大面积烧伤患者早期切痂冷冻异体皮移植效果评价

Clinical application and assessment of cryopreserved alloskin graft on excised burn wound in the major burned patients in their early stage

  • 摘要: 目的:为了观察及评价大面积烧伤患者早期切痂冷冻异体皮移植的临床应用和植皮效果。方法:收集我科1987年1月至2002年4月早期休克期48h内切痂创面移植冷冻异体皮的患者112例,分别对本组患者创面的切削痂时间,面积、部位,出血量、自体皮与创面移植的比例,更换敷料时间以及植皮成活率进行了比较,并针对移植大张冷冻异体皮的储存方法,复温后活力的检测进行了分析。结果:本组患者采用速冻玻璃化储存的异体皮较以往的慢冻法提高活力近20%,临床移植该法保存的皮肤具有质地柔软,转红快,成活率高,存活期长等特点,本组112例早期切痂移植冷冻异体皮的临床效果判定,其植皮成活率达到95%以上。结论:早期大面积烧伤患者切痂创面自体微粒皮+大张异体皮移植是提高患者成活率,减少机体感染及并发症的重要治疗手段,而活力良好的异体皮则是早期切痂创面覆盖的有力保证。

     

    Abstract: Objective: To observe and assess the effects of cryopreserved alloskin graft on excised burn wound in the major burned patients in their early stage hosp-italized from January 1987to April 2002. Methods: One hundred and twelve with burned patients undergoing allograft during burn shock stage were retrospectively analyzed,including the time of wound excision, the area and location of wound excis-ion,bleeding volume during escharectomy,the ratio of autologous microskin and excised wound,the first time of dressing chang postoperation,skin taken-rate,etc.Furthermore,the viability of cryopreserved alloskin was checked before graft.Results: There was 20% higher in viability of cryopreserved alloskin by vitrification than that by slow cooling.Meanwhile,the improved cryopreserved alloskin possessed very good quality and might survive for longer time with high skin taken-rate after graft.Conclusion: The graft of microautoskin and cryopreserved alloskin with high viability following early escharectomy is one of the essential treatments for patients with major burn.

     

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