【作者】 韦昌延；

【导师】 杨小辉；

【作者基本信息】 广西医科大学 ， 外科学， 2008， 硕士

【摘要】 目的:观察和探讨使用脱细胞异体真皮基质(acellular allogeneicdermal matrix,Allo-ADM)移植修复深度烧伤和瘢痕整形病人关节功能部位处创面的临床应用效果。方法:选择24例,关节处有深度烧伤或瘢痕增生的患者。将脱细胞异体真皮基质(Allo-ADM)与自体刃厚皮片组成复合皮(Compositeskin,CS),移植于这些病人的共30处位于关节部位的创面上,并在CS移植区周边或附近予单纯刃厚皮移植为对照。作定期随访,观察其成活及外观功能情况等。结果:30处创面CS移植物及对照组植皮全部愈合。在术后6-18个月的随访期内,未观测到明显的排异反应,瘢痕增生不明显,CS移植区皮肤外观和质地较单纯刃厚皮移植优良,关节功能良好。结论:脱细胞异体真皮基质作为一种优良的真皮替代物在修复烧伤、瘢痕整形关节部位创面的应用中取得了令人满意的效果。其成活率高,术后效果与中厚皮移植效果相似,是一种较理想的关节功能区植皮方法,可以作为全厚皮和中厚皮移植的良好替代和补充。更多还原

【Abstract】 Objective:To observe and investigate the effect of acellular allogeneic dermal matrix(Allo—ADM)on cograft in joint functional positions of patients with excision of eschar and post-burn plastic operation.Methods:24 patients with hypertrophic scar and severe burns on joint were used,30 reticulated Allo—ADM were overlapped with autogenous thin split-thickness skins grafts to constitute the CS(composite skin),and were transplanted to the eschar-cutting and scar-cutting wounds in the joints of those patients.The neighbouling autogenous thin split-thickness skins were used as control.After 12-14 days,the dressings were changed,and the long-term follow-up studies and observations were carried out.Results:The 30 composit skin grafts as well as the controls were all survived.Dring the 6～18 months follow-up studies,the rejection was not found;hypertrophic scars were rare;the appearance of composit skin grafts were better than the controls and near to normal skins;function of the jiont were well. Conclusion:the Allo—ADM could be used to Transplant in joint functional positions of patients with excision of eschar and post-burn hypertrophic scars and could produce satisfactory results as dermal substitute,survival rate was high and the results was likeness with the intermediate split-thickness skins transplantation.So we recommend it to be a good complement of intermediate split-thickness skin graft and full-thickness skin graft for transplantation.更多还原