Pan B H, Sun Y, Tang T, Xiang Y, Zhu S H
Burn Institute of PLA, Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai 200433, China.
Department of Health Service, Naval Medical University, Shanghai 200433, China.
Zhonghua Shao Shang Za Zhi. 2020 Sep 20;36(9):861-864. doi: 10.3760/cma.j.cn501120-20190725-00311.
To investigate the effects of microskin transplantation with antigen-free porcine peritoneum (AFPP) as substitutive carrier for allogeneic skin graft in treating patients with extensive deep burns. Medical records of 32 patients with extensive deep burns, hospitalized in Changhai Hospital of Naval Medical University meeting the inclusion criteria were investigated from January 2014 to December 2017. Twenty patients [12 males and 8 females, aged (35.4±2.2) years]with microskin transplantation using allogeneic skin graft as microskin carrier were included in allogeneic skin graft group and 12 patients [6 males and 6 females, aged (32.1±4.8) years] with microskin transplantation using AFPP as microskin carrier were included in AFPP group. On post injury day 3-7, the vital signs of patients were stable and escharectomy and autologous microskin grafting of head were performed. The expansion ratio of microskin, the application time of albumin and antibiotics, the percentage of infectious autologous microskin grafting area, the survival rate of microskin, and dressing change times of patients in 2 groups were recorded. Data were statistically analyzed with test. The expansion ratio of microskin of patient in AFPP group was 14.8±0.6, which was close to 13.5±0.6 of allogeneic skin graft group (=1.531, >0.05). The application time of albumin and antibiotics of patients in AFPP group were close to those of allogeneic skin graft group (=0.027, 1.121, >0.05). The percentage of infectious autologous microskin grafting area of patients in AFPP group was (8.5±1.2)%, which was significantly lower than (18.1±0.6)% in allogeneic skin graft group in 4 weeks after surgery(=7.593, <0.01), the survival rate of microskin of patients in AFPP group was (82.5±1.1)%, which was significantly higher than (72.5±0.6)% in allogeneic skin graft group (=8.689, <0.01). The dressing change time of patients in AFPP group was significantly less than that in allogeneic skin graft group (=4.743, <0.01). Compared with allogeneic skin graft, microskin transplantation with AFPP as carrier can reduce wound infection, improve the survival rate of microskin graft, and reduce dressing change time, so that AFPP is a good carrier of microskin.
探讨以无抗原猪腹膜(AFPP)作为异体皮移植替代载体的微粒皮移植治疗大面积深度烧伤患者的效果。回顾性分析2014年1月至2017年12月海军军医大学附属长海医院收治的符合纳入标准的32例大面积深度烧伤患者的病历资料。将其中20例[男12例,女8例,年龄(35.4±2.2)岁]采用异体皮作为微粒皮载体进行微粒皮移植的患者纳入异体皮组,12例[男6例,女6例,年龄(32.1±4.8)岁]采用AFPP作为微粒皮载体进行微粒皮移植的患者纳入AFPP组。伤后3 - 7天,患者生命体征平稳,行头部切痂及自体微粒皮移植术。记录两组患者微粒皮的扩增倍数、白蛋白及抗生素应用时间、自体微粒皮移植感染面积百分比、微粒皮成活率及换药次数。采用t检验进行统计学分析。AFPP组患者微粒皮的扩增倍数为14.8±0.6,与异体皮组的13.5±0.6相近(t = 1.531,P>0.05)。AFPP组患者白蛋白及抗生素应用时间与异体皮组相近(t = 0.027、1.121,P均>0.05)。术后4周,AFPP组患者自体微粒皮移植感染面积百分比为(8.5±1.2)%,明显低于异体皮组的(18.1±0.6)%(t = 7.593,P<0.01);AFPP组患者微粒皮成活率为(82.5±1.1)%,明显高于异体皮组的(72.5±0.6)%(t = 8.689,P<0.01)。AFPP组患者换药次数明显少于异体皮组(t = 4.743,P<0.01)。与异体皮移植相比,以AFPP作为载体的微粒皮移植可减少创面感染,提高微粒皮移植成活率,并减少换药次数,表明AFPP是一种良好的微粒皮载体。