摘要
背景：已有的研究表明原位皮肤再生法可使深Ⅱ度以内烧伤创面和供皮区创面生理愈合无瘢痕,可促进Ⅲ度烧伤创面坏死组织液化排除、移植皮生长、减少减轻瘢痕,在瘢痕移除创面使用原位皮肤再生法以达到明显减轻瘢痕症状、减少瘢痕的效果,未见相关报道。目的：观察瘢痕移除原位皮肤再生法治疗增生性瘢痕的效果。方法：选择烧伤或创伤后出现多处增生性瘢痕的患者32例,男25例,女7例;年龄16~52岁;瘢痕病程1~11年。每例选择2处瘢痕相似的部位,进行自身对照。实验组采用瘢痕移除、瘢痕皮回植后应用美宝湿润烧伤膏药纱覆盖的原位皮肤再生法治疗;对照组采用瘢痕移除、瘢痕皮回植后应用传统凡士林覆盖治疗。观察比较疗效,应用温哥华瘢痕评估量表评估瘢痕增生情况。结果与结论：两组回植的瘢痕皮均成活。实验组创面愈合速度和质量优于对照组（P〈0.05）;瘢痕移除后6个月,实验组温哥华瘢痕评估量表评估均优于对照组（P〈0.05,P〈0.01）,瘢痕所致的疼痛、瘙痒等症状消失,皮片平整且颜色较回植前明显改善,与周围皮肤接近。结果提示对自体皮源不足、瘢痕面积大的增生性瘢痕患者或不愿增加新的供皮区创面患者,应用瘢痕移除瘢痕皮回植原位皮肤再生的方法治疗是一种较理想的方法。
BACKGROUND：Existing research shows that in situ regeneration of skin deep within the second degree burn wound and donor site wound healed without physical scarring,can promote three-degree burn wounds liquefied necrotic tissue removement,the growth of transplanted skin,reduce scar;scar-shift using the in situ regeneration is expected to reach significantly reduce scar symptoms,and to reduce the effect of scar,which have not be reported.OBJECTIVE：To observe effects of skin regeneration in situ method to remove scar in the treatment of hypertrophic scar.METHODS：A total of 32 patients with many hyperplastic scars,including 25 males and 7 females,aged 16-52 years,disease course of 1-11 years.Two similar scar regions were selected from each patient for self control.In the experimental group,scar removal,scar skin replantation after the application of in situ regeneration of the skin treatment using burn cream coated yarn.In the control group,scar removal,scar skin replantation after the application of traditional Vaseline covered by treatment.Curative effects were observed and compared.Scar hyperplasia was assessed using Vancouver Scar Assessment Scale assessment.RESULTS AND CONCLUSION：Replanted scar skin explants were survived in both groups.In the experimental group,healing speed and quality of wound surface were better than the control group（P 0.05）.After 6 months,the Vancouver Scar Assessment Scale assessment in the experimental group was better than control group（P 0.05,P 0.01）.Scar caused by pain,itching and other symptoms disappeared,skin formation and color back to pre-implantation were significantly improved compared with the surrounding skin almost.Results indicated that with regarding to the lack of autologous skin source,large area of scar in patients with hypertrophic scars or unwilling to add a new donor site wounds in patients,in situ replantation method is an ideal approach.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第18期3327-3330,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
