脱细胞猪皮覆盖自体微粒皮治疗大面积深度烧伤创面的临床研究

发布时间：2018-05-01 02:38

本文选题：脱细胞猪皮 + 微粒皮　；参考：《重庆医学》2016年04期

【摘要】：目的探讨采用脱细胞猪皮覆盖自体微粒皮治疗大面积深度烧伤的临床效果。方法选择2006年1月至2013年1月该院烧伤科收治的大面积深度烧伤患者60例,应用早期削痂术行自体微粒皮移植,以脱细胞猪皮为微粒皮覆盖物。观察覆盖物脱落及微粒皮成活情况,并计算术后28d创面愈合率;术后7、14、21、28d取创面组织标本行HE染色观察组织病理学改变,观察术后1年患者的功能恢复情况。结果术后3d脱细胞猪皮与创面附着良好,大部分猪皮不变色,部分呈褐色,猪皮下偶有积血、积液行剪小孔引流。术后21~28d脱细胞猪皮干燥与基底分离,受压部位有少量积液,但无猪皮溶解,揭去猪皮后见微粒皮成活、融合成片。术后第4周创面愈合率为(81.20±3.31)%。创面组织HE染色显示,术后7d的部分组织切片中可见表皮细胞生长,术后14、21、28d均可见表皮细胞生长,表皮层逐渐增厚,脱细胞猪皮逐渐干燥与基底分离。术后1年患者术区虽有表浅瘢痕,但其弹性和功能均恢复正常。结论脱细胞猪皮可以替代异体皮作为微粒皮移植的良好覆盖物。
[Abstract]:Objective to investigate the clinical effect of acellular pigskin covering autologous microskin in treating large area deep burn. Methods from January 2006 to January 2013, 60 patients with extensive deep burn were treated in our hospital. Autologous skin grafts were performed by early escharectomy, and acellular pig skin was used as the skin covering. The wound healing rate was calculated at 28 days after operation, and the histopathological changes were observed by HE staining and the functional recovery of the patients 1 year after operation was observed by HE staining. Results on the 3rd day after operation, the acellular pig skin attached well to the wound, most of the pigskin did not discoloration, part of the pigskin was brown, there was occasional hemorrhage under the skin of the pig, and the effusion was draining through the small hole. On the 21st and 28th days after operation, the acellular pig skin was dried and the substrate was separated. There was a small amount of fluid accumulated in the compressed part, but no pig skin was dissolved. After the pig skin was removed, the particle skin survived and fused into pieces. The wound healing rate was 81.20 卤3.31 at the 4th week after operation. He staining of wound tissue showed that epidermal cell growth was observed in some tissue sections 7 days after operation, epidermal cell growth and epidermis thickening and acellular pig skin drying and basal separation were observed on 1421 ~ 28 days after operation. 1 year after operation, the area of operation had superficial scar, but its elasticity and function were normal. Conclusion acellular pig skin can replace allogeneic skin as a good covering for particle skin transplantation.
【作者单位】：昆明医科大学第二附属医院烧伤科;
【基金】：昆明医学院联合专项基金(2008CD020)
【分类号】：R644

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