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用于急性烧伤创面一期闭合的皮肤拉伸

Skin stretching for primary closure of acute burn wounds.

作者信息

Verhaegen Pauline D H M, Bloemen Monica C T, van der Wal Martijn B A, Vloemans Adrianus F P M, Tempelman Fenike R H, Beerthuizen Gerard I J M, van Zuijlen Paul P M

机构信息

Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, VU Medical Center, Amsterdam, The Netherlands.

Association of Dutch Burn Centers, Red Cross Hospital, Beverwijk, The Netherlands; Burn Center, Red Cross Hospital, Beverwijk, The Netherlands.

出版信息

Burns. 2014 Dec;40(8):1727-37. doi: 10.1016/j.burns.2014.03.014. Epub 2014 Apr 16.


DOI:10.1016/j.burns.2014.03.014
PMID:24746282
Abstract

BACKGROUND: In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adjacent healthy skin. The short- and long-term effect of Skin Stretch was compared to split skin grafting (SSG) in a randomized controlled trial. METHODS: Patients with burn wounds were randomized for SSG or primary wound closure using Skin Stretch. Follow-up was performed at 3 and 12 months postoperatively. The scar surface area was calculated and the scar quality was assessed, using subjective and objective measurement methods. RESULTS: No significant differences between the SSG and the Skin Stretch group were found for scar surface area. In the Skin Stretch group, a significant reduction of the surface area from 65.4cm(2) (13.6-129.1) to 13.4cm(2) (3.0-36.6) was found at 3 months (p=0.028) and at 12 months postoperatively (65.4cm(2) (13.6-129.1) to 33.0cm(2) (8.9-63.7), p=0.046, Wilcoxon signed ranks test). CONCLUSIONS: Skin Stretch for primary closure of acute burn wounds is a suitable technique and can be considered for specific circumscript full-thickness burn wounds. However, future research should be performed to provide additional scientific evidence.

摘要

背景:在烧伤护理中,一个公认的问题是植皮烧伤创面的瘢痕愈合效果欠佳。为改善这一情况,我们聚焦于一种新技术:切除烧伤创面后进行一期缝合,从而使用皮肤拉伸装置拉伸相邻的健康皮肤。在一项随机对照试验中,将皮肤拉伸术(Skin Stretch)的短期和长期效果与中厚皮片移植术(SSG)进行了比较。 方法:将烧伤创面患者随机分为接受中厚皮片移植术或采用皮肤拉伸术进行创面一期缝合的两组。术后3个月和12个月进行随访。使用主观和客观测量方法计算瘢痕表面积并评估瘢痕质量。 结果:中厚皮片移植组和皮肤拉伸组在瘢痕表面积方面未发现显著差异。在皮肤拉伸组中,术后3个月时表面积从65.4cm²(13.6 - 129.1)显著减少至13.4cm²(3.0 - 36.6)(p = 0.028),术后12个月时从65.4cm²(13.6 - 129.1)减少至33.0cm²(8.9 - 63.7)(p = 0.046,Wilcoxon符号秩检验)。 结论:皮肤拉伸术用于急性烧伤创面的一期缝合是一种合适的技术,对于特定的局限性全层烧伤创面可以考虑采用。然而,未来应开展更多研究以提供更多科学证据。

相似文献

[1]
Skin stretching for primary closure of acute burn wounds.

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[2]
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[3]
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[4]
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[6]
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[7]
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[9]
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[10]
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引用本文的文献

[1]
Utility of Excision and Direct Closure in Burns: A Case Report and Review of the Literature.

Cureus. 2025-2-22

[2]
Skin Stretching Techniques: A Review of Clinical Application in Wound Repair.

Plast Reconstr Surg Glob Open. 2024-12-20

[3]
What are optimum cycles for immediate primary closure of large cutaneous defects?

Sci Prog. 2024

[4]
Skin stretch suturing with Nice knots in the treatment of small- or medium-sized wounds.

J Orthop Surg Res. 2020-10-22

[5]
A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection.

World J Surg Oncol. 2020-9-17

[6]
Closure of a full-thickness scalp burn that occurred during hair coloring using a simple skin-stretching method: A case report and review of the literature.

Arch Plast Surg. 2019-3

[7]
Skin bioprinting: the future of burn wound reconstruction?

Burns Trauma. 2019-2-12

[8]
Systematic review of clinical outcome reporting in randomised controlled trials of burn care.

BMJ Open. 2019-2-15

[9]
EASApprox skin-stretching system: A secure and effective method to achieve wound closure.

Exp Ther Med. 2017-7

[10]
A systematic review of objective burn scar measurements.

Burns Trauma. 2016-4-27

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