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目的:探讨脱细胞异种真皮基质(ADM)在烧伤创面磨、削痂术后覆盖的临床应用。方法:40例烧伤患者男22例,女18例,年龄最小为11个月,最大为80岁,平均面积约9.1%,深Ⅱ°面积平均约8%以上,创面给予包扎,积极补液,待患者生命体征平稳后首次手术时间选择在48~72 h之间,创面行磨、削痂术后用脱细胞异种真皮基质覆盖,术后给予侧灯保温,包扎5~7 d后给予打开,脱细胞异种真皮基质干燥透明,上皮化,有空壳感,用保鲜膜包扎24 h后ADM自动与上皮分离,完全脱落,创面在ADM下上皮化。结果:40例患者手术顺利,术后患者基质覆盖良好,无1例失败,患者对创面恢复满意,磨痂平均用时为(2.2±0.8)h,削痂用时约(2.5±0.9)h,平均去痂时间为7~10 d。结论:ADM在烧伤浅度创面磨、削痂术后覆盖效果良好,病程短,瘢痕增生少甚至无瘢痕,功能恢复良好,随访效果确信可靠,值得推广使用。
Objective: To investigate the clinical application of acellular xenogenic dermal matrix (ADM) in burns wound dressing and capsulotomy. Methods: 40 cases of burn patients were 22 males and 18 females, the youngest was 11 months and the maximum was 80 years old, with an average area of about 9.1%. The depth Ⅱ ° area was about 8% above average. Patients with stable vital signs after the first choice of operation time between 48 ~ 72 h, the wound line grinding, after removal of sclerosing acellular dermal matrix covered with lateral lamp insulation after surgery, after dressing 5 ~ 7 d to open, take off The xenografts of dermal cells were dry and transparent, with epithelialization and empty shell. ADM was automatically separated from epithelium 24 hours after clinging with plastic wrap, and completely disappeared. The wounds were epithelialized by ADM. Results: The operation was successful in 40 patients and the matrix was well covered in the patients. None of the patients failed. The patients were satisfied with the wound restoration. The average time spent grinding abrasions was (2.2 ± 0.8) h, and the time spent cutting off the scars (2.5 ± 0.9) h, Scab time to 7 ~ 10 d. CONCLUSION: ADM has a good covering effect after burns with minimal burns and capsulorhexis, with short course of disease, little or no scar scarring and good function recovery. The follow-up results are believed to be reliable and worthy of promotion.