供皮区创面皮肤再生疗法的临床应用

目的:观察皮肤再生疗法对供皮区创面愈合的作用,寻找提高供皮区创面愈合质量和速度的理想方法。方法:选择供皮区创面刃厚皮28个,薄中厚皮26个,厚中厚皮18个,每个创面分成两个区域,分别随机应用MEBO药纱(实验组)和凡士林纱布(对照组),观察术后疼痛、出血及愈合时间等情况,术后6个月应用温哥华瘢痕评估量表评估上述供皮区瘢痕形成及增生程度,并进行随机自身对照研究。结果:实验组供皮区创面术后无疼痛、出血及瘢痕发生数较对照组少,平均愈合时间:刃厚皮5．3±1．1天,薄中厚皮7．5±3．4天,厚中厚皮13．6±4．9天,对照组分别为8．1±1．2天、10．4±3．2天、18．5±4．2天,组间比较具有非常显著差异(P＜0．01);术后随访6个月瘢痕评分值:中厚供皮区创面实验组低于对照组(P＜0．05)。结论:应用MEBO药纱处理供皮区创面效果优于凡士林纱布,具有止血、止痛、加快供皮区创面生理再生愈合的作用,无明显瘢痕增生,是提高供皮区特别中厚供皮区创面愈合质量和速度的理想方法。

Clinical application of skin regeneration therapy in treating skin donor site wounds

Objective： To observe the effect of skin regeneration therapy on the healing of skin donor site wounds and to find an ideal method for improving the quality and increasing the speed of the healing of wounds. Method： Wounds in skin donor sites after harvesting 28 edge thick skin grafts （ultra -thin skin grafts）, 26 thin intermediate split thickness skin grafts and 18 thick intermediate split thickness skin grafts were divided randomly into 2 groups. Wounds in one group were treated with MEBO gauze and wounds in the other group treated with Vaseline gauze as a control. Pain, bleeding and wound healing time of the 2 groups were compared. Six months later, hyperplastic scars in these wounded areas were assessed using Vancouver Scar Assessment Table. Random auto control was also made. Result： In MEBO group, no pain and no bleeding occurred and the incidence of scar formation was less than that in the control group. In MEBO group, edge thick skin graft donor site wounds healed in 5. 3 ± 1.1 days, thin intermediate split thickness skin graft donor site wounds healed in 7. 5 ± 3.4 days and thick intermediate split thickness skin graft donor site wounds healed in 13.6 ±4. 9 days. In control group, the average wound healing time was respectively 8. 1 ±1.2 days, 10. 4 ±3.2 days and 18.5 ±4.2 days. The difference between the 2 groups was very significant （P 〈0. 01 ）. After followed up for 6 months, in MEBO group, in intermediate split thickness skin graft donor sites, the scar formation asseasment value was less than that in the control group （ P 〈 0. 05 ）. Conclusion： MEBO gauze was superior to Vaseline gauze in treating skin donor site wounds. MEBO has bleeding stopping, pain relieving and wound healing promoting effects. The wounds healed by physiological regeneration without marked formation of scars. MEBO gauze treatment is an ideal method for promoting skin donor site wound healing, especially intermediate split thickness skin graft donor site wounds. It can improve the quality of wound healing and shorten healing time.