摘要
目的总结Meek微型皮片移植术在老年成批大面积烧伤创面修复中应用的临床经验。方法对2013年7月26日解放军第一一八医院收治的一批共13例老年大面积烧伤患者的临床资料进行回顾性分析总结。在患者病情相对稳定后对其创面分批、分期实施Meek微型皮片移植术,移植的Meek微型皮片扩展倍数为1∶6和1∶9,观察该批老年烧伤患者的首次手术面积、总手术面积、平均手术次数、救治成功率、全身创面的愈合时间、患者住院时间,成活患者术后10个月随访植皮区瘢痕增生情况,肘、肩等大关节功能恢复情况。结果 13例患者中有4例因病情不稳定未能实施植皮手术分别于伤后1、11、67、71 d最终死亡。实施Meek微型皮片移植术的9例患者首次手术面积平均为(20.11±3.21)%总体表面积(TBSA),总手术面积平均为(45.21±8.33)%TBSA,平均手术次数为(3.3±1.3)次。救治成功7例,2例患者分别因术后并发脓毒症和术后弥漫性血管内凝血而死亡,救治成功率为78%。存活7例患者的创面平均愈合时间为(65.31±12.52)d,平均住院时间为(96.28±20.02)d。术后随访10个月植皮区瘢痕挛缩轻,肘、肩等大关节功能恢复基本正常。结论Meek微型皮片移植术适合老年成批大面积烧伤创面的修复,可降低老年成批大面积烧伤的病死率,缩短创面的愈合时间,有利于术后功能的恢复,因此,Meek微型皮片移植术是老年成批大面积烧伤创面修复的较佳方法之一。
Objective To summarize the clinic experience by applying Meek microskin grafting to repair the wounds for gerontal patients with group extensive burn. Methods The clinical data about 13 gerontal patients with group extensive burn who were accepted by 118 Hospital of People＇s Liberation Army on July 26, 2013, was retrospectively analyzed and summarized. Upon stabilization, the patients were given Meek microskin grafting in turn and installments, the grafted Meek microskin expanding times were 1：6 and 1：9. First operative area, total operative area, the average operation times, success rate of treatment, overall wound healing time, hospital stay time, the scar hypertrophic condition 10 months after operation and elbow and shoulder such large joints recovery condition were observed. Results Four patients were failed to perform microskin grafting and finally died in 1, ! 1,67, 71 d after injury. Seven patients were successfully rescued among 9 patients after performing Meek microskin grafting, 2 cases died, successful rate of treatment was 78%. First operative area was （20. 11 ± 3.21 ） % total body surface area （ TBSA）, total operative area was （45.21 ± 8.33 ） % TBSA, the average operation times was （ 3.3 ± 1.3 ）. The survival 7 cases with average healing time was （65.31 ~ 12.52） d,hospital stay time was（96.28 ±20.02）d. Follow up 10 months after operation, slight cicatricial contracture in skin grafting area was observed and large joint function was recovered basically. Conclusions Applying Meek microskin grafting to repair wound for gerontal patients with group extensive burn greatly reduced the death rate for gerontal patients with group extensive burn, shorten healing time and in favor of postoperative function recovery, so Meek microskin grafting is one of the good methods to repair the wound for gerontal patients with group extensive burn.
出处
《中华损伤与修复杂志（电子版）》
CAS
2015年第3期44-47,共4页
Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)
基金
南京军区医学科研课题(12MA023)
