中能提高植皮成活率,能缩短创面愈合时间,减轻对供皮区的损害,缩短住院时间,能获得良好的修复效果,值得推广应用。

Objective:To investigate the effect of autologous scalp transplantation on severe scar wounds in children.Method:A total of 48 cases of children with severally scar wounds from February 2018 to January 2020 were selected and divided into three groups by random table method.The effects of negative pressure oxygen irrigation combined with autologous scalp transplantation group (observation group),artificial dermis combined with autologous scalp transplantation group (control group 1) and medium thickness skin transplantation group (control group 2) on the repair of severe scar wounds in children were compared.The survival rate of skin graft,wound healing time of donor site and Vancouver scar score were compared among the three groups.According to the data extracted from the medical record,the hospitalization time and total costs of the three groups were calculated.Result:The skin graft survival rate of observation group and control group 1 were higher than that of control group 2 (P<0.05).Healing time of donor site and the hospitalization time of control group 2 were longer than that of observation group and control group 1 (P<0.05);and total cost of observation group and control group 2 were less than that of control group 1 (P<0.05).There were significant differences in scar color,vascular distribution,thickness and softness of VSS scores among the three groups before repair and 12 months after repair (P<0.01).There was no significant difference in VSS score among the three groups 12 months after repair (P>0.05).Conclusion:Autologous scalp transplantation can improve the survival rate of skin grafting,shorten the wound healing time,reduce the damage to the donor site,shorten hospitalization time,obtain well repair effect,which is worthy of popularization and application.