脱细胞异体真皮和自体薄皮片复合移植在烧伤整形中的临床应用效果(1)
【摘要】 目的：研究脱细胞异体真皮和自体薄皮片复合移植在烧伤整形中的临床应用效果。方法：本次研究选取2018年5月-2019年6月笔者所在医院收治的122例烧伤整形患者。按治疗方式的不同将其分为单一组和联合组，每组61例。单一组实施自体薄皮片移植，联合组实施脱细胞异体真皮和自体薄皮片复合移植。比较两组治疗后1个月瘢痕美容评估与评级量表(SCAR)评分、血清肿瘤坏死因子-α(TNF-α)和白介素-6(IL-6)水平、创面细菌量、瘢痕增生发生率(轻度、中度、重度)及治疗后6个月的皮片收缩率、皮片成活率、再次手术率。结果：治疗后，联合组SCAR评分、TNF-α和IL-6水平、创面细菌量均优于单一組，差异有统计学意义(P<0.05)。联合组轻度瘢痕增生发生率高于单一组，而中度、重度瘢痕增生发生率均低于单一组，差异有统计学意义(P<0.05)。联合组皮片收缩率为3.28%，低于单一组的14.75%，差异有统计学意义(P<0.05);联合组皮片成活率为95.08%，高于单一组的83.61%，差异有统计学意义(P<0.05);联合组再次手术率为1.64%，低于单一组的11.48%，差异有统计学意义(P<0.05)。结论：采用脱细胞异体真皮和自体薄皮片复合移植共同修复烧伤组织，能缓解炎症，降低创面细菌量，保证皮片成活，减轻瘢痕增生，移植效果理想，皮肤恢复良好，在烧伤整形中的应用价值高。
【关键词】 脱细胞异体真皮 自体薄皮片移植 烧伤 整形 皮片成活率 瘢痕增生
doi：10.14033/j.cnki.cfmr.2020.26.011 文献标识码 B 文章编号 1674-6805(2020)26-00-03
Clinical Application Effect of Acellular Allogeneic Dermis and Autologous Thin Skin Graft in Burn Plastic Surgery/PAN Shi. //Chinese and Foreign Medical Research， 2020， 18(26)： -32
[Abstract] Objective： To study the clinical effect of acellular allogeneic dermis and autologous thin skin graft in burn plastic surgery. Method： In this study， 122 patients with burn plastic surgery admitted in our hospital from May 2018 to June 2019 were selected. According to the different treatment methods， they were divided into the single group and the combined group， with 61 cases in each group. The single group received autologous thin skin graft， while the combined group received acellular allogenic dermis and autologous thin skin graft. The scar cosmetic assessment and rating scale (SCAR) scores， serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)， wound bacterial count， incidence of scar hyperplasia (mild， moderate， severe) at 1 month after treatment， and skin graft shrinkage rate， skin graft survival rate and reoperation rate at 6 months after treatment were compared between the two groups. Result： After treatment， the SCAR score， TNF-α and IL-6 levels and wound bacterial count in the combined group were all better than those in the single group， and the differences were statistically significant (P<0.05). The incidence of mild scar hypertrophic in the combined group was higher than that in the single group， while the incidence of moderate and severe scar hyperplasia in the combined group were lower than those in the single group， the differences were statistically significant (P<0.05). The skin graft shrinkage rate of the combined group was 3.28%， which was lower than 14.75% of the single group， the difference was statistically significant (P<0.05). The skin graft survival rate of the combined group was 95.08%， which was higher than 83.61% of the single group， the difference was statistically significant (P<0.05). The reoperation rate of the combined group was 1.64%， which was lower than 11.48% of the single group， the difference was statistically significant (P<0.05). Conclusion： The composite transplantation of acellular allogeneic dermis and autologous thin skin graft can alleviate inflammation， reduce the wound bacterial count， ensure the survival of skin graft and reduce scar hyperplasia. The transplantation effect is ideal and the skin recovery is good. It has high application value in burn plastic surgery., http://www.100md.com(潘实)
【关键词】 脱细胞异体真皮 自体薄皮片移植 烧伤 整形 皮片成活率 瘢痕增生
doi：10.14033/j.cnki.cfmr.2020.26.011 文献标识码 B 文章编号 1674-6805(2020)26-00-03
Clinical Application Effect of Acellular Allogeneic Dermis and Autologous Thin Skin Graft in Burn Plastic Surgery/PAN Shi. //Chinese and Foreign Medical Research， 2020， 18(26)： -32
[Abstract] Objective： To study the clinical effect of acellular allogeneic dermis and autologous thin skin graft in burn plastic surgery. Method： In this study， 122 patients with burn plastic surgery admitted in our hospital from May 2018 to June 2019 were selected. According to the different treatment methods， they were divided into the single group and the combined group， with 61 cases in each group. The single group received autologous thin skin graft， while the combined group received acellular allogenic dermis and autologous thin skin graft. The scar cosmetic assessment and rating scale (SCAR) scores， serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)， wound bacterial count， incidence of scar hyperplasia (mild， moderate， severe) at 1 month after treatment， and skin graft shrinkage rate， skin graft survival rate and reoperation rate at 6 months after treatment were compared between the two groups. Result： After treatment， the SCAR score， TNF-α and IL-6 levels and wound bacterial count in the combined group were all better than those in the single group， and the differences were statistically significant (P<0.05). The incidence of mild scar hypertrophic in the combined group was higher than that in the single group， while the incidence of moderate and severe scar hyperplasia in the combined group were lower than those in the single group， the differences were statistically significant (P<0.05). The skin graft shrinkage rate of the combined group was 3.28%， which was lower than 14.75% of the single group， the difference was statistically significant (P<0.05). The skin graft survival rate of the combined group was 95.08%， which was higher than 83.61% of the single group， the difference was statistically significant (P<0.05). The reoperation rate of the combined group was 1.64%， which was lower than 11.48% of the single group， the difference was statistically significant (P<0.05). Conclusion： The composite transplantation of acellular allogeneic dermis and autologous thin skin graft can alleviate inflammation， reduce the wound bacterial count， ensure the survival of skin graft and reduce scar hyperplasia. The transplantation effect is ideal and the skin recovery is good. It has high application value in burn plastic surgery., http://www.100md.com(潘实)