摘要
目的探讨可吸收性生物敷料在特大面积深度烧伤患者膝部创面修复中的应用效果。方法选取2010年1月至2014年9月收治的8例特大面积烧伤患者,年龄23~45岁,均为90%体表面积以上深度烧伤,自身皮源极为有限。在伤情平稳后,膝部创面削痂,在其上覆盖可吸收性敷料;如果是已有肉芽生长的膝部创面,刮除不洁的肉芽组织,然后再覆盖可吸收性生物敷料。2~3周后,揭除敷料表面的硅胶膜行刃厚头皮移植。结果完全成功修复7例膝部创面,1例因感染导致部分可吸收性敷料脱落,多次换药后行头皮移植封闭。随访3个月至2年,膝部移植区皮肤色泽与正常皮肤接近,弹性可,耐摩擦,瘢痕轻,关节活动自如不受限。结论使用可吸收性生物敷料加头皮移植修复特大面积烧伤后膝部创面能有效保证膝关节外观及功能,值得推广应用。
Objective To evaluate the clinical efficiency of absorbable biological dressing in repairing the knee wounds caused by exceptionally large area burns. Methods Eight patients( aged from 23 to 45) suffering from exceptionally large area burns admitted in our department from January 2010 to September 2014 were recruited in this study. They were all with deep burns covering more than 90% total body surface area( TBSA),and few of them had healthy skin source for grafting. After their conditions were stable,escharectomy was operated on the knee wounds. Then the absorbable biological dressing was grafted on the operation wounds. If there was unclean granulation tissue growing on the wound surface,it would be shaved and then covered with the absorbable biological dressing. In 2 or 3 weeks later,the silicone membrane of the absorbable biological dressing needed to be removed and the split-thickness scalp was grafted on the surface. Results Seven wounds were successfully repaired,and the other wound got serious infection,which leaded part of the absorbable biological dressing to shedding. The wound was healed after several dressing and split-thickness scalp grafting. During the follow-up of 3 months to 2 years,the skin grafting area got good appearance,sound elasticity,and satisfactory anti-friction capability,but had no obvious scar formation. The knee joint was flexible with no restriction. Conclusion Repairing of deep burned knee wounds with the absorbable biological dressing and split-thickness scalp grafting can achieve good appearance and function in the skin grafting area. This method is worth of wide application.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2015年第19期1926-1929,共4页
Journal of Third Military Medical University
基金
国家自然科学基金青年科学基金项目(81401602)~~
关键词
可吸收性生物敷料
膝部创面
特大面积烧伤
absorbable biological dressing
knee wounds
exceptionally large area burns
