自体刃厚头皮片移植厚中厚皮片供区以抑制瘢痕增生.docVIP

自体刃厚头皮片移植厚中厚皮片供区以抑制瘢痕增生[摘要]目的：探讨应用自体刃厚头皮片移植厚中厚皮片供区以抑制瘢痕增生的可行性及应用效果。方法：烧伤后全身大范围的增生性瘢痕患者24例，行功能部位的增生性瘢痕切除，应用非功能部位的大张厚中厚皮片修复，厚中厚皮片供区应用刃厚头皮片移植修复。结果：24例患者非功能部位厚中厚皮片供区经刃厚头皮片移植后，未见有明显的瘢痕增生。经随访半年至2年11例，2年以上3例，均未见有明显的瘢痕增生。头皮片供区无瘢痕形成，头发生长良好。结论：应用自体刃厚头皮片移植厚中厚皮片供区抑制瘢痕增生是一种可行的方法,值得临床推广。 [关键词]刃厚头皮片；厚中厚皮片；供区；瘢痕增生 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2007）10-1358-02 The clinical research of scalp epidermal skin graft inhibit scar hypertrophy on intermediate split thickness skin graft donor Site LIANG Jie,WU Hao-jun,ZHANG Wen-guang,LI Rui-jun,HAO Xin-guang (1.Department of Plastic Surgery, Affiliated Hospital of Guangdong Medical College,Zhanjiang 524001,Guangdong, China; 2.Department of BUrns Surgery, Affiliated Hospital of Guangdong Medical College) Abstract：ObjectiveTo study the clinical significance of scalp epidermal skin graft used to inhibit scar hypertrophy on intermediate split thickness skin graft donor Site. MethodsAfter the intermediate split thickness skin graft was cut to cover the wound on the recipient area, the wound on the donor Site was repaired by scalp epidermal skin graft.ResultsFrom 2000 to 2006, the technique was used in 24 patinets. scars on the donor Site were invisible or not obvious. ConclusionIt suggests that scalp epidermal skin graft could effectively inhibit scar hypertrophy on intermediate split thickness skin graft donor Site. The technique was used easily and effectly and gave a satisfactory result. Key words:scalp epidermal skin graft; intermediate split thickness skin graft; donor Site; scar hypertrophy 对于烧伤后全身大范围的增生性瘢痕的整形有时需多次修复，早期手术常采取瘢痕切除，大张厚中厚皮片移植修复的方式[1]，尤其对关节功能部位。但常因皮片供皮区切取过深或因愈合时间长，创面反复感染、破溃、出血等原因，愈合后遗留瘢痕甚至是增生性瘢痕而影响局部外观，给患者生活带来不便。同时因瘢痕产生而无法再次成为供皮区，从而影响后期修复。本科于2000年10月～2006年9月应用自体刃厚头皮片移植于厚中厚皮片供皮区抑制瘢痕增生24例，取得了良好的效果，报道如下。 1资料和方法 1.1 一般资料：本组24例，其中男16例，女8例，年龄12～45岁，无其他严重合并症。均为烧伤愈合后全身大面积的增生性瘢痕形成（时间1～13年)的患者。13例为双上肢、8例为双下肢3例为颈部。厚中厚皮片的供区：13例在腹部，9例在大腿内侧，2例在胸部。供区面积最大20cm×25cm，最小12cm×10cm。 1.2 方法：手术在气管插管全麻下进行。将瘢痕完整切除后，根