甘油保存异体皮在特重化学烧伤创面的应用

目的：探讨甘油保存异体皮在特大面积深度化学烧伤治疗中的应用。方法：回顾分析8例特大面积三乙基铝所致的深度烧伤，应用甘油保存异体皮覆盖创面的临床资料。其中7例患者在同一天内收治，8例均为男性．年龄19～46岁,平均年龄为29．25岁，创面面积80％～97％，平均为90％，其中Ⅲ度面积在50％～95％，平均为55．63％。其中7例伴吸入性损伤，行气管切开术，6例行呼吸机辅助通气。患者均在急诊室行补液、输血等支持治疗，彻底清创，行焦痂切开减压术，创面予SD—Ag外敷，并均在3～7d内分别分次行切痂术并采用甘油保存异体皮(GPA)覆盖创面，然后有计划地分别分次行自体皮片移植取代甘油保存异体皮，采用邮票植皮法和异体皮打洞自体皮嵌入移植法。切痂次数为2～3次，平均2．5次，植皮数为2～10次，平均7．2次。供皮区均为头皮，取皮次数为2～10次，平均7．2次。结果：2例因呼吸系统严重灼伤而分别于伤后13d和28d死于呼吸系统并发症，其Ⅲ度创面分别为30％和60％，死时的创面覆盖率分别为100％和80％。其余6例2个月后创面基本为自体皮片所覆盖，皮片愈合良好，皮片存活率约70％～90％，平均80％。头皮愈合良好。结论：甘油保存异体皮是大面积深度化学烧伤创面一种较好的临时覆盖物，它可以改善创面血供条件，为自体皮片移植做准备，提高自体皮片移植的存活率，为大面积深度化学烧伤的治疗赢得了时间，提高了救治成功率。

The Value of Glycerol Preserved Allograft (GPA) in the Treatment of the Severe Chemical Burn Wounds

Objective: To discuss the value of glycerol preserved allograft (GPA) in the treatment of severe, large area, deep chemical burn wounds. Methods: A retrospective analysis was performed on the use of glycerol preserved allograft (GPA) in the treatment of severe, large area, deep chemical burn wounds of 8 cases. Results: Two cases of them were dead respectively on the 13 day and 28 day because of the severe burn of the respiratory systems. The other 6 cases' wounds had been covered by autograft transplantations winthin two months. Conclusion:The glycerol preserved allograft is a good temporary material in the treatment of the severe , larger area, deep chemical burn wounds.