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[混合皮肤移植与微粒皮移植修复大面积深度烧伤的比较]

[Comparison between intermingled skin transplantation and microskin grafting in repairing massive deep burn].

作者信息

Huang Bo-gao, Liao Zhen-jiang, Zhang Qin, Dou Yi

机构信息

Department of Burns, Ruijin Hospital, Medical College of Shanghai Jiao Tong University, Shanghai 200025, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2009 Dec;25(6):448-50.

Abstract

OBJECTIVE

To study difference in curative effect between intermingled skin transplantation (IT) and microskin grafting (MG) in repairing massive deep burn.

METHODS

Clinical materials of 101 patients with massive deep burn hospitalized from 1992 to 2008 were retrospectively summarized. Patients were divided into IT group (n = 52) and MG group (n = 49). The size of initial donor site for autologous skin, the wound size initially covered with autologous skin, the survival rate of initial autologous skin grafting, the theoretical expansion multiple of the autologous skin, the actual expansion multiple of the autologous skin, the total size of donated autologous skin, the remained wound condition, and the function of large joint of patients in two groups were compared.

RESULTS

In IT group and MG group, the size of initial donor site for autologous skin was respectively (3.25 +/- 0.48)%TBSA and (3.01 +/- 0.21)%TBSA, the wound size initially covered by autologous skin was respectively (30.4 +/- 3.6)%TBSA and (41.4 +/- 1.3)%TBSA, the survival rate of autologous skin grafting was respectively (99.9 +/- 1.9)% and (87.5 +/- 6.8)%, the theoretical expansion multiple of the autologous skin was respectively 9.5 +/- 1.3 and 13.9 +/- 1.4, the actual expansion multiple of the autologous skin was respectively 9.5 +/- 1.3 and 12.0 +/- 1.5, the difference between two figures of each index was statistically significant (P < 0.05). There was no statistical significant difference between IT and MG group in respect of the total size of donated autologous skin [respectively (14.2 +/- 1.9) and (14.0 +/- 2.1)%TBSA, P > 0.05]. There were 23 patients (44.2%) with residual wounds over 0.5%TBSA in IT group, and 37 cases (75.5%) in MG group. There were 34 patients (65.4%) with good function of large joints in IT group, and 18 cases (36.7%) in MG group.

CONCLUSIONS

Expansion multiple of autologous skin after MG is obviously larger than that after IT, thus limited skin source can be fully used. The wound healing quality and the restoration of large joint function of patients treated with IT are better than those of patients treated with MG.

摘要

目的

研究混合皮肤移植(IT)与微粒皮移植(MG)修复大面积深度烧伤的疗效差异。

方法

回顾性总结1992年至2008年住院治疗的101例大面积深度烧伤患者的临床资料。将患者分为IT组(n = 52)和MG组(n = 49)。比较两组患者自体皮初始供皮区面积、初始自体皮覆盖创面面积、初始自体皮移植成活率、自体皮理论扩张倍数、自体皮实际扩张倍数、自体皮总供皮面积、残余创面情况及大关节功能。

结果

IT组和MG组自体皮初始供皮区面积分别为(3.25±0.48)%TBSA和(3.01±0.21)%TBSA,初始自体皮覆盖创面面积分别为(30.4±3.6)%TBSA和(41.4±1.3)%TBSA,自体皮移植成活率分别为(99.9±1.9)%和(87.5±6.8)%,自体皮理论扩张倍数分别为9.5±1.3和13.9±1.4,自体皮实际扩张倍数分别为9.5±1.3和12.0±1.5,各指标两组间差异有统计学意义(P < 0.05)。IT组和MG组自体皮总供皮面积分别为(14.2±1.9)%TBSA和(14.0±2.1)%TBSA,差异无统计学意义(P > 0.05)。IT组有23例(44.2%)残余创面超过0.5%TBSA,MG组有37例(75.5%)。IT组有34例(65.4%)大关节功能良好,MG组有18例(36.7%)。

结论

MG术后自体皮扩张倍数明显大于IT术后,可充分利用有限的皮肤资源。IT治疗患者的创面愈合质量及大关节功能恢复优于MG治疗患者。

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