薄层头皮与脱细胞异体真皮复合移植临床研究

Clinical study of thin scalp and acellular allogeneic dermis composite graft

目的 :为烧伤后期整形手术寻求理想的创面覆盖物。方法 :将用滚轴式取皮刀或电动取皮刀取下的头皮薄皮片用生理盐水反复冲洗 ,洗净毛发备用。切除挛缩的瘢痕组织 ,充分松解局部 ,电凝止血 ,生理盐水冲洗创面 ,将脱细胞异体真皮移植于创面上 ,周围边缘简单固定 ,然后将头皮薄皮片覆盖于脱细胞异体真皮上 ,包扎固定。结果 :12例病人 ,16个手术部位 ,功能部位瘢痕松解 ,应用脱细胞异体真皮头皮薄皮片移植 ,15个手术部位成活良好 ,1例手背部因皮下淤血 4× 3cm2 皮片未成活 ,通过局部换药、引流 ,于术后 18d愈合。植皮成活率在 98%以上。术后关节功能恢复满意。结论 :脱细胞异体真皮薄层头皮复合移植 ,修复烧伤或外伤引起的功能部位瘢痕挛缩 ,不但恢复了关节部位的功能 ,而且取皮区不形成新的瘢痕 ,头皮取皮区毛发生长后可不留痕迹。是理想的手术方法。

Objective: To seek an ideal method to repair wound in burns plastic surgery. Methods: The thin scalp was cut from head, the hair was washed off with physiological sodium chloride solution. The scar was cut off and the contracture tissue was separated and relaxed ,bleeding was ceased. The acellular allogeneic dermis was transplanted on the wound then the thin scalp was covered on the allogeneic dermis. The composite skin was stably fixed on the wound. Result: All the graft composite skin survived in 15 places in 12 cases, in a case 4×3cm 2 skin was dead. The joint function recovery was satisfied. Conclusion: With the advantages of good function recovery and no scar in skin supply part, the acellular allogeneic dermis and thin scalp composite graft is an ideal therapy to repair wound across joint in burns plastic surgery.