应用异种皮作微粒皮移植覆盖物治疗深度烧伤的临床观察

目的探讨异种(猪)皮作为微粒皮移植覆盖物的可行性。方法选择10例深度大面积烧伤患者,于患者行切痂植皮术前1 d,将1只50 kg左右的纯白猪处死后清洗、剃毛、消毒,切取2张含少量脂肪的皮片,用鼓式取皮机反取成全厚或中厚皮。先播散自体微粒皮,再将猪皮打孔覆盖其上加压包扎。观察患者术后猪皮排异、微粒皮成活情况,以及创面愈合时间和术后1年患者的功能恢复情况。结果术后2周猪皮完整、与创面粘贴好;术后4～5周猪皮呈干痂状,逐渐与微粒皮分离,微粒皮已生长融合,创面基本愈合;术后6～8周猪皮全部脱落,创面愈合。10例患者创面愈合时间为42～56 d(50±5)d]。术后1年见患者术区虽有表浅瘢痕,但其弹性和功能均恢复正常。结论用猪皮替代同种异体皮覆盖自体微粒皮修复深度烧伤创面可行。

Clinical observation of xenoskin to cover microskin graft in the treatment of patients with deep burns

OBJECTIVE: To explore the feasibility of application of xenoskin as microskin graft covering. METHODS: Ten patients with deep and extensive burns were enrolled in the study. A white pig weighing about 50kg was cleaned and shaved(without boiled water treatment) after being slaughtered. After conventional disinfection, two pieces of skin with little amount of fat were removed from the pig and processed to full-thickness or split-thickness skin. Before operation they were perforated and autogeneic microskin was scattered onto it. After escharectomy they were grafted on the wound, and the wound was dressed and bandaged with pressure. The rejection of the xenoskin, the survival of the microskin grafts, the wound healing time,and the functional recovery of the patients 1 year after operation were observed. RESULTS: The porcine skin was intact, and stuck well to the wound within 2 post-operation weeks ( POW). But it turned to form a dry scab, and gradually separated from the autogeneic microskin during 4 - 5 POW. The xenoskin completely fell off and the wound healed during 6 - 8 POW . The wound healing time of the 10 patients was 42 - 56 days (50 +/- 5) d]. Though there were thin scars 1 year after operation, the elasticity and function of the skin were normal. CONCLUSION: It is feasible to use procine skin as a substitute of alloskin to cover autogenous microskin.