磨痂保留变性真皮刃厚皮片移植修复深Ⅱ度烧伤创面疗效分析

摘要

Objective To assess the feasibility of abrading treatment of retained denatured dermis and autologous ra-zor-thin skin grafting for deep second-degree burns wound. Methods The abrading of retained denatured dermis and autolo-gous grafting of large sheet razor-thin skin was performed on 33 burns in 20 patients with deep second-degree burns on hand or forearm. The survival, appearance and function of grafted skin were observed after wound healed. Results Al grafted skins survived, except 1/10 of grafted skin in one case was necrotic. And after 3 to 12 months of fol ow-up, the grafted skins were e-lastic and flexible with a bit of pigmentation;there were no"goose bump", sebaceous cyst, hyperplastic scar or"two skins"formed. The skin-grafted hands functioned wel . The overal rate of perfectness reached 91.3%after operation. Conclusion The abrad-ing treatment of retained denatured dermis and autologous razor-thin skin grafting is a feasible minimal y invasive surgery for treatment of deep second-degree burns.%　　目的探讨磨痂保留变性真皮刃厚皮片移植修复深Ⅱ度烧伤创面的疗效。方法选取采用磨痂保留变性真皮移植自体大张刃厚皮片治疗的20例（33处手背、前臂深Ⅱ度）烧伤创面，术后随访3～12个月，观察皮片成活情况、创面愈合后局部外观和活动功能。结果20例（33处皮片）中1例（1处）约3cm×5cm大小皮片坏死，其余皮片全部成活。移植皮片轻度色素沉着，无挛缩起“鸡皮疙瘩”现象，无皮脂腺囊肿及“二层皮”形成，外形满意。局部无瘢痕增生，皮肤有弹性，质地柔软，手活动功能良好，优良率91.3%。结论磨痂保留变性真皮移植自体大张刃厚皮片是治疗深Ⅱ度烧伤创面的微创手术方式，值得推广应用。