Fang Zhuoqun, Li Jun, Wang Kejia, He Ting, Wang Hongtao, Xie Songtao, Yang Xuekang, Han Juntao
Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shanxi, China.
Department of Plastic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
J Invest Surg. 2022 Oct;35(10):1779-1788. doi: 10.1080/08941939.2022.2101164. Epub 2022 Jul 19.
This study introduced a novel method to reconstruct large areas of scarring caused by burns via combining autologous scar-related tissue with spit-thickness skin grafting (ASTCS).
25 patients underwent reconstruction after scar resection surgeries around the joints were analyzed between Jan 2012 and Jan 2018. Patient demographics and clinical parameters were collected, autologous scar-related tissue was modified to meshed structure, and the split-thickness skin was acquired from the scalp. The scar was resected and punched by a meshing machine with a thickness of 0.3-0.5 mm at a ratio of 1:1. The secondary wounds were covered by the epidermis from a donor site. The surgical areas were bandaged for 7-10 days before the first dressing change.
25 patients (mean [SD] age, 26.4 [18.8] years; 16 [64%] men) underwent wounds reconstructive operations due to scar resection were reviewed. Wound location of 9 (22%), 8 (19.5%), 9 (22%), 7 (17.1%) and 8 (19.5%) cases were reconstructed in axillary, hand and wrist, popliteal fossa, elbow and neck, respectively. 39 sites of transplanted tissues survived well, and 2 sites were cured after two weeks of dressing changes. Except the analysis of injury causes, nutritional status, wound area and hospital days, patients with scar deformities in joint areas achieved satisfactory function by assessing the Vancouver Burn Skin Score and the Barthel Index Scale Scores after 12-month follow-up.
Combining autologous scar-related tissue with skin grafting provided a novel method for treating large areas of burn scars with better functional outcomes.
本研究介绍了一种通过将自体瘢痕相关组织与中厚皮片移植（ASTCS）相结合来重建大面积烧伤瘢痕的新方法。
分析2012年1月至2018年1月期间25例接受关节周围瘢痕切除术后重建手术的患者。收集患者人口统计学和临床参数，将自体瘢痕相关组织修改为网状结构，并从头皮获取中厚皮片。用厚度为0.3 - 0.5毫米的网状机以1:1的比例切除并打孔瘢痕。供皮区的表皮覆盖二次创面。手术区域包扎7 - 10天，然后首次换药。
回顾了25例（平均[标准差]年龄，26.4[18.8]岁；16例[64%]为男性）因瘢痕切除而接受伤口重建手术的患者。分别有9例（22%）、8例（19.5%）、9例（22%）、7例（17.1%）和8例（19.5%）患者的伤口位于腋窝、手和腕部、腘窝、肘部和颈部并进行了重建。39个移植组织部位存活良好，2个部位经两周换药后治愈。除了分析损伤原因、营养状况、伤口面积和住院天数外，通过在12个月随访后评估温哥华烧伤皮肤评分和巴氏指数量表评分，关节部位有瘢痕畸形的患者功能恢复良好。
自体瘢痕相关组织与皮肤移植相结合为治疗大面积烧伤瘢痕提供了一种新方法，功能效果更佳。
