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慢性烧伤创面植皮时手术切除与不切除肉芽组织的对比研究。

Comparative study of skin grafting with and without surgical removal of granulation tissue in chronic burn wounds.

作者信息

Dhar Sanjay, Saraf Rakesh, Gupta Anand K, Raina Bhavani

机构信息

Department of Surgery, Govt. Medical College, Jammu, India.

出版信息

Burns. 2007 Nov;33(7):872-8. doi: 10.1016/j.burns.2006.11.012. Epub 2007 Jun 4.

Abstract

A prospective comparative study of skin grafting of chronic wounds with and without surgical removal of granulation tissue was done on 51 patients with an objective of finding a better method of skin grafting objectively in the chronic burns wounds. Comparative study was done on those patients who had wounds on both the sides of their body. Wounds present on the right side of the body labeled as Group A were skin grafted after removal of granulation tissue and wounds present on left side of the body labeled as Group B were skin grafted without removal of granulation tissue. There was no significant difference in the comparative bacteriology, graft uptake and cosmetic appearance of the grafts. We found no effect of bacteriology and chronicity of the wounds on the uptake of grafts in the two groups. Serum albumin levels <4 g% was found to be associated with statistically significant decreased graft uptake only in Group A wounds. It was further observed that Group A wounds were associated with more blood loss, less secure haemostasis, prolonged surgical duration and thus more cost of surgery as compared to Group B wounds.

摘要

对51例患者进行了一项前瞻性比较研究,该研究针对有或没有手术切除肉芽组织的慢性伤口进行皮肤移植,目的是客观地找到一种在慢性烧伤伤口中更好的皮肤移植方法。对身体两侧都有伤口的患者进行了比较研究。身体右侧的伤口标记为A组,在切除肉芽组织后进行皮肤移植;身体左侧的伤口标记为B组,在不切除肉芽组织的情况下进行皮肤移植。两组在比较细菌学、移植物摄取和移植物的外观方面没有显著差异。我们发现,伤口的细菌学和慢性对两组移植物的摄取没有影响。仅在A组伤口中,血清白蛋白水平<4 g%与移植物摄取的统计学显著降低相关。进一步观察发现,与B组伤口相比,A组伤口失血更多、止血不牢固、手术时间延长,因此手术成本更高。

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