摘要
探讨缺表皮第二层自体微粒头皮移植治疗特大面积烧伤患者的可行性,选择2000-01/2006-05唐山钢铁公司医院烧伤科收治的特大面积烧伤患者29例,平均烧伤面积(86.26±3.79)%,Ⅲ度烧伤面积(52.69±9.11)%。诊断依据:根据1970年全国烧伤会议确定的标准,热烧伤系指单纯由热力所造成的局部或全身性损伤,如热水、火焰、蒸汽、钢(铁)水等所致损伤。每例患者均取两层皮片:首先于头部取含表皮的自体刃厚头皮,约0.5%体表面积,厚0.10～0.25mm,作为正常自体微粒头皮移植组;再于同一部位取面积、厚度均相同的缺表皮第二层头皮,作为缺表皮第二层自体微粒头皮移植组。两组皮片分别放入不同的剪皮杯内制备微粒皮浆,涂抹于新鲜异种猪皮的组织面,然后移植于较为对称、烧伤面积基本相等的两处Ⅲ度切痂创面上,扩张比例为1:10～1:15,抗菌药物纱布包扎。术后第2,3,4,5周末观察异体皮脱落处露出创面的愈合情况,两组创面愈合率均随着时间延长而逐渐提高,相同时间点比较组间差异无显著性意义(t=0.09～0.12,P均>0.05)。表明缺表皮第二层自体微粒头皮移植是一种有效的治疗大面积烧伤患者的方法,缓解了大面积烧伤患者自体皮源匮乏的困难。
To explore the possibility of the second layer of autologous head micro skin lacking of epidermis grafting in extensive burn patients. From January 2000 to May 2006 a total of 29 patients with extensive burn were enrolled at Department of Burns, Hospital of Tangshan Steel and Iron Co., Ltd., Tangshan. The equation of the burned areas was（86.26±3.79）% of the total body surface, and the equation of Ⅲ-degree burned areas was （52.69±9.11）%. The standard of diagnosis： According to the standard decision of national burned meeting in 1970, heating burned referred to local or the whole body burn hurted by heating powers, such as hot water, flames, steam, the melted steel （iron） and so on, In each patient, the first layer of autologous skins, Which the thick were among 0.10 mm -0.25 mm and the areas were about 0.5% of the total body surface, cut on the head was designed as the group of normal autologous head micro-skins （group A）. And the second layer of autologous skins, which the thickness and areas were just as the first layer of head skins cut in the same place, were employed as the group of second layer of autologous head micro-skin lacking of epidermis （group B）, The skin of each group were put into two different skin cutting-cups and prepared into micro-skin, then was spread onto the fresh tissue surface of the heterologous pigskin. In the end, it was separately transplanted onto two symmetrical spots of Ⅲ-degree post-escharectomy burn of each patient （expiation rate of 1：10-1： 15）, and then banded up with antiseptic dressing. The wound-healing rate was observed on the end of the 2^nd, 3^rd 4^th and 5^th weeks after grafting in the places of heterologous pigskin, The wound healing rates increased gradually along with the time, There were no significant differences of healing rates between the two groups at the same time （t =0.09-0.12,P〉 0.05）, It indicated that the grafting of the second layer of autologous head micro-skin lacking of epidermis is an effective method in healing extensive bum patients and relaxes the tensity of lacking of autologous skin.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第4期746-747,共2页
Journal of Clinical Rehabilitative Tissue Engineering Research
