早期削痂保留变性真皮治疗大面积深ⅱ度烧伤疗效观察

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1、早期削痂保留变性真皮治疗大面积深Ⅱ度烧伤疗效观察【摘要】目的观察早期削痂保留变性真皮移植有效覆盖物(生物敷料、自体皮)治疗以深Ⅱ度创面为主的大面积烧伤患者的临床效果。方法对68例大面积深Ⅱ度烧伤创面行早期(1~3d)削痂术，削痂后创面保留变性的真皮组织，大部分创面以生物敷料覆盖，对于功能部位或接近Ⅲ度的深Ⅱ度(临界Ⅲ度)创面，以自体皮覆盖，功能部位植入薄中厚或中厚皮，并对32例功能部位植皮患者随访6~12个月，观察患者总体治愈情况及创面愈合效果。结果本组患者术后2~3周创面愈合，功能部位植入皮片有5例出现局灶性坏

2、死，其余皮片全部存活。无一例出现脓毒症及多器官功能障碍综合征，治愈率为98．5%。随访32例患者中，26例其皮肤外观、弹性及功能恢复良好，6例有轻、中度的功能障碍。结论大面积深Ⅱ度烧伤采用早期削痂并保留变性真皮，同时移植有效覆盖物，既可有效减少全身感染的发生率，预防或减少并发症的发生，提高治愈率，又可缩短创面愈合时间，减轻瘢痕形成，且功能部位早期得以良好修复，从而提高创面愈合质量。【关键词】烧伤；削痂；变性真皮；生物敷料；皮肤移植8Clinicalobservationsoftangentialexcisionw

3、iththepreservationofdenatureddermisonthedeeppartialthicknessburnwoundsinearlyperiodJIAJun,YANGTao,SONGGuo-dong,etal.DepartmentofBurns,JinanCentralHospitalattachedtoShandongUniversity,Shangdong250013,China【Abstract】ObjectiveToevaluatetheeffectofutilitycovering

4、graftonthedeeppartialthicknessburnwoundswiththepreservationofdenatureddermisaftertangentialexcisioninburnpatients.MethodsTangentialexcision,withthepreservationofdenatureddermis,wasperformedin68burnpatientswithin3postburndays.Mostoftherawsurfacewascoveredwithb

5、iologicaldressing,andmiddle-thicknessautoskinwasgraftedinfunctionpositionandnearfullthicknessburnwound.32patientswerefollowedupfrom6to12monthsandthetotalhealingconditionofpatientsandhealingeffectwereobserved.ResultsThewoundconcretedwithin2~3weekspostoperating

6、day.Exceptthatfocalnecrosiswasencounteredin5patientsofthegraftsinfunctionposition,the8skingraftsurvivedwell.Thehealingratewas98．5%.Thegraftedskinin26patientswasexcellentintheappearance,elasticityandfunctionafter6to12monthsoffollowup,atthesametime,lightormediu

7、mfunctionaldisturbancewasdiscoveredintheother6patients.ConclusionThemethodoftangentialexcisioninpatientswiththedeeppartialthicknessburnwoundsandutilitycoveringgrafting,withthepreservationofdenatureddermis,notonlycanreducetheincidencerateofgeneralinfectioneffe

8、ctively,decreasetheoccurrenceofcomplication,andenhancethewoundhealingrate,butalsocanshortenthecuringtime,relievescarring,andimprovethehealingquality.【Keywords】Burns;Tangentialexcision;Den