自体表皮细胞移植治疗白癜风影响皮片成活率的因素探讨

目的　探讨自体表皮细胞移植治疗白癜风影响皮片成活率因素。方法　选择腹部皮肤为供皮区 ,予PFG Ⅰ表皮细胞分离机进行负压与温度双重分离 ,使其形成水疱 ,将供皮区的疱壁剪下备用。受皮区局麻后 ,子皮肤磨削机磨去白斑表皮 ,直至局部出现点状出血为止。将供皮区剪下的疱壁覆盖于受皮区 ,供应区及受皮区分别加压包扎 ,定期观察皮片成活情况。结果　 3 84例患者进行自体表皮细胞移植术后 ,有 3 67例皮片成活 ,成活率占治疗总数 91 .3 6%;未成活 1 7例 ( 2 4块 )占治疗总数 4.42 %。皮片未成活原因 ( 1 )创面感染化脓 3例 ( 5块 )占治疗总数 0 .78%。 ( 2 )创面术后浸水 6例( 7块 )占治疗总数 1 .5 6%。 ( 3 )正常表皮贴反了 2例 ( 2块 )占治疗总数 0 .5 2 %。 ( 4 )受皮创面太浅 2例( 3块 )占治疗总数 0 .5 2 %。 ( 5 )移植术后皮片过早脱落 4例 ( 7块 )占治疗总数 1 .0 4%。结论　自体表皮细胞移植治疗白癜风疗效确切 ,皮片成活率高 ;明确了影响皮片成活率的因素及制定相应的预防措施 ,能够进一步提高皮片的成活率。

Influential Factor of Skin Graft Survival Rate after Auto-epidermic Cells Grafting on Treating Vitiligo

Objective To explore the influential factors of skin graft survival rate after auto epidermic cells grafting on treating vitiligo. Methods The skin grafts were taken from patient's abdomen by PFG Ⅰ epidermic cells' separator dependingon the negative pressure and suitable temperature. After the localanesthesia of the skin received region, the vitiliginous epidermis of the region had been whittling by skin polisher until the petechial hemorrhage occurred on the region. And then, the skin grafts taken from the supplied region were covered on the received region and followed the compression bandage of the supplied region and the received region. The survived state of the skin grafts was observed and analysed at regular intervals.Results There were 367 cases of all 384 treating cases survived in our study, that is, the survival rate of the cases was 91. 36%.But there were still 17 cases didn't survive, that is, the non survival rate of the cases was 4. 42%. The cormon causes of the non survival cases were that ① The infection of the wound surface were 3 cases, which took 0. 78% of all treating cases. ②The postoperating immersion of the wound surface were 6 cases,which took 1. 56% of all treating cases. ③The trans position of the skin grafts were 2 case, which took 0. 52% of all treating cases.④ The superficiality of the wound surface were 2 cases, which took 0. 52% of all treating cases. ⑤ The early exfo1iation of the skin grafts after treating were 4 cases, which took 1. 04% of all treating cases. Conclusion The auto epidermic cells grafting have the definitive effectiveness on treating vitiligo and the survival rate of skin graft is much high. Also our study suggested that some clear causes could result in the failure of some skin grafts survival. Avoiding these causes could heighten the survival rate of the skin grafts further.