利用削痂的健康真皮组织填充中厚皮供皮区对增生性疤痕影响的临床研究

摘要

目的：探索利用削痂的健康真皮组织填充中厚皮供皮区减轻增生性疤痕的新方法。方法选择需要行中厚皮移植的住院烧伤患者24例，随机分成3组，即痂皮移植组、自体刃厚皮回植组和对照组，每组患者8例，痂皮移植组术中以滚轴取皮刀将需植皮创面削痂至健康层次，挑取有健康真皮的痂皮备用，以气动取皮机取大腿中厚皮移植于术区，大腿中厚皮供皮区选取约10×10 cm大小的观察部位，以所选的带有健康真皮的痂皮剪成约1×1 cm大小游离移植；自体刃厚皮回植组以气动取皮刀取刃厚皮移植于约10×10 cm大小的中厚皮供皮区；对照组采用自身同体对照。结果痂皮移植组与自体刃厚皮回植组愈合时间比对照组愈合时间明显缩短。瘢痕温哥华评分痂皮移植组与自体刃厚皮回植组比较差异无统计学意义（ P＞0．05）；对照组瘢痕温哥华评分为（3．714±2．498），显著高于痂皮移植组与自体刃厚皮回植组（P＜0．01）。结论利用削痂的健康真皮组织填充中厚皮供皮区能缩短中厚皮供皮区愈合时间，并减轻瘢痕的增生。%Objective To explore the clinical effect of the healthy dermal tissue filling the thick skin area in order to reduce hyper -trophic scars.Methods Choosing 24 burned patients who needed to transplant thick skin hospitalization .The patients were randomly di-vided into three groups , the group of crusts transplantation , autologous thick replantation group and control group , eight cases in each group .Crusts transplant group surgery was applied the roller blade to take the skin graft to a healthy level of tangential excision wounds , and picked healthy dermis crusts for a spare use .Skin drum machine or pneumatic machine was applied to take the skin thickness skin graft in surgery thigh area.Thick skin area of thighs were selected for observation site about 10 ×10cm size, the selected scab with healthy dermis cut about 1 ×1cm size graft.Autologous thick replantation group were applied to take the skin knife or pneumatic roller blade thickness skin graft take about 10 ×10cm size of thick at the donor site .The control group control were used their own body .Results The healing time crusts autologous transplantation group and thick replantation group were significantly shorter than the contrast group .There was no signifi-cant difference (P>0.05) between Vancouver scar score crusts and autologous transplantation group .Vancouver scar score in the control group was (3.714 ±2.498), significantly higher than the scab autologous transplantation group with thick replantation group (P<0.01). Conclusion Making the use of healthy dermal tissue cut in thick crust filled donor sites could shorten thick and shorten the healing time .