- 期刊
The Use of Composite Acellular Allodermis-Ultrathin Autograft on Joint Area in Major Burn Patients - One Year Follow-Up
例用複合性異體真皮和超薄自體皮在嚴重燒傷病人－1年追蹤經驗
摘要
疤痕攣縮燒傷病人皮膚移植後的長期困擾，特別在關節部位，皮膚移植片中所含真皮層厚度，是決定移植後功能及美觀的一個重要因素，所以如何提供一層真皮是皮膚重建的一個重要問題，異體真皮(AlloDerm)是含有正常真皮的膠原蛋白結構及基底層，我們利用此異體真皮來當作真皮層的來源，其上再覆蓋上超薄的自體皮來重建傷口，再這12位病人中，我們利用此一複合性皮膚在其燒傷後關節部位皮膚缺損。這些複合性皮膚移植的平均存活率為91.5%，由於我們只取很薄的自體皮膚，所以手術後供皮區可以很快癒合，同時也可以很快的再一次使用為供皮區，經過一年後的臨床追蹤，這些複合性皮膚不論在在皮膚品質、功能或是美觀上均有不錯的結果。
關鍵字
無資料並列摘要
Scar contracture is a major long-trem sequelae meshed split-thickess skin grafts in the case of full-thickness burn injuries, and especially in joint areas. Se-vere contracture around joints amy lead to loss of mobility. The thickess of the derimis in the autograft plays a major role in the functional and cosmetic outcomes of the third degree burn. How to replace lost dermis is a major problem in skin restoration following severe burns. The human allograft skin (AlloDerm) is an acel-lular dermal matrix with normal collagen bundling organization and intact base-ment membrane complex. We present 12 cases of clinical application of a composite grafting technique in with the allogeneic skin (AlloDerm) provided source of dermis, and and ultrathin autograft (0.004~0.006 inch in thickness) provided epidermis. In these patients, The composite grafts were applied to full-thickness burn wounds over various articular skin surfaces. The average skin take rate was 91.5%. These ultrathin autografts allow the donor sites to heal faster. The mean time of donor site reepithelization was 6 days. All patients had nearly normal range of joint motion (average 95% of normal) after one year’s follow up. Wound assessment over time has shown supple skin that has been resistant to trauma and infection. The cosmetic results were judged to be fair good by surgeons and patients after one year’s follow up.