甘油保存异体皮在特重化学烧伤创面的应用

The Value of Glycerol Preserved Allograft (GPA) in the Treatment of the Severe Chemical Burn Wounds

目的:探讨甘油保存异体皮在特大面积深度化学烧伤治疗中的应用。方法:回顾分析8例特大面积三乙基铝所致的深度烧伤,应用甘油保存异体皮覆盖创面的临床资料。其中7例患者在同一天内收治,8例均为男性,年龄19-46岁,平均年龄为29.25岁,创面面积80％-97％,平均为90％,其中Ⅲ度面积在50％-95％,平均为55.63％。其中7例伴吸入性损伤,行气管切开术,6例行呼吸机辅助通气。患者均在急诊室行补液、输血等支持治疗,彻底清创,行焦痂切开减压术,创面予SD-Ag外敷,并均在3-7d内分别分次行切痂术并采用甘油保存异体皮(GPA)覆盖创面,然后有计划地分别分次行自体皮片移植取代甘油保存异体皮,采用邮票植皮法和异体皮打洞自体皮嵌入移植法。切痂次数为2-3次,平均2.5次,植皮数为2-10次,平均7.2次。供皮区均为头皮,取皮次数为2-10次,平均7.2次。结果:2例因呼吸系统严重灼伤而分别于伤后13d和28d死于呼吸系统并发症,其Ⅲ度创面分别为30％和60％,死时的创面覆盖率分别为100％和80％。其余6例2个月后创面基本为自体皮片所覆盖,皮片愈合良好,皮片存活率约70％-90％,平均80％。头皮愈合良好。结论:甘油保存异体皮是大面积深度化学烧伤创面一种较好的临时覆盖物,它可以改善创面血供条件,为自体皮片移植做准备,提高自体皮片移植的存活?

Objective: To discuss the value of glycerol preserved allograft (GPA) in the treatment of severe, large area, deep chemical burn wounds. Methods: A retrospective analysis was performed on the use of glycerol preserved allograft (GPA) in the treatment of severe, large area, deep chemical burn wounds of 8 cases. Results: Two cases of them were dead respectively on the 13 day and 28 day because of the severe burn of the respiratory systems. The other 6 cases' wounds had been covered by autograft transplantations winthin two months. Conclusion:The glycerol preserved allograft is a good temporary material in the treatment of the severe , larger area, deep chemical burn wounds.