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目的通过对Ⅲ°烧伤创面早期削痂后保留健康脂肪组织行自体皮移植,探讨Ⅲ°烧伤创面的理想治疗方式。方法按条件选取2009年9月至2010年12月该院烧伤中心收治的Ⅲ°烧伤患者31例,烧伤早期削痂,术中评估脂肪组织活性并保留健康脂肪组织,同体行大张皮移植与小皮片移植,术后分别观察皮片存活率、愈合时间、创面愈合分级及远期疗效。结果大张皮移植存活率、愈合时间、创面愈合分级及远期疗效优良率分别为(95.67±4.28)%、(11.48±2.73)d、100.0%、90.3%;小皮片移植分别为(92.72±8.31)%、(16.52±3.12)d、83.9%、71.0%。大张皮移植较小皮片移植愈合时间短,且创面愈合分级及远期疗效佳,差异有统计学意义(P<0.05)。结论烧伤创面削痂后保留健康脂肪组织,大张皮移植较小皮片移植愈合时间短,疗效更佳。皮源充足时,适用于烧伤创面位于功能部位或暴露部位的治疗。
Objective To investigate the ideal treatment of Ⅲ ° burn wound by autograft transplantation of healthy fat tissue after initial scabbing of Ⅲ ° burn wound. Methods According to the conditions, 31 patients with Ⅲ ° burns treated in the hospital from September 2009 to December 2010 were selected. The scab was removed early in the burn, the activity of adipose tissue was evaluated and the healthy adipose tissue was preserved in the operation. Small skin graft, after surgery were observed skin graft survival, healing time, wound healing grading and long-term efficacy. Results The survival rate, healing time, wound healing grading and long-term curative effect were (95.67 ± 4.28)%, (11.48 ± 2.73) d, 100.0% and 90.3% respectively. The skin grafts were (92.72 ± 8.31)%, (16.52 ± 3.12) d, 83.9%, 71.0%. Large skin graft smaller skin graft healing time is short, and the wound healing grading and long-term curative effect, the difference was statistically significant (P <0.05). Conclusions The healthy fat tissue is preserved after the burn wound is cut and scabbed. The transplantation of large skin grafts with shorter skin graft has shorter healing time and better curative effect. Sufficient skin source, apply to burn wounds in the treatment of functional or exposed parts.