论文部分内容阅读
目的总结Meek微型皮片移植术在老年成批大面积烧伤创面修复中应用的临床经验。方法对2013年7月26日解放军第一一八医院收治的一批共13例老年大面积烧伤患者的临床资料进行回顾性分析总结。在患者病情相对稳定后对其创面分批、分期实施Meek微型皮片移植术,移植的Meek微型皮片扩展倍数为1∶6和1∶9,观察该批老年烧伤患者的首次手术面积、总手术面积、平均手术次数、救治成功率、全身创面的愈合时间、患者住院时间,成活患者术后10个月随访植皮区瘢痕增生情况,肘、肩等大关节功能恢复情况。结果 13例患者中有4例因病情不稳定未能实施植皮手术分别于伤后1、11、67、71 d最终死亡。实施Meek微型皮片移植术的9例患者首次手术面积平均为(20.11±3.21)%总体表面积(TBSA),总手术面积平均为(45.21±8.33)%TBSA,平均手术次数为(3.3±1.3)次。救治成功7例,2例患者分别因术后并发脓毒症和术后弥漫性血管内凝血而死亡,救治成功率为78%。存活7例患者的创面平均愈合时间为(65.31±12.52)d,平均住院时间为(96.28±20.02)d。术后随访10个月植皮区瘢痕挛缩轻,肘、肩等大关节功能恢复基本正常。结论Meek微型皮片移植术适合老年成批大面积烧伤创面的修复,可降低老年成批大面积烧伤的病死率,缩短创面的愈合时间,有利于术后功能的恢复,因此,Meek微型皮片移植术是老年成批大面积烧伤创面修复的较佳方法之一。
OBJECTIVE: To summarize the clinical experience of Meek mini skin grafts in the repair of large-area burn wounds in elderly patients. Methods A total of 13 cases of elderly patients with extensive burn admitted to the 118th Hospital of PLA on July 26, 2013 were retrospectively analyzed. After the patient’s condition was relatively stable, Meek mini skin graft was performed in batches and in stages. The magnified Meek mini-skin graft was 1: 6 and 1: 9. The first operation area, Surgical area, the average number of operations, the success rate of treatment, healing time of the whole body wound, hospital stay, surviving patients 10 months follow-up scar skin hyperplasia, elbow, shoulder and other large joint function recovery. Results Of the 13 patients, 4 patients failed to undergo skin grafting because of their unstable condition, and eventually died on the 1st, 11th, 67th, and 71st day after injury respectively. The mean operative area was (20.11 ± 3.21)% of the total surface area (TBSA) and the mean operative area was (45.21 ± 8.33)% TBSA in the 9 patients who underwent Meek microdermabrasion. The average number of operations was (3.3 ± 1.3) Times. The treatment was successful in 7 cases, 2 patients died of postoperative concurrent sepsis and postoperative diffuse intravascular coagulation, the success rate of treatment was 78%. The average wound healing time was (65.31 ± 12.52) days and the average length of stay in the 7 patients survived (96.28 ± 20.02) d. After 10 months of follow-up, the scar contracture in skin graft area was light, and the function recovery of elbow, shoulder and other large joints was basically normal. Conclusion Meek mini skin grafting is suitable for the repair of large-area burn wounds in aged patients. It can reduce the fatality rate of large-area burns in aged patients and shorten the wound healing time, which is beneficial to the recovery of postoperative function. Therefore, Meek micro-skin graft Transplantation is one of the better ways to repair massive burn wounds in old age.