异种异体脱细胞真皮基质与自体微粒皮复合移植的临床观察

目的 探讨异体、异种脱细胞异体真皮基质与自体复合移植的可行性。方法 5例大面积Ⅲ度烧伤创面早期切痂，2例3个部位采用异种脱细胞真皮基质移植，3例3个部位采用同种脱细胞真皮基质移植，将基质缝合固定。微粒皮均匀涂布在异体皮的真皮面上，覆盖于创面上，缝合包扎固定。未移植脱细胞真皮基质的创面作对照观察，微粒皮与创面比例为1：5。结果 异种脱细胞真皮基质移植部位表皮覆盖率75％。采用同种脱细胞真皮基质移植部位表面覆盖率94％。随访时间最长2年复合移植皮肤弹性好、无水胞和溃疡，愈合质量优于对照部位创面。结论 应用脱细胞异体真皮基质与自体微粒皮复合移植是可行性的，同种细胞真皮基质的复合移植成活率明显优于异种脱细胞真皮基质的复合移植。

The clinical application on composite graft of acellular dermal matrix and auto-microskin on deep burns

Objective To present the clinical application of composite graft of acellular heterogenous or allo-dermis matrix(ADM)with thin auto-microskin on burn wound Methods 5 inpatients with full thickness skin burn wounds were transplanted with 3 allo-ADM and 2 heterogenous ADM after eschar was excised,then the auto-microskin and allo-human skin were covered on the area of the matrix,the wound where no ADM grafting were covered as control groups only with auto-microskin and allo-human skin,The area of donor to wound is 1:5.Results Survived rate of 5 pieces composite skin that ADM with auto-microskin were grafted.After following up for two year,the skins of complex grifting had well elastic and smooth texture compared to auto-micrtoskin grafted.Conclusions The graft effectiveness of ADM and auto-microskin was better than that of auto-microskin,and this method could be used on major deep burn wound healing.