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治疗皮肤移植供区:残余皮肤使用与聚氨酯泡沫的比较研究

Treating skin graft donor sites: a comparative study between remnant skin use and polyurethane foam.

作者信息

Ki Sae Hwi, Ma Sung Hwan, Choi Jong Hwan, Sim Seung Hyun, Kim Hyung Muk

机构信息

Department of Plastic Surgery, Inha University Hospital, Incheon, Korea.

Department of Plastic Surgery, Inha University School of Medicine, Incheon, Korea.

出版信息

J Wound Care. 2019 Jul 2;28(7):469-477. doi: 10.12968/jowc.2019.28.7.469.

Abstract

OBJECTIVE

Excess remnant skin is retained for use in additional grafting in case of split-thickness skin graft (STSG) failure. We hypothesise that regrafting with remnant skin offers greater efficacy and advantages in wound healing and donor site appearance.

METHODS

Skin graft donor sites were assessed by comparing those regrafted with remnant skin with those treated with polyurethane foam dressing. Healing time, pain, patient satisfaction, itching sensation, skin stiffness and irregularity between regrafting and foam dressing were compared. The aesthetic satisfaction of donor site was evaluated by four board-certified plastic surgeons. The differences were tested statistically.

RESULTS

A total of 39 patients received a STSG due to skin or soft tissue wounds caused by burn, trauma and cancer reconstruction. The donor site healing time was shorter with remnant skin regrafting compared with foam dressing. There was no difference with respect to donor site pain between the two treatment groups. At two weeks after skin graft, patient satisfaction was higher in those treated with remnant skin than in those treated with foam dressing. Aesthetic assessment was improved after 12 weeks.

CONCLUSION

Donor site dressing using remnant skin appears to improve wound healing and enhance the aesthetic outcome of donor sites.

摘要

目的

保留多余的残余皮肤,以备在中厚皮片(STSG)移植失败时用于额外的移植。我们假设用残余皮肤进行再次移植在伤口愈合和供皮区外观方面具有更高的疗效和优势。

方法

通过比较用残余皮肤再次移植的供皮区与用聚氨酯泡沫敷料治疗的供皮区来评估皮肤移植供皮区。比较再次移植和泡沫敷料之间的愈合时间、疼痛、患者满意度、瘙痒感、皮肤硬度和不平整度。由四位获得董事会认证的整形外科医生评估供皮区的美学满意度。对差异进行统计学检验。

结果

共有39例患者因烧伤、创伤和癌症重建导致的皮肤或软组织伤口接受了中厚皮片移植。与泡沫敷料相比,用残余皮肤再次移植的供皮区愈合时间更短。两个治疗组在供皮区疼痛方面没有差异。皮肤移植后两周,用残余皮肤治疗的患者满意度高于用泡沫敷料治疗的患者。12周后美学评估得到改善。

结论

使用残余皮肤进行供皮区敷料似乎可以改善伤口愈合并提高供皮区的美学效果。

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