上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (5): 600-.

• 经验交流 • 上一篇    下一篇

大面积烧伤瘢痕的后期整复治疗

郑捷新, 张 勤, 刘 琰, 牛轶雯, 刘 健   

  1. 上海交通大学 医学院瑞金医院灼伤整形科, 上海 200025
  • 出版日期:2010-05-25 发布日期:2010-05-28
  • 作者简介:郑捷新（1960—）, 男, 副主任医师, 学士；电子信箱: zhengjiexin7@hotmail.com。

Reconstructive surgery for scar of extensive burn in later stage post burn

ZHENG Jie-xin, ZHANG Qin, LIU Yan, NIU Yi-wen, LIU Jian   

  1. Department of Burn and Plastic Surgery, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2010-05-25 Published:2010-05-28

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摘要：

目的 为解决大面积烧伤患者后期瘢痕整复治疗时的皮源问题提供一种有效的临床治疗方案。方法 选择大面积烧伤后期进行整复治疗的患者21例，其中行瘢痕皮片移植术15例（47例次手术），瘢痕皮瓣移植术6例。分别在患者的瘢痕部位切取断层皮片或瘢痕皮瓣，行皮片移植术或皮瓣移植术，并在供皮区行邮票皮片回植。结果 在47例次瘢痕皮片移植术中，皮片全部成活42例，手术部位外观明显改善，功能恢复。6例瘢痕皮瓣移植术病例中，5例皮瓣全部成活，手术部位创面修复，功能改善；1例瘢痕皮瓣表皮坏死，经过局部换药后伤口愈合，手术部位功能基本恢复。结论临床实践证实瘢痕皮片和瘢痕皮瓣移植适用于皮源奇缺的大面积烧伤患者的后期整复治疗，能提供足够的皮源。

关键词: 烧伤, 瘢痕, 皮片移植, 皮瓣, 供皮区

Abstract:

Objective To explore an optimal method of providing efficient donor sites for the reconstructive surgery for scar of extensive burn in later stage post burn. Methods Twenty-one patients undergoing reconstructive surgery for extensive burn in later stage post burn were selected, among whom 15 were performed split-skin grafting (47 times of operations) and the other 6 received skin flap grafting. Split-skin grafts or flaps were harvested from scar skin, splitskin grafting or skin flap grafting was performed, and stamp-like grafts were reimbursed to the donor sites. Results In 47 times of split-skin grafting, skin grafts survived in 42 times of operations, with improved appearance of operative sites and functional recovery. Of 6 cases undergoing skin flap grafting, the flaps of 5 cases survived, with restoration of wound surface of operative sites and improved function. While the other 1 case with skin flap grafting experienced skin flap necrosis, and wound closure was achieved after local changes of dressing, with function restoration of operative sites. Conclusion Split-skin grafts and flaps harvested from scar skin are proved as effective way of providing efficient donor sites for reconstructive surgery for scar of extensive burn in later stage post burn.

Key words: burn, scar, split-skin graft, flap, donor site