手腕部深度烧伤削切痂植大张自体皮疗效观察

目的通过手腕部深度烧伤不同治疗方法的比较，探讨手腕部深度烧伤的理想治疗方法。方法将60例共83只手腕部深度烧伤患者随机分成A、B2组，A组采用早期削切痂移植大张自体皮，B组采用肉芽创面移植邮票状自体皮，观察2组手部创面修复时间和功能恢复情况。结果A组一次植皮成功率与B组相比，无显著性差异（97．7％vs 100．0％，P〉0．05）；A组愈合时间与B组相比，有极显著性差异（14．0±1．2）d vs （37．0±1．4）d，P〈0．01]；A组优良率与B组相比，有极显著性差异（95．3％vs 30．0％，P〈0．01）。结论早期削切痂移植大张自体皮术治疗手腕部深度烧伤能有效保护手腕部的功能，疗效优于肉芽创面移植邮票状自体皮术。

Therapeutic Efficacy of Transplanting Large Sheet of Split-thickness Autografts after Shaving or Excising Eschar in Deeply Burned Hands or Wristes

Objective To explore the ideal treatment methods of the deep burn wounds in the hands or wristes. Methods 60 patients with 83 deeply burned hands （wristes） were randomly divided into two groups. Group A：transplanting large sheet of split thickness autografts after early shaving or excising eschar. Group B： transplanting stamp autografts in granulation wound. Then healing time and functional rehabilitation were observed and compared. Results There was no obviously different in achievement ratio of skin transplantation for one stage repair between group A and B（97.7% vs 100.0% ,P〉0.05）. While there were obviously differents in wound healing time （14.0±1. 2）d vs （37. 0±1. 4）d] and rate of fitness （95.3% vs 30.0%） between them（P〈0. 01）. Conclusion Compared with transplanting stamp autografts in granulation wound, treatment with transplanting large sheet of split-thickness autografts after shaving or excising eschar early was more effective in protecting function of hands or wristes.