摘要
目的探讨非头部反复取皮移植手术在大面积深度烧伤患者中的应用价值。方法我院收治的火焰烧伤患者20例,采用Zimmer气动取皮刀,于胸部、腹部、上臂、大腿、阴囊及足背及足趾取皮,采用多种术式修复全身创面。分析患者治疗的临床疗效,记录分析不同供皮区取皮间隔时间、取皮次数、愈合时间。结果 20例患者共行Meek植皮术26次,新鲜条状猪皮与自体邮票皮相间移植术39次,异体皮和自体微粒皮移植术8次,自体邮票皮游离移植术36次。20例患者中,治愈19例,治愈率达95%,1例由于烧伤后休克,抢救不及时死亡。创面完全封闭时间为伤后58-95 d,平均（76±15）d。足背及足趾取皮间隔时间较短（P〈0.05）,其余供皮区取皮间隔时间相近。上臂、大腿、阴囊取皮次数较少（P〈0.05）,余供皮区取皮次数相近。各供皮区愈合时间比较无显著性差异（P〉0.05）。结论对于头皮不能利用的大面积烧伤患者,采用Zimmer气动取皮刀于胸部、腹部、足背及足趾取皮,治疗效果良好,值得临床推荐。
Objective To investigate the curative effects of repeated skin grafting in non-head donor sites in patients with extensive deep burns. Methods 20 cases with extensive deep burns in our hospital were selected as the object and the Zimmer motor dermatome was used for skin grafting. Different non-head donor sites were used. Curative effects,skin grafting interval time,skin grafting frequency and healing time were collected. Results 20 patients underwent 26 times of Meek dermatoplasty,39 times of fresh strips pigskin and autologous stamp skin grafting,8 times of allo-skin and particulate auto-skin grafting,and 36 times of free stamp auto-skin transplantation. 19 of 20（ 95 %） were cured,and 1 case died of severe shock. Wound completely closed time was 58 - 95 days,（ 76 ± 15） days for average. The interval time of skin grafting at dorsalis and digitorum sites was relatively shorter（ P〈0. 05）. The frequency of skin grafting at the upper arm,thigh and scrotum was fewer（ P〈0. 05）. There was no significant difference of the skin healing time（ P〉0. 05）. Conclusion For patients with extensive deep burns,skin grafting at chest,abdomen,dorsalis,pedis and toes by Zimmer motor dermatome shows good effects,which is worthy of generalization.
出处
《中国现代手术学杂志》
2015年第1期50-52,共3页
Chinese Journal of Modern Operative Surgery
作者简介
蒋建纲，男，4l岁，公安消防总队医院烧伤整形科主治医师。
