| 童海东,戴如冰.自体网状皮移植联合生物敷料覆盖改善烧伤瘢痕的临床疗效[J].浙江中西医结合杂志,2016,26(11): |
| 自体网状皮移植联合生物敷料覆盖改善烧伤瘢痕的临床疗效 |
| Clinical efficacy of autologous skin graft combined with biological dressings on post-burn scars |
| 投稿时间：2016-03-17 修订日期：2016-06-01 |
| DOI： |
| 中文关键词: 自体皮移植 联合生物 瘢痕 |
| 英文关键词:autologous skin graft Joint biological scar |
| 基金项目: |
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| 中文摘要: |
| 【】目的 观察自体网状皮移植联合生物敷料覆盖改善烧伤瘢痕的临床疗效。方法 24例烧伤后瘢痕增生挛缩患者,完全切除挛缩瘢痕,松解组织粘连后,创面覆盖Pelnac加强型植入式人工真皮。术后2～3周,再取患者自体网状皮片行二期植皮。观察创面愈合情况、创周炎性反应情况、瘢痕形成情况,患者于术后3个月测量康复评定指标手指关节总活动度和日常生活活动能力以判断瘢痕挛缩改善情况。结果 术后5例患者创周有红肿热痛、渗出等炎症反应,4周以后仍未愈合,需进行进一步手术治疗；其余患者创面愈合较快,两周内开始明显愈合,手术总有效率为79.2%。经手术修复后,创面收缩率显著增高,具有统计学意义(p<0.05)。瘢痕挛缩明显改善,关节活动度及生活功能情况术前与术后3个月相比,均具有统计学差异(p<0.001)。结论 自体网状皮移植联合生物敷料覆盖治疗烧伤后瘢痕挛缩,能避免换药痛苦,一期愈合率高,值得临床推广。 |
| 英文摘要: |
| ABSTRACT Object: Objective to observe the reticular skin autograft combined biological dressing clinical effect for the treatment of mixed degree burns.Methods: A total of 24 patients with scar contracture were enrolled in this study. The contracture scar tissues were completely resected, then the wounds were covered with Pelnac artificial dermis. After 2 to 3 weeks, the second skin grafts were given to the patients with autologous skin grafts. The wound healing, inflammatory response around wound and scar hyperplasia were detected after operation. The clinical efficacy of the treatment was also evaluated. Results: 5 patients showed acute inflammation response after operation, such as pain, heat, redness, swelling and exudation. Slowly wound healing and obvious scar hyperplasia were detected in these patients, so the further surgery would be needed. The wounds of the other patients were in a good state, and the scars were flat and soft without obvious scar hyperplasia. The total effective rate for this treatment was 79.2%. Conclusion: Mesh skin autograft combined biological dressing mixed degree burn treatment, can reduce skin graft area, reduce the switching frequency of the bandage and avoid pain, primary healing rate is high, worth clinical promotion |
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