脱细胞猪皮为覆盖物的微粒皮移植修复大面积深度烧伤创面

背景：目前用作微粒皮的覆盖物除异体皮外包括猪皮、羊皮、自体焦痂、凡士林油纱布等,由于猪皮皮肤结构与人体相近似,价廉易得,是目前使用较为广泛的微粒皮覆盖物。目的：观察脱细胞猪皮为覆盖物的微粒皮移植术运用于大面积深度烧伤治疗中的临床效果。方法：对15例大面积深度烧伤患者采用早期切（削）痂术或肉芽创面清创后,行自体微粒皮移植、以脱细胞猪皮为覆盖物,移植后观察覆盖物脱落以及创面修复情况进行回顾性分析。结果与结论：术后脱细胞猪皮与创面粘贴良好,术后5～7d首次换药见脱细胞猪皮呈黄褐色或紫黑色,脱水干燥,猪皮下偶有少量积液,开窗引流后猪皮未溶解脱落;三至四周脱细胞猪皮干燥坏死、与创面逐步分离,猪皮脱落后创面完全愈合,鲜有创面裸露,创面愈合后瘢痕较轻,外观及弹性可。提示,脱细胞猪皮可替代大张异体皮成为微粒皮移植术的理想覆盖物,可使大面积深度烧伤创面修复达到较为理想的效果。

Acellular porcine skin to cover auto-microskin graft for repair of extensive deep burns

BACKGROUND：Besides allogeneic skin,porcine skin,buckskin,autoallergic eschar,or vaseline gauze are used as microskin coverings,especially the porcine skin,which is extensive used due to similar to human skin structures and low costs. OBJECTIVE：To observe the clinical effects of acellular porcine skin to cover auto-microskin on extensive deep burns. METHODS：Fifteen cases with extensive deep burns were treated with removal of eschar at the early stage or granulation tissue debridement,transplantation of auto-microskin covered with acellular porcine skin. The rejection of acellular porcine skin,the survival of the microskin grafts and wound repair of skin were observed and retrospectively analyzed postoperatively. RESULTS AND CONLUSION：The acellular porcine skin could suck intact in the wound postoperatively. And it turned to cinnamomeous or purple black and a dry scab within 5-7 post-operation days,a small amount of exudate was found under covering occasionally,and the acellular porcine skin did not become soft and was not stripped after fenestration and drainage. The porcine skin gradually separated from the auto-microskin during 3-4 weeks post-operation. The wound completely healed,and the appearance and elasticity of skin recovered to some extent,and scars were inconspicuous. The results showed that it is reliable to use acellular porcine skin as a substitute of alloskin to cover auto-microskin in the treatment of extensive deep burns,and the wound is ideally repaired.