河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (10): 1166-1170.doi: 10.3969/j.issn.1007-3205.2021.10.010

• • 上一篇    下一篇

双层人工真皮移植在关节深度烧伤创面的早期修复效果

  

  1. 河北省唐山工人医院烧伤整形二科，河北 唐山 063000
  • 出版日期:2021-10-25 发布日期:2021-10-28
  • 作者简介:何静（1995-），女，四川巴中人，河北省唐山工人医院医师，医学硕士，从事烧伤整形疾病诊治研究。
  • 基金资助:
    河北省科技计划项目（16277727D）

Early repair effect of double-layer artificial dermis grafting on deep burn wounds of joints

  1. The Second Department of Burns and Plastic Surgery, Tangshan Workers Hospital, Hebei Province, Tangshan 063000, China
  • Online:2021-10-25 Published:2021-10-28

HTML

PDF (PC)

119

摘要： 目的 探讨双层人工真皮早期应用于关节深度烧伤创面的治疗效果。
方法 选择40例伴关节部位深度烧伤的特重度烧伤患者作为研究对象，按治疗方式随机分为观察组和对照组（各20例），观察组关节深度烧伤创面于受伤后3~5 d行切/削痂术后植入Lando双层人工真皮覆盖创面，待真皮血管化良好后去除硅胶层，植入自体刃厚皮片。对照组关节部位深度烧伤创面于伤后3~5 d行切/削痂术后自体刃厚皮片移植术。记录两组自体刃厚皮植入后7 d皮片成活率、21 d创面愈合率。创面愈合后指导康复性训练，统计关节部位水泡、疼痛、瘙痒发生率，随访并评估关节部位瘢痕增生及烧伤后患者生活质量。
结果 植皮术后7 d换药时，观察组皮片成活率高于对照组，术后21 d，观察组创面愈合率高于对照组，观察组水泡、疼痛、瘙痒发生率低于对照组，差异有统计学意义（P＜0.05）。随访12个月，根据温哥华瘢痕量表量表评分，观察组瘢痕增生情况好于对照组，根据BSHS-B评分，观察组烧伤后生活质量情况优于对照组，差异有统计学意义（P＜0.05）。
结论 双层人工真皮早期移植修复关节部位深度烧伤创面，植皮成活率高，创面不良事件发生率低，关节部位瘢痕增生不明显，烧伤患者生活质量高。


关键词: 烧伤, 双层人工真皮, 关节创面

Abstract: Objective To explore the effect of early application of double-layer artificial dermis in the treatment of deep burn wounds of joints. 
Methods A total of 40 patients with severe and deep burn wounds of joints were selected as research subjects, and randomly divided into the observation group(n=20) and the control group(n=20) according to different treatment methods. In the observation group, the deep burn wounds of joints were treated with escharectomy or tangential excision at 3-5 d after injury, and then the wound were covered with Lando double-layer artificial dermis. After good vascularization of the artificial dermis, the silica gel layer was removed and the autologous split-thickness skin was grafted. In the control group, escharectomy or tangential excision was performed on deep burn wounds of joints at 3-5 d after injury, and then the thin split-thickness autograft was performed. The survival rate of skin graft at 7 d after implantation and the healing rate of wound surface at 21 d after implantation were recorded. After wound healing, the rehabilitation training was guided, the data on the incidence of joint blister, pain and pruritus were collected, and the quality of life of patients who suffered joint scar hyperplasia and burn was evaluated.  
Results The survival rate of skin grafts in the observation group was higher than that in the control group at dressing change at 7 d after skin graft surgery. The wound healing rate in the observation group was higher than that in the control group at 21 d after surgery. The incidence of blisters, pain, and pruritus in the observation group was lower than that in the control group, with statistical significance(P＜0.05). After 12 months of follow-up, according to the Vancouver Scar Scale score, the observation group had better scar hyperplasia than the control group. According to the BSHS-B score, the observation group had better quality of life after burn than the control group, with statistical significance(P＜0.05). 
Conclusion Double-layer artificial dermis can be safely applied to the early treatment of deep burn wounds of joints in patients, which has a high survival rate of skin grafts, low incidence of adverse wound events, insignificant scar hyperplasia at joints, and high quality of life for burn patients. 


Key words: burns, double-layer artificial dermis, joint wounds 

版权所有 © 《河北医科大学学报》编辑部
本系统由北京玛格泰克科技发展有限公司设计开发