復合皮移植修復燒傷功能部位創面療效評價_《中國修復重建外科雜志》

作者：

孟祥海 , 王曉琳 , 李學擁 , 李望舟 , 呂小星 , 蔣立 , 袁琰琴 , 李躍軍

第四軍醫大學唐都醫院燒傷整形科（西安，710038）;

關鍵詞：

脫細胞同種異體真皮自體刃厚皮復合移植燒傷創面修復

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【摘要】目的探討脫細胞同種異體真皮與自體刃厚皮復合移植修復深度燒傷功能部位創面的療效。方
法 2002 年6 月－ 2008 年12 月，收治30 例燒傷及瘢痕整形患者共42 個創面。男25 例，女5 例；年齡3 ～ 52 歲，中位
年齡31 歲。燒傷24 例35 個創面，其中深Ⅱ度23 個創面，Ⅲ度12 個創面；病程3 ～ 45 d，平均24 d。瘢痕整形6 例7 個
創面；病程9 ～ 21 d，平均16 d。42 個創面分別位于頸部2 個，手部4 個，前臂及肘部8 個，肩部3 個，腘窩6 個，膝部4 個，小腿及足踝部15 個。徹底清創、削痂及切除瘢痕后，創面范圍為10 cm × 10 cm ～ 30 cm × 20 cm。采用一步法將脫細胞同種異體真皮與自體刃厚皮復合移植修復創面。結果術后27 例39 個（92.9%）創面復合皮移植完全成活；3 例3 個
（7.1%）創面復合皮部分壞死，分別經換藥和自體皮片移植術后愈合。患者均獲隨訪，隨訪時間30 ～ 34 個月，平均32 個月。復合皮有輕度色素沉著，外觀平整，質地柔軟，彈性好，皮膚耐磨；復合皮無攣縮及瘢痕增生，功能部位活動正常。刃厚皮供皮區未見瘢痕增生。結論脫細胞同種異體真皮與自體刃厚皮復合移植修復功能部位深度燒傷及瘢痕整形創面，可
獲得良好外形及功能。

引用本文： 孟祥海,王曉琳,李學擁,李望舟,呂小星,蔣立,袁琰琴,李躍軍. 復合皮移植修復燒傷功能部位創面療效評價. 中國修復重建外科雜志, 2012, 26(2): 219-222. doi: 復制

1.	Heck EL, Bergstresser PR, Baxter CR. Composite skin graft: frozen dermal allografts support the engraftment and expansion of autologous epidermis. J Trauma, 1985, 25(2): 106-112.
2.	Wainwright DJ. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns, 1995, 21(4): 243-248.
3.	孫維國, 樊星. 脫細胞異體真皮修復燒傷瘢痕的臨床觀察. 中國美容醫學, 2008, 17(7): 974-975.
4.	Wang HJ, Chou TD, Tsou TL, et al. The application of new biosynthetic artificial skin for long-term temporary wound coverage. Burns, 2005, 31(8): 991-997.
5.	Patton JH Jr, Berry S, Kralovich KA. Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. Am J Surg, 2007, 193(3): 360-363.
6.	Zhang X, Deng Z, Wang H, et al. Expansion and delivery of human fibroblasts on micronized acellular dermal matrix for skin regeneration. Biomaterials, 2009, 30(14): 2666-2674.
7.	張瑋, 姜篤銀, 楊定文, 等. 無細胞異體真皮基質在關節功能部位整復中的應用. 實用全科醫學, 2004, 2(2): 101-102.
8.	Soejima K, Chen X, Nozaki M, et al. Novel application method of artificial dermis: one-step grafting procedure of artificial dermis and skin, rat experimental study. Burns, 2006, 32(3): 312-318.
9.	姜篤銀, 付小兵. 無細胞異種真皮基質降解因素的研究. 中華實驗外科雜志, 2003, 20(4): 360-361.
10.	Feng X, Tan J, Pan Y, et al. Control of hypertrophic scar from inception by using xenogenic (porcine) acellular dermal matrix (ADM) to cover deep second degree burn. Burns, 2006, 32(3): 293-298.
11.	Atherton DD, Tang R, Jones I, et al. Early excision and application of matriderm with simultaneous autologous skin grafting in facial burns. Plast Reconstr Surg, 2010, 125(2): 60e-61e.
12.	Loss M, Wedler V, Künzi W, et al. Artificial skin, split-thickness autograft and cultured autologous keratinocytes combined to treat a severe burn injury of 93% of TBSA. Burns, 2000, 26(7): 644-652.
13.	張建超, 沈國良, 趙小瑜, 等. 網狀中厚皮片移植聯合負壓封閉引流修復皮膚軟組織缺損. 中國誤診學雜志, 2009, 9(34): 8317-8319.
14.	Sun Y, Pan Y, Chen S, et al. Clinical application of microskin grafting to repair granulation or decrustation wounds. J Burn Care Res, 2006, 27(4): 515-519.
15.	潘云川, 徐家欽, 袁素, 等. 異體脫細胞真皮基質加自體刃厚皮復合移植遠期隨訪評價. 中華燒傷雜志, 2010, 26(6): 439-443.
16.	Bellemare J, Roberge CJ, Bergeron D, et al. Epidermis promotes dermal fibrosis: role in the pathogenesis of hypertrophic scars. J Pathol, 2005, 206(1): 1-8.
17.	陳璧, 姜篤銀, 賈赤宇, 等. 復合皮移植的實驗研究與臨床應用. 中華燒傷雜志, 2004, 20(6): 347-350.
18.	Wainwright DJ, Bury SB. Acellular dermal matrix in the management of the burn patient. Aesthet Surg J, 2011, 31(7 Suppl): 13S-23S.
19.	李東杰, 宋慧鋒, 賈曉明, 等. 脫細胞異體真皮基質修復燒傷后不穩定性瘢痕的臨床應用及病理學觀察. 中國修復重建外科雜志, 2010, 24(6): 653-656.
20.	Tang B, Zhu B, Liang YY, et al. Early escharectomy and concurrent composite skin grafting over human acellular dermal matrix scaffold for covering deep facial burns. Plast Reconstr Surg, 2011, 127(4): 1533-1538.

