削痂保留变性真皮治疗小儿大面积深Ⅱ度烧伤疗效分析

摘要

Objectives To compare the effect of the treatment of the large area deepⅡ degree burn wounds in children with the tangential excision artificial leather cover on retained denatured dermis or grafting autologous skin. Methods Retrospective analysis of 15 cases of children treated in February 2011 to March 2014,divided into two groups according to surgical methods.Artificial leather Group:Preservation of denatured dermis during Eschar shaving in 7 cases.Graft group:8 cases were transplanted with autologous scalp after the excision of the skin graft.Statistical the bacterial culture results of wound secretion in 2 groups 3 days before surgery and 2 weeks after operation,the healing time and scar hyperplasia were compared between the two groups.The Data was performed with T test or Fisher exact probability method. Results Two groups wound bacterial culture results were negative before operation.The bacterial culture results were similar in the 2 groups after operation(P>0.05).Graft group healing time(11.9 ± 1.5)d was significantly shorter than artificial leather group(23.4 ± 2.4)d, t=11.54,P<0.01.Follow up for 1 years,Scar hyperplasia was similar in the two groups. Conclusion Application of Escher retained denatured dermis covering artificial skin or skin grafting can't reduce scar hyperplasia,but the skin graft can shorten healing time.%目的:比较削痂保留变性真皮覆盖人工皮或移植自体皮治疗小儿大面积深Ⅱ度烧伤创面的效果.方法:将2011年2月-2014年3月收治的15例患儿,按手术方法不同分为两组,进行回顾性分析.人工皮组:应用削痂保留变性真皮覆盖人工皮7例;植皮组:应用削痂保留变性真皮后移植自体头皮8例.统计2组术前3d及术后2周创面分泌物细菌培养结果,比较两组患儿创面愈合时间和瘢痕增生情况.对数据进行t检验或Fisher确切概率法分析.结果:术前2组创面细菌培养结果均为阴性.术后2组创面细菌培养结果相近(P>0.05).植皮组创面愈合时间(11.9±1.5)d明显短于人工皮组(23.4±2.4)d,t=11.54,P<0.01.随访1年,瘢痕增生情况两组相近.结论:应用削痂保留变性真皮覆盖人工皮或植皮并不能减轻瘢痕增生,但植皮可以缩短创面愈合时间.