Zhang J L, Liu S H, Wang D Y, Jiang M J, Xie W G, Xi M M
Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2025 Jun 20;41(6):569-576. doi: 10.3760/cma.j.cn501225-20240615-00231.
To analyze the effects of acellular allogeneic dermis combined with autologous split-thickness skin grafts in repairing deep burn wounds in head, face, neck, and torso in children. This study was a historical control study. Thirty children who were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as our hospital) from January 2013 to May 2018 and underwent autologous split-thickness skin grafting alone for repairing deep burn wounds were selected as control group, including 15 males and 15 females, aged from 7 months to 13 years. Thirty-one children who were admitted to our hospital from June 2018 to May 2021 and underwent acellular allogeneic dermis combined with autologous split-thickness skin grafting for repairing deep burn wounds were selected as observation group, including 17 males and 14 females, aged 6 months to 13 years. The wound healing time of children in the two groups was recorded, the survival rates of skin grafts on 15 d after operation were calculated, and the incidences of adverse reactions such as pain and pruritus after wound healing were calculated. One year after operation, the Vancouver scar scale (VSS) was used to score the scars in the grafted area in the two groups of children in terms of color, thickness, softness, and vascular distribution, and the total VSS score was calculated; the satisfaction of one family member of children with the curative effect was investigated by using the efficacy satisfaction questionnaire developed by our hospital, and the satisfaction rate was calculated. The wound healing time of children in control group was significantly shorter than that in observation group (=8.86, <0.05). There were no statistically significant differences in the survival rates of skin grafts on 15 d after operation, and the incidences of pain and pruritus after wound healing in children between the two groups (>0.05). One year after operation, the scores of thickness, softness, color, and vascular distribution and the total score of VSS of scars in the skin grafting areas in children in observation group were 1 (0, 1), 2 (1, 2), 1 (0, 1), 1 (0, 1), and 4 (3, 5), which were significantly lower than 3 (2,4), 3 (3, 4), 2 (2, 3), 2 (2, 3), and 11 (10, 12), respectively in control group (with values of 6.20, 6.10, 6.42, 6.16, and 6.73, respectively, <0.05). One year after operation, the satisfaction rate with the curative effect of one family member of children in observation group was 96.77% (30/31), which was significantly higher than 76.67% (23/30) in control group (<0.05). Acellular allogeneic dermis combined with autologous split-thickness skin grafts for repairing deep burn wounds in head, face, neck, and torso in children can improve the wound healing quality, alleviate scar, and increase the satisfaction degree of children's family members. It is worthy of promotion and clinical application.
分析脱细胞异体真皮联合自体中厚皮片移植修复儿童头面颈及躯干深度烧伤创面的效果。本研究为历史性对照研究。选取2013年1月至2018年5月在武汉大学同仁医院&武汉市第三医院（以下简称我院）住院，单纯行自体中厚皮片移植修复深度烧伤创面的30例儿童作为对照组，其中男15例，女15例，年龄7个月至13岁。选取2018年6月至2021年5月在我院住院，行脱细胞异体真皮联合自体中厚皮片移植修复深度烧伤创面的31例儿童作为观察组，其中男17例，女14例，年龄6个月至13岁。记录两组儿童创面愈合时间，计算术后15 d皮片成活率，计算创面愈合后疼痛、瘙痒等不良反应发生率。术后1年，采用温哥华瘢痕量表（VSS）对两组儿童移植区瘢痕的颜色、厚度、柔软度及血管分布进行评分，计算VSS总分；采用我院自行编制的疗效满意度调查问卷，调查儿童1名家属对疗效的满意度，计算满意度。对照组儿童创面愈合时间显著短于观察组（=8.86，<0.05）。两组儿童术后15 d皮片成活率、创面愈合后疼痛及瘙痒发生率比较，差异无统计学意义（>0.05）。术后1年，观察组儿童移植区瘢痕厚度、柔软度、颜色、血管分布评分及VSS总分分别为1（0，1）、2（1，2）、1（0，1）、1（0，1）、4（3，5），显著低于对照组的3（2，4）、3（3，4）、2（2，3）、2（2，3）、11（10，12）（值分别为6.20、6.10、6.42、6.16、6.73，均<0.05）。术后1年，观察组儿童1名家属对疗效的满意度为96.77%（30/31），显著高于对照组的76.67%（23/30）（<0.05）。脱细胞异体真皮联合自体中厚皮片移植修复儿童头面颈及躯干深度烧伤创面，可提高创面愈合质量，减轻瘢痕，提高患儿家属满意度，值得推广应用。
