生物敷料联合自体皮移植修复老年患者深度烧伤创面效果探讨

目的:探讨生物敷料联合自体皮移植修复老年患者深度烧伤创面效果。方法:选择2012年6月-2016年8月笔者医院收治的80例老年深度烧伤患者为研究对象,随机分为观察组和对照组,每组40例。观察组采用生物敷料加自体皮移植进行治疗,对照组直接采用自体皮移植进行治疗。比较两组患者治疗效果、创面愈合时间、术后换药次数、上皮组织完全覆盖创面时间、住院时间、疼痛评分及并发症发生情况。结果:观察组治疗总有效率为97.50%高于对照组的80.00%,差异有统计学意义(P0.05);观察组患者创面愈合时间、术后换药次数、上皮组织完全覆盖创面时间、住院时间及疼痛评分均明显低于对照组,差异有统计学意义(P0.05);观察组患者并发症发生率为10.00%显著低于对照组的45.00%,差异有统计学意义(P0.05)。结论:将生物敷料联合自体皮移植术应用于老年患者深度烧伤创面修复,可以有效促进创面愈合,提高疗效,减少并发症发生,值得临床推广应用。     

腹部带蒂超薄皮瓣在手和前臂皮肤软组织损伤中的临床应用

目的探讨腹部带蒂超薄皮瓣在修复手和前臂皮肤软组织损伤中的治疗效果。方法选取26例(41个皮瓣)创面均在手和前臂的深度创面患者,术中将手和前臂的创面清创,按照清创后创面的形状与大小切取腹部带蒂皮瓣,将皮瓣中远端修薄后转移覆盖到手和前臂的皮肤软组织缺损创面上,术后3周左右断蒂。结果 26例患者中,1例患者皮瓣大部分坏死,行截指手术后皮瓣远端少许坏死,经换药后愈合,其余25例患者40个皮瓣均完全成活。术后随访6个月,手和前臂的移植皮瓣不臃肿、质地柔软,无需再行皮瓣修薄手术,外观与功能恢复比较满意。结论应用腹部带蒂超薄皮瓣修复手和前臂皮肤软组织损伤引起的缺损创面具有操作简单、手术安全性高、术后外形与功能恢复佳等优点。     

乳腺癌改良根治术后顽固性皮下积液手术修复的效果

目的探讨乳腺癌改良根治术后顽固性皮下积液的手术修复效果。方法本科室采用手术方法修复乳腺癌改良根治术后形成的顽固性皮下积液11例,手术采用去除皮下积液空腔囊壁、空腔内留置引流管并接持续负压吸引、空腔外用荷包加压固定等手段。结果 10例患者一期治愈,1例皮瓣与基底未贴合,二期行扩创手术与自体皮移植手术后修复。11例患者术后均随访3个月,术区皮瓣与基底粘合紧密,皮下积液未复发,皮瓣无坏死与缺损。结论应用手术方法修复乳腺癌改良根治术后顽固性皮下积液安全有效,操作方便。     

克氏针软组织固定在手指烧伤后畸形整形中的临床应用

<正>手指深度烧伤后常易发生瘢痕增生,继发关节僵硬、挛缩畸形,影响骨、关节、肌腱、血管与神经发育,故瘢痕增生挛缩畸形一旦影响功能,应尽早手术。为了方便手指烧伤后瘢痕挛缩畸形整形手术的术中操作、术后手指固定,并且为了减少对组织的损伤,笔者对56例99个烧伤后瘢痕挛缩畸形的手指采用术中、术后克氏针软组织固定[1],取得了良好的效果。     

烧伤后肺损伤病因及预后回顾性分析

1 对象与方法 1.1 病例入选与排除标准 (1)患者年龄16 ～ 65岁;烧伤总面积大于或等于50％ TBSA;伤后10 d内出现不同程度的急性肺损伤(ALI)或急性呼吸窘迫综合征(ARDS),两者诊断标准参见文献[1-2].(2)排除有慢性肺源性疾病史及重要脏器基础疾病史患者;排除颅脑外伤、开放性骨折、腹腔脏器损伤等严重脏器复合伤患者.     

血小板源性生长因子BB对体外培养肌腱细胞增殖的影响

Objective To study the effect of platelet-derived growth factor-BB (PDGF-BB) in dif-ferent concentrations on proliferation of tendon cells cultured in vitro. Methods Rat tendon cells were cultured and identified in vitro. The rat tendon cells were cultured in PDGF-BB nutrient solution in different concentrations. They were then divided into 1, 5, 10, 20, 50, 100, 150, 200, 250 ng/mL PDGF-BB groups (cultured with 0.1 mL 0.5% PBS with addition of 1, 5, 10, 20, 50, 100, 150, 200, 250 ng/mL PDGF-BB respectively). Tendon cells in control group were cultured with 0.1 mL 0.5% FBS. Proliferation of tendon cells was detected by MTT test. The absorbance values of tendon cells in control group and 20 ng/mL PDGF-BB group before culture and after cultured for 12, 24, 36, 48, 60, 72 hs were determined. Results The isolated cells were identified to be rat tendon cells as they were Type Ⅰ collagen staining posi-tive and Type Ⅲ collagen staining negative. Compared with that of control group, the absorbance values of other groups were all increased, except for that of 250 ng/mL PDGF-BB group (P<0.05 or P<0.01). Besides, the absorbance value rose gradually with the increase of the concentration of PDGF-BB on, and then diminished gradually with the increase of the concentration of PDGF-BB from 20 ng/mL on. Tendon cells in 20 ng/ml PDGF-BB group began to increase in number when cultured for 12 hs, and it reached the highest level (0.53±0.04) at 48 h, which were obviously higher than those of control group at 24-72 h (P<0.01). The absorbance value of tendon cells in 20 ng/mL PDGF-BB group was significantly higher than that of control group at 24, 36, 48, 60, 72 h after culture (P<0.01 ). Conclusions PDGF-BB can promote the proliferation of tendon cells in a definite range of concentration and time.