摘要
目的探讨瘢痕断层皮片联合人工真皮在关节部位烧伤瘢痕整复中的可行性。方法选取2010年1月至2018年1月东莞市人民医院烧伤整形外科收治的40例关节部位烧伤后出现瘢痕增生的患者作为研究对象,并按照随机数表法将其随机分为研究组(20例)与对照组(20例),其中研究组患者采用瘢痕断层皮片联合人工真皮修复关节部位瘢痕,对照组患者单纯采用瘢痕断层皮片修复关节部位瘢痕,对比观察两组患者术后创面Ⅰ级愈合率、温哥华瘢痕量表(Vancouver scar scale,VSS)评分、关节活动度(range of motion,ROM)评分,评估瘢痕修复效果。结果术后随访6个月,研究组患者的创面Ⅰ级愈合率为85.0%,明显高于对照组患者的创面Ⅰ级愈合率55.0%,P<0.05,差异具有统计学意义;治疗后6个月,研究组患者的VSS评分为(3.1±0.4)分,明显低于对照组患者的VSS评分(5.7±1.1)分,P<0.05,差异具有统计学意义;治疗后6个月,研究组患者的ROM评分为(90.8±4.5)分,明显高于对照组患者的ROM评分(79.9±7.6)分,P<0.05,差异具有统计学意义。结论瘢痕断层皮片联合人工真皮移植可促进关节部位烧伤瘢痕整复患者术后创面Ⅰ级愈合,降低瘢痕增生程度,提高关节活动度,在关节部位烧伤瘢痕整复中具有较高的可行性。
Objective To explore the feasibility of scar split thickness skin graft combined with artificial dermis in the repair of burn scars at joints.Methods A total of 40 patients with scar hyperplasia after burns at joints,admitted into the Burn and Plastic Surgery Department of Dongguan People’s Hospital from January 2010 to January 2018 were divided into a study group(20 cases)and a control group(20 cases)according to the random number table.The patients in the study group were treated with scar split thickness skin graft combined with artificial dermis while the patients in the control group with only scar split thickness skin graft.The gradeⅠwound healing rate,Vancouver scar scale(VSS)score,and range of motion(ROM)score were compared between the two groups to evaluate the effect of scar repair.Results The postoperative 6 month follow up visit showed that the gradeⅠwound healing rate in the study group was 85.0%,being much higher than 55.0%in the control group,and the difference was statistically significant(P<0.05).After 6 months of treatment, the VSS score in the study group was (3. 1 ±0. 4) points, being much lower than (5. 7 ±1. 1) points in thecontrol group, and the difference was statistically significant (P < 0. 05). After 6 months of treatment, the ROM score inthe study group was (90. 8 ±4. 5) points, being much higher than (79. 9 ±7. 6) points in the control group, and also thedifference was statistically significant (P <0. 05). Conclusion Scar split thickness skin graft combined with artificial der mis can help achieve the grade I wound healing in patients with burn scars at joints, reduce scar hyperplasia and improvejoint mobility, presenting high feasibility in repairing burn scars at joints.
作者
叶东成
黄静
万里
牛占国
黄晓栋
Ye Dongcheng;Huang Jing;Wan Li;Niu Zhanguo;Huang Xiaodong(Burn and Plastic Surgery Department,Dongguan People’s Hospital,Dongguan City,Guangdong 523000,China)
出处
《中国烧伤创疡杂志》
2019年第5期368-372,共5页
The Chinese Journal of Burns Wounds & Surface Ulcers
关键词
瘢痕断层皮片
人工真皮
关节
烧伤
瘢痕增生
整形
修复
可行性
Scar split thickness skin graft
Artificial dermis
Joint
Burn
Scar hyperplasia
Plastic surgery
Repair
Feasibility
