CAJ | 학술논문

背景:已有的研究表明原位皮肤再生法可使深Ⅱ度以内烧伤创面和供皮区刨面生理愈合无瘢痕,可促进Ⅲ度烧伤创面坏死组织液化排除、移植皮生长、减少减轻瘢痕,在瘢痕移除创面使用原位皮肤再生法以达到明显减轻瘢痕症状、减少瘢痕的效果,未见相关报道.目的:观察搬痕移除原位皮肤再生法治疗增生性瘢痕的效果.方法:选择烧伤或刨伤后出现多处增生性瘢痕的患者32例,男25例,女7例;年龄16～52岁;瘢痕病程1～11年.每例选择2处瘢痕相似的部位,进行自身对照.实验组采用瘢痕移除、瘢痕皮回植后应用美宝湿润烧伤膏药纱覆盖的原位皮肤再生法治疗:对照组采用瘢痕移除、瘢痕皮回植后应用传统凡士林覆盖治疗.观察比较疗效,应用温哥华瘢痕评估量表评估瘢痕增生情况.结果与结论:两组回植的瘢痕皮均成活.实验组创而愈合速度和质量优于对照组(P<0.05):瘢痕移除后6个月,实验组温哥华瘢痕评估量表评估均优于对照组(户<0.05,P<0.01),瘢痕所致的疼痛、瘙痒等症状消失,皮片平整且颜色较回植前明显改善,与周围皮肤接近.结果提示对自体皮源不足、瘢痕面积大的增生性瘢痕患者或不愿增加新的供皮区创面患者,应用瘢痕移除瘢痕皮回植原位皮肤再生的方法治疗是一种较理想的方法.
배경:이유적연구표명원위피부재생법가사심Ⅱ도이내소상창면화공피구포면생리유합무반흔,가촉진Ⅲ도소상창면배사조직액화배제、이식피생장、감소감경반흔,재반흔이제창면사용원위피부재생법이체도명현감경반흔증상、감소반흔적효과,미견상관보도.목적:관찰반흔이제원위피부재생법치료증생성반흔적효과.방법:선택소상혹포상후출현다처증생성반흔적환자32례,남25례,녀7례;년령16～52세;반흔병정1～11년.매례선택2처반흔상사적부위,진행자신대조.실험조채용반흔이제、반흔피회식후응용미보습윤소상고약사복개적원위피부재생법치료:대조조채용반흔이제、반흔피회식후응용전통범사림복개치료.관찰비교료효,응용온가화반흔평고량표평고반흔증생정황.결과여결론:량조회식적반흔피균성활.실험조창이유합속도화질량우우대조조(P<0.05):반흔이제후6개월,실험조온가화반흔평고량표평고균우우대조조(호<0.05,P<0.01),반흔소치적동통、소양등증상소실,피편평정차안색교회식전명현개선,여주위피부접근.결과제시대자체피원불족、반흔면적대적증생성반흔환자혹불원증가신적공피구창면환자,응용반흔이제반흔피회식원위피부재생적방법치료시일충교이상적방법.
BACKGROUND: Existing research shows that in situ regeneration of skin deep within the second degree bum wound and donor site wound healed without physical scarring, can promote three-degree burn wounds liquefied necrotic tissue removement, the growth of transplanted skin, reduce scar; scar-shift using the in situ regeneration is expected to reach significantly reduce scar symptoms, and to reduce the effect of scar, which have not be reported.OBJECTIVE: To observe effects of skin regeneration in situ method to remove scar in the treatment of hypertrophic scar. METHODS: A total of 32 patients with many hyperplastic scars, including 25 males and 7 females, aged 16-52 years, disease course of 1-11 years. Two similar scar regions were selected from each patient for self control. In the experimental group, scar removal, scar skin replantation after the application of in situ regeneration of the skin treatment using burn cream coated yarn. In the control group, scar removal, scar skin replantation after the application of traditional Vaseline covered by treatment. Curative effects were observed and compared. Scar hyperplasia was assessed using Vancouver Scar Assessment Scale assessment. RESULTS AND CONCLUSION: Replanted scar skin explants were survived in both groups. In the experimental group, healing speed and quality of wound surface were better than the control group (P< 0.05). After 6 months, the Vancouver Scar Assessment Scale assessment in the experimental group was better than control group (P < 0.05, P < 0.01). Scar caused by pain, itching and other symptoms disappeared, skin formation and color back to pre-implantation were significantly improved compared with the surrounding skin almost. Results indicated that with regarding to the lack of autologous skin source, large area of scar in patients with hypertrophic scars or unwilling to add a new donor site wounds in patients, in situ replantation method is an ideal approach.