摘要
目的研究组织工程真皮联合烧伤疤瘢痕表皮移植在瘢痕整形中的应用价值。方法以2017年7月-2021年7月九江市第一人民医院烧伤科收治的65例烧伤瘢痕病例为研究对象,采用随机数字表法分为观察组(32例)与对照组(33例)。观察组应用脱细胞异体真皮联合瘢痕表皮移植治疗,对照组采用自体中厚皮片移植治疗,比较两组治疗效果(创面愈合率、创面收缩率、植皮成活率、二次手术率)、创面愈合时间、患者和观察者瘢痕评估量表(POSAS)评分、并发症、瘢痕增生程度。结果两组创面愈合率、创面收缩率、植皮成活率、二次手术率比较,差异无统计学意义(P>0.05);两组植皮区创面愈合时间比较,差异无统计学意义(P>0.05),但观察组供皮区创面愈合时间短于对照组(P<0.05);两组治疗后POSAS评分均有下降(P<0.05),但组间比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);观察组轻度增生率高于对照组,重度增生率低于对照组(P<0.05)。结论组织工程真皮联合烧伤瘢痕表皮移植在瘢痕整形中具有确切的效果,其植皮效果、瘢痕修复作用与自体中厚皮移植效果相当,同时可避免供皮区瘢痕增生,缩短其愈合时间,且不增加并发症风险。
Objective To study the application value of tissue engineering dermis combined with burn scar epidermis transplantation in scar plastic surgery.Methods From July 2017 to July 2021,65 cases of burn scars admitted to the Department of Burns,Jiujiang First People's Hospital were selected as the research objects.They were divided into observation group(32 cases)and control group(33 cases)by random number table method.The observation group was treated with acellular allogenic dermis combined with scar epidermis transplantation,while the control group was treated with autologous medium-thickness skin graft transplantation.The therapeutic effects(wound healing rate,wound contraction rate,skin graft survival rate,secondary operation rate),wound healing time,patient and observer scar assessment scale(POSAS)score,complications and scar hyperplasia degree were compared between the two groups.Results There was no significant difference in wound healing rate,wound contraction rate,skin graft survival rate and secondary operation rate between the two groups(P>0.05).There was no significant difference in wound healing time between the two groups(P>0.05),but the wound healing time of the donor site in the observation group was shorter than that in the control group(P<0.05).The POSAS scores of the two groups decreased after treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).The mild hyperplasia rate of the observation group was higher than that of the control group,and the severe hyperplasia rate was lower than that of the control group(P<0.05).Conclusion Tissue engineered dermis combined with burn scar epidermal transplantation has a definite effect in scar plastic surgery.Its skin grafting effect and scar repair effect are equivalent to those of autologous medium-thick skin transplantation.At the same time,it can avoid scar hyperplasia in the donor site,shorten the healing time,and do not increase the risk of complications.
作者
丁毓威
曹青
杨陆涛
潘拥军
DING Yu-wei;CAO Qing;YANG Lu-tao;PAN Yong-jun(Department of Burns,Jiujiang First People's Hospital,Jiujiang 332000,Jiangxi,China)
出处
《医学信息》
2023年第5期131-134,共4页
Journal of Medical Information
基金
江西省卫生健康委科技计划(编号:SKJP220211691)。
关键词
瘢痕整形
组织工程真皮
表皮移植
脱细胞异体真皮
瘢痕增生
Scar surgery
Tissue engineered dermis
Epidermal transplantation
Acellular allogeneic dermis
Scar hyperplasia
