组织工程皮肤修复烧伤后残余创面的临床观察

目的：观察创面直径为5-7cm的烧伤后残余创面应用组织工程皮肤治疗的效果。方法：笔者单位2008年5月-2012年7月的12例烧伤后残余创面患者，采用同体对照的研究方法，每例患者选择2处直径为5-7cm的残余创面，随机分为组织工程皮肤治疗组和对照组。两组创面细菌培养阳性菌株均相同。两组受试创面面积比较差异无统计学意义（P〉0．05），具有可比性。患者均进行浸浴治疗后，受试创面给予外用莫匹罗星软膏，每日换药1次。在局部感染控制后组织工程皮肤治疗组创面清创后移植组织工程皮肤，对照组继续换药治疗，同时予以全身抗感染治疗。结果：本组12例患者组织工程皮肤治疗组创面均在移植组织工程皮肤后1-2周愈合，均未进行自体皮移植，愈合质量良好；对照组创面在相同时间内均未愈合，最终均给予自体皮移植而愈合。结论：经充分创面准备后移植组织工程皮肤可用于修复直径较大的烧伤后残余创面，以替代传统的自体皮移植。

Clinical observation on the repairing of residual burn wounds with tissue engineering skin

Objective To evaluate the clinical efficacy of tissue engineering skin （TES） on residual burn wounds with diameter of 5-7 cm. Methods Twelve patients with residual burn wounds in our department from May 2008 to July 2012 were selected. In accordance with self-control principle, two residual burn wounds with diameter of 5-7 cm were selected from every patient and were divided into group TES and group C randomly. The germiculture results of 2 groups were the same. There was no significant difference in wound area between 2 groups （P〉0.05）. Every patient was treated with dipping bath therapy and applied locally with Mupirocin ointment on the selected wounds. The drugs were changed once every day. The wound of group TES was transplanted with tissue engineering skin after wound debridement when the local infection was controlled. The wound of group C was applied with Mupirocin ointment continually. Systemic anti-infection treatment was performed at the same time. Results Every wound of group TES healed well at 1-2 weeks after tissue engineering skin transplantation. But the wound of group C did not healed at the same time, which healed after autologous skin transplantation finally. Conclusion Tissue engineering skin transplantation after sufficient preparation of wound bed could be used for the repairing of residual burn wounds with biggish diameter instead of autologous skin transplantation.