1. Heck EL, Bergstresser PR, Baxter CR. Composite skin graft: frozen dermal allografts support the engraftment and expansion of autologous epidermis. J Trauma, 1985, 25(2): 106-112.
2. Wainwright DJ. Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns. Burns, 1995, 21(4): 243-248.
3. 孫維國, 樊星. 脫細胞異體真皮修復燒傷瘢痕的臨床觀察. 中國美容醫學, 2008, 17(7): 974-975.
4. Wang HJ, Chou TD, Tsou TL, et al. The application of new biosynthetic artificial skin for long-term temporary wound coverage. Burns, 2005, 31(8): 991-997.
5. Patton JH Jr, Berry S, Kralovich KA. Use of human acellular dermal matrix in complex and contaminated abdominal wall reconstructions. Am J Surg, 2007, 193(3): 360-363.
6. Zhang X, Deng Z, Wang H, et al. Expansion and delivery of human fibroblasts on micronized acellular dermal matrix for skin regeneration. Biomaterials, 2009, 30(14): 2666-2674.
7. 張瑋, 姜篤銀, 楊定文, 等. 無細胞異體真皮基質在關節功能部位整復中的應用. 實用全科醫學, 2004, 2(2): 101-102.
8. Soejima K, Chen X, Nozaki M, et al. Novel application method of artificial dermis: one-step grafting procedure of artificial dermis and skin, rat experimental study. Burns, 2006, 32(3): 312-318.
9. 姜篤銀, 付小兵. 無細胞異種真皮基質降解因素的研究. 中華實驗外科雜志, 2003, 20(4): 360-361.
10. Feng X, Tan J, Pan Y, et al. Control of hypertrophic scar from inception by using xenogenic (porcine) acellular dermal matrix (ADM) to cover deep second degree burn. Burns, 2006, 32(3): 293-298.
11. Atherton DD, Tang R, Jones I, et al. Early excision and application of matriderm with simultaneous autologous skin grafting in facial burns. Plast Reconstr Surg, 2010, 125(2): 60e-61e.
12. Loss M, Wedler V, Künzi W, et al. Artificial skin, split-thickness autograft and cultured autologous keratinocytes combined to treat a severe burn injury of 93% of TBSA. Burns, 2000, 26(7): 644-652.
13. 張建超, 沈國良, 趙小瑜, 等. 網狀中厚皮片移植聯合負壓封閉引流修復皮膚軟組織缺損. 中國誤診學雜志, 2009, 9(34): 8317-8319.
14. Sun Y, Pan Y, Chen S, et al. Clinical application of microskin grafting to repair granulation or decrustation wounds. J Burn Care Res, 2006, 27(4): 515-519.
15. 潘云川, 徐家欽, 袁素, 等. 異體脫細胞真皮基質加自體刃厚皮復合移植遠期隨訪評價. 中華燒傷雜志, 2010, 26(6): 439-443.
16. Bellemare J, Roberge CJ, Bergeron D, et al. Epidermis promotes dermal fibrosis: role in the pathogenesis of hypertrophic scars. J Pathol, 2005, 206(1): 1-8.
17. 陳璧, 姜篤銀, 賈赤宇, 等. 復合皮移植的實驗研究與臨床應用. 中華燒傷雜志, 2004, 20(6): 347-350.
18. Wainwright DJ, Bury SB. Acellular dermal matrix in the management of the burn patient. Aesthet Surg J, 2011, 31(7 Suppl): 13S-23S.
19. 李東杰, 宋慧鋒, 賈曉明, 等. 脫細胞異體真皮基質修復燒傷后不穩定性瘢痕的臨床應用及病理學觀察. 中國修復重建外科雜志, 2010, 24(6): 653-656.
20. Tang B, Zhu B, Liang YY, et al. Early escharectomy and concurrent composite skin grafting over human acellular dermal matrix scaffold for covering deep facial burns. Plast Reconstr Surg, 2011, 127(4): 1533-1538.

《中國修復重建外科雜志》

復合皮移植修復燒傷功能部位創面療效評價

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《中國修復重建外科雜志》

復合皮移植修復燒傷功能部位創面療效評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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