保留变性真皮并移植大张自体皮的方法修复颈部深度烧伤27例

目的：回顾研究我院过去9年间27例颈部深度烧伤三种治疗方法的疗效。方法：自然愈合组,普通换药而愈;切除真皮植皮组,切除全层烧伤皮肤至正常组织,再移植自体大张全厚皮片或中厚皮片;保留变性真皮植皮组,用削痂或刮痂的方法,清除创面上的坏死组织,再移植自体大张断层皮片。结果：自然愈合组全部有不同程度瘢痕增生,严重影响外观及功能;切除真皮植皮组中移植全厚皮片的外观功能恢复较好,移植的中厚皮片收缩显著,外观功能恢复较差;保留变性真皮植皮组皮片收缩不明显,外观功能恢复较好。结论：用削痂时保留变性真皮并移植大张自体皮的方法修复颈部深度烧伤能够获得较好的临床效果。

Treatment of neck deep burn with preserved-degenerative dermis by tangentiai excision and large sheet of skin autografting:report of 27 cases

Objective：To retrospective study of deep neck burn treatment efficacy of three methods of 27 cases over the past nine years.Methods：Natural healing group,healed with natural dressing change;removal of dermal skin graft group,removal of full-thickness burn skin to normal tissue and re-transplantation of autologous large sheet of full-thickness skin or mid-thickness skin;preserved-degenerative dermis of skin graft group,removal of necrotic tissue on the wound with tangential excision or scraping callus and transplantation of autologous large sheet of split-thickness skin.Results：Natural healing group,all of which had varying degrees of scar and seriously affected the appearance and function;removal of der mal skin graft group,in mid-thickness skin graft skin contraction significantly and with bad recovery of the appearance and function,but with better recovery in full-thickness skin graft;preserved-degenerative dermis of skin graft group,skin con traction was not obvious with good appearance and functional recovery.Conclusion：Treatment of neck deep burn with preserved-degenerative dermis by tangential excision and large sheet of skin autografting can obtain better clinical effects.