中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
12期
921-923
,共3页
申传安%柴家科%张琳%李东杰%庹晓晔%蔡建华%王淑君%朱华%蔡金东
申傳安%柴傢科%張琳%李東傑%庹曉曄%蔡建華%王淑君%硃華%蔡金東
신전안%시가과%장림%리동걸%탁효엽%채건화%왕숙군%주화%채금동
皮肤移植%瘢痕%烧伤%外科,整形
皮膚移植%瘢痕%燒傷%外科,整形
피부이식%반흔%소상%외과,정형
Skin transplantation%Cicatrix%Burns%Surgery,plastic
目的 观察自体头皮移植修复瘢痕皮肤中厚供皮区创面的临床效果.方法 对2011年1至12月解放军总医院第一附属医院烧伤整形科收治的13例以瘢痕皮肤为中厚供皮区的大面积烧伤后整形患者(植皮组)的临床资料进行回顾性分析,瘢痕供皮区创面均采用自体中厚头皮皮片移植,并使用负压治疗技术固定皮片,手术后第7天拆除敷料,观察植皮组皮片成活率；术后12个月随访时应用温哥华瘢痕量表评分、瘙痒评分和瘢痕增生率(凸起瘢痕面积/瘢痕供皮区面积×100％)评价瘢痕供皮区瘢痕增生情况.并与2010年1至12月采用油纱覆盖瘢痕皮肤为中厚瘢痕供皮区的13例大面积烧伤后整形患者(对照组)的临床资料进行对比分析.结果 两组患者性别和年龄的差异无统计学意义,具有可比性(P＞0.05).植皮组术后第7天移植头皮全部成活,瘢痕供皮区创面愈合时间(7 d)显著少于对照组(平均20 d)(P＜0.01).术后12个月,植皮组瘢痕供皮区瘢痕量表评分、瘙痒评分和瘢痕增生率分别为(1.5±0.5)、(1.2±0.4)分和14.6％±7.6％,均显著低于对照组的(6.7±1.1)、(2.0±0.7)分和55.8％±12.2％(均P＜0.01).结论 头皮移植修复瘢痕皮肤中厚供皮区创面具有较好的临床效果.
目的 觀察自體頭皮移植脩複瘢痕皮膚中厚供皮區創麵的臨床效果.方法 對2011年1至12月解放軍總醫院第一附屬醫院燒傷整形科收治的13例以瘢痕皮膚為中厚供皮區的大麵積燒傷後整形患者(植皮組)的臨床資料進行迴顧性分析,瘢痕供皮區創麵均採用自體中厚頭皮皮片移植,併使用負壓治療技術固定皮片,手術後第7天拆除敷料,觀察植皮組皮片成活率；術後12箇月隨訪時應用溫哥華瘢痕量錶評分、瘙癢評分和瘢痕增生率(凸起瘢痕麵積/瘢痕供皮區麵積×100％)評價瘢痕供皮區瘢痕增生情況.併與2010年1至12月採用油紗覆蓋瘢痕皮膚為中厚瘢痕供皮區的13例大麵積燒傷後整形患者(對照組)的臨床資料進行對比分析.結果 兩組患者性彆和年齡的差異無統計學意義,具有可比性(P＞0.05).植皮組術後第7天移植頭皮全部成活,瘢痕供皮區創麵愈閤時間(7 d)顯著少于對照組(平均20 d)(P＜0.01).術後12箇月,植皮組瘢痕供皮區瘢痕量錶評分、瘙癢評分和瘢痕增生率分彆為(1.5±0.5)、(1.2±0.4)分和14.6％±7.6％,均顯著低于對照組的(6.7±1.1)、(2.0±0.7)分和55.8％±12.2％(均P＜0.01).結論 頭皮移植脩複瘢痕皮膚中厚供皮區創麵具有較好的臨床效果.
목적 관찰자체두피이식수복반흔피부중후공피구창면적림상효과.방법 대2011년1지12월해방군총의원제일부속의원소상정형과수치적13례이반흔피부위중후공피구적대면적소상후정형환자(식피조)적림상자료진행회고성분석,반흔공피구창면균채용자체중후두피피편이식,병사용부압치료기술고정피편,수술후제7천탁제부료,관찰식피조피편성활솔；술후12개월수방시응용온가화반흔량표평분、소양평분화반흔증생솔(철기반흔면적/반흔공피구면적×100％)평개반흔공피구반흔증생정황.병여2010년1지12월채용유사복개반흔피부위중후반흔공피구적13례대면적소상후정형환자(대조조)적림상자료진행대비분석.결과 량조환자성별화년령적차이무통계학의의,구유가비성(P＞0.05).식피조술후제7천이식두피전부성활,반흔공피구창면유합시간(7 d)현저소우대조조(평균20 d)(P＜0.01).술후12개월,식피조반흔공피구반흔량표평분、소양평분화반흔증생솔분별위(1.5±0.5)、(1.2±0.4)분화14.6％±7.6％,균현저저우대조조적(6.7±1.1)、(2.0±0.7)분화55.8％±12.2％(균P＜0.01).결론 두피이식수복반흔피부중후공피구창면구유교호적림상효과.
Objective To study the effects of using auto-scalp for repairing donor site of thickness from cicatricial skin with auto-scalp grafting.Methods A total of 13 cases with donor site of thickness from cicatricial skin from January 2011 to December 2011 were analyzed.Wounds of donor site from cicatricial skin were grafted with auto-scalp and scalp were fixation was applied with negative pressure.The survival rate of auto-scalp graft was observed at Day 7 post-operation.At Month 12,hyperplastic scars at these donor sites of cicatricial skin were assessed through Vancouver Scar Assessment Table,scar itch assessment and scar proliferation rate.Wounds in the other thirteen cases with donor site of thickness from cicatricial skin from January 2010 to December 2010 were covered with vaseline gauze as control.Results No significant difference existed in the gender and age of the two groups patients (P ＞ 0.05).The auto-scalp graft all survived.And the average healing time of donor-site wound in cicatricial skin in grafting group (7 days) was significantly decreased than that of control group (a mean of 20 days) (P ＜ 0.01).After followed up for twelve months,the scar formation assessment value (1.5 ± 0.5),scar itch assessment (1.2 ± 0.4) and scar proliferation rate (14.6％ ± 7.6％) in grafting group were significantly less than those of control group (6.7 ±1.1,2.0 ±0.7,55.8％ ± 12.2％,all P＜0.01).Conclusion Auto-scalp grafting may greatly shorten the healing procedure and ameliorate the quality of donor-site of thickness from cicatricial skin.
