摘要
目的应用刃厚皮片修复深度烧伤创面和瘢痕切除创面,往往形成不同程度的畸形和功能障碍,比较观察应用无细胞猪真皮基质与自体薄皮片复合移植的临床效果。方法2001-06/2002-08上海第二医科大学瑞金医院烧伤科收治深度烧伤创面需手术植皮的患者43例,瘢痕手术患者1例,共44例,男33例,女11例;年龄(33.39±17.08)岁,平均4～92岁;43例烧伤患者的烧伤面积为(36.63±25.88)%总体表面积。应用无细胞猪真皮基质移植体薄皮片复合移植的创面共65处,其中烧伤创面为64处,瘢痕切除创面1处。移植创面选择深度烧伤创面切削痂至新鲜、健康组织层面;瘢痕切除后止血满意的新鲜创面。移植方法一步法,选择复合条件的创面,移植无细胞猪真皮基质(真皮乳头层向上,与创面平整紧贴,周边可予缝合固定),并立即取大张自体薄皮片移植于无细胞猪真皮基质上,外覆粗网眼油纱布,并用局部抗菌药物浸渍的绷带包扎固定,再以消毒烫纱包扎。二步法,首次手术时,移植无细胞猪真皮基质后,外覆生物膜或辐照猪皮等生物敷料,然后用局部抗菌药浸渍的绷带包扎固定,外加消毒烫沙加压包扎。通常在1周内再次手术,揭去覆盖于无细胞猪真皮基质上的生物敷料,然后与一步法一样进行大张自体薄皮片的移植。结果应用无细胞猪真皮基质与自体皮复合移植成功率为89.06%,?
AIM: To observe the clinical effect of composite grafting of porcine acellular dermis matrix (ADM) with the autograft for repairing skin deficiency wounds, because plerosis on deep burn wound and scar resection with razor thin graft always leads to malformation and disfunction.METHODS: During June 2001 to August 2002,44 patients,including 43 burn wounds and 1 scar excision wound, 33 males and 11 females, aged 4-92 years old, averagely (33.39±17.08) years old, were hospitalized for skin graft in the Department of Burn, Ruijin Hospital of Shanghai Second Medical University. The burn surface area of the 43 patients was(36.63±25.88) %of total body surface. Composite graft of porcine acellular dermis matrix (ADM)with the autograft in skin deficiency wounds was applied in 65 wounds, including 64 burn wounds and 1 scar excision wound.The implantation surface choice:The deep burn wound was operated by eschar excision or tangential excision to remove the necrotic tissues until the fresh and healthy tissue appeared.Graft ways: One step grafting, proper wound surface was adopted and the porcine ADM was implanted (ADM papillary layer upward, close to the wound, and fixed by sew around), an was lay under the autograft thin skin, covered with pachy insula vaseline gauze, and then was fixed with bandage which had been partially dipped by antibacterial drugs, at last bound up with disinfectant burnt gauze.Two step grafting, in the first operation, after the implantation of porcine ADM, the wound was covered by biological dressing or irradiation porcine,etc.And then was fixed with bandage which had been partially dipped by antibacterial drugs, and bound up with disinfectant burnt sand plus compression. Generally one week later, the second operation was performed. The biological dressing was removed, and then the implantation was carried out as the first operation.RESULTS: The success rate of composite graft application was 89.06%, and 88.89%was on the burn wounds surface.Six months later, the contracture of composite grafting w
出处
《中国临床康复》
CSCD
2004年第23期4768-4769,共2页
Chinese Journal of Clinical Rehabilitation
