深度烧伤修复重建与康复治疗相关问题探讨

A discussion regarding reconstruction and rehabilitation of patients with deep burn wound

With the advances in resuscitation,infection control,and metabolic management,the treatment strategies for burn patients have improved remarkably in the last half century.As a result,more patients with deep burn wound survived,and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treat-ment strategy making and the new techniques performing.In the present discussion,early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair,the use of composite skin grafting,the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue.etc.Besides these,more attention should be given to the repair and reconstruction in specialized functional parts of the body,such as head and face,neck,hand,female breast.perineum,and joint areas,after a deep burn.The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity.Adequate treatment of deep burn wound demands a number of important measures in-eluding the timing of surgery,adoption of essential techniques,suitable types of wound covering materials,motivated rehabilita-tion,and necessary psychological therapy.The optimal recovery of damaged part of body after burn should depend on the similar-ity of rebuild tissue structure to simulate the nature of the origi-nal tissue in the cellular,histological,anatomic characteristics,which is the aim of all burn wound care and the basis of the ap-pearance and function repair or reconstruction.