Jonsson C E, Dalsgaard C J
Department of Plastic Surgery, Karolinska Hospital, Stockholm, Sweden.
Plast Reconstr Surg. 1991 Jul;88(1):83-92; discussion 93-4.
Since 1979, 16 patients with facial and neck burns have been treated with excision and skin grafting within the first 4 days of injury. The injuries were tangentially excised and immediately covered with split-thickness skin grafts. Detailed consecutive results are presented. The patients can be divided into three groups. Group 1 consisted of small subdermal or circumscribed deep dermal burns of the face (n = 8). Healing was quick. Some patients developed signs of overgrafting. As a late result, unevenness and discoloration were seen. Group 2 consisted of mixed deep dermal and subdermal burns of the face and neck (n = 5). Usually, minor areas had to be regrafted. Some patients developed hypertrophic scars at border areas. In the completely excised and grafted area, the skin was smooth, pliable, and discolored. Group 3 consisted mostly of subdermal burns of the face and neck (n = 3). The surgical trauma was significant. Small areas had to be regrafted. Ectropion and microstomia developed. It is concluded that in selected cases of deep dermal and subdermal burns, early excision and skin grafting will result in faster healing and less scarring than expectant treatment.
自1979年以来，16例面部和颈部烧伤患者在受伤后的头4天内接受了切除和植皮治疗。创面采用削痂法切除，并立即覆盖中厚皮片。本文呈现了详细的连续治疗结果。患者可分为三组。第一组包括面部小面积皮下或局限性深度真皮烧伤患者（n = 8）。愈合迅速。部分患者出现植皮过度的迹象。后期可见皮肤不平整和色素沉着。第二组包括面部和颈部深度真皮与皮下混合烧伤患者（n = 5）。通常，小面积区域需要再次植皮。部分患者在边缘区域出现增生性瘢痕。在完全切除并植皮的区域，皮肤光滑、柔软且有色素沉着。第三组主要为面部和颈部皮下烧伤患者（n = 3）。手术创伤较大。小面积区域需要再次植皮。出现了睑外翻和小口畸形。结论是，在选定的深度真皮和皮下烧伤病例中，早期切除和植皮比期待疗法愈合更快且瘢痕更少。
