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探讨缺表皮第二层自体微粒头皮移植治疗特大面积烧伤患者的可行性,选择2000-01/2006-05唐山钢铁公司医院烧伤科收治的特大面积烧伤患者29例,平均烧伤面积(86.26±3.79)%,Ⅲ度烧伤面积(52.69±9.11)%。诊断依据:根据1970年全国烧伤会议确定的标准,热烧伤系指单纯由热力所造成的局部或全身性损伤,如热水、火焰、蒸汽、钢(铁)水等所致损伤。每例患者均取两层皮片:首先于头部取含表皮的自体刃厚头皮,约0.5%体表面积,厚0.10～0.25mm,作为正常自体微粒头皮移植组;再于同一部位取面积、厚度均相同的缺表皮第二层头皮,作为缺表皮第二层自体微粒头皮移植组。两组皮片分别放入不同的剪皮杯内制备微粒皮浆,涂抹于新鲜异种猪皮的组织面,然后移植于较为对称、烧伤面积基本相等的两处Ⅲ度切痂创面上,扩张比例为1:10～1:15,抗菌药物纱布包扎。术后第2,3,4,5周末观察异体皮脱落处露出创面的愈合情况,两组创面愈合率均随着时间延长而逐渐提高,相同时间点比较组间差异无显著性意义(t=0.09～0.12,P均>0.05)。表明缺表皮第二层自体微粒头皮移植是一种有效的治疗大面积烧伤患者的方法,缓解了大面积烧伤患者自体皮源匮乏的困难。
To investigate the feasibility of scleral autograft scalp skin grafting in the treatment of extra-large area burn patients. Twenty-nine patients with extensive burns were enrolled in the Department of Burns, Tangshan Iron and Steel Hospital from January 2000 to May 2006, with an average burn area of 86.26 ± 3.79. %, Ⅲ degree burn area (52.69 ± 9.11)%. Basis for diagnosis: According to the criteria established at the National Burn Conference of 1970, thermal burns refer to local or systemic injuries caused solely by heat, such as hot water, flames, steam, steel (iron) water, and the like. Each patient was taken two layers of skin: first in the head to take the skin containing the autologous blade thick scalp, about 0.5% body surface area, thickness 0.10 ~ 0.25mm, as a normal autologous scalp transplantation group; then take the same area, The same thickness of the second layer of the scalp of the scalp, as the lack of epidermal second layer of scalp autografting group. Two sets of skins were placed in different shearing cup preparation of microparticle slurry, smear on the tissue surface of fresh xenograft pigskin, and then transplanted in more symmetrical, burns area two equal Ⅲ degree eschar wound, the expansion ratio 1: 10 ~ 1: 15, antibacterial gauze bandage. At the end of the 2nd, 3rd, 4th and 5th weeks after operation, the healed wounds exposed to the exfoliated allograft were observed. The wound healing rates of both groups were gradually increased with the prolongation of time. There was no significant difference between the two groups at the same time point (t = 0.09 ~ 0.12, P> 0.05). It is indicated that the second layer of scalp autograft scalp transplantation is an effective method to treat large area burn patients and alleviates the difficulty of autologous skin scarcity in large area burn patients.