Chen Lei, Yang Jing, Wang De-Yun, Jiang Jun-Mei, Zhang Bao-de, Zhao Zun-Jiang, Chen Xu-Lin, Lv Da-Lun
Department of Burn and Plastic Surgery, First Affiliated Hospital of Wannan Medical College, Wuhu, PR China.
Department of Burns, First Affiliated Hospital of Anhui Medical University, Hefei, PR China.
Int Wound J. 2024 Jan;21(1):e14341. doi: 10.1111/iwj.14341. Epub 2023 Aug 7.
To evaluate the efficacy of one-step acellular dermis combined with autologous split thickness skin grafting in the treatment of burn or trauma wounds by a multicenter controlled study. In patients with extensive burns, it is even difficult to repair the wounds due to the shortage of autologous skin. The traditional skin grafting method has the disadvantages of large damage to the donor site, insufficient skin source and unsatisfactory appearance, wear resistance and elasticity of the wound tissue after skin grafting. One-step acellular dermis combined with autologous ultra-thin split thickness skin graft can achieve better healing effect in the treatment of burn and trauma wounds. A total of 1208 patients who underwent single-layer skin grafting and one-step composite skin grafting in the First Affiliated Hospital of Wannan Medical College, Wuhan Third People's Hospital and Lu 'an People's Hospital from 2019 to 2022 were retrospectively analysed. The total hospitalization cost, total operation cost, hospitalization days after surgery, wound healing rate after 1 week of skin grafting and scar follow-up at 6 months after discharge were compared and studied. The total cost of hospitalization and operation in the composite skin grafting group was significantly higher than those in the single-layer autologous skin grafting group. The wound healing rate after 1 week of skin grafting and the VSS score of scar in the follow-up of 6 months after discharge were better than those in the single-layer skin grafting group. One-step acellular dermis combined with autologous ultra-thin split thickness skin graft has high wound healing rate, less scar, smooth appearance and good elasticity in repairing burn and trauma wounds, which can provide an ideal repair method for wounds.
通过多中心对照研究评估一步法脱细胞真皮联合自体中厚皮片移植治疗烧伤或创伤创面的疗效。对于大面积烧伤患者，由于自体皮肤短缺，创面修复甚至困难。传统的植皮方法存在供区损伤大、皮肤来源不足以及植皮后创面组织外观、耐磨性和弹性不理想等缺点。一步法脱细胞真皮联合自体超薄中厚皮片移植在烧伤和创伤创面治疗中可取得较好的愈合效果。回顾性分析了2019年至2022年在皖南医学院第一附属医院、武汉市第三人民医院和六安市人民医院接受单层植皮和一步法复合皮移植的1208例患者。比较并研究了总住院费用、总手术费用、术后住院天数、植皮1周后创面愈合率以及出院后6个月瘢痕随访情况。复合皮移植组的住院和手术总费用显著高于单层自体皮移植组。植皮1周后创面愈合率以及出院后6个月随访时瘢痕的VSS评分均优于单层植皮组。一步法脱细胞真皮联合自体超薄中厚皮片移植在修复烧伤和创伤创面时具有创面愈合率高、瘢痕少、外观平整且弹性良好的特点，可为创面提供理想的修复方法。
