瘢痕移除原位再生皮肤组织器官的研究

目的 探讨一种增生性瘢痕的理想治疗方法,为病理性瘢痕防治研究打下基础.方法 对32 例自体皮源不足、瘢痕面积较大的增生性瘢痕患者,应用瘢痕移除及瘢痕皮回植原位再生皮肤疗法进行治疗,每例选择两处瘢痕相似的部位,进行随机自身对照研究,试验组采用皮肤原位再生复原疗法（MEBT/ MEBO）,对照组采用凡士林纱布覆盖治疗.结果 实验组愈合速度和质量优于对照组; 术后6 个月,应用温哥华瘢痕评估量表评估：瘢痕移除前后有显著性差异,试验组优于对照组（P 〈0.05）; 瘢痕所致的疼痛、瘙痒等症状消失,皮片平整且颜色与周围皮肤接近.结论 对自体皮源不足、瘢痕面积较大的增生性瘢痕患者或恐供皮区术后又出现增生性瘢痕时,应用瘢痕移除及瘢痕皮回植原位再生皮肤的方法治疗,不失为一种理想的方法.

Study on the in situ Regeneration of Skin Tissue Organ after the Removal of Scarred Skin

Objective To explore the ideal method of a hypertrophic scar treatment, so as to lay the foundation for the study of pathological scar prevention and treatment. Methods A total of 32 patients with large-sized hypertrophic scar and inadequate autologous skin source were entolled for study and two similar scar sites of each patient were selected for randomized control study.Test group was treated with in situ skin regenerative therapy（MEBT/MEBO）,control group using Vaseline gauze for treatment .Results Healing rate and quality of the test group was superior to that of the control group;6 months after surgery,the assessment with Vancouver scar assessment scale showed there was significant differences before and after the scar removal,the effect in study group was better than the control group（P〈0.05）;scar-induced pain,itching and other symptoms disappeared,the grafted skin was smooth and the color was closer to that of surrounding skin compared with that before replantation.Conclusion Patients with large-sized hypertrophic scar and inadequate autologous skin source or in the fear of postoperative hypertrophic scar on donor site can be treated by the method of scarred skin replantation after scar removal and MEBT/MEBO,which is an ideal approach in clinic.